scholarly journals Home Environment as a Predictor of Long-Term Executive Functioning following Early Childhood Traumatic Brain Injury

2017 ◽  
Vol 24 (1) ◽  
pp. 11-21 ◽  
Author(s):  
Christianne Laliberté Durish ◽  
Keith Owen Yeates ◽  
Terry Stancin ◽  
H. Gerry Taylor ◽  
Nicolay C. Walz ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Early Childhood ◽  
Brain Injury ◽  
Executive Functioning ◽  
Home Environment ◽  
Group Differences ◽  
Severe Tbi

AbstractObjectives:This study examined the relationship of the home environment to long-term executive functioning (EF) following early childhood traumatic brain injury (TBI).Methods:Participants (N=134) were drawn from a larger parent study of 3- to 6-year-old children hospitalized for severe TBI (n=16), complicated mild/moderate TBI (n=44), or orthopedic injury (OI;n=74), recruited prospectively at four tertiary care hospitals in the United States and followed for an average of 6.8 years post-injury. Quality of the home environment, caregiver psychological distress, and general family functioning were assessed shortly after injury (i.e., early home) and again at follow-up (i.e., late home). Participants completed several performance-based measures of EF at follow-up. Hierarchical regression analyses examined the early and late home environment measures as predictors of EF, both as main effects and as moderators of group differences.Results:The early and late home environment were inconsistent predictors of long-term EF across groups. Group differences in EF were significant for only the TEA-Ch Walk/Don’t Walk subtest, with poorer performance in the severe TBI group. However, several significant interactions suggested that the home environment moderated group differences in EF, particularly after complicated mild/moderate TBI.Conclusions:The home environment is not a consistent predictor of long-term EF in children with early TBI and OI, but may moderate the effects of TBI on EF. The findings suggest that interventions designed to improve the quality of stimulation in children’s home environments might reduce the long-term effects of early childhood TBI on EF. (JINS, 2018,24, 11–21)

Long-term outcomes and prognostic factors in pediatric patients with severe traumatic brain injury and elevated intracranial pressure

2008 ◽  
Vol 2 (4) ◽  
pp. 240-249 ◽  
Author(s):  
Jay Jagannathan ◽  
David O. Okonkwo ◽  
Hian Kwang Yeoh ◽  
Aaron S. Dumont ◽  
Dwight Saulle ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Intracranial Pressure ◽  
Pediatric Patients ◽  
Elevated Intracranial Pressure ◽  
The Mean

Object The management strategies and outcomes in pediatric patients with elevated intracranial pressure (ICP) following severe traumatic brain injury (TBI) are examined in this study. Methods This study was a retrospective review of a prospectively acquired pediatric trauma database. More than 750 pediatric patients with brain injury were seen over a 10-year period. Records were retrospectively reviewed to determine interventions for correcting ICP, and surviving patients were contacted prospectively to determine functional status and quality of life. Only patients with 2 years of follow-up were included in the study. Results Ninety-six pediatric patients (age range 3–18 years) were identified with a Glasgow Coma Scale score < 8 and elevated ICP > 20 mm Hg on presentation. The mean injury severity score was 65 (range 30–100). All patients were treated using a standardized head injury protocol. The mean time course until peak ICP was 69 hours postinjury (range 2–196 hours). Intracranial pressure control was achieved in 82 patients (85%). Methods employed to achieve ICP control included maximal medical therapy (sedation, hyperosmolar therapy, and paralysis) in 34 patients (35%), ventriculostomy in 23 patients (24%), and surgery in 39 patients (41%). Fourteen patients (15%) had refractory ICP despite all interventions, and all of these patients died. Seventy-two patients (75%) were discharged from the hospital, whereas 24 (25%) died during hospitalization. Univariate and multivariate analysis revealed that the presence of vascular injury, refractory ICP, and cisternal effacement at presentation had the highest correlation with subsequent death (p < 0.05). Mean follow-up was 53 months (range 11–126 months). Three patients died during the follow-up period (2 due to infections and 1 committed suicide). The mean 2-year Glasgow Outcome Scale score was 4 (median 4, range 1–5). The mean patient competency rating at follow-up was 4.13 out of 5 (median 4.5, range 1–4.8). Univariate analysis revealed that the extent of intracranial and systemic injuries had the highest correlation with long-term quality of life (p < 0.05). Conclusions Controlling elevated ICP is an important factor in patient survival following severe pediatric TBI. The modality used for ICP control appears to be less important. Long-term follow-up is essential to determine neurocognitive sequelae associated with TBI.

scholarly journals Catechol-O-Methyltransferase Genotypes and Parenting Influence on Long-Term Executive Functioning After Moderate to Severe Early Childhood Traumatic Brain Injury

2017 ◽  
Vol 32 (6) ◽  
pp. 404-412 ◽  
Author(s):  
Brad G. Kurowski ◽  
Amery Treble-Barna ◽  
Huaiyu Zang ◽  
Nanhua Zhang ◽  
Lisa J. Martin ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Early Childhood ◽  
Brain Injury ◽  
Executive Functioning

scholarly journals The pattern of hospital-community-home (HCH) nursing in tracheostomy patients with severe traumatic brain injury: is it feasible?

2020 ◽  
Author(s):  
Xiangyi Yin ◽  
Jie Wu ◽  
Lihui Zhou ◽  
Chunyan Ni ◽  
Minyan Xiao ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Nursing Care ◽  
Severe Traumatic Brain Injury ◽  
Barthel Index ◽  
Control Group ◽  
Term Care ◽  
Severe Tbi

Abstract Background: Tracheostomy is very common in patients with severe traumatic brain injury (TBI), and long-term nursing care are needed for those patients. We aimed to evaluate the effects of hospital-community-home (HCH) nursing in those patients. Methods: Tracheostomy patients with severe TBI needing long-term care were included. All patients underwent two months long follow-up. Glasgow coma score (GCS), Karnofsky, Self-Anxiety Scale (SAS) (SAS) and Barthel assessment at the discharge and two months after discharge were evaluated. The tracheostomy related complications were recorded and compared.Results: A total of 60 patients were included. There weren’t significant differences between two groups in the GCS, Karnofsky, SAS and Barthel index at discharge((all p>0.05), the GCS, Karnofsky and Barthel index was all significantly increased after two months follow-up for two groups (all p<0.05), and the GCS, Karnofsky and Barthel index at two months follow-up in HCH group was significantly higher than that of control group(all p<0.05), but the SAS at two months follow-up in HCH group was significantly less than that of control group(p=0.009). The incidence of block of artificial tracheal cannula and readmission in HCH group were significant less than that of control group (all p<0.05).Conclusion: HCH nursing care is feasible in tracheostomy patients with severe TBI, future studies are needed to further evaluate the role of HCH nursing care.

Catechol-O-Methyltransferase Genotypes and Parenting Influence Long-term Executive Functioning after Early Childhood Traumatic Brain Injury

2015 ◽  
Vol 96 (10) ◽  
pp. e2-e3 ◽  
Author(s):  
Brad Kurowski ◽  
Amery Treble-Barna ◽  
Huaiyu Zang ◽  
Nanhua Zhang ◽  
Keith Yeates ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Early Childhood ◽  
Brain Injury ◽  
Executive Functioning

scholarly journals The pattern of hospital-community-home (HCH) nursing in tracheostomy patients with severe traumatic brain injury: is it feasible?

2020 ◽  
Author(s):  
Xiangyi Yin ◽  
Jie Wu ◽  
Lihui Zhou ◽  
Chunyan Ni ◽  
Minyan Xiao ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Nursing Care ◽  
Severe Traumatic Brain Injury ◽  
Barthel Index ◽  
Control Group ◽  
Severe Tbi

Abstract Background Tracheostomy is very common in patients with severe traumatic brain injury (TBI), and long-term nursing care are needed for those patients. We aimed to evaluate the effects of hospital-community-home (HCH) nursing in those patients. Methods Tracheostomy patients with severe TBI were included. Glasgow coma score (GCS), Karnofsky, Self-Anxiety Scale (SAS) and Barthel assessment at the discharge and two months after discharge were evaluated. Results A total of 60 patients were included. There weren’t significant differences between two groups in the GCS, Karnofsky, SAS and Barthel index at discharge((all p > 0.05), the GCS, Karnofsky and Barthel index was all significantly increased after two months follow-up for two groups (all p < 0.05), and the GCS, Karnofsky and Barthel index at two months follow-up in HCH group was significantly higher than that of control group(all p < 0.05), but the SAS at two months follow-up in HCH group was significantly less than that of control group(p = 0.009). The incidence of block of artificial tracheal cannula and readmission in HCH group were significant less than that of control group (all p < 0.05). Conclusion HCH nursing care is feasible in tracheostomy patients with severe TBI, future studies are needed to further evaluate the role of HCH nursing care.

Self-awareness four years after severe traumatic brain injury: discordance between the patient’s and relative’s complaints. Results from the PariS-TBI study

2017 ◽  
Vol 32 (5) ◽  
pp. 692-704 ◽  
Author(s):  
Camille Chesnel ◽  
Claire Jourdan ◽  
Eleonore Bayen ◽  
Idir Ghout ◽  
Emmanuelle Darnoux ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Severe Traumatic Brain Injury ◽  
Significant Relationship ◽  
Injury Severity ◽  
Chronic Phase ◽  
Functional Independence ◽  
Severe Tbi

Objective: To evaluate the patient’s awareness of his or her difficulties in the chronic phase of severe traumatic brain injury (TBI) and to determine the factors related to poor awareness. Design/Setting/Subjects: This study was part of a larger prospective inception cohort study of patients with severe TBI in the Parisian region (PariS-TBI study). Intervention/Main measures: Evaluation was carried out at four years and included the Brain Injury Complaint Questionnaire (BICoQ) completed by the patient and his or her relative as well as the evaluation of impairments, disability and quality of life. Results: A total of 90 patient-relative pairs were included. Lack of awareness was measured using the unawareness index that corresponded to the number of discordant results between the patient and relative in the direction of under evaluation of difficulties by the patient. The only significant relationship found with lack of awareness was the subjective burden perceived by the relative (Zarit Burden Inventory) ( r = 0.5; P < 0.00001). There was no significant relationship between lack of awareness and injury severity, pre-injury socio-demographic data, cognitive impairments, mood disorders, functional independence (Barthel index), global disability (Glasgow Outcome Scale), return to work at four years or quality of life (Quality Of Life after Brain Injury scale (QOLIBRI)). Conclusion: Lack of awareness four years post severe TBI was not related to the severity of the initial trauma, sociodemographic data, the severity of impairments, limitations of activity and participation, or the patient’s quality of life. However, poor awareness did significantly influence the weight of the burden perceived by the relative.

scholarly journals Does Apolipoprotein e4 Status Moderate the Association of Family Environment with Long-Term Child Functioning following Early Moderate to Severe Traumatic Brain Injury? A Preliminary Study

2016 ◽  
Vol 22 (8) ◽  
pp. 859-864 ◽  
Author(s):  
Amery Treble-Barna ◽  
Huaiyu Zang ◽  
Nanhua Zhang ◽  
Lisa J. Martin ◽  
Keith Owen Yeates ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Executive Functioning ◽  
Parenting Style ◽  
Family Environment ◽  
Adaptive Functioning ◽  
Behavioral Adjustment ◽  
Child Functioning ◽  
E4 Allele

AbstractObjectives:To examine whether apolipoprotein e4 (APOE) status moderates the association of family environment with child functioning following early traumatic brain injury (TBI).Methods:Sixty-five children with moderate to severe TBI and 70 children with orthopedic injury (OI) completed assessments 6, 12, 18 months, and 3.5 and 6.8 years post injury. DNA was extracted from saliva samples and genotyped for APOE e4 status. Linear mixed models examined moderating effects of APOE e4 status on associations between two family environment factors (parenting style, home environment) and three child outcomes (executive functioning, behavioral adjustment, adaptive functioning).Results:Children with TBI who were carriers of the e4 allele showed poorer adaptive functioning relative to non-carriers with TBI and children with OI in the context of low authoritarianism. At high levels of authoritarianism, non-carriers with TBI showed the poorest adaptive functioning among groups. There were no main effects or interactions involving APOE and executive functioning or behavioral adjustment.Conclusions:The APOE e4 allele was detrimental for long-term adaptive functioning in the context of positive parenting, whereas in less optimal parenting contexts, being a non-carrier was detrimental. We provide preliminary evidence for an interaction of APOE e4 status and parenting style in predicting long-term outcomes following early TBI. (JINS, 2016,22, 859–864)

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