Effects of dominance and vision on unipedal balance tests in futsal players using a triaxial accelerometer.

Optimal postural control improves performance and reduces the risk of injury in futsal. In this context, wearable accelerometers may detect velocity changes of the centre of mass during a task, enabling the analysis of postural control in different environments. This work aimed to determine the influence of vision and dominance on unipodal static postural balance in non-professional athletes. Twenty-four university male futsal players performed a unipodal balance test to assess their body sway using a triaxial accelerometer. To assess dominance, the preferred limb for kicking the ball was considered, while vision was manipulated by asking participants to close their eyes during the test. Root mean square (RMS) and sample entropy (SaEn) of centre of mass variables were analysed. For statistical analysis, a multivariate analysis of variance model was used. Our results suggest an effect of vision, but not of dominance nor the interaction between vision and limb dominance. Specifically, a higher-acceleration RMS in the mediolateral axis was observed, as well as an increased SaEn in the three axes. To conclude, unipodal postural demand in futsal players under visual input suppression was not influenced by their limb dominancy.

Training in neuropsychiatry: views of early career psychiatrists from across the world.

BACKGROUND: Training and practice in neuropsychiatry varies across the world. However, little is known about the experiences and opinions of early career psychiatrists (ECPs) across different countries regarding neuropsychiatry. AIMS AND METHOD: To investigate neuropsychiatry training experiences, practices and opinions among ECPs across different countries. An online survey was distributed to ECPs in 35 countries across the world. RESULTS: A total of 522 participants took part in this study. Responses show that neuropsychiatry is integrated to a variable extent in psychiatric training curricula across the world. Most respondents were not aware of the existence of neuropsychiatric training or of neuropsychiatric units. Most agreed that training in neuropsychiatry should be done during or after the psychiatry training period. Lack of interest among specialty societies, lack of time during training, and political and economic reasons are regarded as the main barriers. CLINICAL IMPLICATIONS: These findings call for an improvement in the extent and in the quality of neuropsychiatry training across the world.

Oblique multi-periscopic prism for field expansion of homonymous hemianopia.

Oblique Fresnel peripheral prisms have been used for field expansion in homonymous hemianopia mobility such as walking and driving. However, limited field expansion, low image quality, and small eye scanning range limit their effectiveness. We developed a new oblique multi-periscopic prism using a cascade of rotated half-penta prisms, which provides 42° horizontal field expansion along with 18° vertical shift, high image quality, and wider eye scanning range. Feasibility and performance of a prototype using 3D-printed module are demonstrated by raytracing, photographic depiction, and Goldmann perimetry with patients with homonymous hemianopia.

Analysis of Ana/Dfs70 Pattern in a Large Cohort of Autoimmune/Autoinflammatory Diseases Compared with First Degree Relatives and Healthy Controls Evaluated from Colombia.

BACKGROUND: The presence of Antinuclear antibodies/Dense Fine Speckled 70 (ANA/DFS70) has been proposed as a negative biomarker in the process of exclusion of systemic autoimmune/autoinflammatory rheumatic diseases (SARD). The purpose was to evaluate and characterize ANA/DFS70 patients in a large Colombian population with SARD; rheumatoid arthritis (RA), Psoriasis (PsO), Undifferentiated connective tissue disease (UCTD), first-degree relatives of (FDR), and healthy controls (HC). METHODS: ANA determination was performed using indirect immunofluorescence. Samples with positive dense fine granular staining in the nucleoplasm of the interphase cell (AC2) fluorescence were confirmed with CytoBead/ANA and ANA/modified (Knocked out for the PSPI1 gen). RESULTS: 530 mestizo Colombian participants were included. ANA/DFS70 antibody positivity in the whole group was 2.3%, and 0.8% in SARD; no RA patients were positive. ANA/DFS70 positives in UCTD were three women; the average time of evolution of the disease was 9.4 years. The most frequent clinical findings were arthralgias, non-erosive arthritis, and Raynaud's phenomenon. The PsO positive was a woman with C-reactive protein (CRP) positivity and a negative erythrocyte sedimentation rate (ESR) without any other positive autoantibody or extracutaneous manifestation. FDR and HC positives were 7/8 women. All were negative for other autoantibodies. CONCLUSIONS: ANA/DFS70 autoantibodies were present in Colombian patients with SARD at a shallow frequency, they were more prevalent in healthy individuals.

Patología dual en personas sin hogar en el Área de Salud de Avilés / Dual pathology in homeless people in the Avilés Health Area

El objetivo principal del presente estudio es estimar la prevalencia de trastornos mentales graves y de uso de sustancias en personas en la situación de estar sin hogar. El trabajo se realizó a partir de los datos obtenidos de una muestra representativa de personas sin hogar en Avilés (Asturias) (n=100) utilizando la Entrevista Neuropsiquiátrica Internacional (M.I.N.I.). Los resultados de nuestro estudio ponen de manifiesto una estrecha relación entre el uso de sustancias y el sinhogarismo. Más de la mitad de las personas sin hogar tiene trastornos relacionados con el uso de sustancias en comparación con el uso problemático de sustancias en la población general. Se discute la atención psicosocial y la organización de una red de apoyo a las personas sin hogar. (AU)

The main objective of the present study is to estimate the prevalence of severe mental disorders and substance use in the homeless situation. The work was carried out from the data obtained from a representative sample of homeless people in Avilés (Asturias) (n = 100) using the International Neuropsychiatric Interview (M.I.N.I.). The results of our study reveal a close relationship between substance use and homelessness. More than half of the homeless have substance use disorders compared to problem substance use in the general population. Psychosocial care and the organization of a support network for the homeless are discussed. (AU)

Dual pathology in homeless people in the Avilés Health Area / Patología dual en personas sin hogar en el Área de Salud de Avilés

The main objective of the present study is to estimate the prevalence of severe mental disorders and substance use in the homeless situation. The work was carried out from the data obtained from a representative sample of homeless people in Avilés (Asturias) (n = 100) using the International Neuropsychiatric Interview (M.I.N.I.). The results of our study reveal a close relationship between substance use and homelessness. More than half of the homeless have substance use disorders compared to problem substance use in the general population. Psychosocial care and the organization of a support network for the homeless are discussed. (AU)

El objetivo principal del presente estudio es estimar la prevalencia de trastornos mentales graves y de uso de sustancias en personas en la situación de estar sin hogar. El trabajo se realizó a partir de los datos obtenidos de una muestra representativa de personas sin hogar en Avilés (Asturias) (n=100) utilizando la Entrevista Neuropsiquiátrica Internacional (M.I.N.I.). Los resultados de nuestro estudio ponen de manifiesto una estrecha relación entre el uso de sustancias y el sinhogarismo. Más de la mitad de las personas sin hogar tiene trastornos relacionados con el uso de sustancias en comparación con el uso problemático de sustancias en la población general. Se discute la atención psicosocial y la organización de una red de apoyo a las personas sin hogar. (AU)

Multi-periscopic prism device for field expansion.

Patients with visual field loss frequently collide with other pedestrians, with the highest risk being from pedestrians at a bearing angle of 45°. Current prismatic field expansion devices (≈30°) cannot cover pedestrians posing the highest risk and are limited by poor image quality and restricted eye scanning range (<5°). A new field expansion device: multi-periscopic prism (MPP); comprising a cascade of half-penta prisms provides wider shifting power (45°) with dramatically better image quality and wider eye scanning range (15°) is presented. Spectacles-mounted MPPs were implemented using 3D printing. The efficacy of the MPP is demonstrated using perimetry, photographic depiction, and analyses of the collision risk covered by the devices.

Adicción y dolor crónico: ¿cómo prevenir su estigmatización terapéutica? / Addiction and chronic pain: how to prevent itstherapeutic stigmatization?

Tanto el dolor crónico como las adicciones son problemas complejos de salud que en la última década han tomado condiciones epidémicas en los países occidentales. Ello ha condicionado un intenso debate sobre el uso terapéutico de sustancias analgésicas potencialmente adictivas como son los opioides y los cannabinoides. Una consecuencia indeseable de la indeterminación clínica relacionada con estos problemas emergentes es la estigmatización de las personas que sufren dolor crónico, quienes han comenzado a ser el foco de prejuicios sociales que ya sufren los enfermos adictos. Se describe la utilidad del concepto de "alostasis" para evitar el estigma asociado al desconocimiento de estos problemas complejos de salud. Se propone que la neuropsiquiatría entendida desde una perspectiva antropológica puede ayudar en la integración teórica del abordaje y tratamiento del dolor crónico y la adicción como problemas estrechamente relacionados

Chronic pain and addiction disorders are both complex health problems which take epidemic dimension in the last decade in occidental countries. It has conditioned a profound debate on the therapeutic use of potentially addictive analgesic substances as opioids and cannabinoids are. An undesirable consequence of the clinical indeterminacy related with these emergent problems is the stigmatization of persons suffering chronic pain, which are beginning to be the focus of social prejudices the addiction patients are suffering. The utility of the concept "allostasis" to avoid the stigma related to the unknowledge of these complex health problems is described. It is proposed that neuropsychiatry understood under an anthropological perspective can be helpful in the theoretical integration for the management and treatment of chronic pain and addiction as closely related problems

Síndrome de desmoralización. Estimación de la prevalencia en una población de pacientes en cuidados paliativos en domicilio / The demoralisation syndrome. An estimation of its prevalence in patients receiving palliative care at home

OBJETIVO: El síndrome de desmoralización (SD) es una situación psicoemocional que se caracteriza por la desesperanza, el desamparo, la pérdida de sentido y el distrés existencial. Pretendemos conocer la prevalencia del SD en nuestro medio en pacientes avanzados atendidos por un equipo de cuidados paliativos. METODOLOGÍA: Se incluyeron de manera consecutiva 100 pacientes en situación avanzada atendidos por el Equipo de Soporte Domiciliario de Cuidados Paliativos que dieron su consentimiento informado. Mantenían unas condiciones físicas y neuropsicológicas suficientes para completar una entrevista semiestructurada y los cuestionarios específicos (ESASr, termómetro de malestar emocional, PPS, Barthel, HADS).como criterios diagnósticos del SD se emplearon los de Kissane. El estudio recibió la aprobación del Comité Ético del Área de Salud. RESULTADOS: Se encontraron 4 casos de SD, lo que supone una prevalencia del 4% (IC 95%: 2-10%). Estos enfermos que se mostraron diferentes del resto de la muestra en las siguientes características: edad <70 años (p = 0,02), estudios universitarios (p = 0,03), ausencia de actitud religiosa (p = 0,07) y presencia de sufrimiento (p = 0,01). También presentaban una mayor intensidad en síntomas como cansancio (p = 0,01), ansiedad (p <0,001) y desánimo (p = 0,07). CONCLUSIÓN: En nuestro medio hemos encontrado una prevalencia de SD únicamente del 4% en una población de pacientes atendidos por un Equipo Domiciliario de Cuidados Paliativos. Es probable que las condiciones para entrar en el estudio y el empleo de criterios diagnósticos relativamente estrictos hayan influido en este resultado

OBJECTIVE: The demoralisation syndrome (DS) is a psycho-emotional situation characterized by despair, helplessness, loss of meaning, and existential distress. We intend to establish the prevalence of DS in advanced patients treated by a Palliative Care Team in our SETTING: METHODOLOGY: We included 100 consecutive advanced patients treated at home by a Palliative Care Team. To be included we required informed consent, and adequate physical and neuropsychological conditions to complete a semi-structured interview and the questionnaires (ESASr, PPS, Barthel, emotional distress thermometer, HADS). We used Kissane's diagnostic criteria of DS. The study was approved by our Ethics Committee. RESULTS: Four cases of DS were found, representing a prevalence of 4% (95% CI: 2% to 10%). The characteristics of these patients that were different from the rest of the sample were: age <70 years (p = 0.02), university studies (p = 0.03), absence of religious attitude (p = 0.07), presence of suffering (p = 0.01). They also showed greater intensity of symptoms such as asthenia (p = 0.01), anxiety (p < 0.001), and depression (p = 0.07). CONCLUSIONS: In our setting we found a prevalence of DS of only 4% in a population of patients treated by a Home Palliative Care Team. The conditions for entering the study and the use of relatively strict diagnostic criteria may have influenced this result

Cenesthopathy and Subjective Cognitive Complaints: An Exploratory Study in Schizophrenia.

BACKGROUND/AIMS: Cenesthopathy is mainly associated with schizophrenia; however, its neurobiological basis is nowadays unclear. The general objective was to explore clinical correlates of cenesthopathy and subjective cognitive complaints in schizophrenia. METHODS: Participants (n = 30) meeting DSM-IV criteria for psychotic disorder were recruited from a psychiatry unit and assessed with: Association for Methodology and Documentation in Psychiatry (AMDP) system, Positive and Negative Syndrome Scale, Frankfurt Complaint Questionnaire (FCQ), and the Bonn Scale for the Assessment of Basic Symptoms (BSABS). For quantitative variables, means and Spearman correlation coefficients were calculated. Linear regression following backward method and principal component analysis with varimax rotation were used. RESULTS: 83.3% of subjects (73.3% male, mean age, 31.5 years) presented any type of cenesthopathy; all types of cenesthetic basic symptoms were found. Cenesthetic basic symptoms significantly correlated with the AMDP category "fear and anancasm," FCQ total score, and BSABS cognitive thought disturbances. In the regression analysis only 1 predictor, cognitive thought disturbances, entered the model. In the principal component analysis, a main component which accounted for 22.69% of the variance was found. CONCLUSIONS: Cenesthopathy, as assessed with the Bonn Scale (BSABS), is mainly associated with cog-nitive abnormalities including disturbances of thought initiative and mental intentionality, of receptive speech, and subjective retardation or pressure of thoughts.

Validation of a spectral light scattering method to differentiate large from small particles in intraocular lenses.

A psychophysical approach has been designed to measure straylight from intraocular lenses (IOLs) in vitro. This approach uses a clinical straylight meter (C-Quant) and an observer's eye as optical detector. Based on this, we introduced a method for study of straylight-wavelength dependency for IOLs. This dependency can be used to distinguish between 2 types of scattering particles (small and large) as defined by Mie theory. Validation was performed using a turbidity standard and scattering filters. Several IOLs were analyzed to identify potential scattering sources. Large particles were found to predominate in scattering from the studied lenses. This was confirmed by straylight-angular dependency found in these IOLs.

Ocular Straylight with Different Multifocal Contact Lenses.

PURPOSE: Multifocal contact lenses have been growing in popularity as a modality to correct presbyopic eyes, although visual side effects such as disability glare have been reported. The objective of this study was to investigate the effect of multifocal contact lenses on disability glare by means of ocular straylight. METHODS: A prospective randomized, comparative study was performed that included 16 subjects free of ocular pathology. Straylight was measured using a commercial straylight meter with the natural and dilated pupil. Participants were fitted with Proclear Multifocal (Distance/Near), ACUVUE Oasys for Presbyopia, and Air Optix Aqua Multifocal randomized to the left or right eye. Straylight measurements were repeated with the contact lens in situ after the pupil dilation. Results obtained with the dilated pupil without contact lens acted as a control. RESULTS: Diameter of the natural and dilated pupil was 2.87 ± 0.40 mm and 7.45 ± 0.86 mm, respectively (P < .001). After pupil dilation, straylight increased from 0.92 ± 0.13 log(s) to 1.04 ± 0.11 log(s) (P < .001). Of the four studied lenses, a significant difference was only found between Air Optix and the control group (P = .006). The latter showed also slightly increased light scatter. CONCLUSIONS: A difference in measured straylight was found between the studied multifocal lenses. The observed variability and the straylight-pupil size dependency should be taken into account to avoid elevated straylight in multifocal contact lens wearers. The reason for the observed differences in straylight must be the subject of future studies.

Influence of Ametropia and Its Correction on Measurement of Accommodation.

PURPOSE: Amplitude of accommodation (AA) is reportedly greater for myopic eyes than for hyperopic eyes. We investigated potential explanations for this difference. METHODS: Analytical analysis and computer ray tracing were performed on two schematic eye models of axial ametropia. Using paraxial and nonparaxial approaches, AA was specified for the naked and the corrected eye using the anterior corneal surface as the reference plane. RESULTS: Assuming that axial myopia is due entirely to an increase in vitreous chamber depth, AA increases with the amount of myopia for two reasons that have not always been taken into account. First is the choice of reference location for specifying refractive error and AA in diopters. When specified relative to the cornea, AA increases with the degree of myopia more than when specified relative to the eye's first Gaussian principal plane. The second factor is movement of the eye's second Gaussian principal plane toward the retina during accommodation, which has a larger dioptric effect in shorter eyes. CONCLUSIONS: Using the corneal plane (placed at the corneal vertex) as the reference plane for specifying accommodation, AA depends slightly on the axial length of the eye's vitreous chamber. This dependency can be reduced significantly by using a reference plane located 4 mm posterior to the corneal plane. A simple formula is provided to help clinicians and researchers obtain a value of AA that closely reflects power changes of the crystalline lens, independent of axial ametropia and its correction with lenses.

Method for in vitro assessment of straylight from intraocular lenses.

Ocular straylight has been measured by means of psychophysical methods over the years. This approach gives a functional parameter yielding a straight comparison with optically defined light scattering, and the point-spread-function. This is of particular importance when the effect of intraocular lenses (IOLs) on postoperative straylight is sought. An optical system for straylight measurements of IOLs was adapted to a commercial device (C-Quant, Oculus), which employs such psychophysical method. The proposed modifications were validated using light-scattering filters and some sample IOLs. The measurements were performed by 3 observers to prove that results are independent from straylight of the eye. Other applications will be discussed.

Mindfulness en perspectiva / Mindfulness into perspective

El Midfulness (Mf) es un tipo de psicoterapia basada en el budismo y que tiene un uso creciente en trastornos de ansiedad, afectivos y por dolor. Una de sus principales técnicas es la focalización de la atención en el momento presente. Al tener una fundamentación explícita en las prácticas espirituales budistas, y al proceder de un entorno cultural oriental, su aplicación clínica debe buscar mecanismos para facilitar su encaje. Se realiza una revisión narrativa con el objetivo de proporcionar la integración del Mf con otras técnicas de psicoterapia. Se clarifican concretamente: 1) los orígenes budistas comunes al Mf y a otras formas de psicoterapia y 2) la integración del conocimiento sobre los mecanismos neurobiológicos del Mf en los actuales modelos de neurociencia. Se concluye que el Mf puede integrarse con otros programas psicoterapéuticos y que sus postulados son falsables en el diálogo científico actual con la neurociencia clínica (AU)

Mindfulnes (Mf) is a Buddhism based type of psychotherapy and has an increasing application in anxiety, affective and pain disorders. Focusing of attention in present moment is one of its mainly techniques. As it has an explicit foundation in Buddhist spiritual practice, and also proceed from an eastern cultural environment, implementation in the clinical practice should be provided. A narrative review is performed in order to facilitate Mf integration with other psychotherapy techniques. Manly to aspects are addressed: 1) Mf common Buddhist origins and other psychotherapy types and 2) inclusion of Mf neurobiological mechanism knowledge in present neuroscience models. We conclude that Mf can be integrated with other psychotherapy programs and that contain falsifiable assumptions on current scientific dialog with clinical neuroscience (AU)

Factores asociados al ingreso hospitalario y evaluación de un programa de gestión de casos para trastorno mental grave mediante un estudio de cohortes históricas / Factors associated with hospital admission and evaluation of a case management program for severe mental disorder by a historical cohort study

Introducción: Las personas con trastorno mental grave (TMG) presentan serias dificultades para desarrollar una vida normalizada, por lo que son necesarios programas de atención comunitaria que mejoren sus condiciones de vida e integración social. Este trabajo pretende evaluar el funcionamiento de un programa de gestión de casos (PGC) en Segovia (España). Metodología: Se realiza una primera fase descriptiva valorando el funcionamiento del PGC en 2011 mediante variables sociodemográficas, asistenciales y clínicas. Se estudian los factores asociados a la ocurrencia de ingreso hospitalario. Finalmente, mediante un diseño de cohortes históricas, se evalúa el riesgo de ingreso del PGC comparando con una cohorte no expuesta. Se emplean técnicas estadísticas bi y multivariantes con cálculo de riesgos relativos e intervalos de confianza. Resultados: En 2011 se atiende a 82 pacientes en el PGC, principalmente hombres de mediana edad. La evolución clínica media es de 19 años y la permanencia media en el PGC superior a los 6 años. El 78% pertenecen al espectro diagnóstico de la esquizofrenia. El ingreso afecta al 27% de los pacientes. Ser mujer, ser atendido por equipos de salud mental I-II, el aumento de visitas domiciliarias y el abandono del seguimiento son los factores predictores de ingreso, mientras la mayor evolución clínica es factor protector. No se detecta efecto protector del PGC frente al ingreso hospitalario en los diferentes análisis del estudio de cohortes históricas. Conclusiones: Es necesario evaluar de forma sistemática los programas de atención comunitaria dirigidos al TMG con el fin de realizar ajustes y modificaciones tendentes a la mejora de su efectividad clínica (AU)

Introduction: People with severe mental disorder (SMD) have serious difficulties in developing a normal life, so community care programs to improve their living conditions and social integration are necessary. This work evaluates the performance of a case management program (CMP) in Segovia (Spain).Methodology: We conduct a first descriptive phase evaluating the performance of the CMP in 2011 by sociodemographic, health services and clinical variables. We study the factors associated with the occurrence of hospital admission. Finally, using a historical cohort design, we assess the risk of hospital admission of CMP compared to unexposed cohort. Bi and multivariate statistical techniques are employed to perform the analysis with the calculation of relative risks and confidence intervals. Results: In 2011, 82 patients are cared for in the CMP, mainly middle-aged men. The average clinical course is 19 years and the average stay in the CMP over 6 years. 78%belong to the diagnosis of schizophrenia spectrum. Income affects 27% of patients. Women, mental health teams I-II, increased home visits and abandonment of monitoring are predictors of income, while the highest level of clinical course is protective. No protective effect of income is detected for the CMP in the different analyzes of the historical cohort study. Conclusions: It is necessary to systematically assess community care programs directed at SMD to make adjustments and modifications aiming at improving their clinical effectiveness (AU)

[Factors associated with hospital admission and evaluation of a case management program for severe mental disorder by a historical cohort study]. / Factores asociados al ingreso hospitalario y evaluación de un programa de gestión de casos para trastorno mental grave mediante un estudio de cohortes históricas.

INTRODUCTION: People with severe mental disorder (SMD) have serious difficulties in developing a normal life, so community care programs to improve their living conditions and social integration are necessary. This work evaluates the performance of a case management program (CMP) in Segovia (Spain). METHODOLOGY: We conduct a first descriptive phase evaluating the performance of the CMP in 2011 by sociodemographic, health services and clinical variables. We study the factors associated with the occurrence of hospital admission. Finally, using a historical cohort design, we assess the risk of hospital admission of CMP compared to unexposed cohort. Bi and multivariate statistical techniques are employed to perform the analysis with the calculation of relative risks and confidence intervals. RESULTS: In 2011, 82 patients are cared for in the CMP, mainly middle-aged men. The average clinical course is 19 years and the average stay in the CMP over 6 years. 78% belong to the diagnosis of schizophrenia spectrum. Income affects 27% of patients. Women, mental health teams I-II, increased home visits and abandonment of monitoring are predictors of income, while the highest level of clinical course is protective. No protective effect of income is detected for the CMP in the different analyzes of the historical cohort study. CONCLUSIONS: It is necessary to systematically assess community care programs directed at SMD to make adjustments and modifications aiming at improving their clinical effectiveness.

Quantitative phase microscopy of transparent samples using a liquid crystal display.

We propose a new quantitative phase microscope based on spatial filtering of the beam carrying the sample-induced wavefront. A prototype built using a transmissive liquid crystal display for the experimental demonstration of the principle and preliminary results obtained with artificial and biological samples are presented.

Dimensions of attention impairment and negative symptoms in schizophrenia: a multidimensional approach using the conners continuous performance test in a Spanish population.

OBJECTIVES: The aim of this study was to assess the specific features of attention impairment in patients with schizophrenia and the correlation between those features and the patients' clinical status. METHODS: We administered the Conners Continuous Performance Test (CPT-II), with cognitive and clinical scales, to 40 Spanish inpatients with schizophrenia and 40 healthy controls, and used a cross-sectional design to compare the groups' performances. We identified correlations between the measures and used multiple regression analyses to develop models showing how attention impairment contributed to clinical status. RESULTS: The patients with schizophrenia showed significantly poorer performance than controls in 5 CPT-II measures that were related to focused attention. We also found that CPT-II measures primarily linked to focused attention had a significant association with negative symptoms. These CPT-II measures predicted 37% of the variability in negative symptoms in the regression model. We observed a more modest relationship among CPT-II measures of disorganized thought symptoms, global functioning, and general cognitive performance. CONCLUSIONS: Attention impairment in schizophrenia primarily involves difficulty in focusing attention, mainly related to negative symptoms. By contrast, sustained attention and vigilance seem to be affected only as a secondary consequence of the impairment to focusing attention.