We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
A 24-kDa collagenase was localized in the Gymnorhynchus gigas plerocercoid immunohistochemically by peroxidase complex staining using polyclonal antibodies from NMRI mouse sera immunized with purified enzyme. Immunoreactivity was determined at different parts of the body (scolex, vesicle and caudal region) and mainly localized in microtriches and parenchymal tissues of the scolex and vesicle. These results, along with the absence of the enzyme in the plerocercoid excretion–secretion products, suggest that the 24-kDa collagenase is produced by parenchymal cells in the anterior region and transported to the outer regions of the worm It is possible that the enzyme plays an important role in degrading parasite tissues during the moulting process.
A preliminary purification has been carried out by continuous elution electrophoresis of a 49.5 kDa protease of crude extracts from Dicrocoelium dendriticum eggs. The enzyme showed a high capacity to degrade the collagen derivative azocoll at acidic pH. Although it is necessary to carry out further experiments to confirm any physiological role, this protease could be implicated in penetration mechanisms.
Proteolytic activities of soluble and insoluble fractions of the free-living soil nematode Caenorhabditis elegans were measured across a range of substrates, temperatures and pH conditions. Several protease inhibitors were also tested under these conditions. Results of these studies indicate that proteolytic activity is present in cytosolic (CF) and non-cytosolic (NCF) fractions of C. elegans extracts at every condition of pH, temperature and buffer assayed. On the other hand, the use of different protease inhibitors demonstrated the existence of exo and endoproteases types in CF as well as NCF. Moreover our results show that the use of two protease inhibitor mixed types proposed by several authors are not enough to avoid this lytic activity when homogenates of this nematode are employed in biochemical assays.
To investigate the occurrence of traumatic stress symptoms (TSS) among healthcare workers active during the COVID-19 pandemic and to obtain insight as to which pandemic-related stressful experiences are associated with onset and persistence of traumatic stress.
Methods
This is a multicenter prospective cohort study. Spanish healthcare workers (N = 4,809) participated at an initial assessment (i.e., just after the first wave of the Spain COVID-19 pandemic) and at a 4-month follow-up assessment using web-based surveys. Logistic regression investigated associations of 19 pandemic-related stressful experiences across four domains (infection-related, work-related, health-related and financial) with TSS prevalence, incidence and persistence, including simulations of population attributable risk proportions (PARP).
Results
Thirty-day TSS prevalence at T1 was 22.1%. Four-month incidence and persistence were 11.6% and 54.2%, respectively. Auxiliary nurses had highest rates of TSS prevalence (35.1%) and incidence (16.1%). All 19 pandemic-related stressful experiences under study were associated with TSS prevalence or incidence, especially experiences from the domains of health-related (PARP range 88.4–95.6%) and work-related stressful experiences (PARP range 76.8–86.5%). Nine stressful experiences were also associated with TSS persistence, of which having patient(s) in care who died from COVID-19 had the strongest association. This association remained significant after adjusting for co-occurring depression and anxiety.
Conclusions
TSSs among Spanish healthcare workers active during the COVID-19 pandemic are common and associated with various pandemic-related stressful experiences. Future research should investigate if these stressful experiences represent truly traumatic experiences and carry risk for the development of post-traumatic stress disorder.
During the COVID-19 pandemic, people with mental disorders were exposed to a common and prolonged source of stress. Studies focusing on the consequences of the pandemic on individuals with a history of mental disorder are scarce, but they suggest a higher vulnerability as compared to the general population.
Objectives
We aimed at identifying predictors of stress resilience maintained over time among these people during the first two years of the pandemic.
Methods
The presented study is part of a larger 2-year, 5-wave international longitudinal online survey.
The Patient Health Questionnaire, the Generalized Anxiety Disorder scale and the PTSD Checklist DSM-5 were used as latent class indicators for a proxy measure of distress. Specifically, a Latent-Class Analysis was performed to identify a group that showed resilient outcomes across all waves.
We investigated socio-demographic characteristics, economic and housing status, lifestyle and habits, pandemic-related issues, and chronic disease. Adherence to and approval of the restrictions imposed, trust in governments and the scientific community during the pandemic were also assessed. Social support, fear of contamination and personal values were investigated respectively through the Oslo Social Support Scale, the Padua Inventory, and the Portrait Values Questionnaire. The aforementioned characteristics were used to predict sustained resilience through a logistic regression.
Results
A total of 1711 participants out of the total sample (8011 participants from 13 different countries) reported a diagnosis of mental disorder before the pandemic. Nine hundred forty-three participants completed at least three of the five versions of the survey and were included in the analysis. A latent class of participants with resilience maintained over time (sustained resilience) was identified, with an estimated probability of 24.8%. The demographic and clinical variables associated with a higher chance of sustained resilience were older age, maintaining a job during the pandemic, and having a larger number of people in the household. In contrast, female gender, losing job during the pandemic, having difficulty meeting basic needs, greater fear of contamination, a stronger focus on hedonism, less social support and feeling lonely resulted in a lower likelihood of being sustained resilient.
Conclusions
This study identified a number of factors that may help predict resilient outcomes maintained over time in people with mental disorders. COVID-19 related predictors of sustained resilience are new findings which might inform resilience-building interventions during pandemics.
To determine predictors of the association between being a Veteran and adult food security, as well as to examine the relation of potential covariates to this relationship.
Design:
Data collected during 2011–2012, 2013–2014 and 2015–2016 National Health and Nutrition Examination Survey (NHANES) were pooled for analyses. Veterans (self-reported) were matched to non-Veterans on age, race/ethnicity, sex and education. Adjusted logistic regression was used to determine the odds of Veterans having high food security v. the combination of marginal, low and very low food security compared with non-Veterans.
Setting:
2011–2012, 2013–2014 and 2015–2016 NHANES.
Participants:
1227 Veterans; 2432 non-Veterans.
Results:
Veteran status had no effect on the proportion of food insecurities between Veterans and non-Veterans reporting high (Veterans v. non-Veteran: 79 % v. 80 %), marginal (9 % v. 8 %), low (5 % v. 6 %) and very low (8 % v. 6 %) food security (P = 0·11). However, after controlling for covariates, Veterans tended to be less likely to have high food security (OR: 0·82 (95 % CI 0·66, 1·02), P = 0·07). Further, non-Hispanic White Veterans (OR: 0·72 (95 % CI 0·55, 0·95), P = 0·02) and Veterans completing some college (OR: 0·71 (95 % CI 0·50, 0·99), P < 0·05) were significantly less likely to experience high food security compared with non-Veterans.
Conclusion:
This study supports previous research findings that after controlling for covariates, Veterans tend to be less likely to have high food security. It also highlights ethnicity and level of education as important socio-economic determinates of food security status in Veterans.
We present WALLABY pilot data release 1, the first public release of H i pilot survey data from the Wide-field ASKAP L-band Legacy All-sky Blind Survey (WALLABY) on the Australian Square Kilometre Array Pathfinder. Phase 1 of the WALLABY pilot survey targeted three
$60\,\mathrm{deg}^{2}$
regions on the sky in the direction of the Hydra and Norma galaxy clusters and the NGC 4636 galaxy group, covering the redshift range of
$z \lesssim 0.08$
. The source catalogue, images and spectra of nearly 600 extragalactic H i detections and kinematic models for 109 spatially resolved galaxies are available. As the pilot survey targeted regions containing nearby group and cluster environments, the median redshift of the sample of
$z \approx 0.014$
is relatively low compared to the full WALLABY survey. The median galaxy H i mass is
$2.3 \times 10^{9}\,{\rm M}_{{\odot}}$
. The target noise level of
$1.6\,\mathrm{mJy}$
per 30′′ beam and
$18.5\,\mathrm{kHz}$
channel translates into a
$5 \sigma$
H i mass sensitivity for point sources of about
$5.2 \times 10^{8} \, (D_{\rm L} / \mathrm{100\,Mpc})^{2} \, {\rm M}_{{\odot}}$
across 50 spectral channels (
${\approx} 200\,\mathrm{km \, s}^{-1}$
) and a
$5 \sigma$
H i column density sensitivity of about
$8.6 \times 10^{19} \, (1 + z)^{4}\,\mathrm{cm}^{-2}$
across 5 channels (
${\approx} 20\,\mathrm{km \, s}^{-1}$
) for emission filling the 30′′ beam. As expected for a pilot survey, several technical issues and artefacts are still affecting the data quality. Most notably, there are systematic flux errors of up to several 10% caused by uncertainties about the exact size and shape of each of the primary beams as well as the presence of sidelobes due to the finite deconvolution threshold. In addition, artefacts such as residual continuum emission and bandpass ripples have affected some of the data. The pilot survey has been highly successful in uncovering such technical problems, most of which are expected to be addressed and rectified before the start of the full WALLABY survey.
Longitudinal data on the mental health impact of the coronavirus disease 2019 (Covid-19) pandemic in healthcare workers is limited. We estimated prevalence, incidence and persistence of probable mental disorders in a cohort of Spanish healthcare workers (Covid-19 waves 1 and 2) -and identified associated risk factors.
Methods
8996 healthcare workers evaluated on 5 May–7 September 2020 (baseline) were invited to a second web-based survey (October–December 2020). Major depressive disorder (PHQ-8 ≥ 10), generalised anxiety disorder (GAD-7 ≥ 10), panic attacks, post-traumatic stress disorder (PCL-5 ≥ 7), and alcohol use disorder (CAGE-AID ≥ 2) were assessed. Distal (pre-pandemic) and proximal (pandemic) risk factors were included. We estimated the incidence of probable mental disorders (among those without disorders at baseline) and persistence (among those with disorders at baseline). Logistic regression of individual-level [odds ratios (OR)] and population-level (population attributable risk proportions) associations were estimated, adjusting by all distal risk factors, health care centre and time of baseline interview.
Results
4809 healthcare workers participated at four months follow-up (cooperation rate = 65.7%; mean = 120 days s.d. = 22 days from baseline assessment). Follow-up prevalence of any disorder was 41.5%, (v. 45.4% at baseline, p < 0.001); incidence, 19.7% (s.e. = 1.6) and persistence, 67.7% (s.e. = 2.3). Proximal factors showing significant bivariate-adjusted associations with incidence included: work-related factors [prioritising Covid-19 patients (OR = 1.62)], stress factors [personal health-related stress (OR = 1.61)], interpersonal stress (OR = 1.53) and financial factors [significant income loss (OR = 1.37)]. Risk factors associated with persistence were largely similar.
Conclusions
Our study indicates that the prevalence of probable mental disorders among Spanish healthcare workers during the second wave of the Covid-19 pandemic was similarly high to that after the first wave. This was in good part due to the persistence of mental disorders detected at the baseline, but with a relevant incidence of about 1 in 5 of HCWs without mental disorders during the first wave of the Covid-19 pandemic. Health-related factors, work-related factors and interpersonal stress are important risks of persistence of mental disorders and of incidence of mental disorders. Adequately addressing these factors might have prevented a considerable amount of mental health impact of the pandemic among this vulnerable population. Addressing health-related stress, work-related factors and interpersonal stress might reduce the prevalence of these disorders substantially. Study registration number: NCT04556565
In this paper, we describe the system design and capabilities of the Australian Square Kilometre Array Pathfinder (ASKAP) radio telescope at the conclusion of its construction project and commencement of science operations. ASKAP is one of the first radio telescopes to deploy phased array feed (PAF) technology on a large scale, giving it an instantaneous field of view that covers $31\,\textrm{deg}^{2}$ at $800\,\textrm{MHz}$. As a two-dimensional array of 36$\times$12 m antennas, with baselines ranging from 22 m to 6 km, ASKAP also has excellent snapshot imaging capability and 10 arcsec resolution. This, combined with 288 MHz of instantaneous bandwidth and a unique third axis of rotation on each antenna, gives ASKAP the capability to create high dynamic range images of large sky areas very quickly. It is an excellent telescope for surveys between 700 and $1800\,\textrm{MHz}$ and is expected to facilitate great advances in our understanding of galaxy formation, cosmology, and radio transients while opening new parameter space for discovery of the unknown.
Describe the prevalence and characteristics of psychotic symptoms in the context of cocaine injection use in a harm reduction program.
To find associations between intravenous cocaine use and other drug use in cocaine dependent patients suffering from cocaine induced psychosis (CIP). Cannabis was found to be a risk factor for developing CIP in non-intravenous cocaine dependence.
Methods
During a period of 6 months professionals from our Outpatient Drug Clinic completed a confidential questionnaire to describe the adverse clinical effects following cocaine injection. It included age, gender, ethnic group, daily consumption rate and other drugs used in the last 30 days.
Results
Survey was achieved with a sample of 75 Caucasians patients, 69 men and 6 women with an average age of 32 years old. Seventeen percent (13/75) had psychotic symptoms, of which 84% (11/13) had hallucinations (visuals 4/11, auditive 7/11 and kinaesthetic 2/11), 15% (2/13) illusions.
Eighteen percent (14/75) had stereotypy movements and 3% (2/75) had aggressive behaviour. Drugs used by CIP patients, the previous 30 days were: 61% (8/13) cannabis, 31% (4/13) opiates and 15% (2/13) alcohol.
Conclusions
Intravenous cocaine use produced acute psychotic symptoms in 17% of our patients, of which 61% used cannabis. Despite the ethical and practical implications of this type of study, it is necessary to do more observational studies with bigger surveys to conclude these results with statistically significance.
Prior to facing the challenges of FM management, an initial diagnosis must be made. To guide general practitioners (GPs) in the early detection of FM in Europe, we developed an easy-to-use screening tool specific to FM.
Method:
A European multidisciplinary expert group was constituted with the aim of providing clinical expertise, defining methodology, and identifying key issues around the detection of FM. Three conceptual models describing factors that may contribute to the identification of FM patients were derived from; a) a comprehensive literature review, 2) clinician focus groups (N=6), and 3) face-to-face interviews with German, French, and English-speaking patients (N=29) conducting by psychologists to explore their attitudes and perceptions of the disease. A FM screening tool was developed in all three languages and tested for comprehension and applicability in FM-diagnosed and FM-suspected patients.
Results:
The models derived from the literature, clinician focus groups, and FM patient interviews showed high consistency. The resulting FM screening tool is comprised of 14 questions that describe patients' pain, fatigue, associated symptoms, impact on everyday life, personal history, and attitudes towards their FM.
Conclusion:
Based on this qualitative study, the detection of FM is likely to require the assessment of multiple psychological factors in addition to symptoms, including patient reporting of personal history and patient behaviour. The quantitative validation of these findings is currently underway.
Prior to facing the challenges of FM management, an initial diagnosis must be made. To guide general practitioners (GPs) in the early detection of FM in Europe, we developed an easy-to-use screening tool specific to FM.
Method:
A European multidisciplinary expert group was constituted with the aim of providing clinical expertise, defining methodology, and identifying key issues around the detection of FM. Three conceptual models describing factors that may contribute to the identification of FM patients were derived from; a) a comprehensive literature review, 2) clinician focus groups (N=6), and 3) face-to-face interviews with German, French, and English-speaking patients (N=29) conducting by psychologists to explore their attitudes and perceptions of the disease. A FM screening tool was developed in all three languages and tested for comprehension and applicability in FM-diagnosed and FM-suspected patients.
Results:
The models derived from the literature, clinician focus groups, and FM patient interviews showed high consistency. The resulting FM screening tool is comprised of 14 questions that describe patients’ pain, fatigue, associated symptoms, impact on everyday life, personal history, and attitudes towards their FM.
Conclusion:
Based on this qualitative study, the detection of FM is likely to require the assessment of multiple psychological factors in addition to symptoms, including patient reporting of personal history and patient behaviour. The quantitative validation of these findings is currently underway.
Major depression was the fourth most important determinant of the burden of human disease in 1990 and is expected to rank second in the world by 2020.
Objectives
As the causes of depression are complex, the identification of modifiable risk and protective factors, and understanding the processes through which they operate is crucial.
Aims
The main aim of the present study is to identify potential risk factors to the development of depression.
Methods
A total of 304 college students completed an on line questionnaire which assessed: depressive symptomathology (IACLIDE; Vaz Serra, 1994), pessimism (LOTR; Scheier, Carver, & Bridges, 1994), dysfunctional attitudes (DAS; Weissman & Beck, 1978) and neuroticism (EPQ; Eysenck & Eysenck, 1969).
Results
The main results indicated that pessimism, dysfunctional attitudes, and neuroticism correlated significantly and positively with depressive symptomathology.
Conclusions
The results suggested that pessimism, dysfunctional attitudes, and neuroticism can be considered risk factors for depression and important variables to be included in the depression prevention program under development. Overall, the results of this study indicate that understanding the relationships between these variables may be important to the prevention of depression.
The authors describe case of a male of 48 years old admitted in an acute psychiatric unit with psychomotor restlessness, temporal disorientation and severe distractibility, although prior to the admission he had shown symptoms of apathy and social retraction suggesting a depressive syndrome. This was a patient without prior psychiatric history, with a good psychosocial functioning and well adjusted prior personality. Within one year, there was a change in his personality and the appearance of an inadequate social conduct, with an insidious onset and gradual progression. CT scan and MRI showed lobar fronto-temporal atrophy. The SPECT showed also changes consistent with a fronto-temporal dementia. During the admission he manifested hyperactivity, some desinhibition, mental rigidity, inflexibility, stereotyped behaviors and persevering with continuous walking and changes in eating habits, alternating severe anorexia with hyperphagia. He also presented distractibility, poor speech with loss of spontaneity, an indifferent attitude, emotional flattening and lack of insight for his condition. In the neuropsychological evaluation initially existed only prejudice of the frontal lobes functions, with preservation of other cognitive functions, but gradually evolved. Addressing to the therapy, it were used various drugs, including SSRI"s, that until now have not proved to be effective in controlling the symptoms, highlighting the difficulty in the psychopharmacological approach of FTD.
Combination therapy of peginterferon and ribavirin for HCV has been recommended as a first choice for chronic hepatitis C. INF therapy has been associated with various IFN-related adverse events, such as psychological disturbances. Beyond that preexisting mental disorders are considered risk factors for INF-alfa-induced severe psychiatric side effects such as depression and/or suicidality, consequently many of these patients remain untreated even tough they fulfil the medical criteria for antiviral treatment of chronic hepatitis C.
The authors relate the case of a patient, 56 year's old, sent to infecciology consultation because she had alterations in abnormal liver function tests. She had a previous history of mental disorder with neurotic personality traits and she was treated with psychiatric medication.
She had treatment for chronic hepatitis C with peginterferon and ribavirin as well psychiatric and psychotherapeutic support.
A low sustained virologic response was obtained however the depressive picture has been difficult to handle so she had had already had a psychiatric hospitalization. There were several adverse life events that can not be forgotten as they certainly trigger and exacerbate the depressive symptomatology.
We assume that psychiatric patients have more depressive symptoms before and during treatment compared with patients without no psychiatric history. This shows that this patients have an increase need for treatment with antidepressants and that a close cooperation with a psychiatrist is always needed.
Non-specific chronic low back pain is one of common causes of disability and a recurrent medical complaint with high costs. From rehabilitative medicine, physiotherapy programs and general postural recommendations are offered. Although this treatment is aimed to reduce disability, severity of pain and anxiety-depressive symptoms, many patients report partial improvements and recurrence of pain. Therefore, a new approach to treat this pathology with a broaden focus on psychososocial issues that might modulate pain and its evolution is required.
Aims and hypothesis
To assess the effectiveness of two complementary interventions to physiotherapy, such as relaxation techniques (specifically, sophrology) and cognitive behavioral intervention. It is hypothesized that intervention groups will significantly improve their adherence to physiotherapy and will gain control over their pain. Ultimately, this will foster better quality of life.
Methods
Longitudinal design with pre-post intervention measures and follow-up appointments (at 6 and 12 months) carried out in a sample of 66 participants. The sample will be divided into three groups: control (physiotherapy), intervention group 1 (physiotherapy & sophrology) and intervention group 2 (physiotherapy & cognitive behavioral intervention). In all groups biomedical aspects regarding type, evolution and characterization of pain as well as several psychosocial factors will be assessed.
Results
Preliminary results are expected by December 2013.
Implications
If hypotheses are confirmed, we will be able to provide empirical evidences to justify a multidisciplinary care model for chronic low back pain, which will favor a significant cost reduction in terms of health care and human suffering.
Becoming aware of being HCV positive has a very negative impact on quality of life and IFN therapy is also responsible for the development of neuropsychiatric side effects (Pariante 2002).
Objective:
This prospective study aims to determine the role of IFN in psychopathological symptoms experienced by patients in treatment, in particular it deals with its impact on quality of life and determines which patients can be safely treated with Peg-interferon α, because the therapy is expensive, has significant side effects and prolonged psychiatric that unfortunately cannot be predicted with absolute certainty.
Methods:
The sample includes 32 patients, including 18 males and 14 females of mean age of 48.19 years (DS. = 9.660) hepatitis C affected, evaluated before the start of peg-interferon antiviral therapy using the interview semi-structured SCID-I and II and self-administered tests Scl90, BDI, SF36 and followed up at first and third months by HAM-a, HAM-D, CGI, YMRS, and sixth months of therapy through Scl90, BDI, SF36, HAM-A, HAM-D, CGI, YMRS.
Conclusions:
Although psychiatric disorders worsened or manifested during the peg-interferon α + ribavirin therapy, only 2 out of 32 patients did not come to the end point of our study because of a psychopathological disease. Despite the predominantly psychopathological depressive symptoms and the marked quality of life reduction, with adequate support, even patients predisposed to mood disorders or anxiety, can take the peg-interferon α, and the presence of a life-time psychiatric diagnosis is not an a priori therapy exclusion criterion.
Schizophrenia and mood disorders -including unipolar depression and bipolar disorder-, are severe mental diseases with a highly heterogeneous symptomatology, among which cognitive dysfunction has progressively emerged as a key cornerstone. Patients suffering from these illnesses show significant deficits in different neurocognitive and social cognition domains. These deficits are evident during acute episodes, and in a high percentage of patients persist in periods of recovery, playing a decisive role on functional and clinical outcome. Nowadays, different pharmacological therapies have been tested, obtaining non-conclusive results. In this context, non-pharmacological strategies, such as neurocognitive remediation, have emerged as promising therapeutic intervention. Neurocognitive remediation comprises a program to rehabilitate cognitively impaired subjects, aiming either to restore their cognitive functioning or to compensate them in specific cognitive domains. One evolving approach, beginning to receive attention for its initial promising results, is computerized cognitive training. This technique employs tasks or games that exercise a particular brain function which target specific neural networks in order to improve cognitive functioning through neuroplasticity in a given neural circuit. In this scenario, we report our recent results with neuropersonaltrainer®-MH; a module for neurocognitive remediation consisting in a computerized telerehabilitation platform that enables cognitive remediation programs to be carried out in an intensive and personalized manner. Our group has applied NPTMH® in a pilot study treating patients with early onset psychotic disorder with positive and promising results, involving an improvement in functionality, neurocognition, and social cognition performance. Furthermore, new trials in bipolar disorder and major depressive disorder have been recently started.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
A previous study, conducted in the province of Novara stated that, from an epidemiological and clinical point of view, being a female, being a migrant, as well as being in the warmer months of the year, or suffering from an untreated psychiatric disease are associated with suicide attempts. Literature suggests there is a positive relation between negative life events and suicidal behaviours. In this study, we intend to deepen knowledge, individuating motivations and meanings underlying suicidal behaviours. This appears a meaningful approach to integrate studies and initiatives in order to prevent suicide and suicidal behaviours.
Aim
To examine possible correlation between socio-demographic and clinical characteristics and motivations underlying suicide attempts.
Methods
Patients aged > 16 years admitted for attempted suicide in the Emergency Room of the AOU Maggiore della Carità Hospital, Novara, Italy, were studied retrospectively from the 1st January 2015 to the 31st December 2016. Each patient was assessed by an experienced psychiatrist with a clinical interview; socio-demographic and clinical features were gathered. Analysis were performed with SPSS.
Results and discussion
Data collection are still ongoing; results and implications will be discussed. We expect to find different motivations in relation to socio-demographic and clinical characteristics [1,2].
Disclosure of interest
The authors have not supplied their declaration of competing interest.