Measuring Change Over Time: A Systematic Review of Evaluative Measures of Cognitive Functioning in Traumatic Brain Injury

Objectives: The purpose of evaluative instruments is to measure the magnitude of change in a construct of interest over time. The measurement properties of these instruments, as they relate to the instrument's ability to fulfill its purpose, determine the degree of certainty with which the results yielded can be viewed. This work systematically reviews all instruments that have been used to evaluate cognitive functioning in persons with traumatic brain injury (TBI), and critically assesses their evaluative measurement properties: construct validity, test-retest reliability, and responsiveness.Data Sources: MEDLINE, Central, EMBASE, Scopus, PsycINFO were searched from inception to December 2016 to identify longitudinal studies focused on cognitive evaluation of persons with TBI, from which instruments used for measuring cognitive functioning were abstracted. MEDLINE, instrument manuals, and citations of articles identified in the primary search were then screened for studies on measurement properties of instruments utilized at least twice within the longitudinal studies.Study Selection: All English-language, peer-reviewed studies of longitudinal design that measured cognition in adults with a TBI diagnosis over any period of time, identified in the primary search, were used to identify instruments. A secondary search was carried out to identify all studies that assessed the evaluative measurement properties of the instruments abstracted in the primary search.Data Extraction: Data on psychometric properties, cognitive domains covered and clinical utility were extracted for all instruments.Results: In total, 38 longitudinal studies from the primary search, utilizing 15 instruments, met inclusion and quality criteria. Following review of studies identified in the secondary search, it was determined that none of the instruments utilized had been assessed for all the relevant measurement properties in the TBI population. The most frequently assessed property was construct validity.Conclusions: There is insufficient evidence for the validity and reliability of instruments measuring cognitive functioning, longitudinally, in persons with TBI. Several instruments with well-defined construct validity in TBI samples warrant further assessment for test-retest reliability and responsiveness.Registration Number:www.crd.york.ac.uk/PROSPERO/, identifier CRD42017055309

İctimai rəyin formalaşmasinda medianin rolu

Cəmiyyətdə mövcud olan ictimai rəy müəyyən insan toplumu və ya icması üçün məqbul hesab edilərək qəbul edilən fikirlərin, münasibətlərin, inancların və digər sosial hadisələrin məcmusudur. Təbii olaraq, bu rəy müəyyən məsələ və ya hadisə üzərində formalaşan bir sosial fenomen hesab edilir. Media ictimai rəyi formalaşdırmaqla cəmiyyətin gələcəyinin müəyyən edilməsində iştirak edir. O, sosial gerçəklik faktlarına, müxtəlif qrupların və ayrı-ayrı şəxsiyyətlərin fəaliyyətinə münasibəti təsbit edir və özündə əks etdirir. Beləliklə, media qeyrirəsmi kütləvi şüurun mövcud olması üsulu olan ictimai rəyin formalaşması və inkişafında həm məqsədyönlü, həm də kortəbii şəkildə iştirak edir. Təbii olaraq, bu qarşılıqlı əlaqə həyat hadisələrinin, sosial təcrübənin və ənənələrin bilavasitə təsiri altında cərəyan edir. Bəs medianın ictimai şüura təsiri mexanizmləri necə formalaşır? Müxtəlif mərhələlərdən keçərək formalaşan ictimai rəy sosial bir fenomenə, gerçəkliyə və fakta çevrilir. Bu, media yarandığı vaxtdan etibarən bütün tarix boyu ictimai və sosial əlaqələrə və fəaliyyətə nüfuz etməklə öz mövcudluğunu qoruyub saxlamışdır. Deməli, qarşılıqlı təmas rejimlərinin olması daim önəm kəsb etmişdir. Bununla belə, ictimai rəyin formalaşmasından danışarkən, medianın ictimai siyasi sistemdə oynadığı rolun bütün təsir mexanizmlərini və yolunu düşünmədən qarşılıqlı əlaqələrin zəncirini müəyyən etmək mümkün deyildir, çünki media hətta özbaşına buraxılmış olsa belə ictimai rəy formalaşdırmaqda əhəmiyyətli rola malikdi

Postmüharibə dövründə əhali arasında yaranmiş psixoloji problemlər və onların aradan qaldırılması

Müharibənin təsiri - birbaşa və dolayı - insan varlığının bütün sahələrinə yayılır. Azərbaycanda I Qarabağ və II Qarabağ müharibələrinin posttravmatik nəticələrinin aradan qaldırılması üçün bu sahədə tədqiqatların aparılması vacibdir. Azərbaycanda postmüharibə dövründə əhalinin psixoloji vəziyyətinin dəyərləndirilməsinə dair araşdırma və tədqiqatların kifayət qədər olmaması psixoloji xidmət sahəsində ləngimələrə səbəb olur. Bu araşdırma Azərbaycanda müharibə travması almış əhalinin psixoloji vəziyyətinə dair əldə ediləcək məlumatların gələcəkdə bu sahədə psixoloji xidmətin təşkil olunmasına töhvə verəcəyi düşünülməkdədir

İctimai rəyin formalaşmasında medianın rolu

Media ictimai rəyi formalaşdırmaqla cəmiyyətin gələcəyinin müəyyən edilməsində iştirak edir. O, sosial gerçəklik faktlarına, müxtəlif qrupların və ayrı-ayrı şəxsiyyətlərin fəaliyyətinə münasibəti təsbit edir və özündə əks etdirir. Beləliklə, media qeyri-rəsmi kütləvi şüurun mövcud olması üsulu olan ictimai rəyin formalaşması və inkişafında həm məqsədyönlü, həm də kortəbii şəkildə iştirak edir. Təbii olaraq, bu qarşılıqlı əlaqə həyat hadisələrinin, sosial təcrübənin və ənənələrin bilavasitə təsiri altında cərəyan edir. Bəs medianın ictimai şüura təsiri mexanizmləri necə formalaşır? Müxtəlif mərhələlərdən keçərək formalaşan ictimai rəy sosial bir fenomenə, gerçəkliyə və fakta çevrilir. Bu, media yarandığı vaxtdan etibarən bütün tarix boyu ictimai və sosial əlaqələrə və fəaliyyətə nüfuz etməklə öz mövcudluğunu qoruyub saxlamışdır. Deməli, qarşılıqlı təmas rejimlərinin olması daim önəm kəsb etmişdir. Bununla belə, ictimai rəyin formalaşmasından danışarkən, medianın ictimai siyasi sistemdə oynadığı rolun bütün təsir mexanizmlərini və yolunu düşünmədən qarşılıqlı əlaqələrin zəncirini müəyyən etmək mümkün deyildir, çünki media hətta özbaşına buraxılmış olsa belə ictimai rəy formalaşdırmaqda əhəmiyyətli rola malikdir

Application of multiple testing procedures for identifying relevant comorbidities, from a large set, in traumatic brain injury for research applications utilizing big health-administrative data

Background: Multiple testing procedures (MTP) are gaining increasing popularity in various fields of biostatistics, especially in statistical genetics. However, in injury surveillance research utilizing the growing amount and complexity of health-administrative data encoded in the International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10), few studies involve MTP and discuss their applications and challenges. Objective: We aimed to apply MTP in the population-wide context of comorbidity preceding traumatic brain injury (TBI), one of the most disabling injuries, to find a subset of comorbidity that can be targeted in primary injury prevention. Methods: In total, 2,600 ICD-10 codes were used to assess the associations between TBI and comorbidity, with 235,003 TBI patients, on a matched data set of patients without TBI. McNemar tests were conducted on each 2,600 ICD-10 code, and appropriate multiple testing adjustments were applied using the Benjamini-Yekutieli procedure. To study the magnitude and direction of associations, odds ratios with 95% confidence intervals were constructed. Results: Benjamini-Yekutieli procedure captured 684 ICD-10 codes, out of 2,600, as codes positively associated with a TBI event, reducing the effective number of codes for subsequent analysis and comprehension. Conclusion: Our results illustrate the utility of MTP for data mining and dimension reduction in TBI research utilizing big health-administrative data to support injury surveillance research and generate ideas for injury prevention. Copyright © 2022 Jana, Sutton, Mollayeva, Chan, Colantonio and Escobar

Sleep quality, internet addiction and depressive symptoms among undergraduate students in Nepal

BACKGROUND: Evidence on the burden of depression, internet addiction and poor sleep quality in undergraduate students from Nepal is virtually non-existent. While the interaction between sleep quality, internet addiction and depressive symptoms is frequently assessed in studies, it is not well explored if sleep quality or internet addiction statistically mediates the association between the other two variables. METHODS: We enrolled 984 students from 27 undergraduate campuses of Chitwan and Kathmandu, Nepal. We assessed sleep quality, internet addiction and depressive symptoms in these students using Pittsburgh Sleep Quality Index, Young’s Internet Addiction Test and Patient Health Questionnaire-9 respectively. We included responses from 937 students in the data analysis after removing questionnaires with five percent or more fields missing. Via bootstrap approach, we assessed the mediating role of internet addiction in the association between sleep quality and depressive symptoms, and that of sleep quality in the association between internet addiction and depressive symptoms. RESULTS: Overall, 35.4%, 35.4% and 21.2% of students scored above validated cutoff scores for poor sleep quality, internet addiction and depression respectively. Poorer sleep quality was associated with having lower age, not being alcohol user, being a Hindu, being sexually active and having failed in previous year’s board examination. Higher internet addiction was associated with having lower age, being sexually inactive and having failed in previous year’s board examination. Depressive symptoms were higher for students having higher age, being sexually inactive, having failed in previous year’s board examination and lower years of study. Internet addiction statistically mediated 16.5% of the indirect effect of sleep quality on depressive symptoms. Sleep quality, on the other hand, statistically mediated 30.9% of the indirect effect of internet addiction on depressive symptoms. CONCLUSIONS: In the current study, a great proportion of students met criteria for poor sleep quality, internet addiction and depression. Internet addiction and sleep quality both mediated a significant proportion of the indirect effect on depressive symptoms. However, the cross-sectional nature of this study limits causal interpretation of the findings. Future longitudinal study, where the measurement of internet addiction or sleep quality precedes that of depressive symptoms, are necessary to build upon our understanding of the development of depressive symptoms in students

Modeling community integration in workers with delayed recovery from mild traumatic brain injury

Background: Delayed recovery in persons after mild traumatic brain injury (mTBI) is poorly understood. Community integration (CI) is endorsed by persons with neurological disorders as an important outcome. We aimed to describe CI and its associated factors in insured Ontario workers with delayed recovery following mTBI. Methods: A cross-sectional study of insured workers in the chronic phase following mTBI was performed at a rehabilitation hospital in Ontario, Canada. Sociodemographic, occupational, injury-related, clinical, and claim-related data were collected from self-reports, medical assessments, and insurers’ referral files. Community Integration Questionnaire (CIQ) scores were compared using analysis of variance or Spearman’s correlation tests. Stepwise multivariable linear regression models were used to evaluate the associations with CI. Results: Ninety-four workers with mTBI (45.2 ± 9.9 years old, 61.2 % male) at 197 days post-injury (interquartile range, 139–416 days) were included. The CIQ total and subscale scores were similar to those reported in more severe TBI samples. The CIQ scores were moderately to strongly correlated with various sociodemographic, claim-related, and clinical variables. In the multivariable regression analysis, several covariates accounted for 36.4 % of the CIQ variance in the final fully adjusted model. Discussion: This study evaluated CI in workers with mTBI, and analyzed its associated variables. Analysis revealed insomnia, head or neck pain, being married or in a relationship, time since injury, and a diagnosis of possible/probable malingering were independently associated with limited CI. Conclusions: Workers with delayed recovery from mTBI experience difficulty with CI. Insomnia is a particularly relevant covariate, explaining the greater part of its variance. To enhance participation, care should focus on clinical and non-clinical covariates

Community-based interventions for adolescents following traumatic brain injury: a systematic review

Background: Chronic impairment following childhood traumatic brain injury has the potential to increase risk of negative outcomes. This highlights potential value of community-based rehabilitation programs. Objectives: To identify research studies examining existing intervention programmes available in community-based rehabilitation to adolescents following TBI to assist with the transition back into the community. Methods: A systematic review of community-based interventions was conducted across different national contexts. All included studies involved a clinical population with TBI, aged 11 to 25 years inclusive. Risk of bias was rated for each included study. Results: Seventeen studies were identified for inclusion in the review, of these eleven distinct interventions were found. The quality of evidence was largely weak and highly variable. Conclusion: The results suggest some improvement in adolescent outcomes following community-based interventions, however higher quality evidence is needed to support specific interventions