Dissertations / Theses on the topic 'Brain damage – Patients – Rehabilitation'
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1
Hill, Heather B. Public Health & Community Medicine Faculty of Medicine UNSW. "Long-term outcomes after severe, traumatic brain injury." Awarded by:University of New South Wales. School of Public Health and Community Medicine, 2004. http://handle.unsw.edu.au/1959.4/22812.
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Predominant theories regarding adjustment and adaptation from the 1960s to mid 1980 are examined. Medical literature relating to outcomes after traumatic brain injury is examined. The gloom in major texts is surprising. The lack of definition of the commonly used term ???long-term??? is discussed. The relative lack of research to guide advice about very long-term prognoses remains a major concern. There are a number of ways of defining reality. Some come from an observer???s view of a person???s life. Some come from the reports of a significant other in the life of the person with TBI. Others come from the words or writings of the person who sustained a serious TBI. Quantitative research excels at summarising data and reaching generalisations based on statistical projections. Qualitative research excels at telling the story from the person???s viewpoint, providing the rich descriptive detail that sets quantitative results into their human context. An opportunistic sample of people who suffered a very severe TBI in 1981 was traced and narratives of their experiences since their injury obtained, either written or converted to text from interview. The texts were analysed using a qualitative technique based on grounded theory. The results of the analysis, the fact that a variety of approaches were used by people to deal with their problems, possible reasons for negative prognoses, and the limitations of the study are highlighted. Possible reasons why negativity appears to pervade the thinking of some health professionals involved with people with TBI, and possible directions for the future in therapy and research are discussed.
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Pendergrass, Thomas M. "Family response to computerized cognitive retraining with brain injured individuals." Virtual Press, 1986. http://liblink.bsu.edu/uhtbin/catkey/468074.
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Computerized cognitive retraining is a technique for remediation of the cognitive and behavioral changes which follow a traumatic brain injury. The technique utilizes specifically developed computer software which builds on the basic foundations of intellectual functioning. While the injured patient is the target of treatment, the method appeared to have an impact on the patient's family as well. Families of patients who participated in computerized cognitive retraining initially appeared to have fewer difficulties with anxiety, depression, and family problems. They also appeared to be more involved in the patient's treatment than were similar families who had not had this experience.The experiment evaluated the secondary psychological effects of computerized cognitive retraining on the brain injured patient's primary caretaker in the family. The dependent variables studied were perception of family involvement in patient treatment, anxiety, depression and perception of family problems.Subjects were recruited from the outpatient case load of the Psychology Department of Fort Sanders Regional Medical Center in Knoxville, Tennessee and from a local support group for families of patients who have experienced a traumatic brain injury. The injured patients and family members participated in the retraining technique. A total of seventeen patient/family member pairs participated in the study.Subjects participated in either the experimental or control treatments. The experimental group underwent five sessions of approximately one hour in length. The patient and family member worked together during the course of the retraining. Brief counseling followed each session. The treatment group used an Atari 800 computer and Bracy's "Foundations" cognitive retraining software package ( Psychological Software Services, Indianapolis, Indiana). The control group was a waiting list, minimum contact group, whose participation was limited to completion of the pre and posttest materials.Family members in both groups completed pre and posttesting packages. These included: a demographic questionnaire, the "Problem Solving Inventory" (Heppner, 1982a, 1982b), the "State/Trait Anxiety Inventory" (Speilberger, 1983), the "Beck Depression Inventory" (Beck, 1961), and the "Scale of Marriage Problems" (Swenson & Fiore, 1982).The experiment utilized Kerlinger's pretest-posttest control group design (Kerlinger, 1973). Patient/family pairs were randomly selected from the available subject pool. Control or experimental treatment groupings were assigned by stratified random sampling. Data were analyzed by the use of two way analysis of variance with repeated measures on one factor. Throughout the analysis, a level of R < .05 was required to infer statistical significance.The results of this experiment did not support the effectiveness of computerized cognitive retraining as a specific intervention method for the families of brain injured individuals. The findings revealed that there were no statistically significant differences between the control and treatment groups on measures of perception of family involvement, depression, or perception of family problems. The treatment group experienced a statistically significant increase in state anxiety following the experimental treatment. The validity, generalizability and implications for these findings were discussed in light of prior research.Recommendations for further research in the area of family response to computerized cognitive retraining include replication of the study with greater numbers of subjects and more sophisticated evaluation and treatment methodology. It is also suggested that future research address the patient's cognitive level, the utilization of varied retraining protocols specific to the patient's level of function, and premorbid psychosocial factors which may influence the process of cognitive remediation.
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Witt-Lajeunesse, Alane, and University of Lethbridge Faculty of Arts and Science. "Effects of behavioral therapies and pharmacological intervention in brain damage." Thesis, Lethbridge, Alta. : University of Lethbridge, Faculty of Arts and Science, 2001, 2001. http://hdl.handle.net/10133/149.
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Maximizing recovery of function after brain injury is the goal for many neuroscientists and rehabilitation medicine professional alike. To further elucidate the neural mechanisms underlying compensatory changes in brain injury and to determine the possibility of enhancing these changes, three experiments are described. Experiment 1 looks at the effects of structured (skilled reaching) versus functional (enriched environment) training with and without FGF-2, a pharmacological intervention, as treatment paradigms for rehabilitation-induced recovery of function in cortical lesion adult rats. Experiment 2 examines the treatment effects of tactile stimulation to enhance motor abilities in postnatal day 4 rat pups sustaining cortical damage. Finally, experiment 3 explores changes in the cortical motor representation after cortical damage. Results indicate a marked improvement on behavioral testing combing FGF-2 and functional training. Tactile stimulation significantly enhances recovery of motor functions. Post-lesion cortical mapping reveals changes in the motor representation utilizing the adjacent posterior parietal cortex.xv, 127 leaves : ill. ; 28 cm.
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Maynard, Hugo. "Memory Deficit Compensation Among Survivors of Traumatic Brain Injury." PDXScholar, 1995. https://pdxscholar.library.pdx.edu/open_access_etds/4871.
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Memory impairment is an outcome of Traumatic Brain Injury (TBI), and associated with lower levels of post-morbid adjustment. This research isolated the memory impairment of retrieval deficit, and examined the efficacy of cues and mnemonics in remediating the impairment. Thirty-three male and female TBI survivors, 18 to 71 years old, were pre-tested for attention (COPY), short-term memory (SD), long-term memory (LD) and recognition memory (RS) employing the Rey Osterrieth Complex Figure Test (CFT), and Subtest. Sixteen subjects demonstrating a retrieval deficit were administered the post-test, with even random assignment into four treatment conditions: a control group (CONTROL), a group administered cues (CUES), a group administered mnemonics {MNEM), and a group administered mnemonics and cues (BOTH) (n = 4). A MANOVA revealed a significant effect of TRIAL (p5.05), no significant effect of TREATMENT, and no interaction. A power analysis indicated the lack of TREATMENT effect could be the result of sample size. Post-hoc t tests revealed a difference across TRIAL for SD and LO in the two experimental conditions which utilized mnemonics. The sample was divided into two groups according to subjects' level of functioning (HIGH and LOW). A MANOVA showed main effects for LEVEL for SD and RS, for TRIAL for SD, LO, and RS, and a LEVEL by TRIAL interaction for COPY (R
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Van, der Merwe Jó-Marié. "Family needs following adult traumatic brain injury." Thesis, University of Port Elizabeth, 2004. http://hdl.handle.net/10948/335.
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Traumatic brain injury (TBI) represents a significant and growing type of disability in South Africa. Coping with the impact of traumatic brain injury is one of the most difficult tasks that can confront a family, and family members experience a wide range of needs as the injured person progresses through rehabilitation. In South Africa, research on family needs following traumatic brain injury has thus far been neglected and rehabilitation resources are sadly lacking. For this reason it is necessary to accumulate knowledge about these families’ needs so as to assist with the planning of future rehabilitation programmes. The study aimed to explore and describe the needs of a sample of families with adult traumatic brain injury individuals in the Eastern Cape utilizing the Family Needs Questionnaire (FNQ). The research approach followed could be described as descriptive and exploratory in nature and was conducted within a quantitative framework. A biographical questionnaire and the FNQ were administered to a heterogeneous sample of 32 family members, including significant others and primary caregivers, of 16 adult traumatically brain-injured individuals, who sustained the TBI one to three years previously, and who underwent rehabilitation treatment at a private rehabilitation hospital in Port Elizabeth. A non-probability, purposive, and convenient sampling method was used. Descriptive statistics were computed to determine the importance and the perceived fulfillment of the needs. The results of the present study indicated that all 40 needs were endorsed by at least half the sample as being important to very important. Furthermore, 52.50% of the needs were endorsed by more than two-thirds of the sample as being important to very important. The needs were rank-ordered according to their importance ratings and the 10 mostly rated as important or very important were identified. These 10 needs were endorsed by between 84.38% and 93.75% of the family members as being important to very important. Six of the important or very important needs related to health information, two to professional support, one to community support, and one to emotional support. The relation between various participant, traumatically brain-injured individual and brain injury characteristics and the 10 important or very important needs, as well as the 10 needs more frequently rated as met were investigated and found to either have a limited or varied relationship. The 10 needs most often rated as met were endorsed by between 43.75% and 56.25% of the family members. Six of the met needs related to health information, two to community support, one to instrumental support, and one to treatment decisions. The highest unmet need was endorsed by 46.88% of the participants and related to the need to discuss their feelings with someone who has gone through the same experience. Based on the findings of the present study, further research on family needs following traumatic brain injury is suggested. It is also recommended that the Family Needs Questionnaire be used to evaluate existing rehabilitation programmes so as to make suggestions as to how to improve them. The results of this study suggested that family members would benefit from receiving educational information material, as well as referrals to professionals for advice and support.
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Palmer, Elizabeth Seccombe. "Psychosocial impact of head injury on the family." CSUSB ScholarWorks, 2001. https://scholarworks.lib.csusb.edu/etd-project/2022.
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Togher, Leanne. "Interpersonal communication skills in the traumatic brain injury population : an analysis across situations." Phd thesis, School of Communication Sciences and Disorders, Faculty of Health Sciences, 1998. http://hdl.handle.net/2123/6643.
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Morris, Paul Graham. "Long-term neuropsychological outcome following subarachnoid haemorrhage or traumatic brain injury." Thesis, University of Stirling, 2001. http://hdl.handle.net/1893/1877.
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Purpose: The principal aim of this project was to investigate the influence of clinical indices of injury severity and polymorphism of the apolipoprotein E gene upon the long-term physical, cognitive and emotional sequelae of traumatic brain injury and spontaneous subarachnoid haemorrhage. It was also intended to determine the extent to which changes occur in these sequelae beyond the initial six months post injury. Method: Sixty-two brain injury patients who had previously taken part in a neuropsychological assessment at six months post injury were traced and participated in a follow-up assessmens some 6-9 years subsequent to their injury. Separately, a group of 70 subarachnoid patients drawn from a consecutive series of neurosurgical admissions participated in a neuropsychological assessment at 14 months subsequent to their haemorrhage. In both studies, the assessment comprised a semi-structured interview and a battery of cognitive measures focusing principally upon memory and executive function tasks. A questionnaire including a range of standardised measures of anxiety, depression and quality of life was left with patients to be returned by post. Results: The ApoE e4 allele did not appear to influence recovery amongst these brain injury survivors, though there are suggestions that it may have an influence upon subgroups of patients. Amongst traumatic brain injury survivors, post-traumatic amnesia was a better predictor of functional or emotional outcome than consciousness based measures. However, consciousness based measures were more predictive of cognitive sequelae and low admission Glasgow Coma Scale was associated with continued improvement on information processing tasks. Other than on these tasks, there was little evidence of change between 6 months and 6-9 years post injury. Amongst the subarachnoid haemorrhage patients, Fisher Grade was found to be more predictive of subsequent Glasgow Outcome Scale and cognitive function than WFNS Grade or other clinical indices. Surviving aneurysmal patients had comparable levels of recovery to patients who had a negative angiogram. In both studies emotional sequelae, in particular anxiety-related difficulties, were found to be a principal factor in the functional outcome of some 40% of patients. Conclusions: Greater emphasis should be placed upon measures of post-traumatic amnesia as predictors of functional recovery in surviving patients. The use of an amnesia measure may also be warranted in studies of outcome following subarachnoid haemorrhage or other stroke. The ApoE e4 allele does not appear to have a strong influence upon functional recovery after brain injury across all patients, though it is possible that it interacts with other factors to influence recovery in subgroups. Greater emphasis should be placed upon the prevention and/or detection and treatment of mood disorders following brain injury. In the absence of intensive rehabilitative interventions, survivors of serious brain injury are more likely to deteriorate than to continue to recover beyond six months post injury.
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Tang, Yuen-ming Lewis, and 鄧遠明. "Clinical outcomes for patients with traumatic brain injury in Kowloon Hospital." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2001. http://hub.hku.hk/bib/B31969938.
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Chan, Jeffery B. "Respite services and acquired brain injury in New South Wales : the perspectives of persons with acquired brain injury, their carers and service providers." University of Sydney, 2008. http://hdl.handle.net/2123/3929.
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Doctor of PhilosophyPersons with acquired brain injury require continuing support and care in various aspects of their lives many years post-injury. Their care and support are mainly provided by family members. While respite is one of a range of critical support systems for carers and people with life-long disability, very little is known about respite in the area of acquired brain injury. The majority of the research on respite has been undertaken in developmental disability, mental health and in aged care, but there is no research to date about respite from the perspectives of the person with a disability, the carer and respite provider. There is also no research that examines these perspectives in the acquired brain injury literature. This study was aimed to address this gap in the literature by investigating respite from the perspectives of the person with acquired brain injury, the carer and the respite provider. It also examined the profile of respite services being provided in the Australian state of New South Wales as there had not been a comprehensive mapping of respite before. Survey methodology was used to gather information from persons with acquired brain injury and their carers who were members of the New South Wales Brain Injury Association, which is the peak advocacy association of people with brain injury. The same methodology was used to gather similar information from members of Interchange Respite Care New South Wales, which is a peak association representing respite providers in the state. The survey questionnaires were developed and designed after an extensive review of the literature, and were reviewed by experts in the fields of respite, disability and acquired brain injury. The survey questionnaire was also trialled on a sample of families. The survey questionnaires for the three participant groups shared several common sections, such as demographic information; factors influencing respite use; expectations of respite; and satisfaction with respite services used by persons or carers. The responses from the three participant groups were analysed and compared using logistic regression and descriptive statistics. The key findings of the study are (a) several characteristics or factors of the person with acquired brain injury and their carer were significantly associated with the use of respite, (b) there were several common factors that all three participant groups reported to influence respite use, and (c) there were several common expectations of respite among the three participant groups. Some of the characteristics or factors that were significantly associated with respite use included the severity of disability, the high level of dependency of the person with acquired brain injury, and the number of days spent in a coma. Common factors reported by all three participant groups to influence respite use included the stress level of the carer and the severity of disability. Factors reported to influence respite use appear to be consistent with the literature in developmental disability. There were common perspectives regarding the expectations of respite among all three participant groups, such as the need for trained and qualified respite staff; a wider range of respite services and more flexibility of respite service provision. The study also indicated a reported lack of sufficient respite for persons with acquired brain injury and their carers. Some of the findings of the study appeared to be consistent with the research literature on acquired brain injury; such as the majority of carers being mainly female; there is a reliance on informal networks for the care and support of the person with acquired brain injury; and the majority of the persons with acquired brain injury being male. The study also found that many respite providers in New South Wales had extensive experience in running a respite service. The findings of the study have important implications for policy direction and development, practice and service delivery, and research. In terms of policy direction and development, implications explored included: a flexible funding model that is responsive to the needs of carer and person with acquired brain injury, and adequately trained and qualified staff and volunteers play an important role in respite provision. Further research is required to understand empirically the benefits and quality of life outcomes over a period of time, such as what types and extent of respite are more beneficial for certain demographic profiles. The study highlights the perspectives of persons with acquired brain injury, their carers and respite providers. Respite is an important support system to enable persons with acquired brain injury to receive the continuing care and support from their carers. Respite in acquired brain injury is a new field that merits further research as it holds the potential for addressing the needs of people with acquired brain injury and their carers.
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Beck, Kelley D. "Personality and the prediction of outcome following rehabilitation in persons with acquired brain injuries: The Millon Behavioral Medicine Diagnostic (MBMD)." Thesis, University of North Texas, 2008. https://digital.library.unt.edu/ark:/67531/metadc9121/.
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Neuropsychological rehabilitation following acquired brain injury is increasingly recognized as essential with the advancements in research evidence of its effectiveness, particularly as current estimates of disability following the most common forms of brain injury (traumatic brain injury and cerebrovascular accident) are so high. Improvements in predictive capabilities of researchers and clinicians are paramount in designing effective interventions. As many variables associated with outcome following brain injury are not controllable (e.g. severity of the injury, age, education), it is essential that rehabilitation programs design interventions to target those variables that are susceptible to amelioration. While personality factors have been shown to affect outcome in other medical illnesses, only a few studies have examined the influence of personality on outcome following neurorehabilitation for acquired brain injury. The results of these studies have been mixed. This study used the Millon Behavioral Medicine Diagnostic (MBMD) to predict outcome as measured by the Mayo-Portland Adaptability Index (MPAI-4) following brain injury rehabilitation in a heterogeneous sample of persons with acquired brain injuries (N = 50). It was hypothesized that specific coping styles scales from the MBMD (Introversive, Dejected, Oppositional), which are based on Millon's personality system, would predict outcome. Results indicated that both the Introversive and Oppositional coping styles scales accounted for significant amounts of variance in outcome beyond that accounted for by the severity of the injury alone (p < .001). In both cases, individuals with mild/moderate-moderate/severe limitations following completion of the rehabilitation program had significantly higher scores on the Introversive and Oppositional coping compared to individuals with more successful outcomes. The hypothesis that a dejected coping style would predict outcome was not supported. Implications for rehabilitation are discussed in the context of Millon's personality system.
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Carney, Nancy Ann. "Patient-Guided Investigation of the Restoration of Health Following Traumatic Brain Injury." PDXScholar, 1998. https://pdxscholar.library.pdx.edu/open_access_etds/2697.
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The development of emergency department medical interventions and the implementation of fast-transport trauma systems has decreased the rate of death resulting from traumatic brain injury (TBI). Without corresponding methods for long-term treatment and recovery, the prevalence of people disabled by TBI has increased, creating a growing public health problem. Investigations generated by physicians, rehabilitation programs, and social scientists, which attempt to associate standard measures of injury severity with outcome, leave unexplained variance in long-term functional status for persons with TBI.
The purpose of this investigation was to use persons with brain injury and their family members, to guide an analysis of the factors that foster successful recovery from brain injury. Three studies were conducted. In Study #1, the method for observation generated by Kurt Goldstein (1934) was adopted to conduct 20 case studies of persons who sustained brain injury. The Schema of the EsEx Couple (Maynard. 1992) was used to orient the investigation. The EsEx Couple Schema proposes that events in human life must be understood by considering the whole system of Person (Essence) in the Environment (Exchange), and the transactions that flow in a recursive loop from Person to Environment and back. Kurt Goldstein's Laws of Organismic Life (1934), a model consistent with that of the EsEx Couple, was used to evaluate the data. Strong patterns associated family and social networks, autonomy, and perceived self-determination with higher levels of recovery, and were used to generate a Model for Recovery.
In Study #2. the Motivational Analysis of Self-Systems Processes (Connell & Wellborn, 1991) was combined with results from Study #1 to generate a Development Model, and to build a survey which was administered to 248 persons with brain injury. Results (1) confirmed the model, indicating factors that contribute to recovery were hypothesized measures of Social Context, Perception, and Engagement; and (2) established a valid instrument, generated by persons with brain injury and their families, for measuring functional status.
In Study #3. results of the survey research were used to return to the case studies to consider where individual lives differ from expected patterns, and why. Deviations from expected patterns were explored to identify how individual differences operate to affect outcome. Recommendations for clinical practice include (1) directing interventions toward family as well as patient, as a method of enhancing the Social Context for the patient, and (2) using careful evaluation of each patient's idiosyncrasies to consider individual interventions.
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Basterfield, Candice. "The cognitive rehabilitation of a sample of children living with HIV : a specific focus on the cognitive rehabilitation of sustained attention." Thesis, Rhodes University, 2015. http://hdl.handle.net/10962/d1017881.
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Pharmacological interventions to treat Human Immunodeficiency Virus (HIV) with antiretrovirals (ARVs), have dramatically improved the survival rates of HIV positive children maturing into adulthood. However, HIV-associated neurocognitive decline still persists in the era of ARVs. Within the framework of brain plasticity, a number of researchers have begun to assess the feasibility of cognitive rehabilitation therapy as a complement to ARVs to reverse neurocognitive decline as a result of HIV (e.g., Becker et al., 2012). Only one study has been conducted in South Africa, by Zondo & Mulder (2014), assessing the efficacy of cognitive rehabilitation in a paediatric sample. The current research builds on the above mentioned study by implementing an experimental approach to examine the effect of cognitive rehabilitation in a sample of both HIV positive and HIV negative children. Five HIV positive and six HIV negative children were assigned to either an experimental or control group. The experimental group underwent two months of cognitive rehabilitation therapy remediating sustained attention, whereas the control group took part in placebo activities. Sustained attention measures were taken before and after the intervention training sessions, using a sustained attention subtest from the Test of Everyday Attention for Children (TEA-CH). A Mann Whitney U Test revealed that the experimental group (Mdn=38.50) did not differ significantly from the control group (Mdn = 37.00) after the cognitive rehabilitation intervention, U=12.00, z= -.55, p= .66, r= -.17. But a Wilcoxon Signed Rank Test found that there was a significant improvement from pretest scores (Mdn=31.00) to posttest scores (Mdn=38.00) following the rehabilitation for HIV positive participants in the sample, T=15.00, z = -2.02, p= .04, r= -.90. This raises the possibility that cognitive rehabilitation could be used as a low cost intervention in underdeveloped contexts
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Krefting, Laura Margaret. "Community re-integration after head injury: A disability ethnography." Diss., The University of Arizona, 1987. http://hdl.handle.net/10150/184268.
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As a result of medical advancement and cultural patterns of Western society, traumatic head injury is increasingly a problem for the injured, their families, medical and social services professionals, and the community at large. Head trauma is remarkable because of the complex nature of the residual disabilities which include long lasting cognitive and emotional problems, social isolation, and family disruption. The purpose of this study was to re-examine the phenomenon of recovery after mild to moderate head injury using an ethnographic research approach. The data were based on the experiences of 21 disabled and their families in the community setting. The disabled represented a range of stages of recovery and severity of disability. The data was collected using three field work strategies: extensive semi-structured interviews, participant observation, and non-academic document review. After collection the data was subjected to thematic and content analysis, that resulted in the selection of themes that characterized the experiences for the head injured and their families. The themes for the head injured informants were: dead days, loneliness, and forgetting. The family members' experiences were represented in the themes: responsibility, vulnerability, tough love, gender differences, and reactions to the experience. Next the data were interpreted using five theoretical concepts from cultural anthropology: liminality, personhood, social labelling, sick role and double bind. In addition, the reflexive influence of the investigator on the research process was addressed. The trustworthiness of the ethnography was assessed in terms of credibility, transferability, dependability and confirmability. Several variables were found to be important to the long term outcome of head injury. These variables were: family directed therapy, double bind communication patterns, and lifelong recovery. Two other factors were found to be critical for the recovery of the head injured. These were economic disincentives to the return to employment and the importance of the social and family environment. In the final section the research and policy implications of the study were discussed in relation to management and service provisions.
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Simblett, Sara Katherine. "Facilitating and measuring psychological adjustment following acquired brain injury." Thesis, University of Cambridge, 2014. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.648800.
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Jansen, van Vuuren Stephanus Petrus. "A multifaceted retrospective analysis of the association between Zolpidem administration and increased brain perfusion and function in neurologically compromised patients." Diss., University of Pretoria, 2014. http://hdl.handle.net/2263/46054.
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This project represents one of the foundation steps to a collaboration between the
Department of Human Physiology, University of Pretoria and the Nuclear Medicine
Department at Steve Biko Academic hospital.
Following the initial discovery of the surprising effect zolpidem has on patients in persistent
vegetative states in 1999 by Dr H.W. Nel - namely that zolpidem administration results in a
significant qualitative increase in brain function, to the extent that patients were able to once
again communicate and respond appropriately to their surroundings - much data has been
collected by both Dr Nel as well as the Nuclear Medicine Department of Steve Biko Hospital.
Over the course of twelve years SPECT scans have been carried out on patients of various
pathologies both before and after a course of zolpidem. To this day, both assessment and
follow up of these and new patients is still being done by the Nuclear Medicine Department
and Dr Nel. As this vast collection of data grows it has become increasingly daunting for a
single research team to consolidate all this information into a usable form and an outside
team has been deemed necessary to facilitate this process.
The primary goal of this study was to quantify the neurological perfusion changes following
zolpidem administration within responder patients. This was achieved through reprocessing
and semi-quantification of the existing SPECT scan records held by the Pretoria Academic
Hospital. Within the group of responder patients (n = 29), 22 patients (~76%) presented a
significant increase in perfusion within at least one lesion with a range of 4.5 - 46.1% (mean
= 11.9%). In opposition to this finding non-responsive lesion perfusion decreased with a
significant mean change of -14.5%. For both sets the p-value was determined to be <0.01.
Of all lesions measured (n = 85) 32% displayed increased perfusion after zolpidem
administration, whereas 30.6% presented with a perfusion decrease.
It was determined that only one lesion is required to respond to zolpidem in a positive
manner to facilitate positive functional improvements with a given patient. In a small minority
of patients post-zolpidem functional improvements seems to be connected to wide-spread
cortical changes as opposed to singular lesional improvements.
This study provides further evidence of zolpidem’s paradoxical action in a subset of brain
damaged individuals. Unique quantification of results allows for additional insight and
provides further understanding the physiological changes associated with zolpidem
administration.Dissertation (MSc)--University of Pretoria, 2014.
tm2015
Physiology
MSc
Unrestricted
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Puelz, Michael. "A program to generate and validate new test versions of a neuropsychological planning test." Virtual Press, 1991. http://liblink.bsu.edu/uhtbin/catkey/834522.
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Computers are used for diagnostic and training in the neuropsychological rehabilitation. PLANTEST is a program for the IBM-PC that was developed for diagnostic support. It implements a test that gives information about the reduced ability of brain-injured patients to make plans regarding a certain task.The presented thesis describes a knowledge-based system that can be used to develop new test versions for PLANTEST. The program is called SolvePT and it can prove the solubility of test material used in PLANTEST. It can also automatically generate new test material. The program uses an exhaustive forward-chaining, depth-first search and is implemented in Prolog. The datastructures and algorithm of the program as well as space and time requirements are discussed.Department of Computer Science
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Simpson, Heather Jayne. "Transformation through adaptation : a grounded theory of the patient experience of Alcohol-Related Brain Damage." Thesis, University of Edinburgh, 2015. http://hdl.handle.net/1842/15671.
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Background: Alcohol Related Brain Damage (ARBD) is an umbrella term used to describe the range of effects that long-term consumption of alcohol can have on the structure and function of the brain. Despite the increasing prevalence of ARBD, there is a lack of research in this area, and as a result, there are no current guidelines and few services available for the treatment of this condition. There is therefore a need to increase the evidence base in this area, which will assist in the understanding, and ultimately treatment, of ARBD. Aims: This thesis consists of two parts. The first is a systematic review journal article which asks the question: “What is the impact of alcohol-abuse on memory function within the first three weeks of alcohol withdrawal?” The second part is a qualitative research project which aims to develop a grounded theory regarding the patient experience of ARBD, identifying and highlighting themes and concepts that are central to the experience. Methods: For the systematic review, four databases were searched. Studies that were included in the review had to have participants with alcohol-dependence; abstinence of less than or equal to three weeks; and to have undergone some form of neuropsychological assessment of memory function. Data from 15 articles were extracted and assessed for quality. For the qualitative study, participants (n=10) were interviewed regarding their experiences of ARBD and the data was then analysed using grounded theory methodology. Results: The results of the systematic review were somewhat ambiguous with some studies reporting impairments in verbal and visual memory, while other studies found no impairments. Episodic memory deficits were present in all studies reviewed. The results of the qualitative study propose a tentative model which describes “transformation through adaptation”. This model hypothesises that successful negotiation of the journey through ARBD hinges on the adaptations that need to be made in order to progress towards transformation. The model is understood in the framework of a number of phases, “Being diagnosed with ARBD, “Focusing on abstinence”, “Taking ownership of life with ARBD” and “Creating a valuable life”, all of which exist within a framework of being supported by specialist services. Conclusions and implications: The systematic review demonstrated some support for deficits in visual and episodic memory within the first three weeks of abstinence, while it appeared that verbal memory was relatively preserved. The heterogeneity of the studies, coupled with the methodological variability, meant that all conclusions need to be considered as tentative, and be interpreted with caution. The main difficulties with interpretation were to do with the confounding factors often found within this client group. The results reinforce the concept of tailored treatment programmes for individuals due to the large variability of the effect of alcohol (and other factors). The qualitative study proposes a model that shows how adaptation appears to play a key role in the successful negotiation of a diagnosis of ARBD. The study describes a series of categories that can be used as a framework to identify and support the changes that are necessary for recovery and reintegration. The value in this study is that the results are directly attributable to individuals who have been diagnosed, and are now successfully living, with ARBD.
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Man, Wai-kwong, and 文偉光. "The empowering of Hong Kong Chinese families with a brain damaged member: its investigation, measurement andintervention." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1996. http://hub.hku.hk/bib/B31235177.
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Blair, Hannah. "Subjective evaluation of quality of life after brain injury : measuring quality of life and the impact of response shift." Thesis, University of Stirling, 2014. http://hdl.handle.net/1893/21458.
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Introduction: After a brain injury there are often long term consequences impacting on QoL. However, this is a complex issue influenced by many factors. As someone recovers and adjusts it is likely that the way in which they evaluate QoL will also change. The theory of response shift suggests people will change the way they evaluate QoL in the face of changes in their life. The aim of this thesis is to investigate what influences a QoL judgement; examining the possibility of response shift. Methods: Quantitative and qualitative methods were used in 4 studies. These were a cross-sectional design utilising an individualised QoL measure (SEIQoL-DW); a longitudinal study utilising a ‘then-test’ approach; a cross-sectional questionnaire study; and a qualitative study using Interpretative Phenomenological Analysis. Study 1 (Ch.3) Results: Correlations between the QoL measures confirm the validity of the SEIQoL-DW; however, correlations were generally stronger for the simpler Hadorn Scale. There was little overall change in mean QoL when current and retrospective judgements were compared. There was evidence for a change in what areas of life were considered most important to QoL following injury. Study 2 (Ch.4) Results: Improvements in reported QoL between baseline and follow-up were small. A then-test indicates that any effect of response shift is small, and non-significant in the current research. There was also little evidence for reprioritisation or re-conceptualisation. Examination of other factors associated with QoL suggest that brain-injury specific factors (BIGI, RBANS) play a role in predicting QoL. Study 3 (Ch.5) Results: QoL was reported as worse post-injury on both Hadorn’s scale and the QOLIBRI-OS; a difference that was more pronounced on the QOLIBRI-OS. Differences were also reported in the importance of different areas of functioning. Change in QoL as measured by the QOLIBRI-OS was significantly influenced by disability as measured by the GOSE, emotional and informational support, and upwards social comparison. Optimism as measured by the LOT, but not upwards social comparison was a significant predictor of change on Hadorn’s scale; GOSE and emotional and informational support remain significant predictors. The GOSE, emotional and informational support, emotional coping styles and optimism were significant predictors of current QoL on the QOLIBRI-OS; and emotional and informational support and optimism were significant predictors of QoL on Hadorn’s scale. Little evidence was found to suggest that the factors proposed in Sprangers and Schwartz’s (1999) model of response shift have predicted relationships with QoL. Two candidate variables were studied: optimism and social support. However neither showed the predicted pattern of relationships. Nonetheless the study supports previous work indicating an influence of optimism and social support on QoL, and indicates that these warrant further study. There were systematic difference between current and retrospective ratings of importance of domains. The level of importance given to the areas of life defined by the QOLIBRI-OS is higher after injury than before, with the exception of “personal and social life” for which there is no significant difference. The areas of life chosen to reflect that which is measured by the GOSE (“work”, “close relationships”, and “social and leisure activities”) are rated as less important with the exception of “close relationships”. These findings provide further support for the idea that QoL domains are re-evaluated after brain injury. Study 4: This was an in depth qualitative investigation of the experience of recovery and adjustment following TBI. Semi-structured interviews and Interpretative Phenomenological Analysis (IPA) were used. Interviews were conducted with 4 men who were 3, 7, 12, and 18 years post injury. Main Outcome and Results: Themes emerging from the analysis were ‘Change: In Self and World’; ‘Reaching a point of realisation’; ‘Support’; ‘Adjusting to change/Coping with day to day life’; and ‘Participation, Goals and Focus’. These themes cover how participants felt both they and their lives had changed as a consequence of their injury; ways they went about coping and adjusting to changes; the importance of support; and the significance of social integration and participation in feeling satisfied with life. Summary and Conclusions: These studies provide evidence for response shift in different ways. There is little evidence for recalibration but there is some indication that reprioritization or reconceptualization may take place. Changes in how important different areas of life are before and after injury suggest that participants are changing the way they view and make evaluations of QoL. Factors identified as being important to QoL judgements were disability, social support (emotional and informational support identified in the questionnaire study and support in the IPA), upwards social comparison, and optimism. The IPA study suggests that functional outcome and participation are important after TBI; while also identifying ways of coping and providing an insight into the experience of recovery from brain injury. The different QoL measures used provides both evidence for their validity, but also evidence for the different conceptualisations of QoL that are measured by different instruments. The findings have implications both for understanding the QoL of the individual and for research on QoL after TBI.
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O'Connor, Christine A. "The effects of oestrogen and progesterone on outcome following experimental traumatic brain injury in rats /." Title page, table of contents and abstract only, 2004. http://web4.library.adelaide.edu.au/theses/09PH/09pho186.pdf.
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Thesis (Ph.D.)--University of Adelaide, Dept. of Pathology, 2004?Includes list of articles published or accepted for publication during the period of PhD candidature. "July, 2004" Includes bibliographical references (leaves 255-293).
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Baillet, Héloïse. "Approche dynamique de l'utilisation d'un cheval mécanique au service de la rééducation posturale de patients cérébrolésés." Thesis, Normandie, 2018. http://www.theses.fr/2018NORMR078/document.
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La thèse présentée a pour objectif d’analyser dans le cadre de l’approche dynamique du contrôle moteur la coordination motrice de participants sains et cérébrolésés évoluant sur un nouvel outil de rééducation, le cheval mécanique. L’analyse de ces coordinations spontanément adoptées par les individus sur ce cheval, ou modifiées suite à l’apprentissage d’une nouvelle coordination grâce à l’ajout d’un biofeedback visuel en temps réel, conduit à participer à (i) déterminer l’utilité du biofeedback dans ce type de tâche et (ii) à évaluer l’intérêt d’un protocole de 24 séances prescrites par nos soins et réalisées sur cet outil. L’objectif final est alors de participer à l’élaboration d’un protocole de rééducation posturale pour une population de patients cérébrolésés. La première étude a permis de mettre en avant le rôle joué par l’expertise dans l’évolution des coordinations posturales des individus sur le cheval mécanique amenant les cavalières expertes vers une coordination posturale plus adaptée (i.e. maintien des patterns en phase et en antiphase), en comparaison aux novices. Par ces analyses, la coordination tronc/cheval mesurée en antiphase, a été mise en lumière, correspondant ainsi à la coordination retrouvée dans l’activité équestre réelle. Par ailleurs, la mise en place d’une méthode d’apprentissage (étude 2) a permis de modifier le comportement postural des individus après seulement 3 séances, selon les conditions d’apprentissage prescrites. La fréquence d’oscillation du cheval avait un impact important sur la coordination des participants, qui adoptaient une coordination en antiphase (fort attracteur) lorsque la contrainte environnementale était élevée. Toutefois, ces observations n’ont pas permis de démontrer le réel intérêt de l’ajout d’un biofeedback visuel dans l’apprentissage d’une nouvelle coordination posturale chez des sujets sains. Enfin, la troisième étude réalisée chez des patients cérébrolésés a montré l’intérêt de cette nouvelle méthode de rééducation sur la coordination posturale de ces patients. Après 24 séances, leur coordination était différente de celle du groupe témoin, permettant de mettre en avant leur capacité à s’adapter aux contraintes et à développer des modes de coordinations posturales spécifiques (tronc/cheval en antiphase) à l’activité afin d’optimiser au mieux leur postureRooted in the dynamical system approach of motor control, the aim of this thesis is to analyze the motor coordination of healthy and brain-damaged participants oscillating on a new rehabilitation tool: the mechanical horse. The analysis of spontaneous coordination exhibited by individuals on this horse and the learned coordination adopted after a learning phase provided by the addition of a visual biofeedback allowed (i) to determine the usefulness of biofeedback in learning an oscillating task and (ii) to evaluate the interest of a 24 sessions rehabilitation protocol performed using the mechanical horse. The final goal is to participate to the development of a postural rehabilitation protocol for a population of brain-damaged patients. The first study allowed to highlight the role of expertise in the dynamics of the postural coordination on the mechanical horse bringing the expert riders towards a more adapted postural coordination (i.e. maintaining in phase and antiphase patterns). Through this first analysis, the spontaneous trunk/horse coordination was highlighted as antiphase, corresponding to the coordination found in real equestrian activity. Furthermore, the implementation of a learning method (study 2) allowed to modify the postural behavior of novice riders after only 3 sessions. The oscillation frequency had a significant impact on the coordination of participants who fell in an antiphase coordination (strong attractor) when the environmental constraint was high. However concerning those novice but healthy participants, this experiment did not demonstrate the real value of an additional video feedback during learning of a new postural coordination. Finally, the third study performed in brain-damaged patients showed the interest of this new rehabilitation method on the postural coordination of these patients. After 24 sessions, their coordination was different from the one of the control group, allowing to highlight their ability to adapt of constraints and to develop specific modes of postural coordination (trunk/horse antiphase) in order to optimize their posture
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Nair, Roshan Das. "Effectiveness of memory rehabilitation following brain damage." Thesis, University of Nottingham, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.444605.
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Sebastián, Romagosa Marc. "Brain computer interfaces for brain acquired damage." Doctoral thesis, Universitat Autònoma de Barcelona, 2020. http://hdl.handle.net/10803/670835.
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El terme Interfície Cervell-Ordinador (ICC), va sorgir als anys 70 pel Dr. Jacques J. Vidal, que mitjançant l’ús de l’electroencefalografia (EEG) fou el primer a intentar proporcionar una sortida alternativa als senyals cerebrals per controlar un dispositiu extern. L’objectiu principal d’aquesta fita era ajudar als pacients amb problemes de moviment i comunicació a relacionar-se amb el seu entorn.
Des de llavors, molts neurocientífics han emprat aquesta idea i han intentat posar-la en pràctica utilitzant diferents mètodes d’adquisició i processament del senyal, nous dispositius d’interacció, noves metes i objectius. Tot això ha facilitat l’aplicació d’aquesta tecnologia en moltes àrees, i actualment les ICC s’utilitzen per jugar a videojocs, moure cadires de rodes, facilitar l’escriptura en persones sense mobilitat, definir criteris i preferències en el món del comerç i el consum, o inclús poden servir com a detector de mentides.
Tot i així, el sector que presenta un major avenç en el desenvolupament de les ICC, és el sector biomèdic. A grans trets, podem utilitzar les ICC amb dues finalitats diferents dins de la neurorehabilitació; substituint una funció perduda o induint canvis en la plasticitat neuronal amb l’objectiu de restaurar o compensar la funció perduda.
Existeixen diferents principis per al registre dels senyals del cervell; de manera invasiva, col·locant els elèctrodes de registre dintre de la cavitat cranial, o de manera no invasiva, col·locant els elèctrodes de registre fora de la cavitat cranial. El mètode més conegut i difós és l’EEG. El seu ús és molt adequat en entorns clínics, té una resolució temporal molt precisa i és possible obtenir una retroalimentació en temps real que pot induir la plasticitat cortical i el restabliment de la funció motora normal.
En aquesta tesi presentem tres objectius diferents: (1) avaluar els afectes clínics de la rehabilitació mitjançant les ICC en pacients amb ictus, ja sigui realitzant un meta-anàlisi dels estudis publicats o avaluant els canvis funcionals dels pacients amb ictus després de la teràpia d’ICC; (2) explorar paràmetres alternatius per quantificar els efectes de les ICC en pacients amb ictus, avaluant diferents biomarcadors de l’EEG en pacients amb aquesta patologia i correlacionant aquests marcadors amb els resultats de les escales funcionals; (3) optimitzar el sistema ICC mitjançant la gamificació d’un avatar.El término Interfaz Cerebro-Computadora (ICC) surgió en los años 70 por el Dr. Jacques J. Vidal, que mediante el uso de la electroencefalografía (EEG) trató de dar una salida alternativa a las señales del cerebro para controlar un dispositivo externo. El objetivo principal de esta hazaña era ayudar a los pacientes con problemas de movimiento o comunicación a relacionarse con el entorno. Desde entonces, muchos neurocientíficos han utilizado esta idea y han tratado de ponerla en práctica utilizando diferentes métodos de adquisición y procesamiento de señales, nuevos dispositivos de interacción y nuevas metas y objetivos. Todo ello ha facilitado la aplicación de esta tecnología en muchas áreas y actualmente las ICC se utilizan para jugar a videojuegos, mover sillas de ruedas, facilitar la escritura en personas sin movilidad, establecer criterios y preferencias de compra en el mundo del comercio y el consumo, o incluso pueden servir como detector de mentiras. Sin embargo, el sector que presenta un mayor avance y desarrollo de las ICC es el sector biomédico. A grandes rasgos podemos utilizar las ICC con dos finalidades distintas dentro de la neurorehabilitación; sustituir una función perdida o inducir cambios en la plasticidad neuronal con el objetivo de restaurar o compensar dicha función perdida. Hay diferentes principios para el registro de las señales del cerebro; de forma invasiva, colocando los electrodos de registro dentro de la cavidad craneal, o no invasiva, colocando los electrodos de registro fuera de la cavidad craneal. El método más conocido y difundido es la EEG. Su uso es adecuado para entornos clínicos, tiene una resolución temporal muy precisa y su retroalimentación en tiempo real puede inducir la plasticidad cortical y el restablecimiento de la función motora normal. En esta tesis presentamos tres objetivos diferentes: (1) evaluar los efectos clínicos de la rehabilitación mediante las ICC en pacientes con ictus, ya sea realizando un meta-análisis de los estudios publicados o evaluando los cambios funcionales en los pacientes con ictus después de la terapia de ICC; (2) explorar parámetros alternativos para cuantificar los efectos de las ICC en pacientes con ictus, evaluando diferentes biomarcadores de electroencefalografía en pacientes con esta patología y correlacionando los posibles cambios en estos parámetros con los resultados en las escalas funcionales; (3) optimizar el sistema ICC utilizando mediante la gamificación de un avatar.
The term Brain Computer Interface (BCI) emerged in the 70's by Dr. Jacques J Vidal, who by using electroencephalography (EEG) tried to give an alternative output to the brain signals in order to control an external device. The main objective of this feat was to help patients with impaired movement or communication to relate themselves to the environment. Since then many neuroscientists have used this idea and have tried to implement it using different methods of signal acquisition and processing, new interaction devices, new goals and objectives. All this has facilitated the implementation of this technology in many areas and currently BCI is used to play video games, move wheelchairs, facilitate writing in people without mobility, establish criteria and purchase preferences in the world of marketing and consumption, or even serve as a lie detector. However, the sector that presents the most marked progress and development of BCI is the biomedical sector. In rough outlines we can use BCI with two different purposes within the neurorehabilitation; to substitute a lost function or to induce neural plasticity changes with the aim to restore or compensate the lost function. To restore a lost function by inducing neuroplastic changes in the brain is undoubtedly a challenging strategy but a feasible goal through BCI technology. This type of intervention requires that the patient invests time and effort in a therapy based on the practice of motor image and feedback mechanisms in real time. There are different principles to record the brain signals; invasively, placing the recording electrodes inside the cranial cavity, or non-invasive, placing the recording electrodes outside of the cranial cavity. The best known and most widespread one is EEG, since they are suitable for clinical environments, have a highly accurate temporal resolution and their real-time feedback can induce cortical plasticity and the restoration of normal motor function. On this thesis we present three different objectives: (1) to evaluate the clinical effects of rehabilitation based on BCI system in stroke patients, either by performing a meta-analysis of published studies or by evaluating functional changes in stroke patients after BCI training; (2) to explore alternative parameters to quantify effects of BCI in stroke patients, by evaluating different electroencephalography biomarkers in stroke patients and correlating potential changes in these parameters with functional scales; (3) to optimize the BCI system by using a new gamified avatar.
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Cleveland, Lynda Gail. "Momentum : a model for motivation in rehabilitation for individuals with traumatic brain injury /." Digital version accessible at:, 1998. http://wwwlib.umi.com/cr/utexas/main.
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吳志萍 and Chi-ping Ng. "Cerebral blood flow monitoring of brain injured patients." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1996. http://hub.hku.hk/bib/B31214484.
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Ng, Chi-ping. "Cerebral blood flow monitoring of brain injured patients /." Hong Kong : University of Hong Kong, 1996. http://sunzi.lib.hku.hk/hkuto/record.jsp?B18777077.
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McCluskey, Annie, University of Western Sydney, College of Social and Health Sciences, and of Nursing Family and Community Health School. "A grounded theory of care management after traumatic brain injury." THESIS_CSHS_NFC_McCluskey_M.xml, 2003. http://handle.uws.edu.au:8081/1959.7/488.
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This study explores the processes and conditions surrounding long-term care decision-making and care management after traumatic brain injury. Grounded theory methodology and methods were used. Semi-structured interviews were conducted with a total of 51 participants in New South Wales, Australia. A grounded theory of care management was developed through constant comparison of data and cases and identified a social problem, a core social process, strategies, conditions and consequences. The basic social problem was the need for ongoing care, a problem which the person with brain injury and others managed collectively. Together, they determined an appropriate care location or living situation, configuration of carers and level of care. This study provides a framework for understanding preferred ways of living with care after brain injury. Increased autonomy was a desired outcome. Living alone and spending time alone were associated with increased autonomy and increased risk. A series of strategies and processes are suggested that allow professionals and family carers to gradually increase risk, and share responsibility for risk management. The findings have implications for health professional and legal practice, education, research and policy.Doctor of Philosophy (PhD)
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Sun, Luning. "Using the Ekman 60 faces test to detect emotion recognition deficit in brain injury patients." Thesis, University of Cambridge, 2015. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.708553.
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Tang, Yuen-ming Lewis. "Clinical outcomes for patients with traumatic brain injury in Kowloon Hospital." Hong Kong : University of Hong Kong, 2001. http://sunzi.lib.hku.hk/hkuto/record.jsp?B23295818.
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Laske, Kate M. "Correlation of assessment measures in a rehabilitation program for individuals with traumatic brain injury." Oxford, Ohio : Miami University, 2004. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=miami1082685973.
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Nylén, Karin. "Studies of biochemical brain damage markers in patients at a neurointensive care unit /." Göteborg : Institute of Neuroscience and Physiology, Department of Neurology, Göteborg University, 2007. http://hdl.handle.net/2077/4599.
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Thiart, Karen. "Traumatic brain injury (TBI) patients’ post-acute rehabilitation : the experience of family members." Diss., University of Pretoria, 2012. http://hdl.handle.net/2263/28339.
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A traumatic brain injury (TBI) is what its name suggests: an extremely traumatic event that affects the most supremely powerful but fragile organ that controls all our bodily functions and holds the essence that makes individuals unique. Some patients with a traumatic brain injury will recover without realising what the effect could have been and others will be left with effects that will last throughout their lives. “Many sufferers will remain severely incapacitated and a lamentably large number will become part of the statistics on the mortality after TBI” (Burns, 2008a:76). The impairments that an individual faces after a TBI will be dealt with in an acute rehabilitation setting. Significant emotions are experienced by patients with a traumatic brain injury. The researcher believes that this emotional reaction is also experienced by the family members. The event may be even more devastating to the family members, because of the impaired cognitive functions of the injured person. Ross and Deverell (2004:36) state that when individuals are diagnosed with disabling conditions, they experience strong emotional reactions. “Feelings of grief, anxiety, inadequacy, anger, guilt, vulnerability and confusion are some of the more common emotions that clients and their families experience when they encounter a disability in themselves or a family member” (Ross and Deverell, 2004:41). After a traumatic brain injury the patient is usually admitted to an intensive care unit (ICU). Once medically stable and able to participate in an active rehabilitation programme, provided this is authorised by the patient’s medical aid, the patient is transferred to a rehabilitation unit. While in ICU, the outcome is very uncertain and the the family often receives very limited support. Patients are often in a coma and unable to communicate. In working with TBI patients, the researcher found that family members receive very limited support, education on the condition and feedback on the patient’s medical state from team members, and therefore become very anxious when the patient is eventually transferred to a rehabilitation unit. In this study, the researcher focused on the family’s experience from the time of the patient’s admission into ICU until discharge from rehabilitation. During the rehabilitation process, family members are encouraged to support their family member in the rehabilitation unit. This is often very difficult for them, as it entails being confronted with reality and the often devastating impact of the injury. The focus of this study is on the experiences of family members while the patient with a TBI is in hospital and in the rehabilitation unit and the challenges they face. The researcher strove to understand the experiences of family members of patients with TBI, from ICU through until discharge from acute rehabilitation. The goal was to explore the experiences of adult family members of the traumatic brain-injured person in post-acute rehabilitation. The research question was: What were the experiences of adult family members of the person with a traumatic brain injury (TBI) during post-acute rehabilitation? A qualitative approach was used in this study, with a collective case study research design. The population for this study was all the family members of patients who underwent rehabilitation as a result of traumatic brain injury in the Life Eugene Marais Hospital, Pretoria, Gauteng. In this study purposive sampling was used to choose participants who were family members of TBI patients. The criteria for sampling of family members as participants were as follows. The patient - had suffered a traumatic brain injury;
- had undergone acute rehabilitation at Life Eugene Marais Hospital for the last four years;
- had completed rehabilitation, in other words had to be post discharge;
- lived in the province of Gauteng; and
- was able to speak and understand English or Afrikaans, irrespective of gender, race, religion, culture or age.
Dissertation (MSW)--University of Pretoria, 2012.
Social Work and Criminology
unrestricted
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Harp, Phillip Allan. "System to compress while electrically stimulating hippocampal brain slices (SCWESH) : design, development, and electromechanical validation." Thesis, Georgia Institute of Technology, 1999. http://hdl.handle.net/1853/16828.
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Beck, Kelley D. Franks Susan F. "Personality and the prediction of outcome following rehabilitation in persons with acquired brain injuries the Millon Behavioral Medicine Diagnostic (MBMD) /." [Denton, Tex.] : University of North Texas, 2008. http://digital.library.unt.edu/permalink/meta-dc-9121.
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Brinker, Kathryn J. "The appreciation and comprehension of lexical humour in patients with right-hemisphere brain damage." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape9/PQDD_0005/MQ42128.pdf.
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Мудренко, Ірина Григорівна, Ирина Григорьевна Мудренко, Iryna Hryhorivna Mudrenko, Оксана Іванівна Коленко, Оксана Ивановна Коленко, and Oksana Ivanivna Kolenko. "Anxiety-depressive disorders in patients with dysarthria against the background of organic brain damage." Thesis, Cambridge University Press, 2021. https://essuir.sumdu.edu.ua/handle/123456789/87558.
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The presence of acquired speech disorders of varying evidence can cause maladjustment and job loss. Often there is no adequate psychological and psychotherapeutic assistance for these patients, which hinders the process of recovery and reintegration into the social environment.
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Droge, Janet. "Syllogistic inferencing in brain injured subjects." Thesis, McGill University, 1987. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=63852.
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Fischer, Sonja. "Awareness of Deficits in Patients with Brain Injuries." Doctoral thesis, Universitätsbibliothek Chemnitz, 2003. http://nbn-resolving.de/urn:nbn:de:bsz:ch1-200300020.
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The purpose of this dissertation was to examine aspects of self-awareness in patients with brain injuries: In Study 1 two measures for the assessment of self-awareness were compared (i.e., questionnaire approach vs. predicted performance method). Study 2 analyses the relationship between awareness, goal setting ability (i.e., the ability to set realistic goals), and outcome in the rehabilitation setting as well as in an experimental taskZiel dieser Dissertation war es, Aspekte des Störungsbewusstseins von Patienten mit Hirnschädigungen zu untersuchen: In Studie 1 wurden zwei Methoden zu Erfassung/Messung des Störungsbewusstseins verglichen (Fragebogen-Methode und Leistungsvorhersage-Methode). In Studie 2 wurde der Zusammenhang zwischen Störungsbewusstsein, realistischen Zielsetzungen, und Rehabilitationserfolg sowohl im Rehabilitationskontext als auch in einer experimentellen Aufgabe untersucht
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Butler, Mary, and n/a. "Care ethics and brain injury." University of Otago. Department of Philosophy, 2008. http://adt.otago.ac.nz./public/adt-NZDU20080214.134301.
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It is generally supposed that a supportive family can have an influence on outcomes for an adult with severe brain injury, but there is very little known about what effective families actually do. In this research the families of five such individuals were involved in an ethnographic project that lasted for one year.
The literature review brought together insights from brain injury, care ethics, disability studies and anthropology. These insights were combined with a process of reflective equilibrium that was applied to the ethnographic material in order to determine the ethics of the carers. Ethics of care in this setting was conceived of as a positive practice ethic, rather than as a series of negative conundrums posed by the brain injury.
The practice ethic shared by carers meant that they all conceived of the need created by brain injury in humanistic terms, rather than in terms of pathology. Carers demonstrated virtues appropriate to their practice as they helped the adult with brain injury to connect with aspects of ordinary life. The best outcomes for the adult with brain injury included being able to engage in productive activity and to make a place in the world. These outcomes could only be achieved with due regard for their safety and subsistence. The practice ethic of carers was demonstrated in the skills and concern that ensured a satisfactory outcome for the adult with brain injury.
This research is a departure from recent research about families affected by brain injury, which has focused on the burden involved in care. An examination of what carers achieve suggests that burden may be associated with the development of caring practice. The transformative capacity of care, for both the carer and the adult with brain injury, is emphasized. However contextual factors, such as adequate compensation, are connected to the capacity of the carer to engage in good practice and these are explored also in this thesis. In particular, relevant aspects of the relationship between families and the Accident Compensation Corporation are explored.
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Luevanich, Chayanit. "A longitudinal study exploring the impact of moderate or severe traumatic head injuries on family caregivers." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2004. https://ro.ecu.edu.au/theses/824.
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Background: This longitudinal study explored the impact on the family caregivers caring for a victim of a moderate or severe traumatic head injury (THI). The study used both quantitative and qualitative method and involved data calculation at three times points: one-month post injury, six months post injury, and one year later. Study Population: The study population comprised 45 family caregivers aged 21 to 72 years old. Thirty-four of the same caregivers were followed at six months and twenty five one year respectively. Methods: Both quantitative and qualitative methods were used to assess the family caregivers. The quantitative dimension comprised the Psychological General Well•Being Schedule (PGWBS, Dupy, 1984), the General Functioning Scale of the Family Assessment Device (FAD-GFS, Epstein, Baldwin, &Bishop, 1983), and the Stanford Acute Stress Reaction Questionnaire (SASRQ, Cardem1, et at., 2000), as well as a range of demographic variables. The PGWBS and the FAD-GFS were completed by family caregivers at three times during the study, and the SASRQ was completed by family caregivers at Time 1. Results: Findings from quantitative method revealed that in the terms of the impact on family functioning, no significant differences were found between the initial stages of injury, six months, and one year post injury at the 0.05 level of significance. Especially in the initial stages of injury, family caregivers of both moderate and severe THI patients were likely to be at risk of developing an acute stress disorder after exposure to the traumatic event. However, the family caregiver's psychological general well-being showed significant difference among three times at the 0.01 level of significance. The qualitative findings showed that most of family caregivers gave the meaning of THI as causing disability and severe injury. The major sources of distress were financial problems and victims’ prognosis or reactions. These caused an impact on caregivers’ financial situations, psychological and health problems, and loss of social interactions. Family caregivers used both problem-focused and emotion-focused coping strategies to deal the traumatic event. The coping strategies and resources that caregivers used to deal with the THI were consistent with the caregiver’s way of life and culture. For example, they used religious coping mechanisms and belief in God or traditional medicine and local wisdom combined with the professional health care sector to help them cope. Conclusion: The results of this study provide insights into the family caregivers experiences, understand how they cope with the crisis event and the impact of THI on their health. Health policy and local government should pay attention and promote the family caregivers’ well-being and welfare to support the family caregivers during their take role as caregivers.
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Fischer, Sonja. "Awareness of Deficits in Patients with Brain Injuries." Doctoral thesis, [S.l.] : [s.n.], 2002. https://monarch.qucosa.de/id/qucosa%3A17955.
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The purpose of this dissertation was to
examine aspects of self-awareness in patients with
brain injuries: In Study 1 two measures for the assessment
of self-awareness were compared (i.e., questionnaire approach
vs. predicted performance method). Study 2 analyses the
relationship between awareness, goal setting ability (i.e., the
ability to set realistic goals), and outcome in the rehabilitation
setting as well as in an experimental task.Ziel dieser Dissertation war es, Aspekte des Störungsbewusstseins von Patienten mit Hirnschädigungen zu untersuchen: In Studie 1 wurden zwei Methoden zu Erfassung/Messung des Störungsbewusstseins verglichen (Fragebogen-Methode und Leistungsvorhersage-Methode). In Studie 2 wurde der Zusammenhang zwischen Störungsbewusstsein, realistischen Zielsetzungen, und Rehabilitationserfolg sowohl im Rehabilitationskontext als auch in einer experimentellen Aufgabe untersucht.
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VandenBerg, Penny M., and University of Lethbridge Faculty of Arts and Science. "Associative diaschisis and skilled rehabilitation-induced behavioral recovery following focal ischemic infact." Thesis, Lethbridge, Alta. : University of Lethbridge, Faculty of Arts and Science, 2002, 2002. http://hdl.handle.net/10133/207.
Full textAbstract:
The time course of peri-infarct diaschisis following a focal ischemic infarct and the effects of delayed rehabilitation on behavioral and functional recovery were examined. Intracortical microstimulation (ICMS) was used to derive topographical maps of forelimb representations within the rat motor cortex and ischemia was induced via bipolar coagulation of surface vasculature. At one hour there was a dramatic expansion of reprentations in control but not ischemic animals. A significant loss of forelimb representations within peri-infarct dysfunction indicates the need for immediate administration of therapeutic interventions following an ischemic event. These results indicate that the timing of rehabilitation does not effect functional and behavioral recovery but does support the need for rehabilitative interventions of facilitate these types of recovery.132 leaves : ill. ; 28 cm.
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Haren, Lacy Ann. "EFFECTS OF A SYSTEMATIC TRAINING PROGRAM ON CATEGORIZATION ABILITIES IN PATIENTS WITH TRAUMATIC BRAIN INJURY." Miami University / OhioLINK, 2006. http://rave.ohiolink.edu/etdc/view?acc_num=miami1145299854.
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Collins, Michael J. "The Use of Hyperbaric Oxygenation Therapy to Change Cerebral Metabolism Rates in Patients with Chronic Brain Damage." NSUWorks, 2009. http://nsuworks.nova.edu/cps_stuetd/20.
Full textAbstract:
Hyperbaric Oxygenation Therapy (HBOT) has a successive history for treating very specific groups of physical conditions. Research by Neubauer and colleagues states that HBOT's ability to increase cerebral metabolism in the brain regenerates dormant neural tissue (Neubauer, Gottlieb, & Pevsner 1994). According to this research, the increase of cerebral metabolism levels restores mental capacity from the neurological insult. Despite promise, uncertainty exists as to whether this is a viable treatment option for people suffering from neural damage. The research results for this experiment will examine the effect of HBOT on cerebral metabolism levels in adults and pediatrics with chronic neurological problems. Fifty individuals diagnosed as having a neurological impairment whom met criteria for the study were analyzed from an archival data set. Criterion required chronic impairment, baseline SPECT, followed by HBOT exposures, and a post SPECT scan. Statistical analyses consisted of a Pearson correlation that examined pre-metabolism rates with total change, a Pearson correlation that examined total change and number of treatments, and a one way ANOVA analysis that examined cerebral metabolism change in patients under 18 and over 18. Results indicated change
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Rankin, Wendi Michele. "Utilizing Art Therapy to Recognize Cognitive-Communication Disabilities in Patients with Traumatic Brain Injury." Ursuline College / OhioLINK, 2008. http://rave.ohiolink.edu/etdc/view?acc_num=urs1211417561.
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Steffey, Dixie Rae. "The relationship between the Wechsler Adult Intelligence Scale - Revised and the Stanford-Binet Intelligence Scale: Fourth Edition in brain-damaged adults." Diss., The University of Arizona, 1988. http://hdl.handle.net/10150/184412.
Full textAbstract:
This study investigated the relationship between the Wechsler Adult Intelligence Scale-Revised (WAIS-R) and the Stanford-Binet Intelligence Scale: Fourth Edition (SBIV) in a brain-damaged adult sample. The sample in this study was composed of 30 adult patients at two residential treatment programs who completed comprehensive psychological evaluations between August, 1986 and November, 1987. Each patient was administered both the WAIS-R and the SBIV as part of these evaluations. Data gathered in this study was submitted to Pearson product moment correlational statistical procedures. Significant correlations were found in the following pairs of summary scores: the SBIV Test Composite Standard Age Score (SAS) and the WAIS-R Full Scale IQ; the SBIV Abstract/Visual Reasoning Area SAS and the WAIS-R Performance IQ; the SBIV Quantitative Reasoning Area SAS and the WAIS-R Verbal Scale IQ; the SBIV Verbal Reasoning Area SAS and the WAIS-R Verbal Scale IQ; the SBIV Short-Term Memory Area SAS and the WAIS-R Verbal Scale IQ; and the SBIV Short-Term Memory Area SAS and the WAIS-R Full Scale IQ. Significant correlations were also found in the following pairs of individual subtest results: the SBIV and WAIS-R Vocabulary subtests; the SBIV Memory for Digits subtest and the WAIS-R Digit Span subtest; the SBIV Pattern Analysis subtest and the WAIS-R Block Design subtest; and the SBIV Paper Folding and Cutting subtest and the WAIS-R Picture Arrangement subtest. Directions for future research were also suggested upon review of the subtest correlation matrix and the descriptive statistics of data generated.
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Luna, Brenda. "Prenatal Environmental Exposure and Neurodevelopmentally Important Gene Expression in Malformed Brain Tissue from Pediatric Intractable Epilepsy Patients." FIU Digital Commons, 2011. http://digitalcommons.fiu.edu/etd/445.
Full textAbstract:
The primary objective of this proposal was to determine whether mitochondrial oxidative stress and variation in a particular mtDNA lineage contribute to the risk of developing cortical dysplasia and are potential contributing factors in epileptogenesis in children. The occurrence of epilepsy in children is highly associated with malformations of cortical development (MCD). It appears that MCD might arise from developmental errors due to environmental exposures in combination with inherited variation in response to environmental exposures and mitochondrial function. Therefore, it is postulated that variation in a particular mtDNA lineage of children contributes to the effects of mitochondrial DNA damage on MCD phenotype. Quantitative PCR and dot blot were used to examine mitochondrial oxidative damage and single nucleotide polymorphism (SNP) in the mitochondrial genome in brain tissue from 48 pediatric intractable epilepsy patients from Miami Children’s Hospital and 11 control samples from NICHD Brain and Tissue Bank for Developmental Disorders.
Epilepsy patients showed higher mtDNA copy number compared to normal health subjects (controls). Oxidative mtDNA damage was lower in non-neoplastic but higher in neoplastic epilepsy patients compared to controls. There was a trend of lower mtDNA oxidative damage in the non-neoplastic (MCD) patients compared to controls, yet, the reverse was observed in neoplastic (MCD and Non-MCD) epilepsy patients. The presence of mtDNA SNP and haplogroups did not show any statistically significant relationships with epilepsy phenotypes. However, SNPs G9804A and G9952A were found in higher frequencies in epilepsy samples. Logistic regression analysis showed no relationship between mtDNA oxidative stress, mtDNA copy number, mitochondrial haplogroups and SNP variations with epilepsy in pediatric patients. The levels of mtDNA copy number and oxidative mtDNA damage and the SNPs G9952A and T10010C predicted neoplastic epilepsy, however, this was not significant due to a small sample size of pediatric subjects. Findings of this study indicate that an increase in mtDNA content may be compensatory mechanisms for defective mitochondria in intractable epilepsy and brain tumor. Further validation of these findings related to mitochondrial genotypes and mitochondrial dysfunction in pediatric epilepsy and MCD may lay the ground for the development of new therapies and prevention strategies during embryogenesis.
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Brink, Petrus Badenhorst Naude. "Neuro Consilio: Stimulating visual, haptic, olfactory and auditory senses to promote passive recovery in acute brain injury and post operative neurological patients." Diss., University of Pretoria, 2020. http://hdl.handle.net/2263/78590.
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The following dissertation analyses how users experience space with their different senses. And how we as designers can utilise this to improve rehabilitative designs’ responsiveness to cater to acute brain injury and post-operative neurological surgery patients.
The medical field has shown a rapid increase in neurological development that changes the way doctors have been treating patients thus far. With the rapid growth in development, the associated disciplines need to react to the change in knowledge to provide a facility that accommodates new treatment methods that will always provide the patient with the best care.
When dealing with specialised fields, the architectural design process is limited by the designers’ experience and knowledge, and when it comes to the medical field, it is almost always limited. The regulations and medical planning guidelines cater to the minimum requirements and systematic applications and not set to adapt to patient needs. Thus a multidisciplinary collaborative effort is needed to address the patient’s wellbeing properly.
For the architectural profession to design responsive environments that help promote the patients’ passive recovery principles, we need to be able to identify the effect our spaces have on the brain.
The research aims to broaden the philosophical approach to design to include rehabilitation principles to create more productive environments for patients.
By studying the effect of the spaces on the brain, we know from the brain’s neuroplasticity that the constructive stimulation of the areas affected will increase its recovery rate. Once the principles have been identified, architectural drivers can be deduced from the data sets.
If correctly implemented, the responsive design principles can help produce better rehabilitative methods that don’t have to rely solely on active rehabilitation applications. The end goal is to have this facility serve as a precedent for future projects with a multidisciplinary healthcare program that aims to incorporate responsible passive neurological treatments.Mini Dissertation (MArch (Prof))--University of Pretoria, 2020.
Architecture
MArch (Prof)
Unrestricted
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Hilborn, Robert Scott. "Psychological characteristics contributing to performance on neuropsychological tests and effort testing." Thesis, University of North Texas, 2008. https://digital.library.unt.edu/ark:/67531/metadc9093/.
Full textAbstract:
The issue of effortful patient performance has been an area of clinical interest in individuals with minor traumatic brain injury (mTBI). Clinical attention to this area has increased largely because of an increase in the number of worker's compensation claims, injury-related lawsuits and/or insanity defense pleas. As patients are presented with the opportunity for secondary gain, the issue of optimum performance on neuropsychological measures becomes salient. In addition to neurocognitive deficits, there are psychological characteristics associated with mTBI including depression, emotional disturbance, personality changes, and other psychopathology. This study utilized the MSVT, a set of standard neuropsychological instruments, and the Minnesota Multiphasic Inventory-2 (MMPI-2) to investigate the relationships between effort, psychological characteristics, and neuropsychological functioning in individuals with minor traumatic brain injuries. The first objective of this study was to determine which psychological factors were related to effort in mTBI. The second objective was to determine if there were differences between groups that performed poorly on effort testing and groups that performed adequately on effort testing, based on relevant psychological characteristics. The results of the analyses supported the first hypothesis. Hysteria was inversely related to effort, and Mania was positively related to effort on one of five measures of effort. The second hypothesis was not supported.