scholarly journals Impact of “Sick” and “Recovery” Roles on Brain Injury Rehabilitation Outcomes

2012 ◽  
Vol 2012 ◽  
pp. 1-10
Author(s):  
David A. Barclay
Keyword(s):  
Brain Injury ◽  
Goal Attainment ◽  
Program Planning ◽  
Psychosocial Distress ◽  
Brief Symptom Inventory ◽  
Bivariate Analysis ◽  
Future Research ◽  
Sick Role ◽  
Shared Variance ◽  
The Impact

This study utilizes a multivariate, correlational, expost facto research design to examine Parsons’ “sick role” as a dynamic, time-sensitive process of “sick role” and “recovery role” and the impact of this process on goal attainment (H1) and psychosocial distress (H2) of adult survivors of acquired brain injury. Measures used include the Brief Symptom Inventory-18, a Goal Attainment Scale, and an original instrument to measure sick role process. 60 survivors of ABI enrolled in community reentry rehabilitation participated. Stepwise regression analyses did not fully support the multivariate hypotheses. Two models emerged from the stepwise analyses. Goal attainment, gender, and postrehab responsibilities accounted for 40% of the shared variance of psychosocial distress. Anxiety and depression accounted for 22% of the shared variance of goal attainment with anxiety contributing to the majority of the explained variance. Bivariate analysis found sick role variables, anxiety, somatization, depression, gender, and goal attainment as significant. The study has implications for ABI rehabilitation in placing greater emphasis on sick role processes, anxiety, gender, and goal attainment in guiding program planning and future research with survivors of ABI.

Early versus Late Tracheostomy: Is There an Outcome Difference?

2019 ◽  
Vol 85 (4) ◽  
pp. 370-375 ◽  
Author(s):  
Adel Elkbuli ◽  
Raed Ismail Narvel ◽  
Paul J. Spano ◽  
Valerie Polcz ◽  
Astrid Casin ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Glasgow Coma Scale ◽  
Primary Outcome ◽  
Injury Severity ◽  
Future Research ◽  
Trauma Patients ◽  
Early Tracheostomy ◽  
Outcome Difference ◽  
The Impact

The effect of timing in patients requiring tracheostomy varies in the literature. The purpose of this study was to evaluate the impact of early tracheostomy on outcomes in trauma patients with and without traumatic brain injury (TBI). This study is a four-year review of trauma patients undergoing tracheostomy. Patients were divided into two groups based on TBI/non-TBI. Each group was divided into three subgroups based on tracheostomy timing: zero to three days, four to seven days, and greater than seven days postadmission. TBI patients were stratified by the Glasgow Coma Scale (GCS), and non-TBI patients were stratified by the Injury Severity Score (ISS). The primary outcome was ventilator-free days (VFDs). Significance was defined as P < 0.05. Two hundred eighty-nine trauma patients met the study criteria: 151 had TBI (55.2%) versus 138 (47.8%) non-TBI. There were no significant differences in demographics within and between groups. In TBI patients, statistically significant increases in VFDs were observed with GCS 13 to 15 for tracheostomies performed in four to seven versus greater than seven days ( P = 0.005). For GCS <8 and 8 to 12, there were significant increases in VFDs for tracheostomies performed at days 1 to 3 and 4 to 7 versus greater than seven days (P << 0.05 for both). For non-TBI tracheostomies, only ISS ≥ 25 with tracheostomies performed at zero to three days versus greater than seven days was associated with improved VFDs. Early tracheostomies in TBI patients were associated with improved VFDs. In trauma patients with no TBI, early tracheostomy was associated with improved VFDs only in patients with ISS ≥ 25. Future research studies should investigate reasons TBI and non-TBI patients may differ.

scholarly journals In-Hospital Mortality Following Traumatic Brain Injury Among Older Medicare Beneficiaries, Comparing Statin Users With Nonusers

2017 ◽  
Vol 33 (6) ◽  
pp. 225-236 ◽  
Author(s):  
Bilal Khokhar ◽  
Linda Simoni-Wastila ◽  
Julia F. Slejko ◽  
Eleanor Perfetto ◽  
Min Zhan ◽  
...  
Keyword(s):  
Older Adults ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Hospital Mortality ◽  
Health Concern ◽  
Future Research ◽  
Small Scale ◽  
Medicare Beneficiaries ◽  
The Impact ◽  
Statin Use

Background: Traumatic brain injury (TBI) is a significant public health concern for older adults. Small-scale human studies have suggested pre-TBI statin use is associated with decreased in-hospital mortality following TBI, highlighting the need for large-scale translational research. Objective: To investigate the relationship between pre-TBI statin use and in-hospital mortality following TBI. Methods: A retrospective study of Medicare beneficiaries 65 and older hospitalized with a TBI during 2006 to 2010 was conducted to assess the impact of pre-TBI statin use on in-hospital mortality following TBI. Exposure of interest included atorvastatin, fluvastatin, lovastatin, pravastatin, rosuvastatin, and simvastatin. Beneficiaries were classified as current, recent, past, and nonusers of statins prior to TBI. The outcome of interest was in-hospital mortality. Logistic regression was used to obtain odds ratios (ORs) and 95% confidence intervals (CIs) comparing current, recent, and prior statin use to nonuse. Results: Most statin users were classified as current users (90%). Current atorvastatin (OR = 0.88; 95% = CI 0.82, 0.96), simvastatin (OR = 0.84; 95% CI = 0.79, 0.91), and rosuvastatin (OR = 0.79; 95% CI = 0.67, 0.94) use were associated with a significant decrease in the risk of in-hospital mortality following TBI. Conclusions: In addition to being the most used statins, current use of atorvastatin, rosuvastatin, and simvastatin was associated with a significant decrease in in-hospital mortality following TBI among older adults. Future research must include clinical trials to help exclude the possibility of a healthy user effect in order to better understand the impact of statin use on in-hospital mortality following TBI.

A Clinical Approach to Neuromuscular Electrical Stimulation for Speech and Swallow in an Acute Rehabilitation Facility

2019 ◽  
Vol 4 (5) ◽  
pp. 1044-1048
Author(s):  
Melissa M. Howard ◽  
Emily R. Rosario
Keyword(s):  
Electrical Stimulation ◽  
Brain Injury ◽  
Patient Population ◽  
Neuromuscular Electrical Stimulation ◽  
Inpatient Rehabilitation ◽  
Future Research ◽  
Clinical Approach ◽  
Rehabilitation Facility ◽  
Acute Rehabilitation ◽  
The Impact

Purpose Neuromuscular Electrical Stimulation (NMES) is a widely used treatment modality for dysphagia therapy despite the inconclusive evidence of its effectiveness. Our objective was to complete a retrospective review to analyze the results of NMES with our patient population in an acute rehabilitation facility. In this clinical focus article, we briefly review the current literature on NMES, discuss a clinical protocol of NMES use in an inpatient rehabilitation hospital, and discuss the need for future research in this area. Conclusions As with much of the NMES literature, we observed improvement in the ability to swallow following a cerebrovascular accident and traumatic brain injury when a combination of swallowing therapy and NMES treatment was used. Although this combination works for our patients to improve swallow function, the impact of swallow therapy alone remains unclear. Further investigative research to clarify NMES protocols and patient population is needed to optimize results. Therefore, a large randomized clinical trial would be beneficial to clearly define the role of NMES in recovery of swallowing ability following a brain injury.

scholarly journals Assessing the Robustness of Mediation Analysis Results Using Multiverse Analysis

2021 ◽  
Author(s):  
Judith J. M. Rijnhart ◽  
Jos W. R. Twisk ◽  
Dorly J. H. Deeg ◽  
Martijn W. Heymans
Keyword(s):  
Mediation Analysis ◽  
Statistical Significance ◽  
Empirical Studies ◽  
Real Life ◽  
Total Effect ◽  
Bivariate Analysis ◽  
Future Research ◽  
Analysis Methodology ◽  
Study Results ◽  
The Impact

AbstractThere is an increasing awareness that replication should become common practice in empirical studies. However, study results might fail to replicate for various reasons. The robustness of published study results can be assessed using the relatively new multiverse-analysis methodology, in which the robustness of the effect estimates against data analytical decisions is assessed. However, the uptake of multiverse analysis in empirical studies remains low, which might be due to the scarcity of guidance available on performing multiverse analysis. Researchers might experience difficulties in identifying data analytical decisions and in summarizing the large number of effect estimates yielded by a multiverse analysis. These difficulties are amplified when applying multiverse analysis to assess the robustness of the effect estimates from a mediation analysis, as a mediation analysis involves more data analytical decisions than a bivariate analysis. The aim of this paper is to provide an overview and worked example of the use of multiverse analysis to assess the robustness of the effect estimates from a mediation analysis. We showed that the number of data analytical decisions in a mediation analysis is larger than in a bivariate analysis. By using a real-life data example from the Longitudinal Aging Study Amsterdam, we demonstrated the application of multiverse analysis to a mediation analysis. This included the use of specification curves to determine the impact of data analytical decisions on the magnitude and statistical significance of the direct, indirect, and total effect estimates. Although the multiverse analysis methodology is still relatively new and future research is needed to further advance this methodology, this paper shows that multiverse analysis is a useful method for the assessment of the robustness of the direct, indirect, and total effect estimates in a mediation analysis and thereby to inform replication studies.

scholarly journals The Emotional Experience behind Sexually Offending in Context

2017 ◽  
Vol 55 (2) ◽  
pp. 242-277 ◽  
Author(s):  
Benoit Leclerc ◽  
Marie Rosenkrantz Lindegaard
Keyword(s):  
Sexual Offenders ◽  
Emotional Experience ◽  
Affective State ◽  
Self Report ◽  
Bivariate Analysis ◽  
Future Research ◽  
Affective States ◽  
Sexual Crime ◽  
The Impact ◽  
Crime Event

Objectives: The current study focused on the role of affective states in adult sexual offending. We look at the prevalence of a range of affective states throughout sexual crime events. We break down the crime event into three stages—immediately before, during, and after the offense. We examine transitions of affective states—stage by stage—but also across victims. Finally, we investigate the impact of situational factors on affective states. Method: The sample consisted of a total of 553 adult males who had been convicted of a sexual offense. Self-report data on sexual crime events were collected from these offenders. Apart from descriptive and bivariate analysis, “affective state-switching patterns” are investigated through transition matrices. Results: Findings show large variations in affective states before, during, and after the offense but show little variation across victims. Alcohol usage and offender–victim relationship were related to affective states of offenders. Conclusions: We conclude that the found association between affective states and decision-making of sexual offenders calls for more research on within crime event variations especially, and future research should focus on causal mechanisms related to affective states.

scholarly journals A Pro-social Pill? The Potential of Pharmacological Treatments to Improve Social Outcomes After Pediatric Traumatic Brain Injury

2021 ◽  
Vol 12 ◽  
Author(s):  
Bridgette D. Semple ◽  
Ramesh Raghupathi
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Social Behavior ◽  
Early Life ◽  
Brain Injuries ◽  
Time Window ◽  
Therapeutic Interventions ◽  
Future Research ◽  
Clinical Literature ◽  
The Impact

Traumatic brain injury (TBI) is a leading cause of injury-induced disability in young children worldwide, and social behavior impairments in this population are a significant challenge for affected patients and their families. The protracted trajectory of secondary injury processes triggered by a TBI during early life—alongside ongoing developmental maturation—offers an extended time window when therapeutic interventions may yield functional benefits. This mini-review explores the scarce but promising pre-clinical literature to date demonstrating that social behavior impairments after early life brain injuries can be modified by drug therapies. Compounds that provide broad neuroprotection, such as those targeting neuroinflammation, oxidative stress, axonal injury and/or myelination, may prevent social behavior impairments by reducing secondary neuropathology. Alternatively, targeted treatments that promote affiliative behaviors, exemplified by the neuropeptide oxytocin, may reduce the impact of social dysfunction after pediatric TBI. Complementary literature from other early life neurodevelopmental conditions such as hypoxic ischemic encephalopathy also provides avenues for future research in neurotrauma. Knowledge gaps in this emerging field are highlighted throughout, toward the goal of accelerating translational research to support optimal social functioning after a TBI during early childhood.

scholarly journals Spatial Neglect Hinders Success of Inpatient Rehabilitation in Individuals With Traumatic Brain Injury

2015 ◽  
Vol 30 (5) ◽  
pp. 451-460 ◽  
Author(s):  
Peii Chen ◽  
Irene Ward ◽  
Ummais Khan ◽  
Yan Liu ◽  
Kimberly Hreha
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Length Of Stay ◽  
Current Knowledge ◽  
Inpatient Rehabilitation ◽  
Functional Independence ◽  
Spatial Neglect ◽  
Future Research ◽  
Discharge Disposition ◽  
The Impact

Background. Current knowledge about spatial neglect and its impact on rehabilitation mostly originates from stroke studies. Objective. To examine the impact of spatial neglect on rehabilitation outcome in individuals with traumatic brain injury (TBI). Methods. The retrospective study included 156 consecutive patients with TBI (73 women; median age = 69.5 years; interquartile range = 50-81 years) at an inpatient rehabilitation facility (IRF). We examined whether the presence of spatial neglect affected the Functional Independence Measure (FIM) scores, length of stay, or discharge disposition. Based on the available medical records, we also explored whether spatial neglect was associated with tactile sensation or muscle strength asymmetry in the extremities and whether specific brain injuries or lesions predicted spatial neglect. Results. In all, 30.1% (47 of 156) of the sample had spatial neglect. Sex, age, severity of TBI, or time postinjury did not differ between patients with and without spatial neglect. In comparison to patients without spatial neglect, patients with the disorder stayed in IRF 5 days longer, had lower FIM scores at discharge, improved slower in both Cognitive and Motor FIM scores, and might have less likelihood of return home. In addition, left-sided neglect was associated with asymmetric strength in the lower extremities, specifically left weaker than the right. Finally, brain injury–induced mass effect predicted left-sided neglect. Conclusions. Spatial neglect is common following TBI, impedes rehabilitation progress in both motor and cognitive domains, and prolongs length of stay. Future research is needed for linking specific traumatic injuries and lesioned networks to spatial neglect and related impairment.

scholarly journals Advancing care for traumatic brain injury: findings from the IMPACT studies and perspectives on future research

2013 ◽  
Vol 12 (12) ◽  
pp. 1200-1210 ◽  
Author(s):  
Andrew I R Maas ◽  
Gordon D Murray ◽  
Bob Roozenbeek ◽  
Hester F Lingsma ◽  
Isabella Butcher ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Future Research ◽  
Impact Studies ◽  
The Impact

Student and Teacher Perceptions of Goal Attainment During Intervention With the Self-Determined Learning Model of Instruction

2020 ◽  
pp. 002246692095026
Author(s):  
Karrie A. Shogren ◽  
Tyler A. Hicks ◽  
Sheida K. Raley ◽  
Jesse R. Pace ◽  
Graham G. Rifenbark ◽  
...  
Keyword(s):  
General Education ◽  
Teacher Perceptions ◽  
Goal Attainment ◽  
Learning Model ◽  
The Self ◽  
Online Resources ◽  
Future Research ◽  
Interpretation Criteria ◽  
Disability Status ◽  
The Impact

A major instructional focus of interventions designed to promote self-determination, such as the Self-Determined Learning Model of Instruction (SDLMI), is to engage students in learning to set their goals, identify action plans, and evaluate their performances. However, little is known about how students define their goal attainment outcomes, or the degree to which students and teachers agree the attainment of goal set using the SDLMI in inclusive general education classes. This study examined the relation between student and teacher ratings of goal attainment during the first semester of a longitudinal, cluster randomized controlled trial of the SDLMI, as well as the impact of student disability status and teacher supports for implementing the SDLMI (i.e., online resources vs. online resources + in-person coaching) on goal attainment. Findings suggested the feasibility of engaging students with and without disabilities in rating their goal attainment process during SDLMI in secondary schools, with kappa analysis indicating that, when credit is given for at least partial agreement between students and teachers, there is a fair amount of interrater agreement using conventional interpretation criteria. Importantly, however, conclusions drawn about the impact of student (i.e., disability status) and teacher factors (i.e., teacher implementation supports) on goal attainment outcomes are impacted by whether student or teaching ratings of goal attainment are utilized as the outcome measure. Implications for future research and practice are described.

Self-Compassion and Quality of Life in Adults Who Stutter

2020 ◽  
Vol 29 (4) ◽  
pp. 2097-2108
Author(s):  
Robyn L. Croft ◽  
Courtney T. Byrd
Keyword(s):  
Quality Of Life ◽  
Social Connectedness ◽  
The Self ◽  
Future Research ◽  
Self Compassion ◽  
Adults Who Stutter ◽  
And Gender ◽  
Relationship Of ◽  
The Impact

Purpose The purpose of this study was to identify levels of self-compassion in adults who do and do not stutter and to determine whether self-compassion predicts the impact of stuttering on quality of life in adults who stutter. Method Participants included 140 adults who do and do not stutter matched for age and gender. All participants completed the Self-Compassion Scale. Adults who stutter also completed the Overall Assessment of the Speaker's Experience of Stuttering. Data were analyzed for self-compassion differences between and within adults who do and do not stutter and to predict self-compassion on quality of life in adults who stutter. Results Adults who do and do not stutter exhibited no significant differences in total self-compassion, regardless of participant gender. A simple linear regression of the total self-compassion score and total Overall Assessment of the Speaker's Experience of Stuttering score showed a significant, negative linear relationship of self-compassion predicting the impact of stuttering on quality of life. Conclusions Data suggest that higher levels of self-kindness, mindfulness, and social connectedness (i.e., self-compassion) are related to reduced negative reactions to stuttering, an increased participation in daily communication situations, and an improved overall quality of life. Future research should replicate current findings and identify moderators of the self-compassion–quality of life relationship.

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