"I remember most of my family seeing it": The presence of others during child physical abuse, as conveyed in forensic interviews with Israeli children.

Child physical abuse is often perceived as a crime perpetrated within the family and out of sight. However, recent studies have indicated the presence of others during incidents of physical abuse. The current study was designed to examine the experiences and perceptions of children who were physically abused in their families concerning the presence of others, as conveyed during their forensic interviews. A thematic analysis of 26 forensic interviews was conducted with Israeli children aged 5-13. Three main themes were identified: (1) Patterns, roles, and coping mechanisms: The multifaceted spectrum of familial abuse; (2) The echoes of family reactions: Shaping children's abuse experiences; and (3) Navigating the storm together: Sibling bonds amidst familial abuse. The children's narratives highlighted their distress and pointed to the abusive and chaotic daily routine in which they lived. In spotlighting their encounters with physical abuse, the children focused on their need to be seen and gain certainty in their daily routines. The discussion highlights the unique and elusive dynamics of families in which child physical abuse occurs and challenges the social perception that physical abuse occurs secretly. The characteristics of such abuse highlight the urgent need for policymakers and professionals to treat the phenomenon of physical abuse within the family as a visible phenomenon.

Design of solar cooking models to enhance energy utilization and environment protection with their cost-benefit analysis: a case study of an institutional area in the state of Rajasthan, India.

A systematic approach and methodology for financial appraisal of the Scheffler dish solar cooker has been presented in this study. An approach is applied to meet the useful cooking energy demand at a location with a high availability of DNI by a Scheffler type of 16 m2 area and the effective aperture area of 11.65 m2, weight of 400 kg, an efficiency of 40% with 980 (kg/year/ m2) steam output at 120 °C. For this analysis, 5 Scheffler dish solar cookers have been selected for preparing boiling type food like rice and pulses for 750 beneficiaries at Vivekananda Global University, Jaipur, Rajasthan, India. Presently, the cooking energy demand is fulfilled by conventional method such as LPG fuel and it makes the system costly and hazardous in certain cases. By using solar cooking at the location, it is analyzed that the cost is significantly reduced along with other socio parameters also which shows the novelty of this study. The serving time of food is taken from 12:30 to 1:30 pm. The total number of cooked rice and pulses is calculated as 586.5 and 838.38 in 325 operating days. The performance of the Scheffler dish solar cooker is found to be higher in terms of the total number of meals cooked per annum by each cooker is 1424, and the saving of LPG per annum by the Scheffler dish cooker is estimated as 679 kg per cooker. This also contributes to improving the health of women, reducing child mortality rate and CO2 emissions. The net monetary benefit is estimated at INR 30,179.9. The payback and discounted payback periods are estimated as 5.3 years and 7.9 years, respectively. The estimated positive value of net present worth also clearly indicates the profitable application of solar cooker.

Understanding time perspective's influence on academic burnout and achievement in Chinese undergraduates.

University students are highly vulnerable to experiencing academic burnout due to various pressures, necessitating an exploration of its causes and effects. Time perspective theory emphasizes how individuals' perspectives of past, present, and future events shape their behavior. Yet, the relationship between time perspective, burnout, and academic achievement remains unclear. This study investigates this association in Chinese undergraduates using survey and official grade point average (GPA) data. Results indicate positive correlations between Past-Negative, Present-Hedonistic (PH), Present-Fatalistic time perspectives, and academic burnout. Additionally, only Present-Hedonistic (PH) and future time perspectives significantly predict GPA. A mediation model reveals misbehavior as a mediator between Present-Hedonistic (PH) time perspective and GPA. These findings highlight time perspective's importance in academic well-being and outcomes, shedding light on the distinct roles of future and Present-Hedonistic time perspectives.

Techno-economic assessment of industrial food waste composting facility: Evaluating bulking agents, processing strategies, and market dynamics.

Techno-economic assessment (TEA) of a valorization of bulking agent (BA) ratios on the food waste compost value chain is made to assess economic feasibility. TEA was performed with two plans (Plan A: existing composting facilities; Plan B: new composting facilities) and each plan was under four scenarios. The BA (i.e. corn stalks, garden waste, and watermelon seedlings) ratio of 5 % (S1), 10 % (S2), 20 % (S3), and garden waste with a ratio of 20 % (S4). Results indicate that S2, with a net present value (NPV) of 128.9 million, represents Plan A's most economically viable scenario. Although the total operating costs of S4 were 18.9 %-23.5 % higher, 25.6 %-42.2 % higher total revenue made S4 have an NPV of 92.9 million, making it the most viable scenario in Plan B. All scenarios show positive NPV within a ± 20 % fluctuation range. Organic fertilizer price, government subsidies, and processing capacity were the key factors influencing NPV.

Effect of present state bias on minimal important change estimates: a simulation study.

PURPOSE: The minimal important change (MIC) in a patient-reported outcome measure is often estimated using patient-reported transition ratings as anchor. However, transition ratings are often more heavily weighted by the follow-up state than by the baseline state, a phenomenon known as "present state bias" (PSB). It is unknown if and how PSB affects the estimation of MICs using various methods. METHODS: We simulated 3240 samples in which the true MIC was simulated as the mean of individual MICs, and PSB was created by basing transition ratings on a "weighted change", differentially weighting baseline and follow-up states. In each sample we estimated MICs based on the following methods: mean change (MC), receiver operating characteristic (ROC) analysis, predictive modeling (PM), adjusted predictive modeling (APM), longitudinal item response theory (LIRT), and longitudinal confirmatory factor analysis (LCFA). The latter two MICs were estimated with and without constraints on the transition item slope parameters (LIRT) or factor loadings (LCFA). RESULTS: PSB did not affect MIC estimates based on MC, ROC, and PM but these methods were biased by other factors. PSB caused imprecision in the MIC estimates based on APM, LIRT and LCFA with constraints, if the degree of PSB was substantial. However, the unconstrained LIRT- and LCFA-based MICs recovered the true MIC without bias and with high precision, independent of the degree of PSB. CONCLUSION: We recommend the unconstrained LIRT- and LCFA-based MIC methods to estimate anchor-based MICs, irrespective of the degree of PSB. The APM-method is a feasible alternative if PSB is limited.

Transcendental Meditation Enriches Nurses' Authentic Presence Through Caring for Self and Others.

Purpose of Study: Given the enormity of the most recent challenges to clinician well-being, intensified by the pandemic, we decided to explore the influence of Transcendental Meditation® (TM)® on the well-being of clinical nurses. The purpose of our study was to use qualitative analysis to enhance our understanding of the experiences of clinical nurses who practiced TM, as viewed through the lens of our conceptual model and Watson's holistic unitary caring science theory. Design and Method: This qualitative study involved a thematic analysis of clinical nurses' written descriptions following the completion of the TM program during the COVID-19 pandemic. Findings: The nurse participants shared their experiences with the practice of TM as creating present moment focus, leading to enhanced self-care, and development of authentic presence with others. The overall theme uncovered in the analysis is that authentic presence is veritas (truth) in knowing, being, doing, and becoming. Conclusions: The findings were congruent with Watson's unitary caring science theory and provided illumination of the holistic value of TM as a self-care strategy for supporting nurses' well-being with the goal of retaining nurses in practice. When nurses care for themselves, they are more likely and able to care for others, thus helping them to enjoy their nursing careers.

What does the Thinking about Relationalism and Humanness in African Philosophy imply for Different Modes of Being Present in the Metaverse?

In this article, I interrogate whether the deployment and development of the Metaverse should take into account African values and modes of knowing to foster the uptake of this hyped technology in Africa. Specifically, I draw on the moral norms arising from the components of communal interactions and humanness in Afro-communitarianism to contend that the deployment of the Metaverse and its development ought to reflect core African moral values to foster its uptake in the region. To adequately align the Metaverse with African core values and thus foster its uptake among Africans, significant technological advancement that makes simulating genuine human experiences possible must occur. Additionally, it would be necessary for the developers and deployers to ensure that higher forms of spiritual activities can be had in the Metaverse to foster its uptake in Africa. Finally, I justify why the preceding points do not necessarily imply that the Metaverse will have a higher moral status than real life on the moral scale that can be grounded in Afro-communitarianism.

Accuracy assessment of patient safety incident (PSI) codes and present-on-admission (POA) indicators: a cross-sectional analysis using the Patient Safety Incidents Inquiry (PSII) in Korea.

BACKGROUND: Among the various methods used, administrative data collected for claims and billing purposes, such as diagnosis codes and present-on-admission (POA) indicators, can easily be employed to assess patient safety status. However, it is crucial that administrative data be accurate to generate valid estimates of adverse event (AE) occurrence. Thus, we aimed to evaluate the accuracy of diagnosis codes and POA indicators in patients with confirmed AEs in the hospital admission setting. METHODS: We analysed the diagnosis codes of 1,032 confirmed AE cases and 6,754 non-AE cases from the 2019 Patient Safety Incidents Inquiry, which was designed as a cross-sectional study, to determine their alignment with the Korean Patient Safety Incidents (PSIs) Code Classification System. The unit of analysis was the individual case rather than the patient, because two or more AEs may occur in one patient. We examined whether the primary and secondary diagnostic codes had PSIs codes matching the AE type and checked each PSI code for whether the POA indicator had an 'N' tag. We reviewed the presence of PSI codes in patients without identified AEs and calculated the correlation between the AE incidence rate and PSI code and POA indicator accuracy across 15 hospitals. RESULTS: Ninety (8.7%) of the AE cases had PSI codes with an 'N' tag on the POA indicator compared to 294 (4.4%) of the non-AE cases. Infection- (20.4%) and surgery/procedure-related AEs (13.6%) had relatively higher instances of correctly tagged PSI codes. We did not identify any PSI codes for diagnosis-related incidents. While we noted significant differences in AE incidence rates, PSI code accuracy, and POA indicator accuracy among the hospitals, the correlations between these variables were not statistically significant. CONCLUSION: Currently, PSI codes and POA indicators in South Korea appear to have low validity. To use administrative data in medical quality improvement activities such as monitoring patient safety levels, improving the accuracy of administrative data should be a priority. Possible strategies include targeted education on PSI codes and POA indicators and introduction of new evaluation indicators regarding the accuracy of administrative data.

A time to reflect: deviations from the balanced time perspective are associated with hypomentalization.

Introduction: Poor mentalization, or lack of capacity to reflect on self and others in terms mental states, thoughts, and feelings, and time perspective biases were both related to mental disorders and lower wellbeing in separate studies. Expanding one prior study, we examined the relationship of mentalization and time perspective, including a measure known as deviations from the balanced time perspective (DBTP) that summarizes time perspective biases across the past, present, and future time frames. Method: A convenience sample of 258 participants responded to a version of the Reflective Functioning Questionnaire (RFQ-8) and a six-dimensional version of the Zimbardo Time Perspective Inventory (S-ZTPI). Given recent evidence that the original two-factor structure of the RFQ may need to be reconsidered, we used confirmatory factor analyses (CFA) to compare alternative models for RFQ as a first step. Results: In line with several recent studies, the CFA favored a unitary model of RFQ-8 reflecting hypomentalization (or uncertainty). The total score showed significant associations with Past Negative, Present Fatalistic, and Future Negative dimensions of S-ZTPI, while hypomentalization was negatively associated with Future Positive. Of major interest, DBTP and hypomentalization showed a strong positive correlation (r = 0.64 for latent constructs; r = 0.62 in an adjusted model). Conclusion: Deviations from the balanced time perspective were substantially related to hypomentalization. Further research is required to examine the generalizability of the finding (e.g., to measures of mentalization focused on others) and to provide a better understanding of the theoretical basis of the link. Potentially shared associations in development (e.g., attachment style) and mindfulness, that may influence both time perspective and mentalization is of interest in this regard.

Gender Differences in Negative Life Events, Present-Moment Awareness, Problem-Solving, and Perceived Stress Among Rural Adolescents.

Drawing on the stressor-perception-coping-response model of stress, this study examined the associations between negative life events, present-moment awareness, problem-solving, and perceived stress among rural adolescents, focusing specifically on gender differences. Using a cross-sectional design, 3519 Chinese rural adolescents completed measures assessing negative life events, present-moment awareness, problem-solving, and perceived stress. Structural equation modeling was employed to examine the hypothesized serial mediation model. The results revealed a positive association between negative life events and perceived stress in rural adolescents, which was serially mediated by present-moment awareness and problem-solving. Furthermore, significant gender differences were observed. Specifically, girls exhibited larger effects than boys in the overall effect of negative life events on perceived stress, the indirect effect of present-moment awareness, and the serial mediating effect. These findings suggest that present-moment awareness and problem-solving may serve as crucial mechanisms for understanding rural adolescents' perceived stress in response to negative life events, particularly among female rural adolescents.

A link between evolution and society fostering the UN sustainable development goals.

Given the multitude of challenges Earth is facing, sustainability science is of key importance to our continued existence. Evolution is the fundamental biological process underlying the origin of all biodiversity. This phylogenetic diversity fosters the resilience of ecosystems to environmental change, and provides numerous resources to society, and options for the future. Genetic diversity within species is also key to the ability of populations to evolve and adapt to environmental change. Yet, the value of evolutionary processes and the consequences of their impairment have not generally been considered in sustainability research. We argue that biological evolution is important for sustainability and that the concepts, theory, data, and methodological approaches used in evolutionary biology can, in crucial ways, contribute to achieving the UN Sustainable Development Goals (SDGs). We discuss how evolutionary principles are relevant to understanding, maintaining, and improving Nature Contributions to People (NCP) and how they contribute to the SDGs. We highlight specific applications of evolution, evolutionary theory, and evolutionary biology's diverse toolbox, grouped into four major routes through which evolution and evolutionary insights can impact sustainability. We argue that information on both within-species evolutionary potential and among-species phylogenetic diversity is necessary to predict population, community, and ecosystem responses to global change and to make informed decisions on sustainable production, health, and well-being. We provide examples of how evolutionary insights and the tools developed by evolutionary biology can not only inspire and enhance progress on the trajectory to sustainability, but also highlight some obstacles that hitherto seem to have impeded an efficient uptake of evolutionary insights in sustainability research and actions to sustain SDGs. We call for enhanced collaboration between sustainability science and evolutionary biology to understand how integrating these disciplines can help achieve the sustainable future envisioned by the UN SDGs.

Some Brief Reflections on "Time" from a Psychoanalytical Perspective.

An attempt is made to encircle time and the times psychoanalytically. They are understood as the result of the interplay of different psychic systems: Timelessness of the Ucs system (psychic reality), actual time in the Pcpt-Cs (perceptual reality), and vectorial-linear time in the Cs/Pcs systems (reality principle). Time shows itself in the moment of presence, but it can only show itself if there is a temporal antecedent. At the same time, time and space are intertwined, so that the past is initially the place where something happened. However, the interplay of the mental systems with time and space can only develop in the object relationship. A short clinical example of an autistoid perversion illustrates this dynamic.

Optimal Rotation Age in Fast Growing Plantations: A Dynamical Optimization Problem.

Forest plantations are economically and environmentally relevant, as they play a key role in timber production and carbon capture. It is expected that the future climate change scenario affects forest growth and modify the rotation age for timber production. However, mathematical models on the effect of climate change on the rotation age for timber production remain still limited. We aim to determine the optimal rotation age that maximizes the net economic benefit of timber volume in a negative scenario from the climatic point of view. For this purpose, a bioeconomic optimal control problem was formulated from a system of Ordinary Differential Equations (ODEs) governed by the state variables live biomass volume, intrinsic growth rate, and area affected by fire. Then, four control variables were associated to the system, representing forest management activities, which are felling, thinning, reforestation, and fire prevention. The existence of optimal control solutions was demonstrated, and the solutions of the optimal control problem were also characterized using Pontryagin's Maximum Principle. The solutions of the model were approximated numerically by the Forward-Backward Sweep method. To validate the model, two scenarios were considered: a realistic scenario that represents current forestry activities for the exotic species Pinus radiata D. Don, and a pessimistic scenario, which considers environmental conditions conducive to a higher occurrence of forest fires. The optimal solution that maximizes the net benefit of timber volume consists of a strategy that considers all four control variables simultaneously. For felling and thinning, regardless of the scenario considered, the optimal strategy is to spend on both activities depending on the amount of biomass in the field. Similarly, for reforestation, the optimal strategy is to spend as the forest is harvested. In the case of fire prevention, in the realistic scenario, the optimal strategy consists of reducing the expenses in fire prevention because the incidence of fires is lower, whereas in the pessimistic scenario, the opposite is true. It is concluded that the optimal rotation age that maximizes the net economic benefit of timber volume in P. radiata plantations is 24 and 19 years for the realistic and pessimistic scenarios, respectively. This corroborates that the presence of fires influences the determination of the optimal rotation age, and as a consequence, the net economic benefit.

Comparative evaluation of insertion characteristics of PLMA using different techniques in the pediatric age group.

Background and Aims: The laryngeal mask airway ProSeal (PLMA) insertion should be easy, fast, and atraumatic. Most studies have been done on adults who cannot be considered as the reflection of pediatric patients. In this study, we compared the first attempt success rate of three techniques of PLMA insertion: introducer, 90° rotation, and pharyngoscopy technique in the pediatric population. Material and Methods: In this prospective comparative randomized study, a total of 135 patients of American Society of Anesthesiology grade I and II, aged three to eleven years, with normal airways scheduled for elective surgery, were randomly allocated into three groups: introducer, 90° rotation, and pharyngoscopy group. Parameters evaluated were: first attempt insertion success rate, insertion time, ease of insertion score, hemodynamic parameters, oropharyngeal seal pressure, manipulations, PLMA blood staining, postoperative sore throat, and hoarseness. Results: First attempt insertion success rate was higher in the 90° rotation (97.78%) and pharyngoscopy (97.78%) group as compared to the introducer group (93.33%). But the result was not statistically significant. PLMA insertion time was the least in the rotation group, followed by the pharyngoscopy and introducer group (P < 0.0001). Mean arterial pressure and heart rate were significantly raised in the pharyngoscopy versus rotation group and the introducer versus 90° rotation group after PLMA insertion. Oropharyngeal seal pressure was significantly higher in the introducer as compared to the rotation group (P = 0.007). Conclusion: All three techniques had a high first-attempt insertion success rate. As the rotation technique had the best result in insertion time and hemodynamic response, it may be considered a good alternative to pharyngoscopy and introducer technique in pediatric patients of age three to eleven years with a normal airway.

Randomized controlled trial of two internet-based written therapies for world trade center workers and survivors with persistent PTSD symptoms.

Posttraumatic stress disorder (PTSD) remains prevalent among individuals exposed to the 9/11 World Trade Center (WTC) terrorist attacks. The present study compared an Internet-based, therapist-assisted psychotherapy for PTSD to an active control intervention in WTC survivors and recovery workers with WTC-related PTSD symptoms (n = 105; 75% syndromal PTSD). Participants were randomized to integrative testimonial therapy (ITT), focused on WTC-related trauma, or modified present-centered therapy (I-MPCT), each comprising 11 assigned written narratives. The primary outcome was baseline-to-post-treatment change in PTSD symptoms on the PTSD Checklist for DSM-5 (PCL-5). Secondary measures included PTSD symptom clusters, depressive/anxiety symptoms, functioning, and quality of life. A significant main effect of time was observed for the primary outcome (average "large" effect size improvement, d = 1.49). Significant and "moderate-to-large" main effects of time were also observed for all PTSD symptom clusters, depressive symptoms, quality of life, and mental health-related functioning (d range=0.62-1.33). Treatment and treatment-by-time interactions were not significant. In planned secondary analyses incorporating 3-month follow-up measures, ITT was associated with significantly greater reductions than I-MPCT in PTSD avoidance and negative alterations in cognitions and mood, anxiety, and mental health-related functioning. Both therapies significantly lowered PTSD symptoms, suggesting they may benefit hard-to-reach individuals with chronic WTC-related PTSD symptoms.

Temporalities of peer support: the role of digital platforms in the 'living presents' of mental ill-health.

This paper considers matters of time in online mental health peer support. Significant evidence of the value of peer support exists, with new digital platforms emerging as part of the digitisation of mental health support. This paper draws from a project exploring the impact of digital platforms on peer support through interviews with users of a major UK-based online peer support platform. Drawing on Gilles Deleuze's concept of the 'living present', the paper highlights how notions of past, present and future operate as co-existing dimensions of the present. The analysis highlights how the immediacy of digital platforms elicits expectations of peer support being 'on tap', which creates challenges when support is not received synchronously. Unlike in-person support, digital platforms facilitate the archiving of support, which can (re)enter the present at any moment through asynchronous communication. Anticipations of the future feature as dimensions of the present in terms of feelings regarding when support may no longer be needed. The paper offers potential implications for social scientific understanding of digital peer support, which include valuable insight for mental health services designing and delivering digital peer support.

It Is Time to Reconsider the 3% Discount Rate.

OBJECTIVES: Health technology assessment (HTA) guidance often recommends a 3% real annual discount rate, the appropriateness of which has received limited attention. This article seeks to identify an appropriate rate for high-income countries because it can influence projected cost-effectiveness and hence resource allocation recommendations. METHODS: The author conducted 2 Pubmed.gov searches. The first sought articles on the theory for selecting a rate. The second sought HTA guidance documents. RESULTS: The first search yielded 21 articles describing 2 approaches. The "Ramsey Equation" sums contributions by 4 factors: pure time preference, catastrophic risk, wealth effect, and macroeconomic risk. The first 3 factors increase the discount rate because they indicate future impacts are less important, whereas the last, suggesting greater future need, decreases the discount rate. A fifth factor-project-specific risk-increases the discount rate but does not appear in the Ramsey Equation. Market interest rates represent a second approach for identifying a discount rate because they represent competing investment returns and hence opportunity costs. The second search identified HTA guidelines for 32 high-income countries. Twenty-two provide no explicit rationale for their recommended rates, 8 appeal to market interest rates, 3 to consistency, and 3 to Ramsey Equation factors. CONCLUSIONS: Declining consumption growth and real interest rates imply HTA guidance should reduce recommended discount rates to 1.5 to 2+%. This change will improve projected cost-effectiveness for therapies with long-term benefits and increase the impact of accounting for long-term drug price dynamics, including reduced prices attending loss of market exclusivity.

Life satisfaction, psychological stress, and present-moment attention: a generalizability study.

During the last decade, many teachers have retired early, leading to increased discussions about how to improve and maintain their mental health. To address this concern early, we designed an online seminar covering the field of positive psychology by emphasizing on mindfulness, positive emotions about one's future, and resources for pre-service teachers. The seminar was designed to increase their wellbeing, as well as to decrease psychological stress. To explore the sensitivity of our measures to change, we investigate the following research questions: To what extent do we assess trait or state variability in students' outcomes and what are the levels of reliability achieved? Fifty-four students in their second year at a German university (median age 22 years) participated and they were asked to fill in questionnaires assessing their life satisfaction, psychological stress, and present-moment attention during each of nine sessions over the course of a semester. We performed Generalizability and Decision Studies to estimate variability between-students and within-students, error of measurement, as well as reliability. Our results show that life satisfaction and psychological stress reached high reliability, suggesting that students' trait and state variability were both assessed with high accuracy. On the other hand, the assessment of present-moment attention would benefit from adding more items to the questionnaires or collecting data from more sessions. We discuss how our findings impact research and practice.

Process design and techno-economic analysis of activated carbon derived from anthracite coal.

Activated carbon (AC), renowned for its versatile applications in water treatment, air purification, and industrial processes, is a critical component in environmental remediation and resource recovery strategies. This study encompasses the process modeling of AC production using anthracite coal as a precursor, involving multiple activation stages at different operating conditions, coupled with a detailed techno-economic analysis aimed at assessing the operational feasibility and financial viability of the plant. The economic analysis explores the investigation of economic feasibility by performing a detailed cashflow and sensitivity analysis to identify key parameters influencing the plant's economic performance, including raw material and energy prices, operational and process parameters. Capital and operational costs are meticulously evaluated, encompassing raw material acquisition, labor, energy consumption, and equipment investment. Financial metrics like Net Present Value (NPV), Internal Rate of Return (IRR), and payout period (POP) are employed, and the results show that AC selling price, raw material cost and plant capacity are the most influential parameters determining the plant's feasibility. The minimum AC production cost of 1.28 $/kg is obtained, corresponding to coal flow rate of 14,550 kg/h. These findings provide valuable insights for stakeholders, policymakers, and investors seeking to engage in activated carbon production from anthracite.

[Insomnia: definitions, epidemiology and changes with age]. / Insomnie : définitions, épidémiologie et évolution avec l'âge.

INSOMNIA: DEFINITIONS, EPIDEMIOLOGY AND CHANGES WITH AGE. Chronic insomnia is a disorder defined as a subjective complaint relating to the quality and/or quantity of sleep associated with daytime impact, and which must be present 3 nights per week for a period of at least 3 months. This is a common sleep problem in the general population and represents a significant proportion of reasons for consultation in the general practice. It requires early identification at all ages of life to allow the establishment of adequate care, which will have the benefit of both improving the quality of life of these patients in the short term and preventing the consequences of chronic insomnia.