How a Diverse Research Ecosystem Has Generated New Rehabilitation Technologies: Review of NIDILRR’s Rehabilitation Engineering Research Centers

Over 50 million United States citizens (1 in 6 people in the US) have a developmental, acquired, or degenerative disability. The average US citizen can expect to live 20% of his or her life with a disability. Rehabilitation technologies play a major role in improving the quality of life for people with a disability, yet widespread and highly challenging needs remain. Within the US, a major effort aimed at the creation and evaluation of rehabilitation technology has been the Rehabilitation Engineering Research Centers (RERCs) sponsored by the National Institute on Disability, Independent Living, and Rehabilitation Research. As envisioned at their conception by a panel of the National Academy of Science in 1970, these centers were intended to take a “total approach to rehabilitation”, combining medicine, engineering, and related science, to improve the quality of life of individuals with a disability. Here, we review the scope, achievements, and ongoing projects of an unbiased sample of 19 currently active or recently terminated RERCs. Specifically, for each center, we briefly explain the needs it targets, summarize key historical advances, identify emerging innovations, and consider future directions. Our assessment from this review is that the RERC program indeed involves a multidisciplinary approach, with 36 professional fields involved, although 70% of research and development staff are in engineering fields, 23% in clinical fields, and only 7% in basic science fields; significantly, 11% of the professional staff have a disability related to their research. We observe that the RERC program has substantially diversified the scope of its work since the 1970’s, addressing more types of disabilities using more technologies, and, in particular, often now focusing on information technologies. RERC work also now often views users as integrated into an interdependent society through technologies that both people with and without disabilities co-use (such as the internet, wireless communication, and architecture). In addition, RERC research has evolved to view users as able at improving outcomes through learning, exercise, and plasticity (rather than being static), which can be optimally timed. We provide examples of rehabilitation technology innovation produced by the RERCs that illustrate this increasingly diversifying scope and evolving perspective. We conclude by discussing growth opportunities and possible future directions of the RERC program

Hospitalisation rate in individuals with schizophrenia treated with long acting injectable atypical antipsychotics in Latin America - the REALAI study

Ctr Invest Pro Salud Mental, Invest Clin, Mexico City, DF, MexicoPro Doctor Serv Med, Pesquisa Clin, Rio De Janeiro, BrazilClin Especialidades Neuropsiquiatr Tlatelolco, Ctr Invest Clin, Mexico City, DF, MexicoUniv Fed Sao Paulo, Psychiat, Sao Paulo, BrazilJanssen Cilag, Med Affairs, Lisbon, PortugalJanssen Cilag, Med Affairs, Bogota, ColombiaUniv Fed Sao Paulo, Psychiat, Sao Paulo, BrazilWeb of Scienc

Development of molecular and morphological markers to improve species-specific monitoring and systematics of Northeast Atlantic and Mediterranean skates (Rajiformes)

The Northeast Atlantic and Mediterranean skates (Rajidae) showed remarkable species diversity but with high morphological and ecological conservatism. Since skates are particularly vulnerable to the bottom trawl fishery, species-specific demographic surveys as well as studies defining life history and evolutionary traits are important in prioritising conservation programs. However, the identification of juveniles and adults of some species may be difficult using referenced guidelines and identification keys. Therefore, we attempt to develop markers for species identification through the parallel analysis of a 16S rDNA gene sequence and of several morphological characters on 135 individuals collected by trawl surveys in the Adriatic Sea and putatively assigned to six taxa. Species-specific haplotypes were defined for Raja miraletus, Raja montagui, Dipturus oxyrinchus, since a solid accordance between species boundaries and well-differentiated haplotypes was observed. Comparative analysis of 16S rDNA sequences allowed the identification of three juvenile specimens of Leucoraja circularis, a species that rarely occurs in the Adriatic Sea. On the contrary, morphological traits and haplotype distribution were largely discordant in Raja asterias and R. clavata. While all putative R. clavata individuals showed a unique haplotype (H-CLA), only 8 of 30 putative R. asterias individuals possessed a second weakly divergent haplotype (H-AST). The remaining 22 R. asterias carried the H-CLA. The multivariate analyses of morphometric and meristic characters in putative R. clavata and R. asterias revealed the clustering of individuals regardless of haplotypes. However, a bimodal distribution of R. asterias and R. clavata samples would suggest that two separated taxa might exist, both sharing the two 16S rDNA haplotypes. The haplotype distribution appeared to be significantly correlated only to the standardised disc length/total length (DL/TL) variation. Three alternative explanations may support this scenario: (i) an incomplete lineage sorting process in two morphologically yet distinct taxa; (ii) a recent hybridisation between the two taxa; (iii) the two taxa are morphologically plastic species and all considered morphological characters may be misleading in discriminating between them at all maturity stages, except for the DL/TL. However, further analyses on larger data sets and using molecular key markers (i.e. nuclear genes) will be needed to definitely resolve the status of these taxa. Molecular relationships among rajid taxa are largely consistent with systematics based on internal and external anatomical features. This multidisciplinary study contributed to defining the pattern of species diversity and abundance of rajids in the Adriatic Sea. © 2003 Elsevier Science B.V. All rights reserved

Public stigmatization of different mental disorders: a comprehensive attitude survey

ISSN:2045-7960ISSN:2045-797

Attitudes of mental health professionals towards persons with schizophrenia: a transcultural comparison between Switzerland and Brazil

CONTEXTO: A estigmatização é uma questão importante no tratamento e no curso da esquizofrenia. A manutenção de atitudes estigmatizantes pode estar relacionada a fatores socioculturais. OBJETIVOS: Comparar atitudes estigmatizantes de profissionais de saúde mental em países culturalmente diversos: Brasil e Suíça. MÉTODOS: Foram analisados dados de duas grandes pesquisas sobre o estigma na Suíça e no Brasil, focando-se no desejo de distância social em relação a indivíduos com esquizofrenia e atitudes de profissionais de saúde mental em relação à aceitação de efeitos colaterais do tratamento psicofarmacológico. RESULTADOS: Profissionais de saúde mental suíços apresentaram níveis significativamente mais elevados de distância social do que suas contrapartes brasileiras. Houve também um efeito fraco de idade, bem como um efeito da interação entre a origem e a idade. Com relação à aceitação de efeitos colaterais, a influência da origem foi bastante fraca. Com exceção do risco de dependência dos psicotrópicos, a aceitação dos profissionais suíços a efeitos colaterais de longa duração foi significativamente maior do que a de seus colegas no Brasil. CONCLUSÕES: A forte associação entre origem e distância social pode estar relacionada à formação sociocultural dos profissionais de saúde mental; em comparação com a Suíça, o Brasil é muito heterogêneo em termos de estrutura étnica e socioeconômica. A aceitação de efeitos colaterais pode também estar relacionada com os medicamentos mais sofisticados (ou seja, drogas antipsicóticas de nova geração) comumente usados na Suíça. = BACKGROUND: Stigmatization is an important issue in the treatment and course of schizophrenia. The maintenance of stigmatizing attitudes may be related to socio-cultural factors. OBJECTIVES: To compare stigmatizing attitudes of mental health professionals in the culturally diverse countries Brazil and Switzerland. METHODS: We analyzed data of two broad stigmatization surveys from Switzerland and Brazil by focusing on the social distance and attitudes of mental health professionals towards the acceptance of side effects of psychopharmacological treatment. RESULTS: Swiss mental health professionals showed significantly higher levels of social distance than their Brazilian counterparts. There was also a weak effect of age as well as an interaction effect between origin and age. With respect to the acceptance of side effects, the effect of origin was rather weak. With the exception of drug dependence, Swiss professionals' acceptance of long-lasting side effects was significantly higher than for their counterparts in Brazil. DISCUSSION: The strong association between origin and social distance may be related to the socio-cultural background of the mental health professionals. In comparison with Switzerland, Brazil is very heterogeneous in terms of ethnicity and socio-economic structure. The distinct acceptance of side effects may additionally be related to the more sophisticated medicaments (i.e. new generation of antipsychotic drugs) commonly used in Switzerland

Stigma toward schizophrenia: do all psychiatrists behave the same? Latent profile analysis of a national sample of psychiatrists in Brazil

Abstract Background An important issue concerning the worldwide fight against stigma is the evaluation of psychiatrists’ beliefs and attitudes toward schizophrenia and mental illness in general. However, there is as yet no consensus on this matter in the literature, and results vary according to the stigma dimension assessed and to the cultural background of the sample. The aim of this investigation was to search for profiles of stigmatizing beliefs related to schizophrenia in a national sample of psychiatrists in Brazil. Methods A sample of 1414 psychiatrists were recruited from among those attending the 2009 Brazilian Congress of Psychiatry. A questionnaire was applied in face-to-face interviews. The questionnaire addressed four stigma dimensions, all in reference to individuals with schizophrenia: stereotypes, restrictions, perceived prejudice and social distance. Stigma item scores were included in latent profile analyses; the resulting profiles were entered into multinomial logistic regression models with sociodemographics, in order to identify significant correlates. Results Three profiles were identified. The “no stigma” subjects (n = 337) characterized individuals with schizophrenia in a positive light, disagreed with restrictions, and displayed a low level of social distance. The “unobtrusive stigma” subjects (n = 471) were significantly younger and displayed the lowest level of social distance, although most of them agreed with involuntary admission and demonstrated a high level of perceived prejudice. The “great stigma” subjects (n = 606) negatively stereotyped individuals with schizophrenia, agreed with restrictions and scored the highest on the perceived prejudice and social distance dimensions. In comparison with the first two profiles, this last profile comprised a significantly larger number of individuals who were in frequent contact with a family member suffering from a psychiatric disorder, as well as comprising more individuals who had no such family member. Conclusions Our study not only provides additional data related to an under-researched area but also reveals that psychiatrists are a heterogeneous group regarding stigma toward schizophrenia. The presence of different stigma profiles should be evaluated in further studies; this could enable anti-stigma initiatives to be specifically designed to effectively target the stigmatizing group

Stigma toward schizophrenia: do all psychiatrists behave the same? Latent profile analysis of a national sample of psychiatrists in Brazil

Abstract Background An important issue concerning the worldwide fight against stigma is the evaluation of psychiatrists’ beliefs and attitudes toward schizophrenia and mental illness in general. However, there is as yet no consensus on this matter in the literature, and results vary according to the stigma dimension assessed and to the cultural background of the sample. The aim of this investigation was to search for profiles of stigmatizing beliefs related to schizophrenia in a national sample of psychiatrists in Brazil. Methods A sample of 1414 psychiatrists were recruited from among those attending the 2009 Brazilian Congress of Psychiatry. A questionnaire was applied in face-to-face interviews. The questionnaire addressed four stigma dimensions, all in reference to individuals with schizophrenia: stereotypes, restrictions, perceived prejudice and social distance. Stigma item scores were included in latent profile analyses; the resulting profiles were entered into multinomial logistic regression models with sociodemographics, in order to identify significant correlates. Results Three profiles were identified. The “no stigma” subjects (n = 337) characterized individuals with schizophrenia in a positive light, disagreed with restrictions, and displayed a low level of social distance. The “unobtrusive stigma” subjects (n = 471) were significantly younger and displayed the lowest level of social distance, although most of them agreed with involuntary admission and demonstrated a high level of perceived prejudice. The “great stigma” subjects (n = 606) negatively stereotyped individuals with schizophrenia, agreed with restrictions and scored the highest on the perceived prejudice and social distance dimensions. In comparison with the first two profiles, this last profile comprised a significantly larger number of individuals who were in frequent contact with a family member suffering from a psychiatric disorder, as well as comprising more individuals who had no such family member. Conclusions Our study not only provides additional data related to an under-researched area but also reveals that psychiatrists are a heterogeneous group regarding stigma toward schizophrenia. The presence of different stigma profiles should be evaluated in further studies; this could enable anti-stigma initiatives to be specifically designed to effectively target the stigmatizing group

Modelo experimental de osteotomia em coelhos imaturos Expeimental model for osteotomy in immature rabbit

Apresenta-se um modelo experimental de osteotomia de fíbula em coelhos com esqueleto imaturo adequado para o estudo do processo de reparação óssea. A osteotomia foi realizada por serra elétrica padronizada, sem utilização de dispositivos de fixação. Este modelo foi testado em cinco coelhos e constou da descrição detalhada de técnica operatória, anestesia e técnica radiográfica. Os animais foram submetidos a eutanásia após cinco semanas e tiveram suas fíbulas encaminhadas para avaliação histológica. Comprovou-se que o modelo é eficiente, simples e de fácil execução, tornando-se opção atraente para todos aqueles que desejam realizar estudos de consolidação óssea durante a imaturidade esquelética.<br>Authors present an experimental model for fibular osteotomy in immature rabbits usefull to study healing bone process. Osteotomy was produced by means of eletric saw without utilization of fixing devices. This model was applied in five rabbit were sacrified after five weeks and had their fibular send for histological evaluation. Operative technique, anesthesia, roetigenografic technique were detailed discribed. The model was proved to be efficient, simple and of easy execution, becoming an atractive option for whoever wish to perform studies of bone healing through skeleon development