Executive function in individuals who are compliant and non-compliant with the conditions of a community-based sentence.

Executive function encompasses multiple processes (e.g. regulating emotions, managing behaviours, problem-solving) essential in daily living. A growing body of neuropsychological research shows a relationship between executive dysfunction and criminal behaviour. However, is executive functioning relevant to sentence management? We examined relationships between self-reported executive functioning and community supervision sentence compliance. Sixty-four individuals serving community-based supervision sentences completed the Behavior Rating Inventory of Executive Function-Adult Version, and their compliance data for six months were collected from probation officer notes. The sample's mean scores were significantly higher (i.e. poorer executive functioning) than those for the normative sample. Those who complied with sentence conditions had higher mean scores than those who were non-compliant. Subsequent exploratory analyses showed that those with poorer executive functioning received more probation officer support to comply with sentence conditions. Attention to responsivity issues like executive function problems may help avoid entrapping people in the criminal justice system.

The association between self-reported traumatic brain injury, neuropsychological function, and compliance among people serving community sentences.

BACKGROUND: Traumatic brain injury is overrepresented in incarcerated samples and has been linked to a number of poor correctional outcomes. Despite this, no research has explored the impact of a recent TBI on compliance outcomes for individuals serving community-based. METHOD: We screened for a history of TBI in 106 adults on community sentences and collected compliance (arrests, sentence violations) and related variables (e.g., risk scores, substance use) over 6 months. Sixty-four participants also completed the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), the Comprehensive Trail Making Test and Color-Word Inference Test. RESULTS: A TBI in the last year predicted a significantly higher likelihood of arrest, even when controlling for risk of reconviction and current substance use, but was not associated with non-compliance with sentence conditions nor with performance on the neuropsychological tests. In addition, no significant associations were found between performance on neuropsychological tests and measures of non-compliance. CONCLUSIONS: TBI in the last year was an independent predictor of arrest. This result suggests that those with a recent TBI on a community sentence may need additional monitoring or support to reduce the risk of reoffending.

Psychosocial functioning at 4-years after pediatric mild traumatic brain injury.

Objective: Behavioral and emotional difficulties are reported following pediatric mild traumatic brain injury (TBI). But few studies have used a broad conceptual approach to examine children's long-term psychosocial outcomes. This study examines children's psychosocial outcomes at 4-years after mild TBI and associated factors.Methods: Parents of 93 children (<16 years) with mild TBI completed subscales of age-appropriate versions of the Strengths and Difficulties Questionnaire, the Behavior Rating Inventory of Executive Function, the Pediatric Quality of Life Inventory, and the Adolescent Scale of Participation questionnaire at 4-years post-injury.Results: Mean group-level scores were statistically significantly higher for hyperactivity/inattention and lower for emotional functioning than published norms. Levels of participation were greater compared to those observed in normative samples. More than 19% met published criteria for clinically significant hyperactivity/inattention, emotional functioning problems, peer relationship problems, and social functioning difficulties. Lower family socio-economic status and greater parental anxiety and depression were associated with overall psychosocial difficulties.Conclusions: Findings indicate that as a group, children with mild TBI are characterized by elevated rates of behavioral, emotional, and social difficulties at 4-years post-injury. Parent mental health may be an untapped opportunity to support children's psychosocial development following mild TBI, with replication required in larger samples.

Co-driving: Passenger actions and distractions.

Approximately one third of car trips involve one or more passengers and yet we know little about how the presence of a passenger helps or hinders safety and efficiency. To date, research in this area has focused on the possible distractive effects of passengers. Although we know that drivers conversing on a mobile phone is distracting and unsafe, epidemiological studies suggest that driving with a passenger has a lower crash risk than driving alone. This paper describes two studies into how drivers and passengers interact during a journey; a survey regarding the most common actions of passengers and how drivers view their helpfulness, and an on-road study of driver and passenger interactions. The results indicated several areas that drivers felt passenger assistance was quite helpful, but in some cases was exhibited very rarely. The on-road study revealed some interesting gender differences in who offers driving support, and who requests it. By understanding how passengers can contribute to safer journeys we can provide that information to drivers at risk, such as those very early or late in their driving careers.

The role of control in risk perception on rural roads.

Risk perception plays an important role in driver behaviour, particularly for speed choice. Risk perception studies use a range of techniques from on-road data collection to ratings of still photos, however participants' ratings differ depending on the study methodology, possibly due to their perception of control. To explore this we conducted a multiple methods study to investigate drivers' perceptions of risk on rural roads. One group of participants drove (Drivers, n = 13) a 180 km route along rural roads (accompanied by a research assistant) and provided verbal risk ratings at thirteen locations of interest. A second group (Passengers, n = 10) provided ratings at the same points when travelling as a passenger in a vehicle (driven by a research assistant). The third group (Observers, n = 14) were shown videos of the same rural roads (filmed from the drivers' perspective) and also provided risk ratings at the same locations. A week later participants were invited to the laboratory to review the video footage and comment on factors that contributed to the risk ratings. Overall, the Observers gave the highest risk ratings and Drivers the lowest. The Observers also provided twice the number of comments to justify their risk rating compared to the other two groups. The results suggest that control, and on-road experience play a significant role in how perceptions of driving risk are formed and the degree of risk experienced. These findings also bring into question the accuracy of using video-based tasks to assess drivers' risk perception (and speed choice), particularly if the findings are used to inform on-road safety interventions.

Driving With ADHD: Performance Effects and Environment Demand in Traffic.

Objective: This research investigated the on-road driving performance of individuals with ADHD across a range of road and traffic conditions to determine whether errors were linked to situational complexity and attentional demands. Method: The everyday driving performance of medicated drivers with ADHD, unmedicated drivers with ADHD, and controls was tested in urban, residential, rural, and highway environments using driver license testing procedures. Results: Unmedicated drivers with ADHD displayed fewer safe driving skills and committed more inattentive and impatient driving errors, particularly in low demand highway and rural driving conditions. Medicated drivers' performance was not reliably different than controls. Participants in both ADHD groups were more likely than controls to report risky driving and involvement in crashes. Conclusion: The results demonstrate that situations with low attentional demand are particularly risky for unmedicated ADHD drivers and suggest that focus on these situations may be useful in improving driving outcomes for this population.

Long-term factor structure of the Rivermead Post-Concussion Symptom Questionnaire in mild traumatic brain injury and normative sample.

BACKGROUND: Previous studies of the Rivermead Post-Concussive Questionnaire(RPQ)'s factor structure were conducted within 1 year post-injury. Post-concussive symptoms may persist, and are common in the general population, so determining if the factor structure in mild-TBI and controls differ is important. This study examined factor structure of the RPQ in adults 4 years post-mild-TBI and in age-/gender-matched controls. METHOD: A total of 232 adults 4 years post-mild-TBI and 232 age-/gender-matched controls completed the RPQ. RESULTS: Both samples produced a three-factor solution (57.98% and 56.44% of variance in the RPQ). Factor 1 for both samples included all RPQ items and accounted for the majority of variance explained (42.6% and 40.7%). After mild-TBI factor 2 included dizziness, vomiting/nausea, irritability, and double vision; whilst in controls it involved headache, dizziness, vomiting/nausea, and slowed thinking. Factor 3 for mild-TBI included vomiting/nausea, blurred vision, slowed thinking, and poor memory; while for controls it was restricted to visual symptoms (blurred vision, light sensitivity, double vision). CONCLUSION: The RPQ factor structure was similar for both groups, although differences were identified in lesser factors. This suggests those with mild-TBI differ minimally from matched controls in the very long term after injury.

Unmoving and unmoved: experiences and consequences of impaired non-verbal expressivity in Parkinson's patients and their spouses.

Purpose: Hypomimia, or facial masking, is a decrease in voluntary control and spontaneous movement of the muscles of the face, which may occur in Parkinson's disease. Little is known about the psychosocial consequences or management of this symptom. The aim of this study was to provide an initial overview of patient & spousal experiences of living with an acquired nonverbal expressive impairment in Parkinson's disease. Method: This qualitative study involved a community sample of individuals with Parkinson's who experienced facial masking, and their close romantic partners. Nine people who had Parkinson's and nine of their spouses or partners participated in separate (individual) semi-structured interviews. Results: A descriptive thematic approach was used to analyze the interview data. Key themes relevant to rehabilitation included the misidentification of masking as negative affect, poor symptom recognition, and unmet health resource needs. Conclusions: The results indicate masking can have an adverse impact on close relationships and psychological well-being. This study presents an initial basis for clinicians working with Parkinson's populations to recognize of the needs of people who experience masking and better support such individuals and their families to live satisfying social and emotional lives. Implications for Rehabilitation People who have Parkinson's and their families are often unaware facial masking is a symptom of Parkinson's disease. Masking may be confused with negative affect and become a barrier to satisfying close relationships. Masking related health resources and support are perceived to be of poor availability and quality. This qualitative study suggests masking be considered as an etiology of interpersonal and psychological difficulties in Parkinson's disease, and encourages better recognition of this unique population's health education needs.

Mind wandering during everyday driving: An on-road study.

This study was an investigation into mind wandering during everyday driving, and its association with crash patterns. We selected a 25 km route on urban roads for analysis of crashes, and an on-road study of mind wandering by a sample of drivers familiar with the route. We analysed reported crashes on the route over a five year period from New Zealand's crash database. For the on-road study a researcher accompanied 25 drivers on the route, asking them what they were thinking about at 15 predetermined road sections. The road sections were selected to include a range of different speed limits and traffic volumes as well as roundabouts, priority intersections and midblocks. Thought samples were categorised as either mind wandering or driving focus, and triggered by the senses, or internally. The frequencies of mind wandering at different road sections on the route were compared to the frequencies of reported crashes along the same route over the preceding five years. Results showed that although all drivers reported mind wandering, it was more likely to be reported at slower, quieter, less complex road sections. Overall, more crashes were reported at priority intersections and midblocks than at roundabouts, but the crash rate (per road section) was higher at roundabouts, where mind wandering was least likely to be reported. These findings suggest that although drivers' minds wander constantly, driving focus is commanded in demanding situations and in response to the actions of other road users. While mind wandering is ubiquitous, drivers are least likely to report mind wandering at locations showing the highest crash rates. More work is needed to test these findings and to provide direction for road safety interventions.

Transitions within a safe road system.

As drivers move through the road transport system they are exposed to a range of different situations and road conditions in a relatively short space of time. Drivers' expectations about what will happen on different types of roads have strong effects on their speed choices, and where they look and what they attend to. As a result it is important to assist drivers to change their expectations when they transition from one road type to another. In this experiment we investigated the effectiveness of different centreline road markings in preparing for a horizontal curve as drivers moved from a motorway to a two-lane rural country road. Fifty individuals were recruited to participate in a video-based simulated driving task to compare three centreline marking types in terms of their effects on speed choice and reactions to a driving hazard (horizontal curve). Although a complex marking previously associated with high risk produced the largest speed reductions during the transition from the motorway, it was the centreline more traditionally associated with rural country roads (dashed white centreline) that was associated with the best hazard reactions post-transition (brake reaction time and speed reduction before a horizontal curve). The findings demonstrated that the look of a road needs to convey a clear and unambiguous message to drivers. The transition to a two-star rural road is best achieved by making the road look like a typical two-star road as soon as possible.

Parent and child ratings of child behaviour following mild traumatic brain injury.

BACKGROUND: Mild traumatic brain injury (mTBI) in children is most commonly associated with parent-reported child behaviour problems. The extent to which parent and child ratings align is unknown. OBJECTIVES: To examine differences in child behaviour and patterns of recovery over the first 12 months following mTBI based on parent and child self-report. METHODS: Ninety-nine children (8-15 years) with mTBI and one of their parents completed the Behavioural Assessment Scale for Children - version 2 to assess child hyperactivity, anxiety and depression at baseline, 1, 6 and 12 months post-injury. Differences between ratings from parents and children were evaluated using Bland-Altman limits of agreement analyses. Child recovery over time was examined using mixed models repeated measures analyses. RESULTS: Parent and child ratings for child hyperactivity, anxiety and depression differed significantly at baseline and these differences remained constant at each follow-up. Parents tended to report more child hyperactivity, anxiety and depression. Over time, parents and children reported fewer child hyperactivity and anxiety problems. CONCLUSIONS: Parents and children have poor agreement in ratings of child behaviour yet there is general agreement in patterns of recovery in the year following mTBI. Findings show the importance of considering both parent and self-report of child behaviour.

Using road markings as a continuous cue for speed choice.

The potential for using road markings to indicate speed limits was investigated in a driving simulator over the course of two sessions. Two types of experimental road markings, an "Attentional" set designed to provide visually distinct cues to indicate speed limits of 60, 80 and 100 km/h, and a "Perceptual" set designed to also affect drivers' perception of speed, were compared to a standard undifferentiated set of markings. Participants (n = 20 per group) were assigned to one of four experimental groups (Attentional-Explicit, Attentional-Implicit, Perceptual-Explicit, Perceptual-Implicit) or a Control group (n = 22; standard road markings). The Explicit groups were instructed about the meaning of the road markings while those in the Implicit and Control groups did not receive any explanation. Participants drove five 10 km simulated roads containing three speed zones (60, 80 and 100 km/h) during the first session. The participants returned to the laboratory approximately 3 days later to drive five more trials including roads they had not seen before, a trial that included a secondary task, and a trial where speed signs were removed and only markings were present. The findings indicated that both types of road markings improved drivers' compliance with speed limits compared to the control group, but that explicit instruction as to the meaning of the markings was needed to realise their full benefit. Although previous research has indicated the benefit of road markings used as warnings to indicate speed reductions in advance of horizontal or vertical curves, the findings of the present experiment also suggest that systematically associating road markings with specific speed limits may be a useful way to improve speed limit compliance and increase speed homogeneity.

Post-concussive symptoms after a mild traumatic brain injury during childhood and adolescence.

OBJECTIVE: Mild traumatic brain injury (mTBI) is common injury during childhood and adolescence but the long-term outcomes are poorly understood. This study examined post-concussive symptoms and behavioural outcomes in children and adolescents up to 24 months post-mTBI. METHOD: Parents of children aged 8-15 years with mTBI completed the BASC-2 and Rivermead Post-Concussion Symptoms Questionnaire at baseline, 1-, 6-, 12- and 24 months post-injury. An age-matched traumatic brain injury-free cohort was recruited and assessed at 12- and 24 months. RESULTS: PCSs decreased significantly over the first 12 months post-injury. At 12- and 24 months post-injury, the mTBI group reported more PCSs and behavioural symptoms compared to controls. Parents of children with mTBI were more likely to report ≥4 problematic PCS symptoms (28% at both time points) compared to controls (7.7% and 1.7% at 12 and 24 months, respectively). The mTBI group was 4.63 times more likely to have four or more ongoing PCS symptoms at 12 months post-injury compared to controls. Headache was the most common acute post-injury symptom (55%), while the most commonly reported persistent symptoms were irritability, frustration, forgetfulness and fatigue. CONCLUSIONS: PCSs are common 2 years post-mTBI in childhood or adolescence. Given this, additional intervention and support is needed for families post-injury.

Driving on urban roads: How we come to expect the 'correct' speed.

The subjective categories that drivers use to distinguish between different road types have been shown to influence the speeds they choose to drive but as yet we do not understand the road features that drivers use to make their discriminations. To better understand how drivers describe and categorise the roads they drive, 55 participants were recruited to drive a video of familiar urban roads in a driving simulator at the speed they would drive these roads in their own cars (using the accelerator and brake pedal in the driving simulator to adjust their speed). The participants were then asked to sort photos of the roads they had just driven into piles so that their driving would be the same on all roads in one pile but different to the other piles. Finally, they answered a series of questions about each road to indicate what speed they would drive, the safe speed for the road, their speed limit belief as well as providing ratings of comfort, difficulty and familiarity. Overall, drivers' categorisation of roads was informed by a number of factors including speed limit belief, road features and markings (including medians), road width, and presence of houses, driveways and footpaths. The participants' categories were congruent with what they thought the speed limits were, but not necessarily the actual speed limits. Mismatches between actual speed limits and speed limit beliefs appeared to result from category-level expectations about speed limits that took precedence over recent experience in the simulator. Roads that historically had a 50km/h speed limit but had been reduced to 40km/h were still regarded as 50km/h roads by the participants, underscoring the point that simply posting a sign with a lower speed limit is not enough to overcome drivers' expectations and habits associated with the visual appearance of a road. The findings provided insights into how drivers view and categorise roads, and identify specific areas that could be used to improve speed limit credibility.

Driving under the influence of drugs: Perceptions and attitudes of New Zealand drivers.

This study explored the patterns of drug driving in New Zealand by investigating 1) drivers' perceptions about impairment caused by legal and illegal drugs 2) countermeasures employed by drivers when under the influence of drugs (e.g., decisions not to drive) 3) drivers' attitudes about police enforcement of drug driving and 4) the factors that predict the likelihood of engaging in drug driving. Participants (n=434) were licensed drivers who completed an online questionnaire. Results of the questionnaire indicated that drivers rated hallucinogens and opiates as being the illegal drugs producing the highest level of driving impairment and cannabis the lowest. For legal drugs, sedatives were rated as having the highest driving impairment and anti-nausea and anti-depressants the lowest. Respondents' drug use history had an effect on their ratings of impairment for anti-anxiety drugs, anti-depressants, kava, sedatives, cannabis and hallucinogens such that drug users reported higher impairment ratings than Non-user. Making a decision not to drive after taking drugs was reported by users of alcohol (73.6%), cannabis (57.0%), strong painkillers (42.5%), and anti-depressants (10.0%). Respondents who reported drink driving were 3.26 times more likely to report drug driving than those reporting no drink driving. Respondents also showed greater acceptance towards driving under the influence of legal drugs (43.5%) compared to illegal drugs (10.3%). Those who did not have favourable attitudes about drug driving were less likely to report having driven under the influence of drugs. Drivers in this sample were less aware of the potential negative effects of legal drugs on driving compared to illegal drugs. More than half the respondents from this study acknowledged drug driving as a road safety issue which needs more resources dedicated to it.

How am I, really? Perceptions of health and distress by women and their midwives.

OBJECTIVE: This study examined agreement between ratings of health and emotional distress by women and their midwives. BACKGROUND: Physical complaints and medical complications during pregnancy can significantly impact a woman's experience of pregnancy. Previous studies have found that women and their healthcare providers may have differing perceptions of their condition and how they are coping with the challenges of pregnancy. METHODS: This study used questionnaires completed by women and their midwives to assess perceptions of health and emotional distress in two contexts. Sixty-eight of the women were on an antenatal unit, hospitalised for complications of their pregnancy; 33 women were a comparison group in community maternity care. FINDINGS: Many women in the hospital experienced high levels of emotional distress and worry about their pregnancy; 45% scored in the clinical range on state anxiety, and 28% screened positive for depression. However, midwives rating emotional distress did not pick up on this consistently, and women and hospital midwives often viewed their health status differently. In the community, women's ratings of their health were more consistent with the ratings of their midwives, and midwives were attuned to acute anxiety, but had more difficulty picking up on cues to depression. CONCLUSION: It is challenging, particularly in the unfamiliar and stressful environment of the antenatal unit, for midwives to assess emotional distress and needs for health information. Deliberate screening for antenatal distress might provide the opening for midwives to empower women to identify their options, strengths, and strategies for self-care and emotional resilience.

Using SmartQuit®, an Acceptance and Commitment Therapy Smartphone application, to reduce smoking intake.

OBJECTIVE: SmartQuit® is a smartphone application (app) for smoking cessation based on Acceptance and Commitment Therapy, a behavioural therapy that encourages individuals to accept internal experiences, such as cravings to smoke, without acting on those experiences or urges. We used a single-subject (A-B-A) design with 10 participants to examine whether SmartQuit® use would reduce cigarette intake in a New Zealand sample. METHODS: 10 smokers tallied their own cravings experienced and cigarettes smoked then sent those tallies to the first author every day until we observed stable patterns (Phase A1). We then gave the participants individual access to the SmartQuit® app (Phase B). When they advised that they had ceased using the app, they again recorded daily cravings and cigarettes smoked for a minimum of three days (Phase A2). We also collected follow-up smoking and craving data at 1, 2 and up to 13 months after completion of Phase A2. RESULTS: Using SmartQuit® reduced our participants' daily cigarette intake significantly in the short-term and three individuals remained smoke-free up to 13 months later. Cravings to smoke did not differ significantly across Phases A1, B and A2, but graphical analysis showed a trend for decreasing cravings. CONCLUSION: Our results suggest that SmartQuit® provides another readily accessible intervention to help people stop smoking and is suited for use with a New Zealand population.

Risk in our midst: Centrelines, perceived risk, and speed choice.

The idea that drivers' perceptions of risk affect their decisions and choices, particularly as regards their speed, is at the heart of many years of our education, engineering, and enforcement strategies to improve road safety. Our previous research has shown that horizontal curvature, road width, vertical curvature and separation from on-coming traffic are principal determinants to perceptions of risk on rural roads. The present study examined the relationship between drivers' perceptions of risk and the speeds they choose to drive. Participants drove high definition videos of familiar rural roads in a driving simulator and a smaller group of participants drove the same roads in a university fleet vehicle similar to the one used in the simulator. The results showed that double yellow and wide centreline markings were associated with lower speed choices and higher perceptions of risk, an effect magnified under high traffic conditions. Similarly, in both the simulator and on the roads, driving on narrow roads was associated with significantly lower speeds and increased risk ratings, while wider roads showed a small but significant increase in speeds as compared to standard width control roads. Finally, a range of other road and traffic conditions such as one-lane bridges, level crossings, police cars, and crash area warning signs were also found to be associated with lower speed choices and higher risk perceptions.

Not all minds wander equally: The influence of traits, states and road environment factors on self-reported mind wandering during everyday driving.

Inattention is a road safety problem, but few studies have focused specifically on mind wandering during everyday driving. This paper explores differences in self-reported mind wandering according to driver demographic characteristics (including age and gender), cognitive traits (such as tendency toward cognitive failure or mindful attention), states (such as feeling tired or stressed) and road environment factors (such as route familiarity). Five hundred and two participants (113 male, average age 44.4 years, SD=14.0years) completed a series of questionnaires (Mindful Attention and Awareness Scale (MAAS), Cognitive Failures Questionnaire (CFQ) and Driver Behaviour Questionnaire (DBQ)), as well as study-specific questions about mind wandering during different personal states and across a range of road and traffic situations. All respondents reported mind wandering during driving at least some of the time. Mind wandering was more likely to be reported on familiar roads than on unfamiliar roads and when drivers are tired. Drivers who reported relatively more mind wandering were younger, reported less mindful attention in daily life, more cognitive failures, and more driving violations and lapses. Together, the findings suggest that mind wandering is common in everyday driving, however any link with crash risk remains unclear. Future research using self-report and naturalistic methods could provide more insight into relationships between mind wandering, error and crash risk.

Concurrent progressive-ratio and fixed-ratio schedule performance under geometric and arithmetic progressions by brushtail possums.

The aim of this study was to compare the demand for food under concurrent progressive- and fixed-ratio schedules. Twelve brushtail possums participated in 16 conditions where schedule, progression and food type were varied. An incrementing schedule increased the fixed-ratio requirement within and across sessions and was arranged as either a geometric sequence (base 2), or an arithmetic sequence (step 5). Two foods were tested: a flaked barley and coco-pop(®) mix versus rolled oats. Overall, performance was similar for most possums in the within- and across-session incrementing schedules. An analysis of the estimates of essential value and break point produced the same account of demand for foods under the geometric or arithmetic progressions and within- and across-session procedures for 8 of 12 possums. Six possums showed higher demand for rolled oats compared to flaked barley, and two possums showed higher demand for flaked barley compared to rolled oats. Incrementing ratios within, rather than between sessions using an arithmetic progression was demonstrated to be a time efficient procedure for investigating demand for different food types without affecting conclusions about the relative demand for those foods.