Getting better acquainted with Auditory Voice Hallucinations (AVHs): A need for clinical and social change

The phenomenon of hearing voices (AVHs) is very much a subject of current scientific interest, both clinically1 and socially. For a long time, auditory hallucinations—perceiving sounds without external stimuli (David, 2004)—were considered an obvious sign of schizophrenic or psychotic psychopathology (Goodwin et al., 1971; Larøi et al., 2012), but these days such an association is no longer taken for granted. Various recent studies in the areas of psychology, psychiatry, and neuroscience have brought a renewal of interest in AVHs. First of all, the move beyond Kraepelinian logic (van Os, 2009; Fusar-Poli et al., 2014) has led us to see AVHs as a phenomenon in their own right, and not just a characteristic of schizophrenia (Fernyhough, 2004). Furthermore, a number of studies in imaging techniques have allowed us to study the phenomenon live, as it occurs, collecting various new data (Shergill et al., 2000). On the other hand, psychological studies with attempts at modeling, have boosted the idea that AVHs are linked to the linguistic and verbal qualities of the subject, thus reducing the association between voice hallucinations and signs of pathology (Johns and van Os, 2001; Pearson et al., 2001; Stanghellini and Cutting, 2003). Other researchers have theorized that hearing voices is a different manifestation of self-awareness (Salvini and Bottini, 2011; Salvini and Quarato, 2011). Even DSM-5 has modified the importance it attaches to hallucinations, in fact although the 4th edition diagnosed “schizophrenia” simply on the basis of the symptom “hallucinations,” in the new edition hallucinations on their own are not considered a sufficient symptom to diagnose the specter of schizophrenia” (American Psychiatric Association, 2013). Many of those suffering from this condition are not under treatment and are not diagnosable in psychopathological terms, which asks ever more questions of health professionals (Iudici, 2015), and which brings with it the risk that the phenomenon of hearing voices may be considered pathological because of a lack of understanding of the problem. One direct implication of this risk concerns non-psychotic and non-schizophrenic hearers of voices who are afraid of being considered mad or disturbed, who very often live in fear for years without talking about it with anyone, although realizing that hearing voices causes no general maladjustment in their lives (Andrew et al., 2008). In the long term this can lead to feelings of alarm in some of them, and when such situations result in a visit to a clinic or a psychiatrist, there are often “suffering and conflicted confessions” about such experiences, especially by people who have never had psychiatric experience (Iudici and Gagliardo Corsi, 2017). These people consequently do not have appropriate information to help them understand their experiences (Faccio et al., 2013). This fact raises further doubts about the direct juxtaposition of auditory hallucinations and diagnoses of mental disturbance, and consequently our interest is in sensitizing clinicians to a broader interpretation of the phenomenon than the traditional view, highlighting the importance of considering more perspectives

Identità in trasformazione. Processi di costruzione narrativa dell'identità e della diagnosi nei percorsi di transizione di genere

The research moves from a postmodern paradigm and from the theoretical perspectives of Symbolic Interactionism (Mead, 1934; Blumer, 1969) and of Social Constructionism (Gergen, 1985; Berger e Luckmann, 1966). According to this theoretical framework, the different aspects related to identities and gender are considered plural and mutable processes of construction, historically and culturally situated and interconnected to the dimensions of the discourse and narratives, of doing and of the performance in every context of daily life (West e Zimmerman, 1987; Denzin, 2003; Salvini, 2011). There are three main objectives of the research and they concern the analysis of the discursive processes of construction of the identity related to the biographies and the narratives of gender transitions; the analysis of the discursive processes connected to the mental health professionals’ practices related to gender transitions, the diagnostic process and the psychological services, as well as possible attributions of sense on the interlocutors’ biographies by mental health professionals; and the reflection on the implications of such discursive processes and narratives in the psychological and psychiatric practices and in the processes of negotiation of meanings among professionals and people in transition, on the light of the complexity of the narratives and the exigencies of people. Narrative interviews (Hermanns, 2004) with 25 people in transition and episodic interviews (Flick, 2007) with 11 professional figures have been deployed. Both types of interviews allow to highlight points of view and personal theories used by the participants to give sense to the process of gender transition and the own experience, told and reconstructed in the dialogue. The methods for the analysis have included discourse analysis (Potter e Wheterell, 1987) and narrative analysis, in particular the version of dialogic-performative analysis (Riessman, 2008), through the identification of interpretive repertoires and self-positions. Narrative and discursive processes have been analyzed underlying the pragmatic and performative elements and the multivoiceness, mine included, as researcher in relation to the others. From the analysis of the interviews, different voices and discourses related to the own biography, as well as to the practices by the professionals, emerge. For the first objective, different narrative and discursive modalities underlie the impact and the pragmatic effect of some dimensions of meaning, such as those related to the ideal or reconstructed “normality”, to the “right-wrong body”, to the deterministic “nature”, to the interpersonal “recognition”, to “pathology” or “deviance” and finally, to the agency and the idiosyncraticity in the construction of the identity. For the second objective, it is possible to underlie the impact and the pragmatic effect of other dimensions of meaning, such as “gender dysphoria” as an ambiguous category, the “adaptation to reality” as an assumption in the transition, “subjectivity versus objectivity”, the “non-binary people” as a dilemma and finally, the “responsibility” and the “power” as critical and relevant aspects in the clinical practice. This research can contribute to highlight the narrative specificities and the exigencies of both groups, and in particular of the people in transition. This can be useful in order to inform and to offer further elements for the comprehension of trans experiences and life stories in the clinical field, problematizing the concept of diagnosis. Finally, the results can contribute to a reflexive knowledge of the clinical work for the gender transition, referring to the different modalities of signify both the diagnosis and the relationship and their pragmatic effects

Moderate-density parity-check codes from projective bundles

New constructions for moderate-density parity-check (MDPC) codes using finite geometry are proposed. We design a parity-check matrix for the main family of binary codes as the concatenation of two matrices: the incidence matrix between points and lines of the Desarguesian projective plane and the incidence matrix between points and ovals of a projective bundle. A projective bundle is a special collection of ovals which pairwise meet in a unique point. We determine the minimum distance and the dimension of these codes, and we show that they have a natural quasi-cyclic structure. We consider alternative constructions based on an incidence matrix of a Desarguesian projective plane and compare their error-correction performance with regards to a modification of Gallager’s bit-flipping decoding algorithm. In this setting, our codes have the best possible error-correction performance after one round of bit-flipping decoding given the parameters of the code’s parity-check matrix

The Representation of the “Science” Construct in the Diagnostic Manuals. An Exploratory Research on the Use of the Scientific Term in the icd-10, in the dsm-5 and in the pdm

Ogni disciplina e approccio teorico si caratterizzano per la ricerca di un definito grado di scientificità che li possa legittimare. Nella comprensione dei fenomeni psicologici e nel campo  terogeneo della psicologia clinica si possono trovare espressioni linguistiche e criteri legati alla scienza differenti tra loro, con altrettante ricadute pragmatiche. In questa ricerca si sono esplorati i significati legati all’uso del termine “scientifico” in alcuni manuali diagnostici: icd-10, dsm-5 e pdm. Il método usato è stato quello della rappresentazione perspicua, ovvero un sistema di analisi linguistica volta a individuare alcune unità simboliche presenti nei manuali. I risultati hanno  onsentito di sottolineare i significati legati ai diversi modi di intendere la scientificità e di avanzare  lcune proposte operative. In conclusione, si può mettere in evidenza come l’uso del costrutto “scienza” e le espressioni linguistiche ad esso collegate sia molto differente nei tre manuali indagati e fa riferimento a campi di significato molto differenti l’uno dalle altre. Si evidenzia infine l’importanza di fondare il costrutto “scienza” in funzione dei propri specifici riferimenti concettuali.Parole chiave: linguaggio, diagnosi, epistemología, rappresentazione perspicua.Cada disciplina teórica se caracteriza por la búsqueda de un grado definido de carácter científico que la puede legitimar. En la comprensión de los fenómenos psicológicos en psicología se pueden encontrar expresiones lingüísticas, criterios científicos e implicaciones pragmáticas diferentes. En  sta investigación intentamos de explorar los significados de la utilización del término “científico”  en  algunos manuales diagnósticos: icd-10,  dsm-5 y pdm. El método utilizado fue el de la representación perspicaz, es decir, un sistema de análisis lingüístico destinado a identificar algunas unidades simbólicas presentes en los manuales. Los resultados obtenidos permitieron subrayar los significados relacionados con diferentes formas de entender la cientificidad y presentar algunas propuestas prácticas. En conclusión, puede destacarse cómo el uso de la construcción “ciencia” y las expresiones lingüísticas relacionadas con esta, son muy diferentes en los tres manuales investigados y se refieren a campos de significado muy diferentes entre sí. Finalmente, se subraya la importancia de fundar la construcción “ciencia” según sus propias referencias conceptuales específicas.Palabras clave: ciencia, lenguaje, diagnosis, epistemología, representación perspicua.Disciplines and theoretical approaches are characterized by the research of a defined scientific status in order to legitimate them. To understand psychological phenomena in the heterogeneous field of clinical psychology, different linguistic expressions and scientific criteria can be found, as well as many pragmatic consequences. In this research we tried to explore the meanings related to the use of the term “scientific” in some diagnostic manuals: the icd-10, the dsm-5 and the pdm. The method used was that of perspicuous representation, i.e. a system of linguistic analysis aimed at identifying some symbolic units present in the manuals. The results allowed to highlight the meanings related to the different understandings of science and to advance some operative suggestions. In conclusion, it can be highlighted how the use of the construct “science” and the linguistic expressions related to it are very different in the three manuals investigated and refers to fields of meaning very different from each other. Finally, the importance of founding the construct “science” according to its own specific conceptual references is underlined.Keywords: Science, language, diagnosis, epistemology, perspicuous representation

Use of different extenders to cryopreservation of Mangalarga Marchador sperm

As biotécnicas aplicadas à reprodução animal como inseminação artificial, transferência e produção in vitro de embriões, indução e sincronização de cio e congelamento de gametas vêm sendo cada vez mais utilizadas na prática veterinária. No entanto, algumas biotécnicas ainda não alcançaram o seu total aperfeiçoamento técnico na reprodução equina, como a criopreservação de sêmen. Objetivou-se avaliar as características pós-descongelamento (motilidade total, vigor e integridade de membrana plasmática e acrosomal) dos espermatozoides de garanhões da raça Mangalarga Marchador (n=5), empregando-se três diluentes de criopreservação. Após a colheita, o sêmen foi diluído na proporção de 1:1 em meio à base de leite em pó desnatado e centrifugado a 600 G por 10 minutos. Após a centrifugação, o sobrenadante foi desprezado e o pellet obtido dividido e ressuspendido com Botucrio, FR5 ou FR6. As amostras foram envasadas em palhetas de 0,5 mL sendo a concentração ajustada para 200x10 6 espermatozoides/mL. As palhetas foram distribuídas em uma plataforma-suporte e estabilizadas a 5 ºC/60 min., em refrigerador comercial. Para o congelamento, as palhetas, posicionadas horizontalmente, foram expostas por 15 minutos ao vapor de nitrogênio líquido, em uma caixa de isopor, a 6 cm acima do nível de nitrogênio líquido. Logo em seguida, as palhetas foram imersas no nitrogênio líquido, acondicionadas em raques e estocadas em botijão criogênico a -196 ºC, para posterior avaliação. Não houve diferença para as variáveis motilidade, vigor e integridade das membranas plasmática e acrossomais quando se utilizaram diluentes que contêm a associação de amidas e glicerol (Botucrio e FR6; P>0,05). As variáveis seminais no diluente contendo apenas glicerol foram inferiores em todas as avaliações (P 0.05). All parameters evaluated were lower for the extender containing only glycerol (P<0.05). The use of cryoprotectants (methylformamide and dimethylformamide) in association with glycerol concentrations around 1 to 2% is an alternative for semen cryopreservation of Mangalarga Marchador breed stallions

CGG Repeat-Induced FMR1 Silencing Depends on the Expansion Size in Human iPSCs and Neurons Carrying Unmethylated Full Mutations

In fragile X syndrome (FXS), CGG repeat expansion greater than 200 triplets is believed to trigger FMR1 gene silencing and disease etiology. However, FXS siblings have been identified with more than 200 CGGs, termed unmethylated full mutation (UFM) carriers, without gene silencing and disease symptoms. Here, we show that hypomethylation of the FMR1 promoter is maintained in induced pluripotent stem cells (iPSCs) derived from two UFM individuals. However, a subset of iPSC clones with large CGG expansions carries silenced FMR1. Furthermore, we demonstrate de novo silencing upon expansion of the CGG repeat size. FMR1 does not undergo silencing during neuronal differentiation of UFM iPSCs, and expression of large unmethylated CGG repeats has phenotypic consequences resulting in&nbsp;neurodegenerative features. Our data suggest that UFM individuals do not lack the cell-intrinsic ability to silence FMR1 and that inter-individual variability in the CGG repeat size required for silencing exists in the FXS population

The Wnt Receptor Ryk Reduces Neuronal and Cell Survival Capacity by Repressing FOXO Activity During the Early Phases of Mutant Huntingtin Pathogenicity

The Wnt receptor Ryk is an evolutionary-conserved protein important during neuronal differentiation through several mechanisms, including γ-secretase cleavage and nuclear translocation of its intracellular domain (Ryk-ICD). Although the Wnt pathway may be neuroprotective, the role of Ryk in neurodegenerative disease remains unknown. We found that Ryk is up-regulated in neurons expressing mutant huntingtin (HTT) in several models of Huntington's disease (HD). Further investigation in Caenorhabditis elegans and mouse striatal cell models of HD provided a model in which the early-stage increase of Ryk promotes neuronal dysfunction by repressing the neuroprotective activity of the longevity-promoting factor FOXO through a noncanonical mechanism that implicates the Ryk-ICD fragment and its binding to the FOXO co-factor β-catenin. The Ryk-ICD fragment suppressed neuroprotection by lin-18/Ryk loss-of-function in expanded-polyQ nematodes, repressed FOXO transcriptional activity, and abolished β-catenin protection of mutant htt striatal cells against cell death vulnerability. Additionally, Ryk-ICD was increased in the nucleus of mutant htt cells, and reducing γ-secretase PS1 levels compensated for the cytotoxicity of full-length Ryk in these cells. These findings reveal that the Ryk-ICD pathway may impair FOXO protective activity in mutant polyglutamine neurons, suggesting that neurons are unable to efficiently maintain function and resist disease from the earliest phases of the pathogenic process in HD. © 2014 Tourette et al

A síndrome de burnout em profissionais docentes: uma revisão integrativa da literatura / Burnout syndrome in teaching professionals: an integrative review of the literature

RESUMO Objetivo: verificar as evidências científicas sobre Síndrome de Burnout (SB) nos profissionais docentes, no período de 2014 a 2018. Método: Trata-se de uma pesquisa descritiva com abordagem qualitativa, através de uma Revisão Integrativa da Literatura (RIL). Nas bases de dados LILALCS e MEDLINE, incluindo artigos originais e de revisão, na língua portuguesa, publicados entre 2014 e 2018. Utilizou-se o protocolo de Ursi para a organização dos dados, e para a análise dos dados a análise de conteúdo de Bardin. Resultados: Buscou-se em 8 artigos, elencou-se duas categorias temáticas: A prevalência da SB em Docentes; Fatores associados ao desenvolvimento da SB nos docentes. Conclusão: A SB se apresenta em alta prevalência nos docentes, em especial os do ensino fundamental. Evidenciou-se fatores associados para o desenvolvimento da SB como: carga horária extensa de trabalho, falta de tempo para lazer e família, trabalhar sob pressão e ambiente hostil. 

Association of Group A Streptococcus Exposure and Exacerbations of Chronic Tic Disorders

Objective: To examine prospectively the association between group A Streptococcus (GAS) pharyngeal exposures and exacerbations of tics in a large multicenter population of youth with chronic tic disorders (CTD) across Europe. Methods: We followed up 715 children with CTD (age 10.7 ± 2.8 years, 76.8% boys), recruited by 16 specialist clinics from 9 countries, and followed up for 16 months on average. Tic, obsessive-compulsive symptom (OCS), and attention-deficit/hyperactivity disorder (ADHD) severity was assessed during 4-monthly study visits and telephone interviews. GAS exposures were analyzed using 4 possible combinations of measures based on pharyngeal swab and serologic testing. The associations between GAS exposures and tic exacerbations or changes of tic, OC, and ADHD symptom severity were measured, respectively, using multivariate logistic regression plus multiple failure time analyses and mixed effects linear regression. Results: A total of 405 exacerbations occurred in 308 of 715 (43%) participants. The proportion of exacerbations temporally associated with GAS exposure ranged from 5.5% to 12.9%, depending on GAS exposure definition. We did not detect any significant association of any of the 4 GAS exposure definitions with tic exacerbations (odds ratios ranging between 1.006 and 1.235, all p values &gt;0.3). GAS exposures were associated with longitudinal changes of hyperactivity-impulsivity symptom severity ranging from 17% to 21%, depending on GAS exposure definition. Conclusions: This study does not support GAS exposures as contributing factors for tic exacerbations in children with CTD. Specific workup or active management of GAS infections is unlikely to help modify the course of tics in CTD and is therefore not recommended