A reflection on motor overflow, mirror phenomena, synkinesia and entrainment

In patients with movement disorders, voluntary movements can sometimes be accompanied by unintentional muscle contractions in other body regions. In this review, we discuss clinical and pathophysiological aspects of several motor phenomena including mirror movements, dystonic overflow, synkinesia, entrainment and mirror dystonia, focusing on their similarities and differences. These phenomena share some common clinical and pathophysiological features, which often leads to confusion in their definition. However, they differ in several aspects, such as the body part showing the undesired movement, the type of this movement (identical or not to the intentional movement), the underlying neurological condition, and the role of primary motor areas, descending pathways and inhibitory circuits involved, suggesting that these are distinct phenomena. We summarize the main features of these fascinating clinical signs aiming to improve the clinical recognition and standardize the terminology in research studies. We also suggest that the term “mirror dystonia” may be not appropriate to describe this peculiar phenomenon which may be closer to dystonic overflow rather than to the classical mirror movements

Abnormal illness behavior and Internet addiction severity: The role of disease conviction, irritability, and alexithymia

While the association between health anxiety and maladaptive Internet use is a well-established finding, no studies have been performed to examine the possible effect of abnormal illness behavior (AIB). AIB is a maladaptive manner of experiencing, evaluating, or acting in response to health and illness that is disproportionate to evident pathology. The aim of this study was to investigate the association between AIB and Internet addiction (IA) severity in a sample of Italian University students. The possible effect of alexithymia, anxiety, and depression was also taken into account. Methods Participants were 115 men and 163 women (mean age = 23.62 ± 4.38 years); AIB was measured via the Illness Behavior Questionnaire (IBQ), and IA severity by the Internet Addiction Test (IAT). Results The most powerful IBQ factor predicting IA severity scores was disease conviction. Irritability was the only emotional IBQ factor associated with IA severity. Nevertheless, disease conviction and alexithymia remained the only significant predictors of IAT scores when hierarchical regression analysis was executed. Discussion and conclusions Our results support previous findings showing that those characterized by health anxiety are more prone to an excessive and maladaptive use of Internet. Moreover, this study showed that irritability was the only emotional aspect of AIB predicting IA severity. This finding is consistent with the cognitive model of hypochondria, which states that cognitive factors (dysfunctional beliefs and assumptions) play a major role in the explanation of this psychopathological condition

Color Vision Impairment in Parkinson's Disease

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Anxiety and depression in Charcot-Marie-Tooth disease: data from the Italian CMT national registry

Background There is little information about neuropsychiatric comorbidities in Charcot-Marie-Tooth disease (CMT). We assessed frequency of anxiety, depression, and general distress in CMT.Methods We administered online the Hospital Anxiety-Depression Scale (HADS) to CMT patients of the Italian registry and controls. HADS-A and HADS-D scores >= 11 defined the presence of anxiety/depression and HADS total score (HADS-T) >= 22 of general distress. We analysed correlation with disease severity and clinical characteristics, use of anxiolytics/antidepressants and analgesic/anti-inflammatory drugs.Results We collected data from 252 CMT patients (137 females) and 56 controls. CMT patient scores for anxiety (mean +/- standard deviation, 6.7 +/- 4.8), depression (4.5 +/- 4.0), and general distress (11.5 +/- 8.1) did not differ from controls and the Italian population. However, compared to controls, the percentages of subjects with depression (10% vs 2%) and general distress (14% vs 4%) were significantly higher in CMT patients. We found no association between HADS scores and disease duration or CMT type. Patients with general distress showed more severe disease and higher rate of positive sensory symptoms. Depressed patients also had more severe disease. Nineteen percent of CMT patients took antidepressants/anxiolytics (12% daily) and 70% analgesic/anti-inflammatory drugs. Patients with anxiety, depression, and distress reported higher consumption of anxiolytics/antidepressants. About 50% of patients with depression and/or general distress did not receive any specific pharmacological treatment.Conclusions An appreciable proportion of CMT patients shows general distress and depression. Both correlated with disease severity and consumption of antidepressants/anxiolytics, suggesting that the disease itself is contributing to general distress and depression

Frequency, entity and determinants of fatigue in Charcot-Marie-Tooth disease

Fatigue, a disabling symptom in many neuromuscular disorders, has been reported also in Charcot-Marie-Tooth disease (CMT). The presence of fatigue and its correlations in CMT was investigated

"Outroduction":A research agenda on collegiality in university settings

Collegiality is the modus operandi of universities. Collegiality is central to academic freedom and scientific quality. In this way, collegiality also contributes to the good functioning of universities’ contribution to society and democracy. In this concluding paper of the special issue on collegiality, we summarize the main findings and takeaways from our collective studies. We summarize the main challenges and contestations to collegiality and to universities, but also document lines of resistance, activation, and maintenance. We depict varieties of collegiality and conclude by emphasizing that future research needs to be based on an appreciation of this variation. We argue that it is essential to incorporate such a variation-sensitive perspective into discussions on academic freedom and scientific quality and highlight themes surfaced by the different studies that remain under-explored in extant literature: institutional trust, field-level studies of collegiality, and collegiality and communication. Finally, we offer some remarks on methodological and theoretical implications of this research and conclude by summarizing our research agenda in a list of themes

Use, tolerability, benefits and side effects of orthotic devices in Charcot-Marie-Tooth disease

Background: Shoe inserts, orthopaedic shoes, ankle-foot orthoses (AFOs) are important devices in Charcot-Marie-Tooth disease (CMT) management, but data about use, benefits and tolerance are scanty. Methods: We administered to Italian CMT Registry patients an online ad hoc questionnaire investigating use, complications and perceived benefit/tolerability/emotional distress of shoe inserts, orthopaedic shoes, AFOs and other orthoses/aids. Patients were also asked to fill in the Quebec User Evaluation of Satisfaction with assistive Technology questionnaire, rating satisfaction with currently used AFO and related services. Results: We analysed answers from 266 CMT patients. Seventy per cent of subjects were prescribed lower limb orthoses, but 19% did not used them. Overall, 39% of subjects wore shoe inserts, 18% orthopaedic shoes and 23% AFOs. Frequency of abandonment was high: 24% for shoe inserts, 28% for orthopaedic shoes and 31% for AFOs. Complications were reported by 59% of patients and were more frequently related to AFOs (69%). AFO users experienced greater emotional distress and reduced tolerability as compared with shoe inserts (p<0.001) and orthopaedic shoes (p=0.003 and p=0.045, respectively). Disease severity, degree of foot weakness, customisation and timing for customisation were determinant factors in AFOs' tolerability. Quality of professional and follow-up services were perceived issues. Conclusions: The majority of CMT patients is prescribed shoe inserts, orthopaedic shoes and/or AFOs. Although perceived benefits and tolerability are rather good, there is a high rate of complications, potentially inappropriate prescriptions and considerable emotional distress, which reduce the use of AFOs. A rational, patient-oriented and multidisciplinary approach to orthoses prescription must be encouraged

Formazione di giovani leader di sanità pubblica: un’esperienza sperimentale dell’Accademia Lombarda di Sanità Pubblica

Introduzione L’Accademia Lombarda di Sanità Pubblica (ALSP), Associazione no-profit fondata nel 2017, ha come obiettivo quello di promuovere il progresso in Sanità Pubblica (SP) attraverso il coinvolgimento di studiosi impegnati a vario titolo nei molteplici ambiti della SP come quello dell’igiene, dell’epidemiologia, della prevenzione, dell’ambiente, della direzione sanitarie, dell’edilizia sanitaria, del management, del diritto e dell’economia sanitaria. A tale scopo l’Accademia ha promosso, all’inizio del 2019, l’iniziativa Academy of Young Leader in Public Health (AYLPH). Si tratta di un percorso didattico-scientifico di un anno rivolto a 10 giovani con background formativo differente, fortemente motivati a sviluppare competenze di leadership in SP e già avviati a carriere professionali e di ricerca. Metodi Questo percorso formativo per i 10 giovani, selezionati con bando competitivo aperto ai soci, basa il suo metodo didattico-formativo su incontri con riconosciuti leader nazionali e internazionali di SP; visite a istituzioni; collaborazione a progetti di ricerca; training specifico sulla scrittura di lavori scientifici; opportunità di partecipare a convegni nazionali internazionali e a corsi brevi ad hoc. Risultati A metà programma, le attività condotte sono state: esperienza di team building in località montana; incontro con alcune importanti figure impegnate, a vari livelli, nella sanità pubblica come l’ex Ministro della salute Beatrice Lorenzin, l’Editor-in-chief della rivista European Journal of Public Health Peter Allebeck, il Presidente EUPHA Natasha Azzopardi-Muscat oltre ai past-Presidenti EUPHA Walter Ricciardi e Martin Mc Kee. Ha fatto seguito un corso intensivo sulle revisioni sistematiche che ha visto l’attivazione di 6 gruppi di ricerca coinvolti in altrettanti progetti di revisione sistematica della letteratura. Ulteriori attività sono state: la partecipazione all’Assemblea Generale dell’Organizzazione Mondiale della Sanità, la partecipazione al Deans’ and Directos’ Retreat dell’ASPHER e al Congresso Americano di Sanità Pubblica (APHA). Sono in programma anche un corso di Public speaking, presso l’Università di Pisa ed alcuni incontri ad hoc. Conclusioni Nel contesto attuale, in cui la salute delle persone è minata da un senso di sfiducia nei confronti delle Istituzioni, dalla mancata equità nell’accesso alle cure e da stili di vita scorretti, la SP ha necessità di formare nuovi leaders in grado di promuovere valori e guidare al cambiamento individuale, organizzativo e politico. La AYLPH rappresenta un’occasione formativa di alto livello per giovani professionisti interessati a conoscere e attuare strategie di leadership in SP

“Outroduction” : a research agenda on collegiality In university settings

Collegiality is the modus operandi of universities. Collegiality is central to academic freedom and scientific quality. In this way, collegiality also contributes to the good functioning of universities’ contribution to society and democracy. In this concluding paper of the special issue on collegiality, we summarize the main findings and takeaways from our collective studies. We summarize the main challenges and contestations to collegiality and to universities, but also document lines of resistance, activation, and maintenance. We depict varieties of collegiality and conclude by emphasizing that future research needs to be based on an appreciation of this variation. We argue that it is essential to incorporate such a variation-sensitive perspective into discussions on academic freedom and scientific quality and highlight themes surfaced by the different studies that remain under-explored in extant literature: institutional trust, field-level studies of collegiality, and collegiality and communication. Finally, we offer some remarks on methodological and theoretical implications of this research and conclude by summarizing our research agenda in a list of themes