Chronic Stress, Sense of Belonging, and Depression Among Survivors of Traumatic Brain Injury

To test whether chronic stress, interpersonal relatedness, and cognitive burden could explain depression after traumatic brain injury (TBI). Design : A nonprobability sample of 75 mild-to-moderately injured TBI survivors and their significant others, were recruited from five TBI day-rehabilitation programs. All participants were within 2 years of the date of injury and were living in the community. Methods : During face-to-face interviews, demographic information, and estimates of brain injury severity were obtained and participants completed a cognitive battery of tests of directed attention and short-term memory, responses to the Perceived Stress Scale, Interpersonal Relatedness Inventory, Sense of Belonging Instrument, Neurobehavioral Functioning Inventory, and Center for Epidemiological Studies Depression Scale;. Findings : Chronic stress was significantly and positively related to post-TBI depression. Depression and postinjury sense of belonging were negatively related. Social support and results from the cognitive battery did not explain depression. Conclusions : Postinjury chronic stress and sense of belonging were strong predictors of post-injury depression and are variables amenable to interventions by nurses in community health, neurological centers, or rehabilitation clinics. Future studies are needed to examine how these variables change over time during the recovery process.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72593/1/j.1547-5069.2002.00221.x.pd

Beyond dressing and driving: Using occupation to facilitate community integration in neurorehabilitation

During the process of community integration, individuals with acquired brain injury may experience difficulties in all areas of occupational performance including self-care, home management, community access, leisure, social activities and vocational pursuits. Community based rehabilitation services provide opportunities to minimise such difficulties by working with clients as they engage in meaningful real-life context-based occupations. The therapeutic use of occupation is at the core of occupational therapy practice. We reflect on the nature and principles of occupation and highlight particular benefits for facilitating community integration after brain injury. This is illustrated using the example of executive dysfunction. Several challenges for the occupational therapy profession arise from the shift in focus from hospital to community based rehabilitation, and the need for further research on community integration after brain injury from an occupational perspective is recognised

A two-component regulatory system playing a critical role in plant pathogens and endosymbionts is present in Brucella abortus and controls cell invasion and virulence

Two mutants showing increased sensitivity to polycations and surfactants were obtained by transposon mutagenesis of virulent Brucella abortus 2308 Nal(r). These mutants showed no obvious in vitro growth defects and produced smooth-type lipopolysaccharides. However, they hardly multiplied or persisted in mouse spleens, displayed reduced invasiveness in macrophages and HeLa cells, lost the ability to inhibit lysosome fusion and were unable to replicate intracellularly. Subsequent DNA analyses identified a two-component regulatory system [Brucella virulence related (Bvr)] with a regulatory (BvrR) and sensory (BvrS) protein. Cloning on bvrR in the BvrR-deficient mutant restored the resistance to polycations and, in part, the invasiveness to polycations and, in part, the invasiveness and the ability to multiply intracellularly. BvrR and BvrS were highly similar (87-89% and 70-80% respectively) to the regulatory and sensory proteins of the chromosomally encoded Rhizobium meliloti Chvl-ExoS and Agrobacterium tumefaciens Chvl-ChvG systems previously shown to be critical for endosymbiosis and pathogenicity in plants. Divergence among the three sensory proteins was located mostly within a periplasmic domain probably involved in stimulus sensing. As B. abortus, R. meliloti and A. tumefaciens are phylogenetically related, these observations suggest that these systems have a common ancestor that has evolved to sense stimuli in plant and animal microbial environments.Dos mutantes que muestran una mayor sensibilidad a los policationes y a los tensioactivos se obtuvieron por mutagénesis de transposones de la Brucella abortus 2308 Nal(r) virulenta. Estos mutantes no mostraron defectos evidentes de crecimiento in vitro y produjeron lipopolisacáridos de tipo suave. Sin embargo, apenas se multiplicaron o persistieron en el bazo de los ratones, mostraron una menor capacidad de invasión en macrófagos y células HeLa, perdieron la capacidad de inhibir la fusión de lisosomas y fueron incapaces de replicarse intracelularmente. Los análisis posteriores del ADN identificaron un sistema regulador de dos componentes [Brucella virulence related (Bvr)] con una proteína reguladora (BvrR) y otra sensorial (BvrS). La clonación en bvrR en el mutante deficiente en BvrR restauró la resistencia a los policationes y, en parte, la capacidad de invasión a los policationes y, en parte, la capacidad de invasión y de multiplicación intracelular. BvrR y BvrS eran muy similares (87-89% y 70-80% respectivamente) a las proteínas reguladoras y sensoriales de los sistemas Rhizobium meliloti Chvl-ExoS y Agrobacterium tumefaciens Chvl-ChvG codificados cromosómicamente, que habían demostrado ser críticos para la endosimbiosis y la patogenicidad en las plantas. La divergencia entre las tres proteínas sensoriales se localizó sobre todo en un dominio periplásmico probablemente implicado en la detección de estímulos. Dado que B. abortus, R. meliloti y A. tumefaciens están filogenéticamente relacionados, estas observaciones sugieren que estos sistemas tienen un ancestro común que ha evolucionado para percibir estímulos en entornos microbianos vegetales y animales.Universidad Nacional, Costa RicaEscuela de Medicina Veterinari