Spread of homeopathy in the early nineteenth century: the comparative approach and the cases of Sweden and Brazil / A difusão da homeopatia no início do século XIX: abordagem comparativa e os casos da Suécia e do Brasil

Abstract The comparative approach has been advocated to overcome some flaws inherent to case studies. Here, the spread of homeopathy in the early nineteenth century is addressed through a comparison of the cases of Sweden and Brazil, where homeopathy met diametrically opposed fates. The parameters used for the comparison are the standard for studies on the early spread of homeopathy, such as the concept of the "introducer," and reception by the medical and academic community, the government, and society at large. The results suggest that analysis of contexts, determinants, and the interactions of practitioners and institutions representing different health care approaches, whether dominant or alternative, seems to provide a more accurate picture of different moments in the global history of medicine.

Resumo A abordagem comparativa foi adotada com o intuito de suplantar algumas falhas inerentes aos estudos de caso. Nela, a difusão da homeopatia no início do século XIX é tratada por meio de uma comparação entre casos da Suécia e do Brasil, onde a homeopatia encontrou destinos diametralmente opostos. Os parâmetros usados para a comparação são padrão para estudos sobre o início da expansão da homeopatia, como o conceito de "introdutor", e a aceitação por parte de governo, comunidades médica e acadêmica, e sociedade como um todo. Os resultados sugerem que a análise de contextos, de determinantes, e das interações de médicos e instituições representando diferentes perspectivas de tratamento médico, fossem elas dominantes ou alternativas, parecem oferecer uma análise mais precisa de diferentes momentos da história global da medicina.

Trasplante uterino: resultados actuales. Preparación de un equipo multidisciplinario en Argentina / Uterine transplant: current results. Preparation of a multidisciplinary team in argentina

El factor uterino absoluto como causa de infertilidad, ya sea la ausencia de útero o la presencia de útero no funcional, es actualmente una patología con posibilidad de tratamiento. El primer intento de trasplante uterino en humanos fue en el año 2000, este falló y el útero necrótico tuvo que ser removido luego de 99 días. Este caso pionero inspiró a varios grupos de investigación alrededor del mundo para comenzar estudios en animales para investigar el trasplante uterino en relación a cirugía, inmunosupresión, rechazo y resultados obstétricos. El primer estudio clínico de trasplante uterino comenzó en Suecia en el año 2013 donde se realizaron nueve procedimientos a partir de donantes vivas. El primer nacido vivo en el mundo a partir de un trasplante uterino se reportó en septiembre del año 2014, luego se comunicaron dos nacimientos más en noviembre de ese mismo año. Desde ese momento se han reportado nacimientos de trasplantes uterinos en Suecia, Estados Unidos y Brasil. El caso de nacido vivo en Brasil es el primer y único nacimiento en el mundo cuya donante fue cadavérica. Todos los casos publicados de trasplante uterino y nacidos vivos serán revisados en detalle en este artículo. En el año 2016 se realizó el primer simposio de trasplante uterino en América Latina bajo el auspicio de la Asociación Latinoamericana de Medicina Reproductiva (ALMER). En ese encuentro, el equipo de la Universidad de Gotemburgo, Suecia, compartió su experiencia en trasplante uterino en humanos. Este fue nuestro puntapié para comenzar un trabajo colaborativo entre nuestro equipo en Rosario y el equipo de Suecia, con la intención de preparar un estudio científico de trasplante uterino en Argentina. Los pasos importantes para este procedimiento serán revisados en este artículo (AU)

Absolute uterine factor infertility, due to absence or non-function of the uterus, is now treatable. The first attempt of human uterus transplantation was in year 2000, but it failed and a necrotic uterus had to be removed after 99 days. This pioneering case inspired several research groups around the globe to initiate animal-based studies to investigate uterus transplantation in relation to surgery, immunosuppression, rejection and pregnancy outcome. The first clinical trial of uterus transplantation was initiated in Sweden in 2013 and involved nine live donor procedures. The world ́s first live birth was reported from that trial in September 2014 and this was followed by two more births within the trial in November 2014. Births after uterus transplantation has since then been reported from Sweden, USA and Brazil. The live birth in Brazil is the first and only birth from a deceased donor so far. All published cases of uterus transplantation and the live births will be review in detail.In 2016 there was the first symposium on uterus transplantation in Latin-America under the auspice of ALMER. At the meeting, the Swedish team shared their experiences of human uterus transplantation. This was the starting point for a collaboration work between our team in Rosario and the Swedish team, with the aim to prepare for a scientific trial of uterus transplantation in Argentina. The important steps in this procedure will be reviewed (AU)

Correlations of water iodine concentration to earlier goitre frequency in Sweden-an iodine sufficient country with long-term iodination of table salt

BACKGROUND@#Before iodination of Swedish table salt in 1936, iodine deficiency resulting in goitre and hypothyroidism was common. Sweden has become iodine sufficient, as shown in a national survey in 2007, proving its iodination fortification programme effective for the general population. The objective of this study was to collect drinking water from water treatment plants nationally and test if water iodine concentration (WIC) correlated to urinary iodine concentration (UIC) of school-aged children in a national survey 2007 to former goitre frequency in 1929 and to thyroid volume data in 2007.@*METHODS@#In 2012, 166 treatment plants, located in 57% (166 of 290) of all Swedish municipalities, were asked to collect drinking water samples of approximately 10 ml. In 2007, tap water samples of the same volume were collected from 30 randomly selected schools for the national survey. Analysis of WIC was done in both treatment plants in 2012 (n = 166) and tap water in 2007 (n = 30). The correlation of WIC to the children's UIC and thyroid volume after iodination was tested based on data from the national survey in 2007. The association of WIC to former goitre frequency was tested based on pre-iodination data, derived from a map of goitre frequency drawn in 1929.@*RESULTS@#The median WIC from water treatment plants was 4.0 μg/L (range 0-27 μg/L). WIC was similar in coastal and inland areas, for both ground and surface water. WIC correlated with historical goitre areas and was lower in the goitre areas than in non-goitre areas (p < 0.001). WIC in the same municipalities as the schools correlated with the UIC of children (p < 0.01), but not with their thyroid volume.@*CONCLUSIONS@#WIC still contributes to iodine nutrition in Sweden, but iodination overrides the goitre effect.

The Third Version of the Copenhagen Psychosocial Questionnaire

INTRODUCTION: A new third version of the Copenhagen Psychosocial Questionnaire (COPSOQ III) has been developed in response to trends in working life, theoretical concepts, and international experience. A key component of the COPSOQ III is a defined set of mandatory core items to be included in national short, middle, and long versions of the questionnaire. The aim of the present article is to present and test the reliability of the new international middle version of the COPSOQ III.METHODS: The questionnaire was tested among 23,361 employees during 2016–2017 in Canada, Spain, France, Germany, Sweden, and Turkey. A total of 26 dimensions (measured through scales or single items) of the middle version and two from the long version were tested. Psychometric properties of the dimensions were assessed regarding reliability (Cronbach α), ceiling and floor effects (fractions with extreme answers), and distinctiveness (correlations with other dimensions).RESULTS: Most international middle dimensions had satisfactory reliability in most countries, though some ceiling and floor effects were present. Dimensions with missing values were rare. Most dimensions had low to medium intercorrelations.CONCLUSIONS: The COPSOQ III offers reliable and distinct measures of a wide range of psychosocial dimensions of modern working life in different countries; although a few measures could be improved. Future testing should focus on validation of the COPSOQ items and dimensions using both qualitative and quantitative approaches. Such investigations would enhance the basis for recommendations using the COPSOQ III.

Designing the Sickness Benefit Scheme in South Korea: Using the Implication from Schemes of Advanced Nations / 보건행정학회지

Currently, the South Korean Government does not provide sickness benefits from the National Health Insurance, which is different from most other Organization for Economic Cooperation and Development countries. The sickness benefit guarantees a part of lost income due to injuries or diseases. The purpose of this study is to propose a sickness benefit scheme for South Korea. To this end, we compare health care systems, sickness benefit schemes, and delivery systems of those in Germany, Japan, and Sweden, focusing on the seven categories: management authority, object, level of payment, duration of payment, qualification requirements, connection with paid sick leave of workplace, and financial resources, and as to delivery system, the six categories: the number of procedures, transferring document between institutions, whether or not utilizing electronic reporting system, applicant, and administrative convenience. Based on the implications derived from the case study, we propose the sickness benefit scheme and its delivery pathway and other details for South Korea. This study is first to propose the sickness benefit for health insurance in Korea with its level of details. More studies should follow with case studies of other countries, as well as productive debates to build a feasible and sustainable sickness benefit system in South Korea.

Workplace Diesel Exhausts and Gasoline Exposure and Risk of Colorectal Cancer in Four Nordic Countries

BACKGROUND: Evidence on associations between occupational diesel exhaust and gasoline exposure and colorectal cancer is limited. We aimed to assess the effect of workplace exposure to diesel exhaust and gasoline on the risk of colorectal cancer. METHODS: This caseecontrol study included 181,709 colon cancer and 109,227 rectal cancer cases diagnosed between 1961 and 2005 in Finland, Iceland, Norway, and Sweden. Cases and controls were identified from the Nordic Occupational Cancer Study cohort and matched for country, birth year, and sex. Diesel exhaust and gasoline exposure values were assigned by country-specific job-exposure matrices. Odds ratios and 95% confidence intervals were calculated by using conditional logistic regression models. The results were adjusted for physical strain at work and occupational exposure to benzene, formaldehyde, ionizing radiation, chlorinated hydrocarbons, chromium, and wood dust. RESULTS: Diesel exhaust exposure was associated with a small increase in the risk of rectal cancer (odds ratio 1/4 1.05, 95% confidence interval 1.02–1.08). Gasoline exposure was not associated with colorectal cancer risk. CONCLUSION: This study showed a small risk increase for rectal cancer after workplace diesel exhaust exposure. However, this finding could be due to chance, given the limitations of the study.

IBD2020 global forum: results of an international patient survey on quality of care

BACKGROUND/AIMS: IBD2020 is a global forum for standards of care in inflammatory bowel disease (IBD). The aim of the IBD2020 survey was to identify and describe variations in quality care of IBD. METHODS: Patients with IBD from Finland, Italy, France, Canada, Germany, UK, Spain and Sweden were surveyed during 2013 to 2014, covering: disease characteristics; impact on life and work; organization and perceived quality of care. RESULTS: Seven thousand five hundred and seven patients participated (median age, 39 years [range, 10–103 years]; 2,354 male [31.4%]), including 4,097 (54.6%) with Crohn’s disease (CD) and 3,410 (45.4%) with ulcerative colitis (UC). Median time from symptom onset to diagnosis was 1 year for both CD (range, 0–47 years) and UC (range, 0–46 years), with no clear evidence of improvement in diagnostic delay over the preceding 24 years. Half of the patients (3,429; 50.0%) rated their care as “excellent” or “very good,” with similar results for CD and UC across countries. Five factors were significantly (P < 0.01) associated with perceived good quality of care: quality of specialist communication; review consultation being long enough; failure to share information; no access to a dietician; speed of advice. CONCLUSIONS: The IBD2020 survey has highlighted areas related to quality of care of IBD from the patients’ perspective, with scope for improvement.

Mesothelioma in Sweden: Dose–Response Analysis for Exposure to 29 Potential Occupational Carcinogenic Agents

BACKGROUND: There is little information on the dose–response relationship between exposure to occupational carcinogenic agents and mesothelioma. This study aimed to investigate this association as well as the existence of agents other than asbestos that might cause mesothelioma. METHODS: The Swedish component of the Nordic Occupational Cancer (NOCCA) study consists of 6.78 million individuals with detailed information on occupation. Mesothelioma diagnoses recorded in 1961–2009 were identified through linkage to the Swedish Cancer Registry. We determined cumulative exposure, time of first exposure, and maximum exposure intensity by linking data on occupation to the Swedish NOCCA job-exposure matrix, which includes 29 carcinogenic agents and corresponding exposure for 283 occupations. To assess the risk of mesothelioma, we used conditional logistic regression models to estimate hazard ratiosand 95% confidence intervals. RESULTS: 2,757 mesothelioma cases were identified in males, including 1,416 who were exposed to asbestos. Univariate analyses showed not only a significant excess risk for maximum exposure intensity, with a hazard ratio of 4.81 at exposure levels 1.25–2.0fb/ml but also a clear dose–response effect for cumulative exposure with a 30-, 40-, and 50-year latency time. No convincing excess risk was revealed for any of the other carcinogenic agents included in the Swedish NOCCA job-exposure matrix. CONCLUSION: When considering asbestos exposure, past exposure, even for short periods, might be enough to cause mesothelioma of the pleura later in life.

A novel Australian tick Ixodes (Endopalpiger) australiensis inducing mammalian meat allergy after tick bite

Tick-induced mammalian meat allergy has become an emergent allergy world-wide after van Nunen et al. first described the association between tick bites and the development of mammalian meat allergy in 2007. Cases of mammalian meat allergy have now been reported on all 6 continents where humans are bitten by ticks, in 17 countries

A Lower Level of Physically Demanding Work Is Associated with Excellent Work Ability in Men and Women with Neck Pain in Different Age Groups

BACKGROUND: The aim of this study was to investigate which physical and psychosocial work demands were associated with excellent work ability in individuals with neck pain, and to investigate age and sex differences in these associations. METHODS: The study sample was obtained from the Statistics Sweden cross-sectional Work Environment survey and consisted of workers who reported neck pain after work (N = 3,212). RESULTS: The findings showed an association between excellent work ability and self-reported low exposure to lifting, twisted work posture, working with hands in shoulder level or higher, and leaning forward without support and combination of exposures containing these work demands. Low exposure to seated work and high demands showed a reversed association. The associations were present mainly among older workers and were generally stronger for men than for women. CONCLUSION: This study indicates that a lower level of physically demanding work is an important element to maintain excellent work ability, especially for the older worker with neck pain.

Dacron graft intussusception technique for treatment of type a aortic dissections: technical notes and preliminary results

Abstract Introduction: Optimal surgical management for acute type A aortic dissection (AAAD) remains unclear. The in-hospital mortality rate is still high (15%), and the intraoperative bleeding is an independent risk factor for hospital mortality. Objective: The aim of our study was describe a new method for aortic anastomosis in the repair of AAAD and report the hospital mortality and bleeding complications. Methods: Between January 2008 and November 2014, 24 patients, 16 male, median age 62 years, underwent surgical treatment of AAAD. The surgical technique consisted of intussusception of a Dacron tube in the dissected aorta, which is anastomosed with a first line of 2-0 polyester everting mattress suture and a second line of 3-0 polypropylene running suture placed at the outermost side. Open distal anastomosis was performed with bilateral selective antegrade cerebral perfusion in 13 (54.1%) patients. Results: Cardiopulmonary bypass and aortic clamping time ranged from 75 to 135 min (mean=85 min) and 60 to 100 min (mean=67 min), respectively. The systemic circulatory arrest ranged from 29 to 60 min (mean=44.5 min). One (4.1%) patient required reoperation for bleeding, due to the use of preoperative clopidogrel. The postoperative bleeding was 382-1270 ml (mean=654 ml). We used an average of 4.2 units of red blood cells/patient. There were two (8.3%) hospital deaths, one due to intraoperative bleeding and another due to mesenteric ischemia. The average length of stay in the intensive care unit and hospital was 44 hours and 6.7 days, respectively. Conclusion: This new method for surgical correction of AAAD was reproducible and resulted in satisfactory clinical outcomes.

Availability of Total Knee Arthroplasty Implants for Metal Hypersensitivity Patients

PURPOSE: To provide information on the type of “hypersensitivity-friendly” components available for primary total knee arthroplasty (TKA) in the current market. MATERIALS AND METHODS: Implant manufactures were identified using the 2013 National Joint Registries of the United Kingdom and Sweden and contacted to obtain information about the products they offer for patients with metal hypersensitivity. RESULTS: Information on 23 TKA systems was provided by 13 implant manufacturers. Of these, 15 systems had options suitable for metal hypersensitivity patients. Two types of “hypersensitivity-friendly” components were identified: 10 implants were cobalt chrome prostheses with a “hypersensitivity-friendly” outer coating and 5 implants were made entirely from non-cobalt chrome alloys. CONCLUSIONS: The results of this study suggest that several hypersensitivity TKA options exist, some of which provide the same designs and surgical techniques as the conventional implants. The information in this study can guide TKA surgeons in making informed choices about implants and identifying implants that could be examined in future controlled studies comparing outcomes between “hypersensitivity-friendly” and conventional implants.

Occupation and mesothelioma in Sweden: updated incidence in men and women in the 27 years after the asbestos ban / 한국역학회지

OBJECTIVES: We updated the Swedish component of the Nordic Occupational Cancer (NOCCA) Study through 2009 in order to investigate the incidence of mesothelioma of the peritoneum and pleura in both genders, and explored occupational exposures that may be associated with mesothelioma. METHODS: The Swedish component of the NOCCA Study includes 6.78 million individuals. Data from this cohort were linked to the population-based Swedish Cancer Registry and Swedish Total Population Registry for three periods between 1961 and 2009, and then further linked to the Swedish NOCCA job-exposure matrix, which includes 25 carcinogenic substances and the corresponding exposure levels for 280 occupations. Multivariate analysis was used to calculate standardized incidence ratios (SIRs) for mesothelioma of the peritoneum and pleura by gender, occupational category, carcinogenic substance, and for multiple occupational exposures simultaneously. RESULTS: A total of 3,716 incident mesotheliomas were recorded (21.1% in women). We found a significantly increased risk of mesothelioma in 24 occupations, as well as clear differences between the genders. Among men, increased risks of mesothelioma of the pleura were observed in male-dominated occupations, with the greatest elevation of risk among plumbers (SIR, 4.99; 95% confidence interval, 4.20 to 5.90). Among women, increased risks were observed in sewing workers, canning workers, packers, cleaners, and postal workers. In multivariate analysis controlling for multiple occupational exposures, significant associations were only observed between asbestos exposure and mesothelioma. CONCLUSIONS: Asbestos exposure was associated with mesothelioma incidence in our study. The asbestos ban of 1982 has yet to show any clear effect on the occurrence of mesothelioma in this cohort. Among women, the occupations of canning workers and cleaners showed increased risks of mesothelioma of the pleura without evidence of asbestos exposure.

Aspectos institucionais, legais, políticos e técnicos para a implementação da Convenção de Estocolmo sobre Poluentes Orgânicos Persistentes: os éteres difenilícos polibromados / Institutional, legal, political and technical aspects for the Stockholm Convention on Persistent Organic Pollutants Implementation the polybrominated diphenyl ethers

Novos poluentes orgânicos persistentes (POPs) têm sido adicionados à lista da Convenção de Estocolmo, exemplificado nesta pesquisa pelos éteres difenílicos polibromados (polybrominated diphenyl ethers-PBDEs) aplicados como retardantes de chama em diversos artigos de consumo (eletrônicos, têxteis, móveis, automóveis e na construção civil). São substâncias semi voláteis, persistentes no ambiente, bioacumulativos nos tecidos adiposos e podem interferir no sistema endócrino humano e dos animais. Os países signatários devem cumprir as medidas estabelecidas e enfrentam desafios para a sua implementação, a julgar pelos poucos países que atualizaram os Planos Nacionais de Implementação (National Implementation Plans-NIPs). Esta pesquisa teve por objetivo identificar os aspectos institucionais, legais, políticos e técnicos para a implementação das exigências oriundas da Convenção de Estocolmo, no que diz respeito aos PBDEs, realizar revisão sistematizada da literatura sobre os artigos colocados no mercado e em unidades de reciclagem de resíduos contendo PBDE e apresentar as experiências de dois países na implementação das medidas. O método de pesquisa de estudo de casos comparados, com o delineamento de casos mais diferentes com o mesmo resultado, foi empregado para a República Tcheca e a Suécia, apoiado por análise de congruência. Entrevistas foram realizadas com profissionais envolvidos com as atividades para a elaboração e a implementação da Convenção de Estocolmo. A revisão sistematizada para PBDEs indicou o aumento da quantidade de artigos científicos a partir de 2008 e os estudos revelaram a presença de PBDEs na poeira e no ar em ambientes internos, como residências e escritórios e nos ambientes internos e externos às instalações de reciclagem de resíduos com avaliação da exposição humana aos PBDEs, e novos estudos devem ser desenvolvidos. A revisão mostrou também que na América Latina e Caribe as publicações ainda são em pequeno número, mas o Brasil tem posição de destaque. O estudo dos dois países revelou que é requerida uma complexa abordagem para a transposição das medidas em âmbito nacional, incluindo legislação sobre gestão de produtos químicos, arranjos institucionais nacionais para a implementação do NIP apoiados por instituições de pesquisas científicas, existência de programas de monitoramento ambiental e de controle de POP-BDEs em artigos de consumo colocados no mercado. Os principais desafios técnicos são a segregação de plásticos, contendo PBDEs em parceria com o setor industrial para identificar o conteúdo PBDEs em artigos em uso que se tornarão resíduos e a viabilização do uso das alternativas tecnológicas. Os benefícios gerados pela implementação da Convenção são a proteção da saúde humana e do meio ambiente, a melhoria da governança, a promoção de assistência técnica, a maior visibilidade sobre riscos de uso de produtos tóxicos, em especial os POPs, a maior interação entre a ciência e as políticas públicas e o aumento das pesquisas cientificas. A Convenção de Estocolmo é um acordo complexo porém contribui com o entendimento mais amplo dos riscos químicos e sobre gestão coordenada das substâncias químicas

Additional new Persistent Organic Pollutants (POPs) have been included to the list of Stockholm Convention, in the research exemplified by means of polybrominated diphenyl ethers (PBDEs) which resist degradation, are transported far from their place of release, where they accumulate in terrestrial and aquatic ecosystems and possess toxic properties, since they are classified as endocrine disruptive chemicals. They were used as brominated flame retardants and applied in many articles/consumer products such as electronics, textiles, vehicles, furniture and building materials. The signatories countries must comply with obligations and measures taken by Convention however they are facing many challenges in order to implement them, once few countries submitted the updated National Implementation Plans (NIPs) to the Convention. This research aims at identifying the institutional, legal, technical and politics aspects in order to transpose those measures to the national level, conducting a systematized research of literature on consumer products that may contain c-BDE put in the market besides recycling units of articles upon becoming wastes, consisting of, containing or contaminated with a chemical PBDEs and presenting the experience of two countries in implementing PBDEs actions plans of the NIPs. The comparative case studies was used as the research method, improved by the most different cases and most similar outcomes, designed for two countries as Czech Republic and Sweden, supported by the congruence analyses. Standardized interviews were applied to professionals involved in elaborating and implementing the Stockholm Convention in the countries. The systematized research indicated the increase from 2008 of the scientific number articles related to PBDEs which presented the occurrence of PBDEs in indoor house, office and recycling units dust and air internal and outdoor environments nearby waste electronic and electric equipment recycling units, with human exposure analyses related to and the researches must be continued, accordingly the conclusions. The comparative case studies of two countries revealed the requirement of a complex chemical substances management approach in order to transpose the PBDEs obligations to the national level, including the industrial chemical and environmental legislations, especially on POP-BDEs in products, a integrated institutional arrangement with the scientific institutional support, environmental monitoring programs and chemical control of the spread of POP-BDEs substances present in a number of consumer products put on the market; as the main challenges are the segregation of plastics containing PBDE in order to avoid recycled articles containing PBDEs and the importance of dialogue with the industrial sector in order to identify the PBDEs content in articles in use and to evaluate technology alternatives to PBDEs as well as promote technical capacities to raise awareness of chemicals to importers and private sector. The benefits generated by the Convention implementation are protection on healthy and environmental, the governance improvement, technical assistance promotion, POPs visibility, science and politics integration and the increase of scientific research

Validity and reliability of the Brazilian Portuguese version of the BACS (Brief Assessment of Cognition in Schizophrenia)

OBJECTIVE: To assess the validity and reliability of the Brazilian Portuguese version of the Brief Assessment of Cognition in Schizophrenia by examining its temporal stability, internal consistency, and discriminant and convergent validity. METHODS: The Brief Assessment of Cognition in Schizophrenia was administered to 116 stable patients with schizophrenia and 58 matched control subjects. To assess concurrent validity, a subset of patients underwent a traditional neuropsychological assessment. RESULTS: The patients with schizophrenia performed significantly worse than the controls (p<0.001) on all subtests of the Brief Assessment of Cognition in Schizophrenia and on the total score, which attests to the discriminant validity of the test. The global score of the Brief Assessment of Cognition in Schizophrenia was significantly correlated with all of the subtests and with the global score for the standard battery. The Brief Assessment of Cognition in Schizophrenia also had good test-retest reliability (rho>0.8). The internal consistency of the Brief Assessment of Cognition in Schizophrenia was high (Cronbach's α  ϝ 0.874). CONCLUSION: The Brazilian Portuguese version of the Brief Assessment of Cognition in Schizophrenia exhibits good reliability and discriminant and concurrent validity and is a promising tool for easily assessing cognitive impairment in schizophrenia and for comparing the performance of Brazilian patients with that of patients from other countries. .