Impact of Early Personal Resources on Long-Term Psychosocial Outcomes After Moderate-to-Severe Traumatic Brain Injury: A Systematic Review.

OBJECTIVE: To investigate the relationship between preinjury or early personal resources and long-term psychosocial outcomes following moderate-to-severe traumatic brain injury (TBI) and examine evidence for the stability of personal resources over time. METHODS: The review protocol was registered with the International Register of Systematic Reviews (PROSPERO, Registration No. CRD4202341056). A search of PsycINFO, Cumulative Index to Allied Health Literature (CINAHL), MEDLINE, Scopus, and Web of Science was conducted from inception to February 23, 2023, for longitudinal studies involving adults with moderate-to-severe TBI that examined: (1) the relationship between preinjury or early personal resources (measured ≤6 months postinjury) and later psychosocial outcomes or (2) stability of personal resources over time with a minimum reassessment interval of 3 months. Two reviewers independently assessed eligibility and rated methodological quality of studies using a checklist informed by Strengthening the Reporting of Observational Studies in Epidemiology. RESULTS: A narrative synthesis was conducted on 14 eligible articles summarizing 12 studies (N = 826). Nine studies examined the impact of preinjury or early personal resources on long-term psychosocial outcomes, most typically at 12 months postdischarge. Out of 9 studies 7 indicated that self-reported preinjury or early personal resources, including productive coping, higher self-esteem and resilience, and lower neuroticism, were associated with better psychosocial outcomes. Evidence from 7 studies examining the stability of personal resources over time was generally mixed, with personality changes (eg, neuroticism, conscientiousness, and extraversion) more evident from informant ratings than self-ratings. CONCLUSION: Preinjury or early personal resources may influence later psychosocial outcomes after TBI. Further research is needed to investigate the stability of personal resources and factors mediating or moderating change across the adjustment trajectory.

The impact of using implementation intentions as task instructions on prospective memory performance after stroke.

Prospective Memory (PM), the ability to remember to carry out intentions in the future, is often impaired after stroke. Little is known about rehabilitation of PM post-stroke with literature limited by small sample sizes and reliance on self-reported memory performance. Implementation intentions may make prospective remembering more automatic and follow a simple if-then structure (if X occurs, then I will do Y), focusing on the cue rather than the task. We aimed to investigate the effect of implementation intentions on PM post-stroke. Twenty-eight individuals with stroke and 27 controls were randomly allocated to a standard instruction or implementation intention condition and completed an assessment battery over two sessions. Implementation intention instructions were provided for PM tasks on the Delayed Message Task, Lexical Decision Prospective Memory Task (LDPMT), and the Virtual Reality Prospective Memory Shopping Task. The implementation intention groups performed better on all PM tasks compared to the standard instruction group, but no results reached statistical significance, likely due to the small sample size. In addition, the implementation intentions group monitored the time significantly more on the LDPMT than those in the standard instruction group.

Establishing the normative and comparative needs of assistive technology provision in Queensland from the agency and funding scheme perspective.

BACKGROUND AND AIMS: Assistive technology services and devices support the participation and inclusion of people living with disability. In Australia, the regulatory bodies, agencies and schemes that manage assistive technology provision are governed by national and / or state-based Acts and Legislation. This study examined the assistive technology sector from the perspective of the regulatory bodies, agencies and schemes. DESIGN AND METHODS: Regulatory bodies, agencies and schemes that manage funding for assistive technology in Australia were identified by the research team. A website audit reviewed publicly available documents and information. Semi-structured interviews with representatives from the agencies and schemes were audio-recorded and transcribed verbatim. FINDINGS: The audit (n =17) found that the range and level of information publicly available was variable. The availability of assistive technology for driving and transport, design and building for access and safety, and mobility was most often promoted. The qualitative findings (n = 11) indicated variability and challenges within four themes: operationalising the legislation; internal assistive technology processes; reasonable and necessary; and risks in the assistive technology pathway. CONCLUSIONS: Regulatory bodies, agencies and schemes are critical to the effectiveness of the sector. The findings identified opportunities for the organisations to review how internal processes are communicated publicly, and for the sector to address the perceived risks related to health professional availability, knowledge and skills, and limited accessibility to trial assistive technology. Subsequent studies explored the perspectives of the assistive technology advisors and suppliers and the recipients of assistive technology services and devices.

Efficacy of Prospective Memory Rehabilitation Plus Metacognitive Skills Training for Adults With Traumatic Brain Injury: A Randomized Controlled Trial.

BACKGROUND: Prospective memory (PM) failure can limit independence and productivity following traumatic brain injury (TBI). Compensatory strategy use may ameliorate the effect of PM impairment on daily life but requires sufficient self-awareness. Metacognitive skills training (MST) can facilitate self-awareness and strategy use and may improve the efficacy of PM rehabilitation. OBJECTIVE: To evaluate the effectiveness of compensatory strategy training (COMP) with an MST component (COMP-MST) for reducing everyday PM failure and improving psychosocial integration in adults with moderate-severe TBI, compared to COMP alone and a control condition. Secondary aims were to evaluate the effect of training on psychometric PM test scores, strategy use, self-awareness, and level of care. METHODS: Assessor and participant-blinded randomized controlled trial with 52 participants (77% male, mean age = 39.0. SD = 13.6) allocated to 3 groups: COMP-MST, COMP, and waitlist control. Interventions were delivered over 6 weekly sessions. Measures were collected pre- and post-intervention and 3-month follow-up. Data were analyzed using unstructured linear mixed-effects modeling for repeated measures and planned contrasts between time-points for each group. RESULTS: The models showed no significant differences between the groups on primary or secondary outcome measures. Significant pre-post intervention improvements were found for significant other's ratings of everyday PM failure for both intervention groups but not the control group, with medium to large effect sizes. Clinically relevant improvements on primary outcomes were found for participants across all 3 groups. CONCLUSIONS: This study found no significant benefits of combining MST with COMP for improving everyday PM and psychosocial integration. CLINICAL TRIAL REGISTRATION: Australian and New Zealand Clinical Trials Registry https://www.anzctr.org.au/ ACTRN12615000996561.

Schwartz Rounds for Staff in an Australian Tertiary Hospital: Protocol for a Pilot Uncontrolled Trial.

BACKGROUND: Schwartz Rounds are a unique, organization-wide interdisciplinary intervention aimed at enhancing staff well-being, compassionate care, teamwork, and organizational culture in health care settings. They provide a safe space wherein both clinical and nonclinical health staff can connect and share their experiences about the social and emotional aspects of health care. OBJECTIVE: Although Schwartz Rounds have been assessed and widely implemented in the United States and United Kingdom, they are yet to be formally evaluated in Australian health care settings. The purpose of this study is to evaluate the feasibility and impact of Schwartz Rounds on staff well-being, compassionate care, and organizational culture, in a tertiary metropolitan hospital in Brisbane, Australia. METHODS: This mixed methods repeated measures pilot study will recruit 24 participants in 2 groups from 2 departments, the intensive care unit and the gastroenterology department. Participants from each group will take part in 3 unit-based Schwartz Rounds. Primary outcomes will include the study and intervention feasibility measures, while secondary outcomes will include scores on the Maslach Burnout Inventory-Human Services Survey, the Schwartz Centre Compassionate Care Scale, and the Culture of Care Barometer. Primary and secondary outcomes will be collected at baseline, after the Rounds, and 3-month follow-up. Two focus groups will be held approximately 2 months after completion of the Schwartz Rounds. Descriptive statistics, paired t tests, chi-square tests, and analysis of variance will be used to compare quantitative data across time points and groups. Qualitative data from focus groups and free-text survey questions will be analyzed using an inductive thematic analysis approach. RESULTS: The study was approved by the Mater Hospital Human Research Ethics Committee (reference number: HREC/MML/71868) and recruitment commenced in July 2021; study completion is anticipated by May 2022. CONCLUSIONS: The study will contribute to the assessment of feasibility and preliminary efficacy of the Schwartz Rounds in a tertiary Australian hospital during the COVID-19 pandemic. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12621001473853; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=382769&isReview=true. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/35083.

Executive function moderates the relationship between temperament and psychological difficulties in middle childhood.

The current study examined the possible moderating influence of hot and cool executive function (EF) on the relationship between temperament and psychological difficulties in middle childhood. One hundred and twenty-six children and their parents (n = 105) participated. Children aged between 5 and 12 years completed three hot (motivational decision-making on the Cambridge Gambling Task (CGT), delayed gratification, and Theory of Mind [ToM]) and three cool EF (working memory, inhibition, and attentional set shifting) measures. Children's parents completed the Behavioral Inhibition Sensitivity (BIS) and Behavioral Approach Sensitivity (BAS) Scale and the Strengths and Difficulties Questionnaire. Hot EF (CGT, ToM) exacerbated the relationship between BAS and externalizing problems. Neither hot nor cool EF moderated the relationship between BIS and internalizing problems. The current findings provide further evidence of a hot-cool distinction in EF in middle childhood, suggesting that these constructs should be investigated separately when assessing EF. In addition, by considering potential interactions between temperament and EF, clinicians/researchers may be able to predict broad categories of psychological problems in middle childhood.

Relations between Executive Functions, Theory of Mind, and Functional Outcomes in Middle Childhood.

This study examined whether hot and cool executive functions (EFs) differentially predicted functional outcomes and the independent and mediating roles of theory of mind (ToM). 126 children completed tests of hot and cool EF, ToM, intelligence, and academic achievement. Parents completed questionnaires of peer problems and prosocial behavior. Hot and cool EFs differentially predicted intelligence and academic achievement, supporting a hot-cool distinction. ToM predicted word reading and prosocial behavior but did not mediate any associations between EF and functional outcomes. Findings contribute to current understandings of EF and its relationship with functional outcomes in middle childhood.

A systematic review of studies that used NIRS to measure neural activation during emotion processing in healthy individuals.

Functional neuroimaging provides an avenue for earlier diagnosis and tailored treatment of psychological disorders characterised by emotional impairment. Near-infrared spectroscopy (NIRS) offers ecological advantages compared to other neuroimaging techniques and suitability of measuring regions involved in emotion functions. A systematic review was conducted to evaluate the capacity of NIRS to detect activation during emotion processing and to provide recommendations for future research. Following a comprehensive literature search, we reviewed 85 journal articles, which compared activation during emotional experience, regulation or perception with either a neutral condition or baseline period among healthy participants. The quantitative synthesis of outcomes was limited to thematical analysis, owing to the lack of standardisation between studies. Although most studies found increased prefrontal activity during emotional experience and regulation, the findings were more inconsistent for emotion perception. Some researchers reported increased activity during the task, some reported decreases, some no significant changes, and some reported mixed findings depending on the valence and region. We propose that variations in the cognitive task and stimuli, recruited sample, and measurement and analysis of data are the primary causes of inconsistency. Recommendations to improve consistency in future research by carefully considering the choice of population, cognitive task and analysis approach are provided.

Self-reported prospective memory after stroke.

Prospective Memory (PM) is the memory for completing future intentions. This study aimed to compare self-reported PM of individuals with stroke to healthy controls, to determine if PM is impaired after stroke. Additionally, self-reported PM for individuals with stroke was compared to significant-other reports, ascertaining a level of self-awareness of PM function. Twenty-eight individuals with stroke, 25 significant-others, and 27 healthy controls completed the Brief Assessment of PM (BAPM) and the Prospective and Retrospective Memory Questionnaire (PRMQ) as part of a larger study. Individuals with stroke reported significantly more Basic Activities of Daily Living (BADL) PM failures compared to controls on Part A of the BAPM. On Part B, individuals with stroke reported BADL PM failures to be less problematic/important than controls, suggesting a lack of self-awareness into the consequences of PM failure. Individuals with stroke also reported significantly more PM and RM failures compared to controls on the PRMQ. No significant differences were found between individuals with stroke and their significant-others on both the BAPM and PRMQ. Results of this study helped to clarify the previous research and highlighted that individuals with stroke reported more PM failures than controls but underestimated the importance of such memory lapses.

The Assessment and Prediction of Prospective Memory after Stroke.

OBJECTIVE: Prospective memory (PM) is the memory used when intentions are to be carried out in the future. Little research has been conducted examining PM after stroke. This study aimed to determine if PM is impaired after stroke through comparison of individuals with stroke to healthy controls. Additionally, it aimed to explore the predictors of PM performance post-stroke. METHOD: Twenty-eight individuals with stroke and 27 neurologically healthy controls completed the Cambridge Prospective Memory Test (CAMPROMPT), 2 self-report PM questionnaires, and multiple cognitive measures. RESULTS: Individuals with stroke performed significantly lower on both event- and time-based PM than controls on the CAMPROMPT, indicating PM impairment. Event-based PM after stroke was significantly predicted by age, retrospective memory (RM), and global cognitive function, whereas time-based PM was only predicted by the metacognitive skill of note-taking. Age and note-taking predicted time-based PM for controls, whereas only age predicted event-based PM for control participants. CONCLUSIONS: The findings of this study have helped to confirm that PM impairment does exist after stroke, particularly when using a standardised PM measure. Furthermore, PM impairment may be predicted by variables, such as age, strategy use, RM, and cognitive ability.

Executive function in middle childhood and the relationship with theory of mind.

A group of 126 typically developing children (aged 5-12 years) completed three cool executive function tasks (spatial working memory, stop signal, intra-extra dimensional shift), two hot executive function tasks (gambling, delay of gratification), one advanced theory of mind task (strange stories with high versus low affective tone), and a vocabulary test. Older children performed better than younger children, consistent with the protracted development of hot and cool executive functions and theory of mind. Multiple regression analyses showed that hot and cool executive functions were correlated but they predicted theory of mind in different ways.