Insomnia, the experience of poor quality or quantity of sleep, is a very common complaint. In the community estimates for the current prevalence of insomnia range from 15 to 28%. Pharmacological treatment of insomia is faster and more effective than other treatments, including psychotherapy, hypnosis, and so on. In pharmacological treatment, benzodiazepines (BZDs) and non-benzodiazepines, including zolpidem, are very common prescribing hypnotic usages because of more effectiveness and safer side-effect profiles. Our retrospective, current observational study is a chart review of 3,152 psychiatric outpatients, attempted to review adverse effects, specifically somnambulism and antegrade amnesia after these medications, to see whether or not, this is an infrequent occurrence in Taiwan population. Of a total 406 long-/intermitted-half-life BZD hypnotics users, 0.25% (1 of 406) reported incidence of somnambulism and anterograde amnesia. However, 5.1% (13 of 255) reported incidence of zolpidem-induced somnambulism and anterograde amnesia. It serves as a reminder for clinicians to inquire of spouses (bed parters) of the patients about any unusual behavior of parasomnia activities when prescribing zolpidem, specifically in Taiwan population.

No description available.

De senaste åren har en ny invändning framförts allt oftare i brottmål, nämligen invändningen från den tilltalades sida att gärningen företagits i sömnen, i somnambult tillstånd. Den fortsättningsvis kallade sömninvändningen ger ett antal intressanta frågeställningar inom straffrätten, men också i gränslandet där juridik och sömnforskning möts. Sömn och medvetande som neurologiska begrepp inrymmer gråskalor; sömn har fyra stadier NREM-sömn följt av REM-sömn och en persons medvetande utreds inom neurologin med hjälp av en åtta-stegsprövning. Ändå tycks juridiken ha en svart-vit föreställning av både sömn och medvetande som ett vara eller icke-vara. När straffansvar prövas förutsätts att personen är vid medvetande, utan att saken egentligen utreds. För att en person ska hållas straffrättsligt ansvarig krävs att både de objektiva och subjektiva brottsförutsättningarna är uppfyllda. Personen ska för att uppfylla de objektiva brottsförutsättningarna ha, 1) utfört en handling som är brottsbeskrivningsenlig, och 2) som inte varit rättfärdigad. I enlighet med den subjektiva brottsförutsättningen måste personen även kunna tillskrivas personligt ansvar för handlingen. Personer som anses ha agerat i somnambult tillstånd går fria från ansvar. Men på vilken grund inträder ansvarsfriheten? Tidigare ansågs rörelser företagna i sömnen inte utgöra handlingar i och med att de saknat bakomliggande vilja, och uteslöts således redan i den objektiva prövningen. I det studerade rättsfallsmaterialet och doktrin verkar det som att domstolarna hanterar sömn såsom brist på med medvetenhet i uppsåtsprövningen, vilket utesluter ansvar inom ramen för den subjektiva prövningen. Troligtvis uppkommer denna förvirring till följd av dels den starka presumtionen för att kroppsrörelser är samma sak som handlingar, dels att tillstånden ”vid medvetande” och ”medveten” ses som samma sak. En kroppsrörelse som företagits i sömnen bör enligt min mening anses ha företagits utan att personen var vid medvetande och således prövas som en objektiv brottsförutsättning. Måltypen ger även en del processuella överväganden. Den tilltalade måste göra sömninvändningen så pass sannolik att den inte kan lämnas utan avseende, varvid åklagaren har att göra invändningen obefogad. Bevisningen förs framför allt med hjälp av sakkunnigutlåtanden av olika sömnforskare. Ett antal sömnforskare är framstående inom måltypen och har etablerat en stark praxis kring hur sannolikheten för somnambulism ska prövas. Risken med de sakkunnigas utlåtanden är att de innebär en stolpig checklista som inte alltid ger utrymme för olika upplevelser av sömngång. Det riskerar att få till följd att den prövning som till sin natur måste förbli en gråskala riskerar att präglas av juridikens svart-vita förhållningssätt.

Abstract / History

In recent years, a new objection has been raised more often in criminal matters, namely the objection of the accused that the act has been committed in a somnambulate state, when he or she was sleepwalking. The so-called sleepdefence entails a number of interesting issues in criminal law, but also in the merging of law and neurology. Sleep and consciousness are neurological concepts that consist of grayscales; sleep has four stages of Non Rapid Eye Movementsleep (NREM), followed by Rapid Eye Movement-sleep (REM), and a person's consciousness is established in neurology using an eight-step method. Nevertheless, the law seems to have a black and white idea of sleep and consciousness as a being, or non-being, and a person’s consciousness is assumed without further examination when examining criminal liability. In order for a person to be held criminally responsible, both the objective and subjective crime prerequisites must be met. In accordance with the objective prerequisites, the person must have, 1) performed an act that meets the prerequisites of a criminal offense, and 2) that was not justifiable. In accordance with the subjective prerequisite, the accused must be attributed personal responsibility for the act. People considered to have acted in a somnambulate state are free of liability. But on what grounds are they free of liability? Previously, movements undertaken while sleeping were not considered acts at all, since they lacked underlying will, thus generating a deficiency in the objective prerequisites. However, in the studied case material and doctrine, it seems that movements while sleepwalking are treated as a lack of criminal intent, thus excluding responsibility within the context of subjective prerequisites. Probably this confusion arises as a result of the strong presumption that body movements are the same as actions, and partly that the mental states "conscious" and "aware" are considered the same. The author argues that sleepwalking is a state in which the person lacks consciousness, and movements undertaken in this state should not be considered acts. This type of indictment also involves some procedural considerations, in which the accused must make the episode of somnambulism likely, and the prosecutor has to disprove it. Evidence in these cases often includes expert reports from different sleep researchers. A few sleep researchers are prominent and have established a practice on how to investigate the probability of somnambulism. The risk of this practice, however, is that it consists of a checklist that does not always provide room for different experiences of somnambulism. It is likely that the trial, which by its nature must remain a grayscale, will be characterized by the black and white approach of the law.

No description available.

Submitted by Renata Lopes (renatasil82@gmail.com) on 2016-01-07T13:16:37Z No. of bitstreams: 1 julianagoncalvesblaser.pdf: 1145879 bytes, checksum: a8431f26237035be63ba806e0f977f3a (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2016-01-25T16:44:33Z (GMT) No. of bitstreams: 1 julianagoncalvesblaser.pdf: 1145879 bytes, checksum: a8431f26237035be63ba806e0f977f3a (MD5) / Made available in DSpace on 2016-01-25T16:44:33Z (GMT). No. of bitstreams: 1 julianagoncalvesblaser.pdf: 1145879 bytes, checksum: a8431f26237035be63ba806e0f977f3a (MD5) Previous issue date: 2015-02-09 / A Psicologia francesa do final do século XIX, recentemente separada da Filosofia, utilizava como um de seus principais métodos o estudo dos estados alterados de consciência e das doenças mentais no intuito de compreender melhor o funcionamento normal da mente humana. Dentre os pioneiros desta Psicologia, destacou-se Pierre Janet. Seu estudo sobre as alterações mentais, principalmente o hipnotismo e a histeria, deram origem às suas concepções sobre força e fraqueza psicológica, dissociação e atividade subconsciente, ideias estas que abriram margem para um novo entendimento da atividade mental fora da consciência, contribuíram para o desenvolvimento da psiquiatria dinâmica e, principalmente, apresentaram à sua época um caráter conciliador entre as novas tendências da psicologia e a antiga psicologia. Contudo, embora tenha sido um autor relevante, seus trabalhos são pouco conhecidos na atualidade e, em língua portuguesa, a bibliografia sobre ele é escassa. Nosso objetivo foi, portanto: (i) analisar o surgimento do conceito de dissociação na obra inicial de Pierre Janet, assim como as suas principais acepções; (ii) apresentar como Janet chegou à formulação deste conceito e como esse se desenvolveu ao longo de sua obra; (iii) explicar o mecanismo da dissociação segundo o autor; (iv) esclarecer o que ocorre com os elementos dissociados da consciência; (v) apresentar a relação da dissociação com outros conceitos fundamentais da obra de Janet, tais como vontade, fraqueza de síntese e automatismo e; (vi) expor as explicações de Janet para a histeria, hipnotismo e duplas personalidades com base na sua teoria da dissociação. Para tanto, realizamos uma leitura analítica da segunda fase de suas obras, que vai desde 1885 a 1894 (contendo 3 livros e 17 artigos), na qual este autor se dedicou a estudar profundamente este tema, buscando estabelecer a definição dos principais conceitos desta fase de suas obras, com ênfase na dissociação, e também as relações existentes entre eles. Como resultados obtivemos que conceito dissociação apareceu pela primeira vez nas obras de Janet em 1887 no artigo L'anesthésie systématisée et la dissociation des phénomènes psychologiques. Nele Janet coloca que a dissociação ocorre quando um item, seja uma memória, uma sensação ou um movimento, não se liga à ideia de eu do sujeito, sendo, portanto, removido da consciência normal. Porém, a partir de 1889, da obra L’automatisme psychologique, não vemos mais aparecer o termo dissociação, mas sim um novo termo, o termo desagregação (désagrégation), o qual acreditamos ser, contudo, seu sinônimo. O mecanismo da dissociação é apresentado por Janet, principalmente, quando ele explica a formação dos sintomas histéricos. Para ele estes sintomas histéricos, ou seja, as anestesias, as abulias, as amnésias e os problemas do movimento são todos causados por uma fraqueza de síntese psicológica que leva, por sua vez à desagregação psicológica. Nestes quadros, devido à fraqueza de síntese, certos grupos de sensações, memórias, emoções ou informações sobre o ambiente deixam de ser sintetizados à ideia de eu (fator fundamental, segundo Janet, para que um fenômeno possa fazer parte da consciência) e, portanto, permanecem dissociados da consciência normal, gerando, respectivamente: as anestesias, as amnésias, as modificações do caráter e as abulias. Estes elementos não sintetizados continuam, contudo, a existir podendo “ficar isolados e desaparecer ou podem se associar com outros fatos igualmente separados de toda a consciência e formar uma segunda personalidade” (Janet, 1887 p.402). A ação destes cada um deles sobre a consciência da histérica, por sua vez, é a raiz do que Janet chamou de acidentes histéricos dentre os quais estão incluídos as contraturas, a catalepsia parcial, o sonambulismo, os ataques, alguns delírios e os atos subconscientes. É possível concluir que a dissociação é de fundamental importância para a compreensão da histeria sob o ponto de vista de Janet e que é também um conceito chave da fase inicial de suas obras. / The French psychologists of the XIX century used, as one of its main methods, the exploration of the altered states of consciousness and mental illness to achieve a better understanding of the normal human mind. Among this French psychologists, Pierre Janet is a central figure. His studies on hysteria and hypnotism gave birth to his conceptions about psychological weakness, dissociation and unconscious activity. His theories held to a new understanding of mental activity occurring outside of conscious awareness, contributed to the development of the dynamic psychiatry and, specially, seemed to conciliate the two divided trends of the XIX century French psychology (the medical and the philosophical one). Even though Pierre Janet be an important French psychologist, in Brazil, there is a lack of studies about him. Because of it, our aim was to: (i) find out when Janet started to use the concept “dissociation”, its definition, and its changes; (ii) show how did Janet conclude about the existence of dissociation of consciousness, (iii) point out the relationship between the dissociation and the mental weakness, (iv) explain the mechanism of dissociation according to Janet, (v) describe what happens to the elements dissociated to normal consciousness and (vi) show the role of dissociation on hysteria, hypnotism and double personality according him. To achieve our goal we analyzed Pierre Janet’s works between 1885 and 1894 (3 books and 17 articles). As a result we noticed that the concept dissociation appeared for the first time in the article of 1887 L'anesthésie systématisée et la dissociation des phénomènes psychologiques. In this article, Janet explains that dissociation happens when an element, a memory or a sensation, is not synthesized to self, being, consequently, removed to the normal consciousness. However, from 1889 and beyond Janet substituted the term dissociation for another one, desegregation, keeping for both the same meaning. The mechanism of dissociation is described by Janet while he is explaining the hysterical symptoms. According to him, its symptoms (anesthesia, amnesia and movement disturbances) are due to a problem to synthesize sensations, memories and information about the environment (respectively) to self. This elements which were not synthesized can continue existing outside the normal consciousness, isolated or grouped, in a more or less complex system, being able to originate a secondary personality. These elements can affect the hysterical psychism giving birth to the hysterical accidents as contractures, the hysterical crises, the delirium, the catalepsies, the somnambulism and the unconscious acts. To sum up, it is possible to conclude that dissociation in a fundamental concept of the initial works of Pierre Janet and it is an essential concept to understand his views of hypnotism, hysteria and double personality.

Les somnambules présentent des caractéristiques qui suggèrent un dysfonctionnement dans la régulation du sommeil lent profond (SLP). La fonction autonome est étroitement liée à la régulation des stades de sommeil et reflète l’intensité du SLP. Notre objectif est d’étudier la fonction autonome pendant le SLP des somnambules et des sujets témoins avant et après une privation de sommeil. Quatorze somnambules adultes (9 femmes et 5 hommes ; 28,1 ± 5,8 ans) et 14 sujets témoins appariés pour l’âge et le sexe (27,8 ± 6,0 ans) ont été évalués par vidéo - polysomnographie pour une nuit de base et pendant le sommeil de récupération après 25 heures de privation de sommeil. La fréquence cardiaque (FC) et les composantes spectrales de la variabilité de la FC ont été évaluées. Les composantes de basses (LF) et de hautes fréquences (HF) en valeur absolue et en unités normalisées (LFn et HFn) ainsi que le ratio LF/HF ont été analysés à partir de segments de 5 minutes d’électrocardiogramme sélectionnés lors du SLP des deux premiers cycles de sommeil. Au cours du premier cycle de sommeil, les somnambules, mais pas les sujets témoins, ont montré une diminution des LFn et du ratio LF/HF ainsi qu’une augmentation des HFn lors du sommeil de récupération par rapport au sommeil normal. Au cours du deuxième cycle, les somnambules ont montré une FC plus élevée en sommeil de récupération par rapport au sommeil de base et l’inverse a été trouvé chez les sujets témoins. Les somnambules ont montré une augmentation de l’activité parasympathique ainsi qu’une diminution de l’activité sympathique au cours du premier cycle du sommeil de récupération par rapport à la valeur initiale. Puisque cette fenêtre de temps est fortement associée à la survenue d'épisodes de somnambulisme chez les sujets prédisposés, cette hyperactivité parasympathique pourrait être impliquée dans la physiopathologie de somnambulisme. / Sleepwalkers show a dysfunction in the regulation of slow-wave sleep (SWS). Autonomic function is closely related to sleep stage regulation and reflects SWS intensity. We thus investigated cardiac autonomic function during SWS in sleepwalkers and controls during normal sleep and recovery sleep following sleep deprivation. Fourteen adult sleepwalkers (9 women, 5 men; 28.1±5.8 years) and 14 sex- and age-matched normal controls (27.8± 6.0 years) were evaluated prospectively by video-polysomnography for one baseline night and during recovery sleep following 25 hours of sleep deprivation. Heart rate (HR) and the spectral components of HR variability during subjects' SWS were investigated during the first and second sleep cycles of both sleep conditions. Five-minute segments of electrocardiographic recordings from SWS were used to investigate HR, low-frequency (LF) and high-frequency (HF) components of the HR spectral decomposition in absolute and normalized units (LFn and HFn), and LF/HF ratio during subjects’ first two sleep cycles. During the first sleep cycle, sleepwalkers, but not controls, showed a decrease in LF/HF ratio and LFn as well as increased HFn from baseline to recovery sleep. During the second sleep cycle, sleepwalkers showed increased HR from baseline to recovery sleep whereas a decrease in HR was observed in controls. Compared to control subjects, sleepwalkers show a greater increase of parasympathetic tone and greater decrease of sympathetic tone during the first sleep cycle of their recovery sleep as compared to baseline. Since the first sleep cycle during recovery sleep constitutes a time window preferentially associated with the occurrence of somnambulistic episodes in predisposed participants, this parasympathetic hyperactivity may be implicated in the pathophysiology of sleepwalking.

The following thesis will merge the field of legal studies with the field of Science, Technology, and Society, and will focus on issues surrounding the gun control debate. The goal is to ultimately bring new light to this hot- button legal topic through the use of STS scholarship. STS tools and theories, which have previously been absent from most gun control discussions, have much to contribute to the discourse in terms of motivating the need for gun control, fully understanding the user-gun relationship, breaking down misconceptions about the technology and its role in society, and further understanding the complex societal network within which guns exist in America. This will begin first with a discussion of the legal history and background of firearms in the United States, and will be followed by an STS analysis of technological agency and somnambulism as they can be applied to guns. Following this, the Actor Network in which firearms in America are imbedded will be explored, in order to better understand why they have been so difficult to regulate. Although this thesis will be heavily policy and law-focused, the aim is not to propose any specific new policy, but instead to use STS to conceptualize gun issues from a new perspective that will allow misconceptions and blockades to be confronted head-on.

No description available.