Sarah Buys, L. Gustafsson, Hannah L Gullo, R. Grimley, M. Summers, A. Campbell
{"title":"Cognition in the first week after stroke: how does it relate to personal and instrumental activities of daily living at follow-up?","authors":"Sarah Buys, L. Gustafsson, Hannah L Gullo, R. Grimley, M. Summers, A. Campbell","doi":"10.1017/BrImp.2021.3","DOIUrl":"https://doi.org/10.1017/BrImp.2021.3","url":null,"abstract":"Abstract Background: The Montreal Cognitive Assessment (MoCA) is routinely used during the early assessment of people after stroke to indicate cognitive effects and inform clinical decision-making. Aim: The purpose of this study was to examine the relationship between cognition in the first week post-stroke and personal and instrumental activities of daily skills at 1 month and 3 months post-stroke. Method: A prospective cohort study consecutively recruited people admitted to the acute stroke ward. Acute cognitive status was measured using the MoCA within 1 week post-stroke onset. Functional outcomes were measured using the Functional Independence Measure (FIM) and the Australian Modified Lawton’s Instrumental Activities of Daily Living Scale (Lawton’s) at 1 month and 3 months post-stroke. Results: Fifty participants with predominantly mild stroke (n = 47) and mean age of 69.8 achieved a mean MoCA score of 23.1. Controlling for age, the MoCA was associated with the overall FIM score at 1 month (P = 0.02). It was nearing significance for the Lawton’s at 1 month (P = 0.06) but was not associated with either outcome at 3 months. A score of less than 23 on the MoCA was indicative of lower scores on both outcomes. Conclusions: A low MoCA score within 1 week of stroke may indicate need for support or rehabilitation due to early impacts on personal activities of daily living, but is not associated with poor functional outcomes at 3 months.","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"14 15 1","pages":"185 - 195"},"PeriodicalIF":0.8,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80668574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Clinical profile of Aboriginal and Torres Strait Islander adults with stroke and traumatic brain injury at a regional Australian hospital: a retrospective chart audit","authors":"Frances Cochrane, S. Siyambalapitiya, P. Cornwell","doi":"10.1017/BrImp.2021.1","DOIUrl":"https://doi.org/10.1017/BrImp.2021.1","url":null,"abstract":"\u0000 \u0000 \u0000 The clinical profile of Aboriginal and Torres Strait Islander adults admitted to hospital with neurological injury is not well documented. Understanding these profiles may enable health professionals to provide more culturally responsive health care for this patient group. This study aimed to report the clinical profile of Aboriginal and Torres Strait Islander adults admitted to a regional Queensland hospital due to stroke or traumatic brain injury (TBI).\u0000 \u0000 \u0000 \u0000 A 2-year retrospective medical record review of Aboriginal and Torres Strait Islander adults (≥18 years) admitted to a regional Queensland hospital with principal diagnoses of stroke or TBI.\u0000 \u0000 \u0000 \u0000 There were 132 Aboriginal and Torres Strait Islander adult stroke (51.5%) or TBI (48.5%) admissions. The mean ages were 56.7 years for stroke and 42.7 years for TBI. The majority of patients (83.3%) were of Aboriginal descent with others identifying as Torres Strait Islander only, or both Aboriginal and Torres Strait Islander. Patients were from 26 diverse home locations across northern Australia, primarily Outer Regional or Remote/Very Remote geographical locations. All patients’ language backgrounds were documented as English only. Over 90% of stroke and 50% of TBI patients presented with medical co-morbidities.\u0000 \u0000 \u0000 \u0000 Patients had diverse geographical locations and cultural backgrounds, with many likely impacted by dislocation from home and country, as well as potential delays in receiving treatment. Despite this diversity, English was documented in patients’ medical records as their only language. The majority of patients also presented with multiple medical co-morbidities. Health professionals should consider these factors to ensure patients receive optimum and culturally responsive health care.\u0000","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"40 1","pages":"281 - 293"},"PeriodicalIF":0.8,"publicationDate":"2021-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72681603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Training persons with early-stage Alzheimer’s disease how to use an electronic medication management device: development of an intervention protocol","authors":"M. Tellier, Claudine Auger, L. Demers","doi":"10.1017/BRIMP.2020.25","DOIUrl":"https://doi.org/10.1017/BRIMP.2020.25","url":null,"abstract":"Abstract Background/Objectives: Medication management is challenging for persons with Alzheimer’s disease (AD) and their caregivers. Electronic medication management devices (eMMDs) are specifically designed to support this task. However, theory-driven interventions for eMMD training with this population are rarely described. This study aimed to develop and assess the appropriateness of an intervention protocol to train persons with early-stage AD how to use an eMMD. Methods: Interviews with three categories of participants [persons with early-stage AD (n = 3), caregivers (n = 3), and clinicians (n = 3)] were conducted to understand medication management needs, perceived usefulness of an eMMD, and to explore training strategies. Subsequently, this knowledge was integrated in an intervention protocol which was validated with the three clinicians. A content analysis led to iterative modifications to maximize the acceptability and coherence of the intervention protocol in a homecare context. Results: The final intervention protocol specifies the expertise required to provide the training intervention and the target population, followed by an extensive presentation of eMMD features. Specific learning strategies tailored to the cognitive profile of persons with AD with step-by-step instructions for clinicians are included. Finally, it presents theoretical information on cognitive impairment in AD and how eMMDs can support them. Conclusions: This intervention protocol with its theoretical and pragmatic foundation is an important starting point to enable persons with early-stage AD to become active users of eMMDs. Next steps should evaluate the immediate and long-term impacts of its implementation on medication management in the daily lives of persons with AD and their caregivers.","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"13 1","pages":"329 - 342"},"PeriodicalIF":0.8,"publicationDate":"2021-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84912066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Barbra Zupan, Leah S Dunn, S. Hackney, Bahtiyorhon Shamshidinova
{"title":"The relationship between vocal affect recognition and psychosocial functioning for people with moderate to severe traumatic brain injury: a systematic review","authors":"Barbra Zupan, Leah S Dunn, S. Hackney, Bahtiyorhon Shamshidinova","doi":"10.1017/BrImp.2020.24","DOIUrl":"https://doi.org/10.1017/BrImp.2020.24","url":null,"abstract":"Abstract The purpose of this review was to explore how vocal affect recognition deficits impact the psychosocial functioning of people with moderate to severe traumatic brain injury (TBI). A systematic review following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines was conducted, whereby six databases were searched, with additional hand searching of key journals also completed. The search identified 1847 records after duplicates were removed, and 1749 were excluded through title and abstract screening. After full text screening of 65 peer-reviewed articles published between January 1999 and August 2019, only five met inclusion criteria. The methodological quality of selected studies was assessed using the Mixed Methods Appraisal Tool (MMAT) Version 2018 with a fair level of agreement reached. A narrative synthesis of the results was completed, exploring vocal affect recognition and psychosocial functioning of people with moderate to severe TBI, including aspects of social cognition (i.e., empathy; Theory of Mind) and social behaviour. Results of the review were limited by a paucity of research in this area, a lack of high-level evidence, and wide variation in the outcome measures used. More rigorous study designs are required to establish more conclusive evidence regarding the degree and direction of the association between vocal affect recognition and aspects of psychosocial functioning. This review is registered with Prospero.","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"193 1","pages":"260 - 280"},"PeriodicalIF":0.8,"publicationDate":"2021-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82556192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. Alharbi, S. Aloyuni, F. Kashoo, M. Waly, Harpreet Singh, Mehrunnisha Ahmad
{"title":"Does transcranial direct current stimulation affect selective visual attention in children with left-sided infantile hemiplegia? A randomized, controlled pilot study","authors":"R. Alharbi, S. Aloyuni, F. Kashoo, M. Waly, Harpreet Singh, Mehrunnisha Ahmad","doi":"10.1017/brimp.2020.20","DOIUrl":"https://doi.org/10.1017/brimp.2020.20","url":null,"abstract":"Infantile hemiplegia due to brain injury is associated with poor attention span, which critically affects the learning and acquisition of new skills, especially among children with left-sided infantile hemiplegia (LSIH). This study aimed to improve the selective visual attention (SVA) of children with LSIH through transcranial direct current stimulation (tDCS).A total of 15 children participated in this randomized, double-blinded, pilot study; of them, 10 experienced LSIH, and the remaining 5 were healthy age-matched controls. All the children performed the Computerized Stroop Color-Word Test (CSCWT) at baseline, during the 5th and 10th treatment sessions, and at follow-up. The experimental (n = 5) and control groups (n = 5) received tDCS, while the sham group (n = 5) received placebo tDCS. All three groups received cognitive training on alternate days, for 3 weeks, with the aim to improve SVA.Two-way repeated measures analysis of variance (ANOVA) showed a statistically significant change in the mean scores of CSCWT between time points (baseline, 5th and 10th sessions, and follow-up) within-subject factor, group (experimental, sham) between-subject factor and interaction (time points X group) (p < 0.005). Furthermore, a one-way repeated measures ANOVA showed significant differences between time point (p < 0.005) for the experimental and control group but not the sham group.These pilot results suggest that future research should be conducted with adequate samples to enable conclusions to be drawn.","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"14 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2020-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83032561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Effects of whole-body vibration on motor function in patients with Parkinson’s disease: a systematic review and meta-analysis","authors":"Chuan He, Caixia Su, Wentong Zhang, Qi Wan","doi":"10.1017/brimp.2020.21","DOIUrl":"https://doi.org/10.1017/brimp.2020.21","url":null,"abstract":"To review the effects of whole body vibration for patients with Parkinson’s disease.Randomized clinical trials comparing whole body vibration with no vibration or conventional physical therapy for patients with Parkinson’s disease were searched up to July 31, 2019.Seven studies with 196 patients were included for quantitative analysis. No significant difference was found between groups in motor score of unified Parkinson’s disease rating scale (UPDRS-III) (WMD [weighted mean difference] = −1.75, 95% CI, −5.40 to 1.90, I2 = 45.8%), functional reach test (SMD [standardized mean difference] = 0.21, 95% CI, −0.29 to 0.71; I2 = 0%), and other balance tests (including Berg balance test and Tinetti score) (SMD = 0.39, 95% CI, −0.01 to 0.80; I2 = 0%). No statistical difference was detected in walking velocity as well (WMD = −0.05, 95% CI, −0.17 to 0.06; I2 = 0%). In contrast, the pooled analysis from four studies on the Time Up and Go test showed favorable results for whole body vibration (WMD = −1.59, 95% CI, −2.90 to −0.28, I2 = 0%).Whole body vibration may not be beneficial over placebo or conventional physical therapy in overall motor function, balance, and walking velocity in patients with Parkinson’s disease. However, it might have positive effects on sit to stand transitions or turning.","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"41 1","pages":"1-12"},"PeriodicalIF":0.8,"publicationDate":"2020-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87348857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Special issue: Knowledge translation and dementia care","authors":"S. Bennett","doi":"10.1017/BrImp.2020.17","DOIUrl":"https://doi.org/10.1017/BrImp.2020.17","url":null,"abstract":"There is a growing body of research demonstrating the effectiveness of interventions that might benefit people living with dementia and their families or caregivers. Yet, it can take years for research findings to be translated into practice for these benefits to be realised. Knowledge translation is a process or series of activities that aims to accelerate the uptake of research in practice. A commonly used definition suggests that it is a dynamic process that includes synthesis, dissemination, exchange and ethically sound application of knowledge to improve health, which occurs within a complex system of interactions between researchers and knowledge users (Canadian Institute of Health Research, n.d.). This special issue largely considers perspectives, experiences and outcomes concerning the application or implementation of a number of evidence-based non-pharmacological interventions for people living with dementia and their families or caregivers. This issue commences with a paper by Linton that explores the relationship between the health of caregivers and the health of the person they provide care for, who had either dementia or a brain injury. Although the paper does not have an implementation focus, it highlights some of the complexities surrounding this relationship – which is at the centre of many of the non-pharmacological interventions described in the rest of this issue. As is sometimes the case, there can be good evidence for the effectiveness of interventions in one population that may hold potential for use in a new population. However, prior to the intervention being implemented with the new population, it needs careful adaptation and testing. Scott et al. describe the adaptation of CarFreeMe – an effective driving cessation programme intervention originally designed for older adults – for people living with dementia and their caregivers. This is an important undertaking given the complexities of navigating this highly sensitive issue. Just because interventions have strong evidence, it does not mean that they will be translated into practice. An example of this is the well-tested Tailored Activity Program (TAP) developed in the USA by Gitlin et al. (2008). Despite at least five randomised controlled trials demonstrating its effectiveness, it is not in use in Australia. An important phase in preparing to implement any new practice is to understand key stakeholders’ perceptions about the intervention and its implementation. Hence, Bennett et al. explore the acceptability of TAP for people living with dementia, their caregivers and health professionals and their views about factors that might influence willingness to provide or receive this intervention, prior to its implementation in Australia. The next two studies in this issue (Culph et al., Rahja et al.) pertain to the implementation of the Care of Persons with Dementia in their Environments (COPE) programme, which originates from same stable (Gitlin, Winter, Dennis, Hodgson, & ","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"1 1","pages":"235 - 236"},"PeriodicalIF":0.8,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81042099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Making sense of self-reported practice impacts after online dementia education: the example of Bedtime to Breakfast and Beyond","authors":"B. Goodenough, J. Watts, Sarah Bartlett","doi":"10.1017/BrImp.2020.19","DOIUrl":"https://doi.org/10.1017/BrImp.2020.19","url":null,"abstract":"To satisfy requirements for continuing professional education, workforce demand for access to large-scale continuous professional education and micro-credential-style online courses is increasing. This study examined the Knowledge Translation (KT) outcomes for a short (2 h) online course about support at night for people living with dementia (Bedtime to Breakfast), delivered at a national scale by the Dementia Training Australia (DTA).A sample of the first cohort of course completers was re-contacted after 3 months to complete a KT follow-up feedback survey (n = 161). In addition to potential practice impacts in three domains (Conceptual, Instrumental, Persuasive), respondents rated the level of Perceived Improvement in Quality of Care (PIQOC), using a positively packed global rating scale.Overall, 93.8% of the respondents agreed that the course had made a difference to the support they had provided for people with dementia since the completion of the course. In addition to anticipated Conceptual impacts (e.g., change in knowledge), a range of Instrumental and Persuasive impacts were also reported, including workplace guidelines development and knowledge transfer to other staff. Tally counts for discrete KT outcomes were high (median 7/10) and explained 23% of the variance in PIQOC ratings.Online short courses delivered at a national scale are capable of supporting a range of translation-to-practice impacts, within the constraints of retrospective insight into personal practice change. Topics around self-assessed knowledge-to-practice and the value of positively packed rating scales for increasing variance in respondent feedback are discussed.","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"49 1","pages":"299 - 313"},"PeriodicalIF":0.8,"publicationDate":"2020-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81875350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Linden, Conall O’Rourke, C. Monaghan, Deborah Rainey
{"title":"Experiences of offenders with traumatic brain injury","authors":"M. Linden, Conall O’Rourke, C. Monaghan, Deborah Rainey","doi":"10.1017/BRIMP.2020.23","DOIUrl":"https://doi.org/10.1017/BRIMP.2020.23","url":null,"abstract":"Traumatic brain injury is recognised as a significant and pervasive health issue among offender populations. Despite this, no qualitative research exists exploring the experiences and perceptions of offenders with TBI in prison.Qualitative interviews were conducted with male and female offenders housed in a UK prison. Interviews examined what participants felt led them to offend, experiences of incarceration, and post-release plans. Presence of TBI was assessed via the Brain Injury Screening Index. Data were analysed by means of inductive content analysis.Both male and female prisoners primarily attributed their incarceration to drugs and alcohol use, with males also referencing more issues with aggression, while mental illness and past abuse were more commonly mentioned among females. A lack of recognition for the possible role of TBI was noted, with several males describing themselves as ‘stupid’ or prone to making ‘poor lifestyle choices’. Both groups indicated a desire to return to education or work post-release.Despite significant rates of injury, there is a clear lack of understanding and consideration of the role of TBI in the behaviour and presentation of offenders. There is need for improved identification and education around TBI early in the criminal justice process.","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"8 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2020-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89076794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}