PROMOTING LAW ENFORCEMENT FOR CHILD PROTECTION: A COMMUNITY ANALYSIS

The Colorado Occupant Protection Project (COPP) intervention provided police with brief instruction concerning the importance of citations for drivers' failure to use child safety seats and special coupons to accompany citations. Coupons were exchangeable by drivers for a safety seat and brief training in its use, plus a waiver of the $50 citation fine. Over 4.5 years of archival records were employed, using an ABA design and a comparison community to evaluate the program. Few tickets were issued for nonuse of safety seats during the 3-year baseline in either community. Citations for nonuse of safety seats increased to over 50 per month during the intervention period at the test site, whereas rates remained essentially zero at the comparison site. After the COPP intervention was removed at the intervention site, citation rates for nonuse of safety seats decreased to about 15 per month. Differences between intervention conditions and settings were statistically significant. During the intervention, officers were 44 times more likely to write citations than were controls. Results suggested that a behavioral program can increase police citation writing for child protection purposes.     

PROBLEM SOLVING TO PREVENT WORK INJURIES IN SUPPORTED EMPLOYMENT

A problem-solving strategy was used to teach three groups of 3 individuals in supported employment how to prevent work-related injuries. The problem-solving strategy was taught in two training phases. The first training phase involved the use of cue cards, and the second involved the withdrawal of the cue cards. Interviews and staged generalization assessments in the participants' natural work environments were conducted before, during, and up to 12 weeks after training. In these assessments, situations were presented that were either similar or dissimilar to situations presented in training. Results of both the interviews and staged assessments indicated that the participants' newly acquired problem-solving skills generalized to similar and dissimilar situations.     

Cognitive sequelae of repeated head injury in a population of intravenous drug users

The relationship between closed head injury and performance on neuropsychological (NP) tests was investigated in a group of intravenous drug users (IVDUs). Subjects with repeated head traumas involving loss of consciousness (LOC) performed worse than both a control group without LOC and reference group with only a single episode of LOC. There were no significant differences between the last two groups. Performance on tests of memory, attention, and motor performance was significantly worse in the group with repeated head injury. The average time since the last episode of LOC was more than 11 years. We conclude from these findings that a single episode of LOC does not result in significant cognitive impairment in this population. Two or more episodes, however, are more likely to produce chronic cognitive impairment.     

Neurobehavioral deficits,adolescent traumatic brain injury,and transition to college

Outcome following traumatic brain injury (TBI) has been frequently evaluated for adults, although there has been minimal research on adolescents with TBI. It has been argued that TBI sequelae may be more difficult for adolescents to adjust to given developmental changes in physical (puberty), interpersonal (self-concept), and environmental domains (transition to college). In addition, it is commonly acknowledged that moderator variables such as psychiatric history, family functioning, substance use, and sexuality impact functional outcome following TBI, although it is often difficult to objectively evaluate these variables. The current study examined relationships among TBI-related deficits, moderator variables, and academic outcomes for six adolescents transitioning to college. The findings suggest that it may not be appropriate to predict functional outcome based solely on objective neuropsychological results. However, moderator variables appear to have a more direct relationship with outcome, depending on the moderator variable and the individual.     

Clinical neuropsychology and brain injury rehabilitation in Israel: A twenty-year perspective

The development of the field of neuropsychology in Israel is primarily the result of the development of rehabilitation services for traumatic brain-injured patients. The responsibility to care for and help disabled veterans has always been an important motivation for the establishment of rehabilitation services. Israel is probably one of the first countries in the world to develop community-based services specifically designed to address the needs of young patients with severe traumatic brain injury. The fairly extensive therapeutic and community services available today for both military and civilian brain-injured persons in Israel are the result of initiatives and funding by the Israel Ministry of Defense's Department of Rehabilitation. There are two principles that characterize most of the programs in Israel: (1) multidimensional remedial intervention and (2) life-time commitment to provide support. The accessibility of patients in a small country enables professionals to conduct follow-up studies in order to evaluate the long-term effects of brain injury. Current developments in neuropsychology are in three directions. First, formal training programs in neuropsychology are being set up. Second, the involvement of neuropsychologists is being extended beyond the treatment of young patients suffering from traumatic brain injury to include the treatment of different brain pathologies in children and the elderly. Third, sophisticated neuroimaging techniques are being applied to studies in cognitive neuropsychology.     

Stress,coping resources,and injury risk

Over the last two and a half decades, researchers have tried to determine if psychological variables predispose or buffer athletes from injury. They have found that sport participants who experience many recent stressors, and who do not have the resources and skills to cope with the stress, seem most at risk for injury. This article reviews that research as well as efforts to identify mechanisms that might explain why the stress-injury relationship occurs and interventions that will hopefully reduce the injury risk. Because the multicomponent stress-injury model of Andersen and Williams (1988) helped provide the impetus and theoretical base for much of that research, it serves as the foundation for organizing and summarizing the findings. Although the research has focused largely on sport injuries, the findings have relevance for understanding and potentially preventing many accidents and injuries that occur outside the realm of sport participation.     

Prevalence of traumatic brain injury in an inpatient psychiatric population

This study investigated the prevalence of traumatic brain injury (TBI) in an inpatient psychiatric population. We hypothesized increased prevalence of TBI relative to the general population due to a variety of risk factors observed in psychiatric patients. One hundred (mean age = 34) psychiatric inpatients completed the revised Head Injury Questionnaire. Chart review of 17 subjects reporting injuries established whether injuries were documented in medical records. Sixty-eight percent of this psychiatric population reported one or more injuries in which they were unconscious or dazed. This number is higher than the prevalence in the general population. Injuries were generally of mild to moderate severity; multiple injuries were common. Chart review of 17 subjects reporting TBI indicated that histories of TBI had not been noted in the medical record. Finally, 63% of TBI subjects reported that their injury predated the onset of their psychiatric symptoms. These results suggest a possible role of TBI in psychiatric symptomatology and have implications for psychiatric treatment in this population.     

The social dynamics involved in recovery and return to sport following a sport-related concussion: A study of three athlete-teammate-coach triads

An athlete's connection to their team and team members is an important part of their sport experience. However, researchers currently know little about the nature of these social dynamics with respect to concussed athletes. Our study explored athletes' recovery and reintegration into the team environment following a sport-related concussion. We conducted semi-structured interviews with each member of three athlete-teammate-coach triads (N = 9). We analysed the data using thematic narrative analysis and present the results as three stories that focused on each athlete's experience. For Cassie, we found two major plot points in her story: the transition in her role (and shift in identity) from athlete to student assistant coach/team manager and, once recovered, back to an athlete on the team. For Jess, we found that the main plot in her story was “pressure”. Specifically, the interplay between internal (placed on herself) and external (perceived from teammates and coaches) pressures to return to sport. In the third and final story, the main plot point was the tensions that arose from Jaden's preferences for social support and the type of support that his teammates and coaches believed he needed during his recovery. Our results highlight the interplay between athlete's personal and social identities, feelings of pressure to return and readiness, and the challenges of providing the right amount and type of social support. This research contributes to our limited understanding of the social dynamics involved in athletes' return to sport following a concussion.     

A systematic review of the effectiveness of machine learning for predicting psychosocial outcomes in acquired brain injury: Which algorithms are used and why?

Clinicians working in the field of acquired brain injury (ABI, an injury to the brain sustained after birth) are challenged to develop suitable care pathways for an individual client’s needs. Being able to predict psychosocial outcomes after ABI would enable clinicians and service providers to make advance decisions and better tailor care plans. Machine learning (ML, a predictive method from the field of artificial intelligence) is increasingly used for predicting ABI outcomes. This review aimed to examine the efficacy of using ML to make psychosocial predictions in ABI, evaluate the methodological quality of studies, and understand researchers’ rationale for their choice of ML algorithms. Nine studies were reviewed from five databases, predicting a range of psychosocial outcomes from stroke, traumatic brain injury, and concussion. Eleven types of ML were employed with a total of 75 ML models. Every model was evaluated as having high risk of bias, unable to provide adequate evidence for predictive performance due to poor methodological quality. Overall, there was limited rationale for the choice of ML algorithms and poor evaluation of the methodological limitations by study authors. Considerations for overcoming methodological shortcomings are discussed, along with suggestions for assessing the suitability of data and suitability of ML algorithms for different ABI research questions.