A new clinical tool for assessing numerical abilities in neurological diseases: numerical activities of daily living

The aim of this study was to build an instrument, the numerical activities of daily living (NADL), designed to identify the specific impairments in numerical functions that may cause problems in everyday life. These impairments go beyond what can be inferred from the available scales evaluating activities of daily living in general, and are not adequately captured by measures of the general deterioration of cognitive functions as assessed by standard clinical instruments like the MMSE and MoCA. We assessed a control group (n = 148) and a patient group affected by a wide variety of neurological conditions (n = 175), with NADL along with IADL, MMSE, and MoCA. The NADL battery was found to have satisfactory construct validity and reliability, across a wide age range. This enabled us to calculate appropriate criteria for impairment that took into account age and education. It was found that neurological patients tended to overestimate their abilities as compared to the judgment made by their caregivers, assessed with objective tests of numerical abilities

Measures of Health-Related Quality of Life Outcomes in Pediatric Neurosurgery: Literature Review

Background Improving value in healthcare means optimizing outcomes and minimizing costs. The emerging pay-for-performance era requires understanding of the effect of healthcare services on health-related quality of life (HRQoL). Pediatric and surgical subspecialties have yet to fully integrate HRQoL measures into practice. The present study reviewed and characterized the HRQoL outcome measures across various pediatric neurosurgical diagnoses. Methods A literature review was performed by searching PubMed and Google Scholar with search terms such as “health-related quality of life” and “pediatric neurosurgery” and then including the specific pathologies for which a HRQoL instrument was found (e.g., “health-related quality of life” plus “epilepsy”). Each measurement was evaluated by content and purpose, relative strengths and weaknesses, and validity. Results We reviewed 68 reports. Epilepsy, brain tumor, cerebral palsy, spina bifida, hydrocephalus, and scoliosis were diagnoses found in reported studies that had used disease-specific HRQoL instruments. Information using general HRQoL instruments was also reported. Internal, test–retest, and/or interrater reliability varied across the instruments, as did face, content, concurrent, and/or construct validity. Few instruments were tested enough for robust reliability and validity. Significant variability was found in the usage of these instruments in clinical studies within pediatric neurosurgery. Conclusions The HRQoL instruments used in pediatric neurosurgery are currently without standardized guidelines and thus exhibit high variability in use. Clinicians should support the development and application of these methods to optimize these instruments, promote standardization of research, improve performance measures to reflect clinically modifiable and meaningful outcomes, and, ultimately, lead the national discussion in healthcare quality and patient-centered care

Outcome measurement in cognitive neurorehabilitation

Introduction: The aim of this chapter is to consider the criteria for selecting outcome measures for evaluating the effects of cognitive neurorehabilitation. The International Classification of Function, Disability and Health (ICF) (World Health Organization, 2001) is used as a framework for deciding what to measure. The properties of the ideal outcome measure are discussed. Examples of outcome measures commonly used in clinical studies are provided and their strengths and limitations considered. The focus is on self-report measures rather than neuropsychological tests as these reflect the effect of cognitive rehabilitation on daily life

Diagnostic Utility of the Impact of Event Scale-Revised in Two Samples of Survivors of War

The study aimed at examining the diagnostic utility of the Impact of Event Scale-Revised (IES-R) as a screening tool for post-traumatic stress disorder (PTSD) in survivors of war. The IES-R was completed by two independent samples that had survived the war in the Balkans: a sample of randomly selected people who had stayed in the area of former conflict (n = 3,313) and a sample of refugees to Western European countries (n = 854). PTSD was diagnosed using the MINI International Neuropsychiatric Interview. Prevalence of PTSD was 20.1% in the Balkan sample and 33.1% in the refugee sample. Results revealed that when considering a minimum value of specificity of 0.80, the optimally sensitive cut-off score for screening for PTSD in the Balkan sample was 34. In both the Balkan sample and the refugee sample, this cut-off score provided good values on sensitivity (0.86 and 0.89, respectively) and overall efficiency (0.81 and 0.79, respectively). Further, the kappa coefficients for sensitivity for the cut-off of 34 were 0.80 in both samples. Findings of this study support the clinical utility of the IES-R as a screening tool for PTSD in large-scale research studies and intervention studies if structured diagnostic interviews are regarded as too labor-intensive and too costly

Prevalence and assessment of traumatic brain injury in prison inmates : a systematic PRISMA review

The primary objectives of the present systematic PRISMA review was: (1) to explore the range of prevalence of TBI in offenders, and whether this is higher than in a control sample; (2) to determine which screening measures are available, and evaluate the evidence on these; and lastly, (3) to evaluate whether prevalence of TBI is associated with increased prevalence of other health conditions and/or offending behaviour. The present systematic PRISMA review explores the peer reviewed literature published since 2005 which has investigated TBI in incarcerated populations using five databases (CINAHL, MEDLINE, PsycARTICLES, Psychology and Behavioral Sciences Collection, PsycINFO) in addition to separate searches conducted on ‘Google Scholar’ using specific search criteria. Seventeen studies were identified which explored the prevalence of TBI in inmates. Only five of the seventeen studies which investigated prevalence of TBI in offender populations looked at juvenile offending. Interestingly, only seven of the 12 studies included both male and female samples (two of which did not report findings separate for males and females. In terms of the assessments used to investigate prevalence, three studies investigated the prevalence of TBI using The Ohio State University (OSU) TBI Identification method (OSU-TBI-ID). Nine studies used one or two questions in order to elicit information on whether the offender had previously experienced a TBI. Only two studies used the Traumatic Brain Injury Questionnaire (TBIQ). One study used the Brain Injury Screening Index (BISI). Lastly evidence of TBI checklist from medical record (14-items) was used in one study. In terms of the implication for further research and practice, the studies identified in this review clearly emphasise the need to account for TBI in managing care in offender populations, which may contribute to reduction in offending behaviours. Additionally, there is a need for further research investigating the clinical utility of screening tools for detecting TBI in offender populations such as The Traumatic Brain Injury Questionnaire (TBIQ), The Brain Injury Screening Index (BISI) and The Ohio State University (OSU-TBI-ID) TBI Identification method

Traumatic Brain Injury and Recidivism among Returning Inmates

In recent years, there has been a surge in research that examines the relationship between traumatic brain injury (TBI) and involvement in the criminal justice system. However, the bulk of this research has been largely retrospective and descriptive, comparing rates of TBI in the offending population with the rates of TBI in the general population. Although findings from these studies indicate a higher prevalence of TBI in the offending population, virtually no studies have examined whether those with TBI are more likely to recidivate. To address this gap, the present study examined rearrest post release from prison among a cohort sample of Indiana inmates who were screened using the Ohio State University Traumatic Brain Injury Identification (OSU-TBI-ID) instrument. Findings indicate that, net of control variables, those with TBI were more likely to recidivate sooner than those without TBI. Policy implications and directions for future research are discussed

Wachkoma - ein anderes Leben : Schmerzerfassungsinstrumente bei Kindern mit schweren, erworbenen Hirnschädigungen

Einleitung: Jährlich fallen schweizweit ungefähr 40 Kinder aufgrund schwerer, erworbenen Hirnschädigungen in ein Wachkoma (Donis & Trojer, 2015). Sie können sich nicht zu ihrem Befinden äussern und so bleibt für das betreuende Fachpersonal unklar, ob die gewählten Massnahmen zur Zustandsverbesserung der Kinder beitragen. Zur Überprüfung dieser Massnahmen verwendet man deshalb im Praxisalltag Verlaufsparameter, die objektive Aussagen ermöglichen. Ziel: Das Ziel ist, reliable, valide und für die Physiotherapie relevante Schmerzassessments für Kinder im Wachkoma zu finden. Solche Assessments helfen, eine bessere und zielorientierte Empfehlung für eine physiotherapeutische Behandlung zu geben und den Therapieverlauf objektiv festzuhalten. Methodik: Mittels einer Literaturrecherche wurden Assessments gesucht, welche für Kinder mit schweren, erworbenen Hirnschädigungen anwendbar sind. Die inkludierten Validierungsstudien wurden bezüglich Methodik und psychometrischen Eigenschaften nach Lienert und Raatz (1998) beurteilt und kritisch diskutiert. Ergebnisse: Für die Schmerzerfassung zeigt die NCS-R die höchsten Werte für Reliabilität und Validität. Offen bleibt die Frage, inwiefern die Ergebnisse dieser Arbeit für Kinder anwendbar sind. Schlussfolgerungen: Da Kinder ab 2 Jahren bereits über entwickelte Schmerzbewältigungsstrategien (Deutscher Hebammenverband, 2010) verfügen, wird empfohlen, den Entwicklungsstand der Kinder immer miteinzubeziehen (Ashwal, 2004). Dadurch könnte die Möglichkeit bestehen, Kinder ab einer gewissen Reife, mit Assessments für Erwachsene zu bewerten