Biomedical subjects

A F van Leeuwen

Publications and source records attributed to A F van Leeuwen.

4 recordsLinked to original sources

PubMed2005

Positive and negative affect after diagnosis of advanced cancer.

Anxiety and depression are studied thoroughly in patients with advanced cancer. However, little is known about the nature of mood disorders in this stage of the disease. We studied positive and negative affect in patients who have had a diagnosis of advanced cancer, and examined how these are related to anxiety and depression, and to other patient and care factors. One hundred and five patients filled out a written questionnaire and were interviewed personally. The PANAS positive affect scores were lower than those in the general population, but the negative affect scores were fairly similar. We found a rather low prevalence of depression (13%) and anxiety (8%) as measured by the HADS. The emotional problems patients mentioned most frequently were anxiety about metastases (26%), the unpredictability of the future (18%) and anxiety about physical suffering (15%). Both positive and negative affect were most strongly related to patient's sense of meaning and peace. We conclude that distinguishing positive and negative affect enhances the understanding of psychological distress of patients with advanced cancer, that seems to be mainly caused by low levels of positive affect. Several theories are discussed to explain this finding, that may contribute to efforts to improve care for these patients.

Adaptation, Psychological↗

PubMed2001

Saccadic binocular coordination in alternating exotropia.

We studied the coordination of binocular eye movements in human subjects with alternating exotropia (divergent strabismus). Binocular saccades were recorded in six subjects during binocular and monocular viewing. Subjects were instructed to make saccades between two continuously lit targets (LED's) presented in an isovergence array (with the straight-ahead target 130 cm from the eyes) in a dimly lit room. For saccades up to 20 degrees amplitude, there were no large differences in the dynamics of the saccades between control and exotropic subjects. However, for larger amplitudes subjects frequently alternated the eye of fixation during saccades. That is, subjects fixated the left target with the left eye and the right target with the right eye. The alternation in eye fixation at the end of the saccade was taken into account in the programming of the saccades. The amplitudes of the alternating saccades were approximately equal to the target amplitude minus the strabismus angle. We conclude that for those saccades where alternation occurs, there is not only a change in the eye of fixation, but also a change in the target representation provided by either eye. Thus, in this group of strabismic patients, saccades may be programmed in a retina-centered coordinate system, if we assume that for making a saccade to a new target in the contralateral visual field its representation on the temporal retinal field of the currently fixating eye is suppressed and the retinotopic target information is derived from the non-fixating eye. In executing the saccade, the non-fixating eye automatically becomes the fixating eye.

Adolescent↗

PubMed1999

Gaze-shift dynamics in subjects with and without symptoms of convergence insufficiency: influence of monocular preference and the effect of training.

We studied gaze-shift dynamics during several gaze-shift tasks and during reading, in five subjects with convergence insufficiency (C.I., a diminished ability to converge), and in ten subjects without C.I. Furthermore, we studied the effect of vergence training in order to verify previous claims that orthoptic exercises can improve vergence performance. We recorded binocular eye movements with the scleral coil technique. Subjects switched fixation between nearby and distant light emitting diodes (LEDs) arranged in isovergence arrays (distances 35 and 130 cm) in a dimly lit room. In both the C.I. and non-C.I. group, two classes of subjects occurred: vergence responders and saccadic responders. During pure vergence tasks, saccadic responders made saccades with no or little vergence; vergence responders made vergence movements with no or small saccadic components. In saccadic responders, fixation of nearby targets was monocular. Subjects with a preferred eye, according to our determination, used the preferred eye. The five C.I. subjects showed idiosyncratic responses with insufficient vergence during most trials. They all had a tendency to alternate fixation between the left and right eye. Vergence-version tasks always elicited larger vergence components than pure vergence tasks. During a reading task, vergence angles were more accurate than during gaze-shifts between LEDs. After the pre-training sessions, nine subjects (one of which had C.I.) practised a pure vergence task three times a day for at least 2 weeks. Vergence amplitudes of four of these subjects were larger after training. We conclude that vergence training can change oculomotor performance. Although C.I. is often associated with abnormal vergence dynamics, there are no typical C.I. vergence dynamics. Unstable monocular preferences may play a role in the aetiology of C.I.

Adult↗

PubMed1998

Dynamics of horizontal vergence movements: interaction with horizontal and vertical saccades and relation with monocular preferences.

We studied the dynamics of pure vergence shifts and vergence shifts combined with vertical and horizontal saccades. It is known from earlier studies that horizontal saccades accelerate horizontal vergence. We wanted to obtain a more complete picture of the interactions between version and vergence. Therefore we studied pure version (horizontal and vertical), pure vergence (divergence and convergence) and combinations of both in five adult subjects with normal binocular vision and little phoria (< 5 degrees). The visual targets were LED's in isovergence arrays presented at two distances (35 and 130 cm) in a dimly lit room. Two targets were continuously lit during each trial and gaze-shifts were paced by a metronome. The two subjects with a strong monocular preference made vergence eye movements together with small horizontal saccades during pure vergence tasks. The other subjects, who did not have a strong monocular preference, made pure vergence movements (without saccades). These findings, suggest that monocular preferences influence the oculomotor strategy during vergence tasks. Vergence was facilitated by both horizontal and vertical saccades but vergence peak-velocity during horizontal saccades was higher than during vertical saccades.

Adult↗