ISSN:0885-9701    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Objective:To explore the possibility that gender has a moderating effect on memory after pediatric traumatic brain injury (TBI).Design:Controlled group study. Gender effects between and within groups were evaluated by means of effect size comparisons and hierarchical regression analysis.Setting:Regional rehabilitation center.Participants:Seventy children with TBI, selected from a 4-year series of consecutive referrals, and 70 demographically matched controls.Main outcome measures:Screening version of the Wide Range Assessment of Memory and Learning (WRAML–S) and the Wechsler Intelligence Scale for Children—Third Edition (WISC–III).Results:Boys with TBI performed worse than girls with TBI, and worse than their counterparts in the control group, on the WRAML–S. There was no gender effect in the control group. Gender explained an additional 9% of the variance in WRAML–S performance over and above injury severity and age variables. However, gender differences were largely attenuated when speed of information processing, as assessed by the WISC–III, was used as a covariate.Conclusion:The effect of TBI on children's memory appears to be moderated by gender and may be mediated by speed of information processing.

ISSN:0885-9701    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Objective:To investigate personal beliefs about seeking social support following traumatic brain injury (TBI) and the relationship of these appraisals to demographic and injury variables, social integration, and quality of life ratings.Setting:The central region of a Midwest state.Participants:Fifty-six adults with TBI who were more than 6 months postinjury and living in the community.Main outcome measures:The Hesitation Scale, a 20-item survey that assesses reasons that people might hesitate to reach out to others in the community, and portions of the Living Life After Traumatic Brain Injury Scale.Results:Negative attitudes and beliefs about seeking social support were significantly related to lower perceptions of social support, lower ratings of quality of life, longer time since injury, being divorced or separated, and living in an urban area. Predictors of higher quality of life ratings included more positive appraisals about seeking social support, living in a rural area, and the ability to engage in productive activity.Conclusions:Positive outcomes after TBI appear to be moderated by living in a rural area, which is associated with more openness to seeking social supports and contributes to better quality of life.

ISSN:0885-9701    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Objective:To examine job stability moderating variables and develop a postinjury work stability prediction model.Design:Multicenter analysis of individuals with traumatic brain injury (TBI) who returned for follow-up at 1, 2, and 3, or 4 years postinjury, were of working age (between 18 and 62 years of age at injury), and were working preinjury.Setting:Six National Institute on Disability and Rehabilitation Research TBI Model System centers for coordinated acute and rehabilitation care.Participants:A total of 186 adults with TBI were included in the study.Main outcome measures:Job stability was categorized as stably employed (employed at all 3 follow-up intervals); unstably employed (employed at one or two of all three follow-up intervals); and unemployed (unemployed at all three follow-up intervals).Results:After injury, 34% were stably employed, 27% were unstably employed, and 39% were unemployed at all three follow-up intervals. Minority group members, people who did not complete high school, and unmarried people were more likely to be unemployed. Driving independence was highly influential and significantly related to employment stability. A discriminant function analysis, which included age, length of unconsciousness and Disability Rating Scale scores at 1 year postinjury, accurately predicted job stability groupings.ConclusionData analysis provided evidence that employment stability is predictable with a combination of functional, demographic, and injury severity variables. Identification of people at risk for poor employment outcomes early on can facilitate rehabilitation planning and intervention.

ISSN:0885-9701    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Objective:In patients with mild traumatic brain injury (MTBI), to assess: (1) changes in financial compensation-seeking status over time and (2) the relationship between compensation-seeking and return to work.Design:Longitudinal evaluation of financial compensation-seeking status (i.e., at intake, 3 months postinjury, and 12 months postinjury) and relationship of such status to return to work.Setting:Outpatient rehabilitation clinic.Subjects:Ninety-seven patients with MTBI.Main outcome measures:Compensation-seeking status at 3 and 12 months and days taken to return to preinjury vocational activity.Results:Those in litigation at intake generally continued to be in litigation at 3 and 12 months postinjury. Those seeking or receiving compensation via administrative means (e.g., sick pay or workers' compensation) at intake were generally not seeking or receiving compensation by 3 months or later, as was the case for most of those not seeking any financial compensation at intake. Patients seeking or receiving financial compensation via litigation and/or administrative means at intake took longer to return to work than did people who were not seeking or receiving compensation at intake.Conclusions:The present study design does not allow for determination of the reasons for the strong relationship between financial compensation-seeking soon post-MTBI and a slow return to work. However, the strength of the present findings indicates that the presence or absence of financial compensation-seeking soon post-MTBI should be routinely evaluated when return to work is an issue.

ISSN:0885-9701    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Objective:To explore factors associated with long-term outcomes of work and marital status in individuals who had experienced a mild head injury (MHI), as well as those who had not.Design:Population-based study using logistical regression analyses to investigate the impact of preinjury characteristics on work and marital status.Participants:Two groups of Vietnam-era Army veterans: 626 who had experienced a MHI an average of 8 years before examination, and 3,896 who had not.Main outcome measures:Demographic characteristics, concurrent medical conditions, early life psychiatric problems, loss of consciousness (LOC), and interactions among these variables were used to predict current work and marital status.Results:Multiple variables were associated with work and marital status in the sample with MHI, accounting for approximately 23% and 17% of the variance in these two outcome variables, respectively. In contrast, the same factors accounted for significantly less variance in outcome in the sample without a head injury—13.3% and 9.4% for work and marital status, respectively.Conclusions:These findings suggest a more potent role for and increased vulnerability to the influence of demographic, medical, and psychiatric factors on outcomes after a MHI. That is, MHI itself moderates the influence of preinjury characteristics on work and marital status. In addition, in those who had a MHI, moderator relationships were found between education and LOC for both work and marital status. Similarly, complex moderator relationships among race, region of residence, and LOC were found for both work and marital status outcomes.

ISSN:0885-9701    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Objective:To examine changes in parent-adolescent interactions after traumatic brain injury (TBI) and their relationship to parent and adolescent adjustment.Design:Concurrent cohort, cross-sectional study. Analysis of variance was used to examine group differences and regression analysis to assess associations between interactional measures and concurrent adjustment.Setting:Four hospitals in north-central Ohio.Participants:Adolescents with severe TBI (25), moderate TBI (22), and orthopedic injuries (35) and their parents.Main outcome measures:Observer ratings of parent-adolescent interactions, Conflict Behavior Questionnaire (CBQ), Family Burden of Injury Interview (FBII), Brief Symptom Inventory (BSI), Family Assessment Device (FAD), Child Behavior Checklist, Vineland Adaptive Behavior Scale, and Children's Depression Inventory.Results:No group differences were found on ratings of parent-adolescent interaction or the parent or child CBQ. However, observed criticism/coldness and self-rated conflict had stronger associations with the FBII, BSI, and FAD in the severe TBI group than in the orthopedic injury group, suggesting that conflict is more disruptive after TBI. Ratings of criticism/coldness and parent and adolescent CBQ scores were also associated with parent and adolescent adjustment.Conclusions:Results support the utility of observational measures in assessing dyadic interactions after TBI.

ISSN:0885-9701    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

The use of antipsychotic medication in treating individuals with traumatic brain injury (TBI) has been controversial. Much of the caution derives from animal studies (and limited human data) with regard to typical antipsychotics. Of note, however, is that similar assumptions have been made about the newer generation of atypical antipsychotics as well. Because these agents have different mechanisms of action as well as different neurotransmitter targets, this may very well be unwarranted. In this article, mechanisms of action of typical and atypical antipsychotics are discussed, with particular attention paid to their use in TBI. Indications and contraindications are presented, and recommendations are made for the responsible prescribing of antipsychotic medications after TBI.

ISSN:0885-9701    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:0885-9701    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:0885-9701    

出版商:OVID    

年代:2003

数据来源: OVID