Paula T Fernandes

University of Campinas, Campinas, Estado de Sao Paulo, Brazil

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Publications (67)56.68 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: The number of research papers in the area of Brain Computer Interface (BCI) assistive technologies is increasing rapidly. In addition, there is a possibility that some prosthetic models based on BCI will soon be available on the market. However, the acceptance and the degree of information that lay people have about this kind of technology is still unclear. The objective of this study was to investigate the diffusion of this top-of-the-edge technology and its acceptance by society. We developed a structured questionnaire and we applied it, in a single day, to passersby in downtown of an urban city with over one million people in Southeastern Brazil. The results showed that almost a third of 336 interviewees (mean age of 37 year-old, range from 15 to 89 years) had never heard about such technology. Most (89 %) of the other two thirds that had already heard of it affirmed that BCI based technologies would help in cases of incapacitating physical disabilities. No association was found when confronting the pattern of the answers with demographical data (p>O.05). We conclude that there is a positive attitude towards assistive technology by the society. The majority of the interviewees claimed to know about it, but it seems that the knowledge is superficial and based on broad science diffusion media. The literature on BCI acceptance is still very limited. Approximation between the scientific community and the end users is advised to bring adequate information and to decrease the degree of fantasy naturally related to this area, avoiding future false expectations.
    Biosignals and Biorobotics Conference (BRC), 2013 ISSNIP; 01/2013
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    ABSTRACT: Stroke is the leading cause of acquired physical impairment in adult in the world. One person in six seconds is having a stroke somewhere in the world. It is estimated that one-third of stroke victims will be handicapped, and will require assistive technology of some sort. There are many BCI therapeutic resources in development that can be used for treating patients who have any physical challenge. The objective of this study is to explore the perception of BCI assistive technology by the post-stroke patients that have sequelae. We applied a home developed questionnaire and conducted a semi-structured interview by phone to explore the perception of patients towards BCI procedures. We studied seven post-ischemic stroke patients (4 men) with a mean age of 63 years (range 34-80 years). Six subjects had incomplete basic education and only one subject had completed high school. The median Rankin score was 3 (range 2-4). We found positive to very positive perception on the usage of BCI. A pleasant experience was described by all patients and no complaints were reported. Most subjects misinterpreted the research procedures regarding them as part of their treatment. In conclusion, the overall perception of BCI by the stroke patients was positive, and there is a willingness of trying this type of technology in particular when physicians are part of the BCI implementation process.
    Biosignals and Biorobotics Conference (BRC), 2013 ISSNIP; 01/2013
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    ABSTRACT: The dissemination of health-related news through newspapers can influence the behavior of patients and of health care providers. We conducted a study to analyze the characteristics of health-related research published by two leading Brazilian newspapers. We retrospectively evaluated health-related news published in the electronic versions of the newspapers Folha de São Paulo and O Estado de São Paulo over a period of three months (July through September, 2009). Only articles mentioning medical research were included. The articles were categorized according to topic, source, study location and the nature of the headline. We also analyzed the presence of background information on the topic, citations of medical periodicals, national contextualization and references to products or companies. Scientific research articles corresponded to 57% and 20% of health-related articles published by Folha de São Paulo and O Estado de São Paulo, respectively. Folha de São Paulo published significantly more articles about national studies, and most articles were written by its own staff. In contrast, most articles in O Estado de São Paulo came from news agencies. Folha de São Paulo also better contextualized its reports for Brazilian society. O Estado de São Paulo tended to cite the name of the periodical in which the study was published more frequently, but their articles lacked national contextualization. The results showed a significant difference in the way in which the studied newspapers report on health-related research. Folha de São Paulo tends to write its own articles and more frequently publishes the results of national research, whereas O Estado de São Paulo publishes articles that originate in news agencies, most of which have little national contextualization.
    Clinics (São Paulo, Brazil) 01/2012; 67(3):261-4. · 1.59 Impact Factor
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    ABSTRACT: Studies have suggested that the thalamus is a key structure in the pathophysiology of juvenile myoclonic epilepsy. The objective of the present investigation was to examine the thalami of patients with juvenile myoclonic epilepsy using a combination of multiple structural neuroimaging modalities. The association between these techniques may reveal the mechanisms underlying juvenile myoclonic epilepsy and help to identify the neuroanatomical structures involved. Twenty-one patients with juvenile myoclonic epilepsy (13 women, mean age=30±9 years) and a control group of 20 healthy individuals (10 women, mean age=31±8 years) underwent MRI in a 2-T scanner. The volumetric three-dimensional sequence was used for structural investigation. Evaluation of the thalamus comprised voxel-based morphometry, automatic volumetry, and shape analysis. Comparisons were performed between patient and control groups. Voxel-based morphometry analysis identified areas of atrophy located in the anterior portion of the thalamus. Post hoc analysis of automatic volumetry did not reveal significant differences between the groups. Shape analysis disclosed differences between patients and controls in the anterior and inferior portions of the right thalamus and in the anterior portion of the left thalamus. The present investigation confirms that thalami of patients with juvenile myoclonic epilepsy are structurally abnormal with impairments located mainly in the anterior and inferior sections.
    Epilepsy & Behavior 06/2011; 21(4):407-11. · 1.84 Impact Factor
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    ABSTRACT: Inflammation and dysfunction of the hypothalamus are common features of experimental obesity. However, it is unknown whether obesity and massive loss of body mass can modify the immunologic status or the functional activity of the human brain. Therefore, the aim of this study was to determine the effect of body mass reduction on brain functionality. In humans, changes in hypothalamic activity after a meal or glucose intake can be detected by functional magnetic resonance imaging (fMRI). Distinct fMRI analytic methods have been developed to explore changes in the brain's activity in several physiologic and pathologic conditions. We used two analytic methods of fMRI to explore the changes in the brain activity after body mass reduction. Obese patients present distinct functional activity patterns in selected brain regions compared with lean subjects. On massive loss of body mass, after bariatric surgery, increases in the cerebrospinal fluid (CSF) concentrations of interleukin (IL)-10 and IL-6 are accompanied by changes in fMRI patterns, particularly in the hypothalamus. Massive reduction of body mass promotes a partial reversal of hypothalamic dysfunction and increases anti-inflammatory activity in the CSF.
    Diabetes 06/2011; 60(6):1699-704. · 7.90 Impact Factor
  • Paula T Fernandes, Dee A Snape, Roy G Beran, Ann Jacoby
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    ABSTRACT: Stigma is a major issue for people who develop epilepsy. Reducing stigma is a major focus of activity for the epilepsy patient support groups globally. In this paper, we introduce some key ideas and debates about the nature of and drivers for the stigma of epilepsy, including recent arguments about the need to frame analyses of the nature of epilepsy stigma within sociological debates about conflict and power. We then consider the role of the legislative process for redressing power imbalances that promote or maintain epilepsy stigma; and the value of tailored educational campaigns and programmes directed at stigma reduction. Finally, we consider the nature of 'difference' as experienced by people with epilepsy and how that difference translates into stigma; and provide evidence from a specific targeted intervention to combat epilepsy stigma that its reduction is an achievable goal.
    Epilepsy & Behavior 03/2011; 22(1):55-62. · 1.84 Impact Factor
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    ABSTRACT: Patients with deficit schizophrenia have worse cognition and poorer social functioning compared to the nondeficit ones. Insight is another domain in which these two groups might differ, but data on insight impairment in deficit versus nondeficit schizophrenia are still scarce. We compared 29 patients with deficit schizophrenia to 44 nondeficit patients and found a tendency to poorer insight in the deficit group. However such tendency disappeared when analysis was controlled for cognition, a domain in which both groups differed significantly. This finding reinforces the pressing need for simultaneous assessment of the several dimensions or domains of schizophrenic psychopathology.
    Schizophrenia Research 02/2011; 128(1-3):124-6. · 4.59 Impact Factor
  • Schizophrenia Research 02/2011; 130(1-3):289-90. · 4.59 Impact Factor
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    ABSTRACT: To estimate the frequency of depression/anxiety and to establish the social, epilepsy and psychiatric characteristics in individuals with epilepsy. A cross-sectional study was employed to evaluate 153 subjects with epilepsy who were identified in a previous community-based survey. First, a structured interview was conducted, followed by a psychiatric evaluation. Subjects with depression were compared to those without, and subjects with anxiety were compared to those without. The prevalence of anxiety and depression was 39.4 and 24.4%, respectively. Both were associated with low schooling (OR 3.8, 95% CI 1.6 to 9.0 and OR 2.8, 95% CI 1.2 to 6.5 for depression and anxiety, respectively), lifetime suicidal thoughts (OR 4.4, 95% CI 1.9 to 10.3 and OR 3.6, 95% CI 1.7 to 7.7) and lifetime suicide attempts (OR 9.3, 95% CI 2.6 to 32.8 and OR 6.9, 95% CI 1.8 to 26.4). The high rates of depression and anxiety reinforced the need for recognition and treatment of mental disorders in epilepsy.
    Arquivos de neuro-psiquiatria 01/2011; 69(2B):342-8. · 0.55 Impact Factor
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    ABSTRACT: Objective: To estimate the frequency of depression/anxiety and to establish the social, epilepsy and psychiatric characteristics in individuals with epilepsy. Method: A cross-sectional study was employed to evaluate 153 subjects with epilepsy who were identified in a previous community-based survey. First, a structured interview was conducted, followed by a psychiatric evaluation. Subjects with depression were compared to those without, and subjects with anxiety were compared to those without. Results: The prevalence of anxiety and depression was 39.4 and 24.4%, respectively. Both were associated with low schooling (OR 3.8, 95% CI 1.6 to 9.0 and OR 2.8, 95% CI 1.2 to 6.5 for depression and anxiety, respectively), lifetime suicidal thoughts (OR 4.4, 95% CI 1.9 to 10.3 and OR 3.6, 95% CI 1.7 to 7.7) and lifetime suicide attempts (OR 9.3, 95% CI 2.6 to 32.8 and OR 6.9, 95% CI 1.8 to 26.4). Conclusion: The high rates of depression and anxiety reinforced the need for recognition and treatment of mental disorders in epilepsy. Depressão e ansiedade na epilepsia: uma amostra da comunidade no Brasil RESUMO Objetivo: Estimar a frequência de depressão/ansiedade em pessoas com epilepsia e estabelecer as características sociais, da epilepsia e psiquiátricas associadas. Método: Foi feito um estudo transversal para avaliar 153 sujeitos com epilepsia identificados em um levantamento prévio feito na comunidade. Primeiramente foi realizada uma entrevista estruturada, seguida de uma avaliação psiquiátrica. Os sujeitos deprimidos foram comparados com aqueles sem depressão e os sujeitos com ansiedade foram comparados com aqueles sem ela. Resultados: A prevalência de ansiedade e depressão foi de 39,4% e 24,4%, respectivamente. Ambas foram associadas a baixa escolaridade (OR 3,8; IC95% 1,6-9,0 e OR 2,8, IC95% 1,2-6,5 para depressão e ansiedade, respectivamente), ideação suicida (OR 4,4; IC95% 1,9-10,3 e OR 3,6; IC95% 1,7-7,7) e tentativa de suicídio (OR 9,3; IC95% 2,6-32,8 e OR 6,9; IC95% 1,8-26,4). Conclusão: As altas taxas de depressão e ansiedade reforçam a necessidade de reconhecimento e tratamento dos transtornos mentais na epilepsia. Palavras-chave: transtornos do humor, ansiedade, depressão, epilepsia, epidemiologia, tentativa de suicídio.
    Arq Neuropsiquiatr. 01/2011;
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    ABSTRACT: INTRODUCTION: The management of epilepsy goes beyond seizure control. So, the Social Interaction Groups (GIS) is an alternative to this integrative approach in epilepsy. PURPOSE: To carry out groups dynamics for health allied professional, social workers, and educators in order for them to use GIS in their communities and for patients. METHODOLOGY: We conducted two GIS - with 21 professionals from social, education and health Departments of city Pedreira. We used validated questionnaires (Self-Esteem Questionnaire, Resilience Questionnaire, Social Skills Inventory and Stigma Scale of Epilepsy) before and after the GIS. RESULTS: The groups showed improvement in knowledge about epilepsy and allowed to share experiences and contribute to solidarity and sense of citizenship. In addition, the use of Traditional Chinese Medicine has reinforced the holistic view of human being. The questionnaires used (pre and post-test) showed positive changes. CONCLUSIONS: It was observed an improvement in all items evaluated, showing that subjects could improve their social skills and, consequently, their resilience. The application of GIS is practical, with a low-cost operation and allows performance in other locations within other situations of chronic conditions that have similar epilepsy's impact.
    Journal of Epilepsy and Clinical Neurophysiology 12/2010; 17(2):70-74.
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    ABSTRACT: Epi-Brazil performed some activities as a part of national movement of epilepsy in our country. The IX National Meeting of Associations and Support Group of People with Epilepsy was held in March 18-19th, 2011, in Ipatinga, MG, with the participation of over 250 people and 10 entities. The event was performed in two principal moments: 1. A board of specialists on epilepsy discussed important themes about epilepsy and 2. The epilepsy' associations presented their activities, difficulties and successes. The major resolutions of the General Assembly were: 1) "We want public policy for Epilepsy" was chosen as the central theme of the 2011 campaign; 2) X National Meeting of Associations and Support Group of People with Epilepsy will take place in March 16-17th of 2012, in Goiania-GO. 3) Reinforcement of involvement of associations in the Epi-Brazil, especially through better exchange of information. 4) Continuity in the Conselho Nacional da Saúde and Fórum Nacional de Patologias Crônicas. 5) Staying in the discussion with the Ministry of Health to pass a Law that establishes a National Program for Epilepsy in primary care.
    Journal of Epilepsy and Clinical Neurophysiology 12/2010; 17(1):30-32.
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    ABSTRACT: As a part of national movement of epilepsy in our country, the VIII National Meeting of Associations and Support Group of People with Epilepsy was held on March 19-20th, 2010, in Campinas, SP. In the first part, a board of specialists on epilepsy answered the questions from the audience. In the second part, the epilepsy' associations presented their activities. The major resolutions of the meeting were: 1. Election of a new board of directors of Epi-Brasil; 2. "Epilepsy yes, prejudice no" was chosen as the central theme of the 2010 campaign; 3. Usage of adequate terms to refer to the patients (to not use the term "epileptic"). 4. in public events, it's recommended to invite the Ministry of Public Defense to join the national actions for epilepsy. 5. An event on epilepsy will be held in Rondônia, in September 2010, with support from Epi-Brasil. 6. Reinforcement of the EPI-Brasil associations; 5. Continuity in the Conselho Nacional da Saúde; 6. Establishment of the actions to approve Minuta of Ministry of Health; 7. The IX National Meeting of Associations and Support Group of People with Epilepsy will take place in Ipatinga-MG, during the period of March 18-19h of 2011.
    Journal of Epilepsy and Clinical Neurophysiology 09/2010; 16(3):122-124.
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    ABSTRACT: Epilepsy has been associated with increased risk of suicide; however, few studies have examined the relationship between epilepsy and suicidal behavior. The aims of this study were to evaluate the frequency of suicidal behavior in people with epilepsy and to identify characteristics that are associated with suicidal ideation in epilepsy. Of 171 people with epilepsy identified in a previous survey, 139 were included. A structured interview was conducted, and a second psychiatric evaluation was scheduled for those who agreed. The frequencies of suicidal thoughts, plans, and attempts during lifetime were 36.7, 18.2, and 12.1%, respectively. The following conditions were strongly associated with suicidal thoughts: anxiety (OR=3.3, 95% CI=1.4-7.5, P=0.001), depression (OR=4.8, 95% CI=1.9-12.5, P=0.001), and two or more standardized psychiatric diagnoses (OR=21.6, 95% CI=4.4-105.9, P<0.0001). Although specific characteristics of epilepsy were found to be related to suicidal thoughts, psychiatric diseases also play an essential role.
    Epilepsy & Behavior 02/2010; 17(4):483-8. · 1.84 Impact Factor
  • European Psychiatry - EUR PSYCHIAT. 01/2010; 25:1347-1347.
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    Lucas Vilas Bôas Magalhães, Paula Teixeira Fernandes, Li Min Li
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    ABSTRACT: INTRODUCTION: Epilepsy is a common neurological condition. Unfortunately there are gaps in knowledge, diagnosis and treatment, and these have impact on economy and psychosocial well being of patients. PURPOSE AND METHODOLOGY: This article discusses the educational aspect of epilepsy, assuming that society in general knows very little about epilepsy, including professionals in general (health, education and social areas), patients and their families. RESULTS AND CONCLUSION: The Education Committee of Brazilian Branch of International League Against Epilepsy aims to promote improvement of knowledge on medical and psychosocial aspects of epilepsy through proposals that can be implemented in order to bring epilepsy out of the shadows.
    Journal of Epilepsy and Clinical Neurophysiology 12/2009; 15(4):172-177.
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    ABSTRACT: To provide information about psychiatric comorbidity and suicidal behavior in people with epilepsy compared to those without epilepsy from a community sample in Brazil. An attempt was made to evaluate all 174 subjects with epilepsy (cases) identified in a previous survey. For every case identified, an individual without epilepsy (control) matched by sex and age was selected in the same neighborhood. A structured interview with validated psychiatric scales was performed. One hundred and fifty-three cases and 154 controls were enrolled in the study. People with epilepsy had anxiety more frequently [39.4% vs. 23.8%, odds ratio (OR) 2.1, 95% confidence interval (CI) 1.2-3.5; p = 0.006], depression (24.4% vs. 14.7%, OR 1.9, 95% CI 1.01-3.5; p = 0.04), and anger (55.6% vs. 39.7%, OR 1.9, 95% CI 1.2-3.1; p = 0.008). They also reported more suicidal thoughts [36.7% vs. 23.8%, OR 1.8, 95% CI 1.1-3.1; p = 0.02), plans (18.2% vs. 3.3%, OR 2.0, 95% CI 1.0-4.0; p = 0.04), and attempts (12.1% vs. 5.3%, OR 2.4, 95% CI 1.1-3.2, p = 0.04) during life than controls. These findings call attention to psychiatric comorbidity and suicidal behavior associated with epilepsy. Suicide risk assessment, mental evaluation, and treatment may improve quality of life in epilepsy and ultimately prevent suicide.
    Epilepsia 11/2009; 51(7):1120-5. · 3.96 Impact Factor
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    ABSTRACT: Computed tomography (CT) images are routinely used to assess ischemic brain stroke in the acute phase. They can provide important clues about whether to treat the patient by thrombolysis with tissue plasminogen activator. However, in the acute phase, the lesions may be difficult to detect in the images using standard visual analysis. The objective of the present study was to determine if texture analysis techniques applied to CT images of stroke patients could differentiate between normal tissue and affected areas that usually go unperceived under visual analysis. We performed a pilot study in which texture analysis, based on the gray level co-occurrence matrix, was applied to the CT brain images of 5 patients and of 5 control subjects and the results were compared by discriminant analysis. Thirteen regions of interest, regarding areas that may be potentially affected by ischemic stroke, were selected for calculation of texture parameters. All regions of interest for all subjects were classified as lesional or non-lesional tissue by an expert neuroradiologist. Visual assessment of the discriminant analysis graphs showed differences in the values of texture parameters between patients and controls, and also between texture parameters for lesional and non-lesional tissue of the patients. This suggests that texture analysis can indeed be a useful tool to help neurologists in the early assessment of ischemic stroke and quantification of the extent of the affected areas.
    Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologicas / Sociedade Brasileira de Biofisica ... [et al.] 10/2009; 42(11):1076-9. · 1.08 Impact Factor
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    ABSTRACT: As a part of national movement of epilepsy in our country, the VII National Meeting of Associations and Support Group of People with Epilepsy was held on March 27th-28th, 2009, in João Pessoa-PB. A training course on epilepsy, offered by ASPE, and lectures regarding medical and psychosocial aspects were ministered. For the epilepsy' associations, the themes emphasized networking on primary care, training courses for the healthy professionals and the creation of a surgical center for epilepsy in João Pessoa. To conclude the event, a Epi-Brasil meeting was held to reinforce the national movement. The major resolutions were: 1. change of board of directors of Epi-Brasil; 2. "Public Policy for epilepsy" was chosen as the central theme of the 2009 campaign; 3. Usage of adequate terms in reference to people or patients with epilepsy, the "epileptic" should not be used. 4. Reinforcement of the EPI-Brasil associations; 5. Continuity in the Conselho Nacional da Saúde; 6. Establishment of the actions to approve Minuta of Ministry of Health that sets a epilepsy program for primary care; 7. The VIII National Meeting of Associations and Support Group of People with Epilepsy will take place in Campinas-SP, during the period of March 19-20th of 2010.
    Journal of Epilepsy and Clinical Neurophysiology 06/2009; 15(2):94-97.
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    ABSTRACT: Experimental animal studies have shown that physical exercise, associated with planning and execution of complex movements, are related to changes in brain structure. In humans, changes in cortical tissue density in relation to physical activity are yet to be fully determined and quantified. We investigated differences on gray matter volume in judo players by using voxel-based morphometry. Comparison between a group of eight internationally competitive judo players and a group of 18 healthy controls showed a significantly higher gray matter tissue density in brain areas of judo players.
    Journal of science and medicine in sport / Sports Medicine Australia. 02/2009; 12(6):688-90.

Publication Stats

349 Citations
56.68 Total Impact Points

Institutions

  • 2004–2012
    • University of Campinas
      • • Instituto de Estudos da Linguagem (IEL)
      • • Faculty of Medical Sciences
      • • Departamento de Neurologia
      Campinas, Estado de Sao Paulo, Brazil
  • 2007
    • São Paulo State University
      • Departamento de Neurologia, Psicologia e Psiquiatria
      São José do Rio Preto, Estado de Sao Paulo, Brazil