Behavioural effects of neocortical and cingulate lesions in the Mongolian gerbil.

The experiments examine the effects of cortical lesions on a variety of behaviours in the Mongolian gerbil (Meriones unguiculatus). Gerbils with either large anterior or posterior lesions were compared with normal gerbils by administering a battery of tests of rodent behaviours such as grooming, eating, social interaction, ventral marking and foot-stomping. In a second experiment, a more detailed investigation was carried out of the effects of focal cortical lesions on ventral marking. The results of these experiments suggest that anterior cortical lesions in gerbils give rise to a number of different deficits in behaviour. The results further suggest that cingulate cortex is part of the neural substrate for ventral marking behaviour. The implications of these results for contemporary theories of frontal lobe function are discussed.

Spinal malformations in the fetuses of HIV infected women receiving combination antiretroviral therapy and co-trimoxazole.

HIV positive women of reproductive age are increasingly treated with a combination of antiretroviral agents, with effects on the developing human fetus that are largely unknown. We report two cases of severe spinal malformations in the fetuses of women treated with combination antiretroviral therapy and co-trimoxazole.

A new protocol for training severely impaired patients in the usage of memory journals.

Although memory disorders are frequently seen in survivors of brain injuries, remediation of patients with severe memory disorders is still relatively neglected in clinical practice due to pessimism by clinicians regarding the efficacy of such remediation. With respect to memory journal training, a further reason for this neglect is likely the lack of readily accessible protocols that therapists can use to work with these patients. The purpose of the present paper is to describe a new memory journal training protocol that was developed to teach brain injury survivors how to compensate for severe memory impairments by using three strengths of most brain injury survivors: immediate attention, procedural memory, and old learning. A training protocol is described that involves baseline testing and a needs assessment, five levels of training exercises, and discharge probe testing. It is concluded that patients with severely impaired memory abilities can learn the present system when care is taken to individualize journals, conduct proper needs assessments, and provide structured training exercises geared to the strengths of memory impaired persons.

Interrater reliability of the Functional Assessment Measure in a brain injury rehabilitation program.

OBJECTIVE: To examine the interrater reliability and completion time of the Functional Assessment Measure, which is the Functional Independence Measure (FIM) plus additional items (FIM+FAM). DESIGN: Interrater reliability study. SETTING: Inpatient rehabilitation units of a postacute care brain injury rehabilitation program. PATIENTS: A convenience sample of 53 extremely severely impaired adult survivors of traumatic brain injuries (40 men, 13 women, mean age 38yrs). MAIN OUTCOME MEASURES: Treatment team members' ratings of the 30 FIM +FAM items, and time taken to complete the FIM+FAM. RESULTS: Intraclass Correlation Coefficients (ICCs) were within the good to excellent range (ICC > .60) for 29 of 30 items and for all subscales except psychosocial adjustment. Higher mean ICC values were obtained for motor domain items than for cognitive/psychosocial domain items. Treatment teams became progressively faster over a 12-week period in completing the FIM+FAM. The generally good to excellent range interrater reliability found in this study helps support the use of the FIM+FAM in rehabilitation settings. Further support was obtained for the finding that motor items are more reliable than cognitive and psychosocial items. Administration of the FIM+FAM can be done in a timely manner in a rehabilitation setting.