National Disability Insurance Scheme timeframes and functional outcomes for inpatient rehabilitation patients: a 5-year retrospective audit.

Objective The aim of this study was to compare National Disability Insurance Scheme (NDIS) timeframes and functional outcomes for a patient population managed in an inpatient hospital rehabilitation unit. Methods A retrospective hospital audit was undertaken of adult patients admitted to a tertiary-level, regional inpatient rehabilitation unit between January 2017 and December 2021 who were either referred, or not, to the NDIS. A hospital NDIS patient database, Australasian Rehabilitation Outcome Centre episode data, and patient medical records were analysed. The main outcome measures included actual rehabilitation length of stay versus expected length of stay, and Functional Independence Measure (FIM) efficiency for all inpatients, with NDIS timeframes analysed for the NDIS-referred patient subgroup. Results Rehabilitation inpatients referred for NDIS services significantly exceeded expected rehabilitation length of stay compared to those not referred to the NDIS. Furthermore, expected length of stay was significantly exceeded for those patients who required implementation of a NDIS plan to safely transition from hospital. FIM efficiency was significantly lower for patients referred to the NDIS. Recent improvement in timeframes for being accepted as a NDIS participant did not reduce length of stay. Conclusions NDIS timeframes for rehabilitation inpatients incur a significant opportunity cost for the provision of efficient inpatient rehabilitation services that are unaccounted for in current benchmarking performance standards.

Interactions across the ages: How concerns about warmth and competence impact age-based stereotype threat in the workplace.

Although the disengagement consequences of age-based stereotype threat in the workplace are well-documented, it is less clear what causes employees to experience age-based stereotype threat. Based on socioemotional selectivity theory, the present study examines whether and why daily cross-age interactions in the workplace lead to stereotype threat. Using a diary study design over 2 weeks, 192 employees (86 employees aged 30 and younger; 106 employees aged 50 and older), completed 3570 reports on daily interactions with coworkers. Results showed that both younger and older employees experienced stereotype threat when they engaged in cross-age interactions compared to interactions with people of a similar age. The characteristics of cross-age interactions that led employees to experience stereotype threat differed by age, however. Consistent with socioemotional selectivity theory, cross-age interactions were problematic for younger employees to the degree that they triggered concerns about competence, whereas concerns about warmth led to stereotype threat among older employees. Daily stereotype threat was associated with reduced feelings of workplace belonging for both younger and older employees but, contrary to expectations, stereotype threat was not related to energy and stress. These findings suggest that cross-age interactions can lead to stereotype threat for both younger and older employees, particularly when younger employees worry they are perceived as incompetent or older employees worry they are perceived as less warm. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Dental anxiety and oral health following stroke: a pilot study.

BACKGROUND: Oral health is often poorer in people living with acquired brain injury relative to non-clinical controls. However, although anxiety disorders become more common following stroke, no study to date has tested whether dental anxiety might contribute to stroke survivors' increased vulnerability to poorer oral health. This pilot study reports the first test of whether the anxiety disturbances that commonly present following stroke extend to dental anxiety, and if dental anxiety in this group is linked to poorer oral health. MATERIALS AND METHODS: First-time stroke survivors (N = 35) and demographically matched controls (N = 35) completed validated measures of dental anxiety, oral health, negative affect, and life satisfaction. RESULTS: Stroke survivors did not differ from controls in their overall levels of dental anxiety or oral health, but uniquely for the stroke group, dental anxiety was strongly associated with poorer oral health, and this effect remained significant even after controlling for negative affect and life satisfaction. CONCLUSION: Stroke survivors who have higher levels of dental-related anxiety may be at increased risk of poorer oral health.

A comprehensive assessment of poststroke social cognitive function.

OBJECTIVE: Stroke-related social cognitive impairment is now well established, but studies vary considerably in the nature and magnitude of the deficits reported, as well as whether there are potential areas of preservation. Because these discrepancies may reflect clinical heterogeneity between the contributing research participants, this study provides the first concurrent assessment of all four core social cognitive domains (theory of mind, emotion perception, social behavior, and affective empathy) in the same stroke cohort. A secondary goal was to test whether the degree of social cognitive impairment varied as a function of the tasks' ecological validity, on the basis that tasks with greater realism may provide a better indication of the implications of any stroke-related difficulties for everyday social interactions. METHOD: Participants included 35 people with first-time, ischemic or hemorrhagic stroke (as confirmed via MRI or CT) aged between 29 and 87 years (M = 64.69; SD = 12.92), and 35 controls matched for age, sex, and years of education. All participants completed a comprehensive social cognitive test battery as well as measures to broadly characterize neurocognitive function and well-being. RESULTS: Relative to controls, affective empathy was selectively preserved (d = 0.02), but stroke-related deficits were identified for theory of mind (d = -0.42), emotion perception (d = -0.48), and social behavior (d = -0.59). The degree of social cognitive impairment did not vary as a function of the tasks' ecological validity. CONCLUSIONS: These data enhance understanding of stroke-related social cognitive impairment and inform the development of tailored, evidence-based rehabilitation efforts. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

An assessment of age differences in theory of mind using the virtual assessment of mentalizing ability.

Prior research has shown that older adults perform more poorly than young on tasks that assess theory of mind (ToM). However, these studies have used tasks that are performed "offline" (i.e., requiring a second-person perspective) as opposed to "online" (i.e., requiring a first-person perspective). Therefore, the present study was designed to establish whether age-related ToM difficulties are also evident when an "online" measure of ToM is used. Forty younger and 40 older adults completed the Virtual Assessment of Mentalizing Ability (VAMA) along with two conventional ToM tasks. No age differences were evident on the conventional measures, but older adults had lower accuracy on the VAMA relative to their younger counterparts. The overall pattern of errors did not differ between the groups. These data provide no evidence that age effects are reduced when stimuli are used that are more likely to engage the mentalizing processes elicited in real life social interactions.

Empathy and theory of mind in Parkinson's disease: A meta-analysis.

In contrast to well-documented deficits in the core social cognitive domains of social perception and theory of mind (ToM), how Parkinson's disease (PD) affects one's empathic capacity remains poorly understood. The current study provides the first meta-analytic review of both ToM and empathy as broad constructs, and also breaks these constructs down to clearly differentiate their overlapping (affective ToM and cognitive empathy) and distinct (affective empathy and cognitive ToM) components. A total of 38 studies contributed to these analyses, with results revealing that, relative to controls, PD is associated with significant and substantial deficits in the domain of cognitive ToM (g = -0.78), as well as the overlapping domains of affective ToM/cognitive empathy (g = -0.69). However, no group differences were identified for affective empathy (g = -0.08). These data speak to there being a potential preservation of affective empathic processing in PD, but because of the relatively limited research base on this topic, recommendations for future research are highlighted.

Structural and functional brain correlates of theory of mind impairment post-stroke.

The ability to understand the mental states of others - also known as Theory of Mind (ToM) - is critical for normal social interactions. We combine behavioural probes with structural and functional brain imaging to provide the first comprehensive analysis of ToM deficits following stroke using the Reading the Mind in the Eyes Test (RMET). First, fMRI was used to identify the functional brain network involved in a non-clinical cohort. Results indicated that, relative to a control task, the RMET increased activity in a widespread functional bilateral network comprising frontal and temporo-parietal areas. To investigate how damage to grey and white matter components of this network can lead to ToM impairment, parcel-based lesion-symptom mapping (PLSM), white-matter tract-wise statistical analysis (TSA) and disconnectome symptom mapping (DSM) were performed using structural images from 64 stroke patients. PLSM results revealed that low scores on the RMET were associated with damage centered around the right posterior frontal gyrus and insula. TSA and DSM results further revealed that low RMET scores were associated with damage to white-matter tracts connecting frontal and temporo-parietal components of the RMET functional network. Together, these findings suggest that making judgements about the mental states of others imposes demands on a large functional network that can easily be disrupted, both by damage to grey matter areas that form part of the network directly, or the white-matter pathways that connect them.

Social perceptual function in parkinson's disease: A meta-analysis.

Social perceptual impairment is a common presenting feature of Parkinson's disease (PD) that has the potential to contribute considerably to disease burden. The current study reports a meta-analytic integration of 79 studies which shows that, relative to controls, PD is associated with a moderate emotion recognition deficit (g = -0.57, K = 73), and that this deficit is robust and almost identical across facial and prosodic modalities. However, the magnitude of this impairment does appear to vary as a function of task and emotion type, with deficits generally greatest for identification tasks (g = -0.65, K = 54), and for negative relative to other basic emotions. With respect to clinical variables, dopaminergic medication, deep brain stimulation, and a predominant left side onset of motor symptoms are each associated with greater social perceptual difficulties. However, the magnitude of social perceptual impairment seen for the four atypical parkinsonian conditions is broadly comparable to that associated with PD. The theoretical and practical implications of these findings are discussed.

A meta-analytic review of social cognitive function following stroke.

Although it is now widely recognised that social cognitive difficulties are often evident following stroke, important questions remain about the nature and magnitude of these difficulties, as well as the factors that determine the magnitude of this impairment. A meta-analysis of 58 datasets involving 2567 participants (937 with stroke, 1630 non-clinical controls) was therefore conducted. The results indicated that three of the four core domains of social cognitive function were significantly disrupted in people with stroke. Specifically, while the effect size for affective empathy failed to attain significance (r = -.33), moderate to large deficits were identified for theory of mind (r = -.44), social perception (r = -.55), and social behaviour (r = -.53). These deficits were robust across both left and right lateralized lesions, across social cognitive assessments that differed in their broader cognitive demands, as well as in tasks that varied in their modality of presentation. These data are discussed in the context of broader neuropsychological models of social cognitive function.