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Ward, Heather Jean, i n/a. "Prospective Memory: Early Developmental Trajectory and Effects of Paediatric Traumatic Brain Injury on its Functioning". Griffith University. School of Psychology, 2005. http://www4.gu.edu.au:8080/adt-root/public/adt-QGU20050804.154501.
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Very little is known about the effects of paediatric traumatic brain injury (TBI) on prospective memory, the memory for future intentions such as remembering to post a letter in the morning or do homework. The main aim of this thesis was to redress that shortcoming in the literature. To investigate the effects of paediatric TBI on prospective memory as reliably and fully as possible, the study of children and adolescents with brain injuries was preceded by a developmental study. Given that the process of recovery from brain injury is imposed on the ongoing process of development, it is important to understand more about the normal developmental trajectory of prospective memory first of all. Study 1 compared the prospective-memory performance of 88 normally developing children, adolescents and young adults. The main task was computerised, and its design was influenced by a prefrontal-lobe model because prospective memory is believed to be mediated by the prefrontal regions of the brain. Variables associated with prefrontal-lobe capacity were manipulated: the cognitive demand of an ongoing task, and the importance of the prospective task. Results of Study 1 found that children remembered to respond to fewer prospective cues than adolescents or adults, but that adolescents and adults remembered similarly. Further, the differences between the children's performance and the adolescents' and adults' widened as the cognitive demand of the ongoing task increased. However, the effects of increasing the cognitive demand did not vary between the adolescents and adults. It made no difference to anyone's performance whether the importance of remembering the prospective cues was stressed or not. On the other hand, performance on executive functions, as measured by the Self-Ordered Pointing Task (SOPT), the Stroop Colour Word Interference Test (Stroop), and the Tower of London (TOL), which are also believed to be affected by prefrontal capacity, produced the same age effects as were produced on the computerised prospective-memory task. Further, performance on the SOPT and Stroop predicted performance on the high-demand level of the prospective-memory task. Study 2 compared 34 children and adolescents with TBI with the non-injured children and adolescents from Study 1 on the same tasks. Results revealed that overall those with TBI had poorer prospective-memory performance than their non-injured peers. However, a different pattern of impairment was evident in the children than in the adolescents. Specifically, the children with TBI performed similarly to their non-injured peers, but the adolescents with TBI were significantly worse than the non-injured adolescents. This trend was most noticeable as the cognitive demand of the ongoing task increased. Further, the age and injury effects were reflected in the performances on the executive-function tests, and the TOL predicted performance on the high-demand, prospective-memory task in those with TBI. Study 3 aimed to examine the ecological validity of Study 2, by investigating whether the impairments in prospective memory in young people with TBI measured quantitatively, were matched with qualitative data. Twelve parents of children and adolescents with mild to severe TBI were interviewed about whether or not their children's injuries impacted on their memory (retrospective and prospective) in everyday life. Results showed that in general most children suffered memory losses as a result of their brain injuries, and that prospective-memory loss caused particular hardships for the children and their families. Taken together, the results of the current research revealed that the development of prospective memory reaches a peak of maturity in adolescence, and that adolescents with TBI show greater decrements in prospective memory than adolescents without TBI, but that this pattern is not evident in children, where those with TBI were not significantly different from those without. These findings give support to the prefrontal-lobe model of prospective memory by showing that prefrontal maturity, which reaches a peak during adolescence, reflects the prospective-memory performance of healthy adolescents, and prefrontal injury, which is very common with TBI, shows the effects of deficits more during adolescence than in earlier years when the prefrontal regions are not yet fully developed. Study 3 showed that impairments in prospective memory that result from TBI translate into disabilities in the real world. As a follow up it is recommended that rehabilitation strategies be designed to assist young people with prospective-memory impairments adjust better to school and the demands of everyday living. The prefrontal-lobe model should guide the design of such strategies.
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Ward, Heather Jean. "Prospective Memory: Early Developmental Trajectory and Effects of Paediatric Traumatic Brain Injury on its Functioning". Thesis, Griffith University, 2005. http://hdl.handle.net/10072/367932.
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Very little is known about the effects of paediatric traumatic brain injury (TBI) on prospective memory, the memory for future intentions such as remembering to post a letter in the morning or do homework. The main aim of this thesis was to redress that shortcoming in the literature. To investigate the effects of paediatric TBI on prospective memory as reliably and fully as possible, the study of children and adolescents with brain injuries was preceded by a developmental study. Given that the process of recovery from brain injury is imposed on the ongoing process of development, it is important to understand more about the normal developmental trajectory of prospective memory first of all. Study 1 compared the prospective-memory performance of 88 normally developing children, adolescents and young adults. The main task was computerised, and its design was influenced by a prefrontal-lobe model because prospective memory is believed to be mediated by the prefrontal regions of the brain. Variables associated with prefrontal-lobe capacity were manipulated: the cognitive demand of an ongoing task, and the importance of the prospective task. Results of Study 1 found that children remembered to respond to fewer prospective cues than adolescents or adults, but that adolescents and adults remembered similarly. Further, the differences between the children's performance and the adolescents' and adults' widened as the cognitive demand of the ongoing task increased. However, the effects of increasing the cognitive demand did not vary between the adolescents and adults. It made no difference to anyone's performance whether the importance of remembering the prospective cues was stressed or not. On the other hand, performance on executive functions, as measured by the Self-Ordered Pointing Task (SOPT), the Stroop Colour Word Interference Test (Stroop), and the Tower of London (TOL), which are also believed to be affected by prefrontal capacity, produced the same age effects as were produced on the computerised prospective-memory task. Further, performance on the SOPT and Stroop predicted performance on the high-demand level of the prospective-memory task. Study 2 compared 34 children and adolescents with TBI with the non-injured children and adolescents from Study 1 on the same tasks. Results revealed that overall those with TBI had poorer prospective-memory performance than their non-injured peers. However, a different pattern of impairment was evident in the children than in the adolescents. Specifically, the children with TBI performed similarly to their non-injured peers, but the adolescents with TBI were significantly worse than the non-injured adolescents. This trend was most noticeable as the cognitive demand of the ongoing task increased. Further, the age and injury effects were reflected in the performances on the executive-function tests, and the TOL predicted performance on the high-demand, prospective-memory task in those with TBI. Study 3 aimed to examine the ecological validity of Study 2, by investigating whether the impairments in prospective memory in young people with TBI measured quantitatively, were matched with qualitative data. Twelve parents of children and adolescents with mild to severe TBI were interviewed about whether or not their children's injuries impacted on their memory (retrospective and prospective) in everyday life. Results showed that in general most children suffered memory losses as a result of their brain injuries, and that prospective-memory loss caused particular hardships for the children and their families. Taken together, the results of the current research revealed that the development of prospective memory reaches a peak of maturity in adolescence, and that adolescents with TBI show greater decrements in prospective memory than adolescents without TBI, but that this pattern is not evident in children, where those with TBI were not significantly different from those without. These findings give support to the prefrontal-lobe model of prospective memory by showing that prefrontal maturity, which reaches a peak during adolescence, reflects the prospective-memory performance of healthy adolescents, and prefrontal injury, which is very common with TBI, shows the effects of deficits more during adolescence than in earlier years when the prefrontal regions are not yet fully developed. Study 3 showed that impairments in prospective memory that result from TBI translate into disabilities in the real world. As a follow up it is recommended that rehabilitation strategies be designed to assist young people with prospective-memory impairments adjust better to school and the demands of everyday living. The prefrontal-lobe model should guide the design of such strategies.Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Psychology
Full Text
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Trenchard, Sian Olivia. "Traumatic brain injury in a paediatric population". Thesis, University of Manchester, 2013. https://www.research.manchester.ac.uk/portal/en/theses/traumatic-brain-injury-in-a-paediatric-population(cf299afa-75ff-4a58-9684-6b332d25715e).html.
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This thesis examined neuropsychological and psychological outcomes following paediatric traumatic brain injury (TBI). The introductory chapter provides an overview of the paediatric TBI literature, giving definitions of key terms and concepts and providing a description of the epidemiology of childhood head injury. Key models relevant to paediatric TBI are introduced, including developmental neurological, cognitive and psychological perspectives. This is followed by a discussion of factors pertinent to outcome after TBI, followed by a description of outcomes relating to cognitive, behavioural, psychological, adaptive and family functioning domains. Existing research demonstrates that poor outcomes are frequently observed in paediatric TBI populations across these domains and difficulties are persistent over time, particularly where children have sustained severe head injury. Thus, research has turned its focus to the prediction of outcomes which can assist clinicians in the identification of those individuals who will require rehabilitation in order to promote their long-term recovery. Whilst the literature has identified injury and demographic factors that can assist in this process, little attention has been given to the potential utility of psychological screening assessment. Given the prevalence of neuropsychological and psychosocial problems after paediatric TBI and lack of empirical data considering factors predictive of difficulty at the post-acute phase, this research aimed to consider the clinical utility of completing a pre-discharge screening assessment in children and adolescents with TBI. Specific areas of consideration included the potential impact of injury severity on neuropsychological functioning, psychosocial impairment and return to full-time schooling. The study design comprised a prospective case series of 11 children and adolescents with TBI (aged 7-15 years), who were assessed both pre- and post-discharge (3-6 month follow-up). Domains of intellectual, emotional, behavioural, and adaptive functioning, health-related quality of life and parenting stress were assessed at both time-points. Clinically significant findings were demonstrated in domains of neuropsychological and psychosocial functioning, particularly for those with a severe TBI. Specifically, ratings of self-reported emotional distress, and parental perceptions of child health-related quality of life were found to be within clinical ranges at pre- and post-discharge for more than half of the participants. The majority of participants with severe injury required further neuropsychological assessment and interventions relating to emotional and/or behavioural management. The post-discharge functioning of this cohort provided preliminary evidence for the clinical utility of cognitive and psychosocial screening after paediatric TBI. The observed level of clinical need, particularly in the severely-injured group indicated that screening was a useful tool for early identification of difficulties, and provided an opportunity for timely intervention. Without screening, children and adolescents with TBI may be discharged to the community without appropriate support in place; raising long-term concerns for the child, family, and the wider social and economic systems. Despite this, further research which explicates these findings within larger samples is required. The discussion chapter reviews these findings in relation to the wider literature, followed by consideration of this study's limitations. The thesis concludes with a description of the clinical implications of the findings and suggested future directions.
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Lalani, Sanam Jivani. "Effects of Traumatic Brain Injury on Pediatric Brain Volume". BYU ScholarsArchive, 2018. https://scholarsarchive.byu.edu/etd/6924.
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This study investigated the effects of lesion presence within larger brain networks (e.g., default mode network (DMN), salience network (SN), and mentalizing network (MN)) in the chronic phase of a pediatric traumatic brain injury (TBI) and the effect on social function. We compared children with a TBI to children with an orthopedic injury (OI) with three different aims. The first aim was to determine whether network volume differed by group (e.g., TBI vs. OI). Second, investigate if lesion presence in a sub component region of the network resulted in total network volume loss for that network. Finally, learn whether network volume would predict outcome on the Behavior Assessment System for Children, Second Edition (BASC-2). Approximately 184 participants (65% male; 70% Caucasian) between the ages of 6-17 years completed testing and a structural MRI scan in the chronic stage (at least one-year post-injury) of the injury. Injury severity included complicated mild, moderate, and severe TBI. Radiological findings were analyzed using recommendations from the Common Data Elements' core (presence or absence of a lesion) and supplementary (lesion type and location) recommendations. Volumetrics for all participants were obtained with FreeSurfer to quantify total network volumes for the DMN, SN, and MN. The parent of each participant completed a behavioral measure for externalizing and internalizing behaviors. Three sets of statistical analyses were completed, including multivariate analysis of covariance, analysis of covariance, and multiple regression, for each of the three aims of the study, respectively. There were significant differences in total DMN volume between the two groups and participants with lesions solely in the MN had lower total MN volume. Moreover, lower total MN volume was associated with worse functioning on measures of externalizing and internalizing behaviors. The larger implications, including developmental and social implications, of these findings are discussed.
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Sheppard-Jones, Nicolas. "Ocular impairment in pediatric mild traumatic brain injury". Thesis, McGill University, 2014. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=121355.
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Mild Traumatic Brain Injuries (mTBI) and concussions are complex injuries with high incidence rates in children and adolescents. There currently exists no 'gold standard' for the diagnosis of concussions, and detection and monitoring are made challenging by highly variable clinical presentations. There is growing evidence that mTBI is associated with oculomotor impairment in adults, and that this type of deficit may serve as a marker for the injury. The literature indicates the question has never been addressed in pediatric mTBI. The research presented here sought to address this knowledge gap by first evaluating smooth pursuit and fixational eye movement integrity in a cohort of children and adolescents suffering from mTBI, and then comparing their performances to control participants not having sustained a head injury. The research yielded mixed findings. On the one hand, we found that fixational eye movements are not impaired in pediatric mTBI; measures of fixational eye movement integrity were comparable across groups. On the other hand, selective deficits in smooth pursuit eye movements were found. Synchronization of eye movement with target motion was significantly poorer for mTBI patients. Their abilities to trace target trajectory accurately and to match target velocity, however, were not found to be impaired. It remains unclear whether the observed deficits were caused by disrupted function of the smooth pursuit system proper, by damage to areas that modulate smooth pursuit through top-down influence, or by a combination of both. These preliminary results suggest that select smooth pursuit paradigms could play a role for diagnosing pediatric mTBI, and reinforce the need for further studies in this novel area of research.Les Traumatismes Crâniens Légers (TCL) et les commotions cérébrales sont des blessures complexes auxquelles les enfants et les adolescents sont particulièrement à risque. Il n'existe pas actuellement d'outil objectif pour le diagnostic et le monitorage de ces blessures, qui sont difficiles à gérer en raison de la grande hétérogénéité clinique qui les caractérise. Un nombre grandissant d'études indique que les TCL peuvent engendrer une dysfonction au niveau des mouvements oculaires chez les adultes, et que ces troubles visuels pourraient servir de marqueurs efficaces pour la détection. La question n'a jamais été posée chez les enfants. Ce projet tente d'apporter une réponse préliminaire, d'abord en évaluant l'intégrité des Mouvements de Poursuite Visuelle (MPV) et de fixation chez des enfants et adolescents atteints d'un TCL, puis en comparant leur performance à celle de sujets contrôles n'ayant pas subi de blessure à la tête. Les résultats obtenus sont mixtes. Aucune dysfonction au niveau des mouvements de fixation n'a été décelée; toutes les mesures utilisées pour évaluer les capacités de fixation étaient comparables par groupe. En revanche, des troubles sélectifs ont été détectés au niveau des MPV. Les patients atteints de TCL éprouvaient en moyenne plus de difficulté à synchroniser le mouvement de leurs yeux avec le mouvement d'une cible. La précision et la vélocité du mouvement ne semblaient pas toutefois affectées. Les résultats ne permettent pas de trancher sur la nature exacte du trouble observé, ce dernier pouvant être causé à la fois par une dysfonction au niveau des circuits visuo-moteurs propre, et par une dysfonction au niveau de structures de plus haut niveau modulant les MPV. Ces résultats préliminaires indiquent que l'évaluation des MPV pourrait contribuer au diagnostic et au monitorage de TCL pédiatriques, et renforcent le besoin d'investigations additionnelles dans ce domaine.
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Rohlwink, Ursula Karin. "Paediatric traumatic Brain Injury: The relationship between Intracranial Pressure and Brain Oxygenation". Master's thesis, University of Cape Town, 2009. http://hdl.handle.net/11427/2889.
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Introduction: Intracranial pressure (ICP) monitoring is a cornerstone of care for patients with severe traumatic brain injury (TBI). The primary goal of ICP treatment is to preserve brain oxygenation, and since brain oxygenation is usually not measured, the control of ICP is used as a surrogate marker. However studies indicating that cerebral hypoxia/ischemia may occur in the face of adequate ICP and cerebral perfusion pressure (CPP) suggest that the interaction between ICP and brain oxygenation is poorly understood and warrants further investigation. This is of particular importance in the context of children in whom the interpretation of relationships between intracranial factors is even more complex due to changing physiological norms with age. To date little scientific data exists in children and treatment threshold values are often extrapolated from adult guidelines. This study aims to better understand the relationship between ICP and brain oxygenation measured as brain tissue oxygen tension (PbtO2) in a large paediatric cohort suffering from severe TBI. Specifically analysis 1) investigated ICP and PbtO2 profiles over time following TBI, 2) examined the relationship between ICP and PbtO2 from time-linked paired observations, 3) explored various critical thresholds for ICP and PbtO2, and 4) interrogated digital data trends depicting the relationship between ICP and PbtO2. The level of agreement between hourly recorded and high frequency electronic data for ICP and PbtO2 was also evaluated. Method: Paired ICP and PbtO2 data from 75 children with severe TBI were tested with correlation and regression. Additional analyses controlled for mean arterial pressure (MAP), arterial partial pressure of oxygen (PaO2), CPP, arterial partial pressure of carbon dioxide (PaCO2) and haemoglobin (Hb) using multivariate logistic regression analysis and general estimating equations. Various thresholds for ICP were examined; these included age-related thresholds to account for the potential influence of age. Receiver-operating curves (ROCs) were used to graphically demonstrate the relationships between various thresholds of ICP and various definitions of low PbtO2. These were constructed for pooled and individual patient data. Interrogation of electronically recorded data allowed for case illustrations examining the relationship between ICP and PbtO2 at selected time points. Hourly and electronic data were compared using Bland and Altman plots and by contrasting the frequency of ICP and PbtO2 perturbations recorded with each system. 5 Result: Analyses using over 8300 hours of paired observations revealed a weak relationship between ICP and PbtO2, with an initially positive but weak slope (r = 0.05) that trended downwards only at higher values of ICP. Controlling for inter-individual differences, as well as MAP, CPP, PaO2, PaCO2 and Hb did not strengthen this association. This poor relationship was further reflected in the examination of threshold ICP values with ROCs, no singular critical ICP threshold for compromised brain oxygenation was discernible. Using age-based thresholds did not improve this relationship and individual patient ROCs demonstrated inter-individual heterogeneity in the relationship between ICP and PbtO2. However, it was clear that in individual patients ICP did exhibit a strong negative relationship with PbtO2 at particular time points, but various different relationships between the 2 variables were also demonstrated. A high level of agreement was found between hourly and electronic data. Conclusion: These results suggest that the relationship between ICP and PbtO2 is highly complex. Although the relationship in individual children at specific time points may be strong, pooled data for the entire cohort of patients, and even for individual patients, suggest only a weak relationship. This is likely because several other factors affect PbtO2 outside of ICP, and some factors affect both independently of each other. These results suggest that more study should be directed at optimising ICP thresholds for treatment in children. The use of complimentary monitoring modalities may assist in this task. Depending on the adequacy of measures of brain perfusion, metabolism or oxygenation, it is possible that targeting a range of ICP values in individual patients may be appropriate; however this would require detailed investigation.
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Peng, Jin. "Follow-up Appointment Adherence after Pediatric Traumatic Brain Injury". The Ohio State University, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=osu1520418824950075.
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Hughes, Keith G. "Predictors of family functioning following pediatric traumatic brain injury". Connect to resource, 1996. http://rave.ohiolink.edu/etdc/view.cgi?acc%5Fnum=osu1261056181.
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Sukhina, Alona. "Developments on Post-Traumatic Brain Injury-Induced Hypothalamic Pituitary Dysfunction: A Pediatric Case". Thesis, The University of Arizona, 2018. http://hdl.handle.net/10150/626895.
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Moran, Lisa M. "Do post-concussive symptoms discriminate injury severity in pediatric mild traumatic brain injury?" The Ohio State University, 2009. http://rave.ohiolink.edu/etdc/view?acc_num=osu1250198689.
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Armstrong, Kira Emily. "The assessments of parent needs following pediatric traumatic brain injury". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp03/NQ44793.pdf.
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Mietchen, Jonathan James. "Social Outcome Following Pediatric Traumatic Brain Injury: A Meta-Analysis". BYU ScholarsArchive, 2018. https://scholarsarchive.byu.edu/etd/7431.
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Objective: Children and adolescents with a history of traumatic brain injury (TBI) are at increased risk for developing social incompetence and impairment in broad psychosocial functioning. The aim of this study was to examine the relationship between history of TBI, social competence, and broad psychosocial functioning using meta-analytic methods. Methods: Studies relating to social outcome following pediatric TBI were searched for using scientific, academic databases. Sixteen studies (N=2,005) met inclusion criteria, and relevant data relating to social functioning was extracted. Meta-analytic methods were used in order to obtain Hedges's g effect size data for mild, moderate, and severe TBI groups. Meta-regressions were also used to examine the effect of potential moderating variables, including Glasgow Coma Scale (GCS), socioeconomic status (SES), gender, control group (typically developing (TD) or orthopedic injury (OI)), and time/age related variables. Finally, publication bias was calculated using funnel plots and Rosenthal's fail-safe N. Results: A dose-response effect was observed with mild (Hedges's g = -0.387), and moderate (Hedges's g = -0.459) groups demonstrating smaller effects when compared to the severe group (-0.814) on measures of broad psychosocial function. A dose-response effect was also observed on measures of social competence, with mild (Hedges's g = -0.098) and moderate (Hedges's g = -0.450) TBI groups demonstrating smaller effect sizes when compared to the severe TBI group (Hedges's g = -0.832). The GCS was a significant predictor of both broad psychosocial functioning (B = 0.065, p < 0.001) and social competence (B = 0.079, p < 0.001), such that more severe injuries predicted poorer social outcomes. Gender was a significant predictor of effect size (B = 0.018, p = 0.05), such that higher proportions of females was associated with smaller effect sizes. Finally, the type of control group used in these studies was also a significant predictor of effect size (B = 0.369, p = 0.03), such that studies that used TD produced larger effect sizes when compared to studies that used OI. Overall, there was little evidence for publication bias. Conclusions: Children and adolescents with a history of TBI demonstrated significant differences from their peers in social competence and broad psychosocial functioning following TBI. The severity of the injury is important in understanding and predicting social outcomes following pediatric TBI. Implications of these findings are discussed.
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Coullie, Charis Blythe. "Adult Psychiatric and Offending Outcomes of Paediatric Mild Traumatic Brain Injury". Thesis, University of Canterbury. Psychology, 2013. http://hdl.handle.net/10092/7802.
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Introduction: Mild traumatic brain injury (mTBI) accounts for the vast majority of all paediatric TBI cases. It is an important public health concern, yet the long-term psychiatric and behavioural outcomes remain imperfectly understood. Aim. This study aims to examine the association between paediatric mTBI and psychiatric and offending outcomes in adulthood, while considering the impact of sex, age at injury and duration since injury on outcome. Participants: Participants with mTBI (n=57) were compared to those with moderate/severe TBI (n=62) and to orthopaedic injury controls (n=42). All participants were injured at age 17 or younger and were 18 years or older at the time of assessment. Outcome measures: Based on the DSM-IV-TR criteria, structured interviews were used to assess participants’ experience of symptoms consistent with major
depressive disorder, anxiety disorders (including generalised anxiety disorder, panic attacks and panic disorder, agoraphobia, social phobia, post-traumatic stress disorder, and specific phobia), and substance abuse and/or dependence. Participants’ were asked to report on their lifetime involvement with offending, arrests, and diversions and/or convictions. Results: At age 18-31, participants with a
paediatric mTBI were significantly more likely than orthopaedic injury controls to endorse symptoms consistent with major depressive disorder by 3.17 times, anxiety disorders by 5.81 times, and internalising disorders in general by 5.80 times and the risk in the mTBI group was greater than that for those with moderate/severe TBI. Females with mTBI were significantly more likely than males, by five times, to endorse an internalising disorder. Paediatric mTBI was not significantly associated with externalising problems when compared with controls; however, males with mTBI were 6.57 times more likely to endorse externalising behaviours than females. Conclusions: Paediatric mTBI is a risk factor for internalising disorders in adulthood, particularly for females. Such findings have implications for assessment and treatment of problems associated with paediatric mTBI.
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Eschler, Benjamin Douglas. "Psychiatric Symptom Severity Following Pediatric Traumatic Brain Injury: A Meta-Analysis". BYU ScholarsArchive, 2018. https://scholarsarchive.byu.edu/etd/7247.
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Objectives: A meta-analysis was conducted to determine the average effect size of internalizing and externalizing symptoms after pediatric traumatic brain injury across a range of severity (mild, moderate, and severe). Two-meta-regressions were also conducted to determine the role of age at injury at time since injury on these effect sizes.Participants and Methods: 9725 titles and abstracts were collected from PubMed, PsycInfo, and Web of Science. Of these, 63 full-text articles were examined for inclusion criteria to determine eligibility for the study. To be included, the studies needed to be published prior to March 2017 in English, needed to have a control group of either orthopedically injured or typically developing peers, and required a reliable and valuable measure of internalizing and externalizing symptoms in children. Studies were excluded for non-accidental head injuries or if the sample recruited was outside the range of 2-17 years old at the time of injury. The analysis was based on 16 studies including 1083 cases of mild TBI, 184 cases of moderate TBI, 214 cases of severe TBI, and 1605 control cases.Results: Analyses revealed a large effect size for internalizing symptoms of children with mild TBI (Hedge<'>s g = -0.624, p = 0.009), a small effect size for moderate TBI (Hedge<'>s g = -0.238, p = 0.029), and a large effect size for severe TBI (Hedge<'>s g = -0.923, p < .001). These findings indicate that parents rate children<'>s internalizing symptoms more severely for brain injured children than for typically developing or non-brain injured peers. These children may be experiencing more severe symptoms such as anxiety and depression regardless of injury severity. For externalizing symptoms, analyses demonstrated a moderate effect size for mild TBI (Hedge<'>s g = -0.531, p = 0.003), a small effect size for moderate TBI (Hedge<'>s g = -0.257, p = 0.007), and a large effect size for severe TBI (Hedge<'>s g = -0.909, p < .001). Thus, children who experienced a TBI demonstrated externalizing symptoms including hyperactivity and impulsivity with the largest effect size associated with severe TBI. The results of the meta-regressions indicated that only injury severity was a significant predictor of symptom severity.Conclusions: Using meta-analytic methods, we found that children who experience traumatic brain injury are rated as exhibiting more severe internalizing and externalizing symptoms across levels of severity. This effect was largest for severe injury and smallest for moderate injury. Caregivers and healthcare practitioners can use this information to better screen for and treat internalizing and externalizing symptoms in children after a traumatic brain injury.
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Ayr, Lauren K. "Dimensions of post-concussive symptoms in children with mild traumatic brain injury". Columbus, Ohio : Ohio State University, 2007. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=osu1181833145.
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Padayachy, L. C. "The prevalence of cerebral hypoxia/ischemia in pediatric severe traumatic brain injury". Master's thesis, University of Cape Town, 2010. http://hdl.handle.net/11427/2887.
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Bongiolatti, Susan Renee. "Attention and memory/learning following pediatric traumatic brain injury a multidimensional pilot study /". [Gainesville, Fla.]: University of Florida, 2003. http://purl.fcla.edu/fcla/etd/UFE0000649.
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Merkley, Tricia L. "Imaging and Behavioral Correlates of the Anterior Cingulate in Pediatric Traumatic Brain Injury". BYU ScholarsArchive, 2012. https://scholarsarchive.byu.edu/etd/2948.
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The anterior cingulate has been implicated in a number of cognitive processes that are at risk following traumatic brain injury (TBI), such as executive function and emotional processing. While the cingulate is believed to play a role in the above-mentioned cognitive processes, the relative roles of gray and white matter in functional outcomes post-TBI are not fully understood. The current study investigated various quantifiable brain properties (e.g., cortical thickness and volume, volume of underlying white matter, and white matter integrity) of the caudal anterior cingulate (CAC) gyrus and their relationships with behavioral measures of cognitive control following pediatric TBI. Parent ratings at three months post-injury indicated that TBI children demonstrated greater difficulty inhibiting inappropriate behavior and effectively transitioning between tasks. Reductions of CAC white matter integrity were observed in TBI participants, in the absence of significant morphometric group differences in this region. Neither CAC morphometrics nor fractional anisotropy (FA) were associated with experimental measures of cognitive control. The current findings indicate that DTI metrics may be more sensitive to brain changes in the region of the CAC following TBI. While strong relationships were not observed between CAC properties and measures of cognitive control, it is possible that study limitations may have obscured potential findings.
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Micklewright, Jackie L. "Adaptive functioning following pediatric traumatic injury the relationship between parental stress, parenting styles, and child functional outcomes /". restricted, 2009. http://etd.gsu.edu/theses/available/etd-06132009-131148/.
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Thesis (Ph. D.)--Georgia State University, 2009.Title from file title page. Tricia Z. King, committee chair; Chris Henrich, Kathleen O'Toole, Erin Tone, Frank Floyd, committee members. Description based on contents viewed Sept. 28, 2009. Includes bibliographical references (p. 124-136).
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Armstrong-Betts, Alison Elizabeth. "Perceptions of Executive Functioning in Young Children Following Traumatic Brain Injury". University of Dayton / OhioLINK, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=dayton1314062861.
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Kilchenmann, Nadine M. "Theory of mind following paediatric traumatic brain injury : a comparative study of South African children". Master's thesis, University of Cape Town, 2011. http://hdl.handle.net/11427/12656.
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Includes bibliographical references (leaves 78-92).“Theory of mind” (ToM) refers to the ability to understand and make inferences about other people’s intentions, feelings and beliefs. The fact that previous research shows an impairment in social competence following traumatic brain injury (TBI) alludes to a potential relationship between TBI and ToM. Although the relationship between paediatric TBI (pTBI) and ToM ability is relatively unexplored, especially within a South African context, previous research on TBI and ToM suggests social impairment following TBI. The current research project was aimed to investigate exactly that. The study reported here investigated this relationship, and specifically focused on the effects of pTBI on ToM ability in 9-15 year old children.
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Moran, Lisa Marie Tonik. "The impact of social information processing on peer relations in pediatric traumatic brain injury". The Ohio State University, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=osu1363358050.
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Smith, Julia M. "Genetic and environmental influences on executive functioning 12 months after pediatric traumatic brain injury". University of Cincinnati / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1439301929.
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Utz, Mackenzie. "Identification of Critical Research and Intervention Needs in Pediatric Traumatic Brain Injury: Stakeholder Perceptions". The Ohio State University, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=osu1523007098993118.
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Wright, Kacie LaRae. "A Comparison of Qualitative and Quantitative White Matter Methods in Pediatric Traumatic Brain Injury". BYU ScholarsArchive, 2018. https://scholarsarchive.byu.edu/etd/7384.
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Magnetic resonance imaging is used to assess white matter (WM) abnormalities including total WM volumes and WM hyperintensities (WMHs). Comparisons between several qualitative and quantitative methods to assess WM that are used in research and clinical settings are lacking in pediatric traumatic brain injury (TBI). This study 1) WM methods including Scheltens ratings, manual tracings, NeuroQuant®, and FreeSurfer; (2) compared total WM volumes and WMHs to assess potentially similar reporting of WM integrity; and (3) assessed the relationship between cognitive functions (intelligence, attention, processing speed, and language) and WM in pediatric TBI.Sixty participants (65% male) between ages 8-13 years old, had a complicated-mild (53%), moderate (15%), or severe TBI (32%) with a mean age of 2.6 at the time of injury. NeuroQuant® WMH volumes had poor agreement (ICC = .24), and did not correlate (r = .12, p = .21) with manually traced WMH volumes. Scheltens WMH ratings had good to excellent agreement and correlated with NeuroQuant® (ICC = .62; r = .29, p = .005) and manually traced WMH volumes (ICC = .82; r = .50, p = .000). NeuroQuant® and FreeSurfer total WM volumes had fair agreement and were correlated (ICC = .52; r = .38, p = .004). No significant difference in total WM volumes were found between complicated-mild and moderate-severe TBI groups, and in subgroups with and without WMHs. Processing speed was significantly associated with Scheltens WMH ratings: p = .004, manually traced WMHs: p = .002, and NeuroQuant® WMHs: p = .007. No other association between cognitive functions and WM volumes or hyperintensities were found. Correlations between NeuroQuant® and manual tracings with processing speed differed by sex, where males had significant correlations but females did not. Deciding when to use manual tracing and NeuroQuant® WMH volumes and Scheltens ratings in clinical or research settings will depend on available resources (e.g., time, technology, funding, and expertise) and purpose of assessing WMHs. Total WM volumes did not appear to capture WM pathology as assessed by WMHs, likely due to the sample being underpowered and that total WM volumes possibly included WMHs. Limitations include restricted range of injury severity, heterogeneity of lesions, and small sample size. Additional research is needed in a larger sample of pediatric TBI.
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Mahomed, Aqeela. "Rehabilitation of executive functioning following pediatric traumatic brain injury: evaluating a goal management training intervention". Master's thesis, University of Cape Town, 2015. http://hdl.handle.net/11427/13690.
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Includes bibliographical references.Background and aims. Executive function (EF), defined as a set of interrelated skills and behavioural competencies required for independent, purposeful, goal-directed activity, are particularly susceptible to impairment following traumatic brain injury (TBI). Despite this knowledge, data concerning the rehabilitation of executive dysfunction in pediatric populations is lacking to date. A Goal Management Training (GMT) intervention, based on Duncan et al.’s (1996) theory of goal neglect, has been successfully implemented for the remediation of EF in adults. The current study adapted the GMT to a healthy South African sample and evaluated the efficacy in a pediatric TBI sample. Method. The study comprised of 3 parts. Part 1 involved the translation and adaptation of the pediatric GMT (pGMT) intervention so that it was suitable for use with South African children. This included the implementation of various health professionals’ evaluations of these adaptations. Part 2 involved evaluating the pGMT by implementing the programme with 3 healthy control participants. Lastly, Part 3 involved evaluating the efficacy of the revised pGMT with 3 children who had sustained a moderate to severe TBIs. For Parts 2 and 3 I employed a multiple case study approach. Data for parts 2 and 3 were analyzed using the Reliable Change Index (RCI; Jacobson & Truax, 1991) . The RCI distinguished between three levels of change, each at confidence levels of 68.2%, 95% and 99%. Outcomes were based on neuropsychological test outcomes, changes in everyday behaviour, self-report measures, and reports from parents and teachers. Results. Regarding the cognitive measures for the TBI group, all three participants did not show improvement on the same domains. Positive changes from pre- to post-intervention on a number of attention and executive function measures at confidence intervals of 68.26% to 99% were evident. Regarding the behavioural measures parents/guardians and/or teachers reported significant positive changes for all of the participants on at least one index at confidence intervals of 68.26% to 99%. In terms of real world generalization, only one participant’s teacher and parents commented on her improvements academically, behaviourally, and socially. No significant real world behavioural changes were reported for the other two participants. Results indicated that the adapted pGMT was successfully applied to the South African context for both healthy and TBI samples, although levels of success, in terms of post-intervention outcomes, varied with each TBI individual. Conclusions. These results suggest that the pGMT intervention could be an efficacious cognitive rehabilitation tool for the remediation of everyday behaviours associated 9 with executive dysfunction in South Africa. However, the variability in the results do not provide conclusive evidence at this stage. Individual, injury-related and familial factors need to be considered and may affect outcome. In addition, limitations such as the small sample size and uncontrolled confounding effects (e.g., practice or maturation effects) could also contribute to seemingly positive effects. Greater evidence from future, larger and more controlled studies, is required
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Rhine, Tara D. M. D. "Applying a Novel Balance Technology to Evaluate Postural Instability following Pediatric Mild Traumatic Brain Injury". University of Cincinnati / OhioLINK, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1368027188.
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Hall, Audrey Rose. "Nonstandardized Assessment of Cognitive-Communication Abilities Following Pediatric Traumatic Brain Injury (pTBI): A Scoping Review". The Ohio State University, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=osu1588149045710777.
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LeBlond, Elizabeth B. S. "Investigating the relationship between parental responsiveness and outcomes of very early traumatic brain injury". University of Cincinnati / OhioLINK, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1553513489869354.
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Erb, Paige Madeline. "Effects of Subconcussive Head Injury on Anxiety". Wittenberg University Honors Theses / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=wuhonors1469103628.
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Webster, Danielle L. M. D. "Higher Volume Hypertonic Saline and Increased Thrombotic Risk Without Improved Survival in Pediatric Traumatic Brain Injury". University of Cincinnati / OhioLINK, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1406810346.
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Mark, Erin M. "The Influence of Premorbid Attention and Behavior Problems on Neurobehavioral Outcomes From Pediatric Mild Traumatic Brain Injury". Ohio University / OhioLINK, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1308314375.
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Dodge, Lydia. "Investigating the effects of acute intracranial pressure and brain oxygenation on neuropsychological outcomes 12 months after severe pediatric traumatic brain injury". Master's thesis, Faculty of Humanities, 2019. http://hdl.handle.net/11427/30832.
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Traumatic brain injury (TBI) is one of the major causes of mortality and morbidity among children and adolescents all over the world and studies suggest a higher incidence of pediatric TBI (pTBI), as well as poorer post-TBI outcomes, in countries with extreme levels of socioeconomic inequality such as South Africa. pTBI leads to a multitude of long-term adverse outcomes in a wide range of domains and in general, a dose-response pattern is evident. Multiple acute and post-acute stage predictors of outcome have been investigated, however acute stage neurological and neurosurgical variables are relatively absent from this knowledge base. This study was conducted to better understand the heterogeneity in outcomes of pTBI: it aimed to investigate the nature and severity of neuropsychological deficits in pTBI patients one year after injury and to investigate the association between acute stage physiological changes in intracranial pressure (ICP) and brain tissue oxygenation (PbtO2) and neuropsychological outcomes one year after pTBI. Results of the study indicated that children who sustained TBI performed significantly poorer than healthy, matched controls on multiple cognitive, behavioural and quality of life domains, however, neither acute ICP nor PbtO2 reliably predicted within-TBI group performance. The results of the study emphasise the poor relationship of ICP and PbtO2, and the complexity of the relationship between acute physiological variables and outcomes after pTBI. Further studies of this kind should be done on large sample sizes and include multiple physiological variables.
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Micklewright, Jackie Lyn. "Adaptive Functioning following Pediatric Traumatic Injury: The Relationship between Parental Stress, Parenting Styles, and Child Functional Outcomes". Digital Archive @ GSU, 2009. http://digitalarchive.gsu.edu/psych_diss/55.
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Moderate and severe pediatric traumatic brain injuries (TBI) are associated with significant familial stress and child cognitive and adaptive sequelae (Taylor et al., 1999). Research has demonstrated a relationship between familial stress and resources and child recovery of functioning following TBI (Taylor et al., 1999). We built on these findings by examining authoritarian parenting values and styles as a mediator of the relationship between parental stress and child adaptive outcomes 12-36 months following TBI or orthopedic injury (ORTHO). Participants were 21 children/adolescents with traumatic brain injuries and 23 with orthopedic injuries and one of their parents/guardians. Parents completed measures of demographics, parental stress, parenting values and styles, and child adaptive functioning. Child participants completed brief demographic questionnaires and intelligence screeners. Moderation was examined using hierarchical multiple regression. Mediation and moderated mediation were examined using bootstrapping tests of the indirect effect of parental stress on child adaptive functioning. After controlling for family insurance status, higher levels of parental stress were associated with reduced child adaptive functioning in the TBI group but not the ORTHO group. An examination of the mediational analyses revealed that higher levels of parental stress were associated with a greater reliance on authoritarian parenting styles, which was associated with reduced overall adaptive functioning and daily living skills across the two injury groups. Therefore, across groups, the relationship between parental stress and child overall adaptive functioning and daily living skills was found to be partially mediated by an authoritarian parenting style. Moderated mediation results revealed the presence of a significant interaction and 95% confidence interval on the socialization domain and indicated that the relationship between authoritarian parenting styles and child adaptive social skills differed significantly between the two groups. Our findings suggest a relationship between parental stress, authoritarian parenting styles, and child adaptive functioning in the 12-36 months following pediatric traumatic injury. Future research should explore the association among these, as well as other potentially mediating variables, both within and between the two groups with the goal of further elucidating the relationship between familial/environmental variables and child adaptive functioning following traumatic brain and orthopedic injury.
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Bellesi, Giulia. "The association between paediatric traumatic brain injury and antisocial behaviour in adulthood : a longitudinal study using the ALSPAC data". Thesis, King's College London (University of London), 2018. https://kclpure.kcl.ac.uk/portal/en/theses/the-association-between-paediatric-traumatic-brain-injury-and-antisocial-behaviour-in-adulthood-a-longitudinal-study-using-the-alspac-data(f3e3b936-e780-4331-adca-1af9df57e5d4).html.
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Despite growing evidence supporting a link between paediatric traumatic brain injury (TBI) and engagement in antisocial behaviour, few studies have taken a rigorous approach in evaluating this. The present review systematically explored previous literature examining the association between TBI before the age of nineteen years old and engagement in severe behavioural problems such as for instance violence, aggression and assault. All articles published from 1990 to 2016 were searched using four major databases (Ovid MEDLINE, PsycINFO, Embase, Web of Science), alongside manual searching and cross-referencing. The level and quality of evidence were evaluated using quality assessment tools selected from previous literature. A total of 14 studies were found to meet eligibility criteria. Taken together, they supported the presence of an association between paediatric TBI and antisocial behaviour, and identified some potentially intersecting factors (e.g., emotional dysregulation, drug and alcohol abuse). However, the studies also consistently presented with a number of methodological limitations, such as, for instance, unclear temporal ordering of TBI and antisocial behaviour; limited information about participants’ pre-injury backgrounds; over-reliance on self-report measures. These make it difficult to make meaningful comparisons across studies and draw definite regarding the directionality of the relationship between TBI and antisocial behaviour, and the mechanisms underpinning this association. The findings indicate that there is a need for more extensive and methodologically sound research on the topic. A novel, age-graded theoretical model examining the relationship between paediatric TBI, antisocial behaviour, and different child- and parent-based risk factors was introduced, before this is described in more detail and tested in the next chapter of the present thesis. The implications of the present systematic review for informing rehabilitation and preventative measures are discussed.
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Figaji, Anthony A. "Multimodality monitoring in paediatric severe traumatic brain injury : the contributions of brain oxygen, transcranial doppler and autoregulation monitoring to conventional methods on monitoring". Doctoral thesis, University of Cape Town, 2008. http://hdl.handle.net/11427/2882.
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Includes abstract.Includes bibliographical references (p. 175-218).
Traumatic brain injury (TBI) is a highly complex clinical condition in the most complex organ of the body. The foundation of care of the patient with severe TBI is the prevention of secondary insults to the brain. This relies on conventional monitoring tools to identify patients at risk, but often these may fail to detect important secondary insults. Moreover, the therapies that are used commonly in the critical care environment all have potential adverse effects, many of which may not be evident. TBI treatment in children is further complicated by changing thresholds with age, and the much smaller evidence base compared to their adult counterparts.
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Fisher, Allison P. "The relation between therapeutic processes and outcomes in Online Family Problem-Solving Therapy for pediatric traumatic brain injury". University of Cincinnati / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=ucin159327291784051.
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Pertab, Jon Leroy. "The Neural Systems of Working Memory: The Sternberg Working Memory Task in a Pediatric Traumatic Brain Injury Sample". BYU ScholarsArchive, 2010. https://scholarsarchive.byu.edu/etd/2520.
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Working memory tasks are associated with the activation of widely distributed neural networks. The Sternberg working memory task has been used to explore the neural correlates associated with changes in memory load and the resolution of interference. Preliminary research suggests that the integrity of the anterior cingulate is correlated with resolving load adjustments but not in resolving interference demands; the opposite pattern of associations have been observed with the right middle frontal gyrus.Participants in the present study were 28 children who had sustained moderate to severe traumatic brain injuries (TBI) and 28 children who had sustained orthopedic injuries (OI). Participants were aged between 7 and 17 years at the time of injury (mean age = 13.2, s.d.=2.3). The groups were matched on age, gender, socioeconomic level, and pre-injury measures of behavioral and emotional functioning. Participants completed the Sternberg working memory task and structural MRI scans three months post injury. Automated brain parcellation software (Freesurfer) was used to calculate volumetric data for regions of interest. Regions of interest included the anterior cingulate and right middle frontal gyrus; additionally, the volume of the corpus callosum was used as an index of overall brain integrity. There were no significant differences between the groups on percent errors on the Sternberg task. Participants in the TBI group had significantly longer reaction times overall than the OI group. Interference in the Sternberg task has the potential to either help or hinder performance. Participants in the OI group displayed the anticipated effects of interference on reaction time whereas the TBI group as a whole did not display this pattern (priming effect not observed). The TBI group had significantly lower volumes in the regions of interest than the OI group. Hypothesized correlations between the regions of interest and changes in load / interference demands were partially supported. Exploratory analyses identified positive correlations between the volume of the right middle frontal gyrus and reaction time measures that warrant further exploration.
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Mogere, Edwin. "Impact of secondary insults on the outcome of paediatric traumatic brain injury : a retrospective cross sectional study at the Red Cross Children’s Hospital, Cape Town". Master's thesis, University of Cape Town, 2013. http://hdl.handle.net/11427/13970.
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Includes bibliographical references.Secondary insults in severe traumatic brain injury (TBI) may worsen outcome; however, these are poorly characterized in children. For example, despite the known association between intracranial pressure (ICP) and poor outcome, there are few large paediatric series on the subject, definitions vary, functional outcome is often not assessed, and the best measures to assess ICP for statistical analysis are unknown. We aimed to document the frequency of secondary insults, and the association of various ICP measures, with outcome in a large cohort of paediatric patients with severe TBI. A retrospective analysis of 5-year prospectively collected data was examined for the frequency of hypoxia, hypotension, raised ICP, and low cerebral perfusion pressure (CPP). ICP parameters included initial ICP, mean ICP in the first 24 hours, mean ICP overall, peak ICP, mean ICP over 20 mmHg, and episodes of ICP over 20 mmHg. Hypotension was defined by age †and height †adjusted mean arterial pressure ranges, and hypoxia was defined as arterial partial pressure of oxygen (PaO2) less than 8kPa or pulse oximetry less than 90%. We examined for univariate and multivariate associations with mortality and the Extended Paediatric Glasgow Outcome Score.
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McGarrett, Collin Kathleen. "Time to Follow Commands, Duration of Post-Traumatic Amnesia, and Total Duration of Impaired Consciousness as Predictors of Outcome Following Pediatric Traumatic Brain Injury". The Ohio State University, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=osu1587156828071613.
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Moscato, Emily L. "Examining the reciprocal influences of adolescent behavior problems and parenting behaviors over time following a randomized controlled trial for pediatric traumatic brain injury". University of Cincinnati / OhioLINK, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1552398917460201.
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Smith, Julia M. "Investigating the relationship between self-regulation (effortful control/executive functioning) and outcomes of very early traumatic brain injury". University of Cincinnati / OhioLINK, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1562673551434214.
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Schrieff, Leigh. "Investigating severe pediatric traumatic brain injury in South Africa : a demographic profile of admissions, brain oxygenation and neuropsychological outcomes and an attention-training intervention". Doctoral thesis, University of Cape Town, 2013. http://hdl.handle.net/11427/10647.
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Includes bibliographical references.The aim of this dissertation was to investigate severe pediatric traumatic brain injury (pTBI) in South Africa. To that end, I conducted three studies, each examining a different aspect of severe pTBI. Study 1 presents a demographic profile of trends in severe pTBI admissions to the Red Cross War Memorial Children's Hospital (RXH) from June 2006 to April 2011. Study 2 examines the associations between secondary injury, as manifest by low brain oxygenation (PbtO2), and neuropsychological outcomes in severe pTBI. Study 3 evaluates the efficacy of an attention-training intervention for severe pTBI, and discusses the implementation of that intervention in the context of a low- and middle-income country. All three studies were cross-sectional and quantitative.
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WELLS, CAROLYN T. "SLEEP PROBLEMS FOLLOWING MODERATE-TO-SEVERE PEDIATRIC TRAUMATIC BRAIN INJURY: PRESENCE, NATURE, LONG-TERM PATTERN, AND RELATIONSHIP TO NEUROPSYCHOLOGICAL DEFICITS". University of Cincinnati / OhioLINK, 2005. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1116193567.
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Wu, Trevor Chuang Kuo. "Longitudinal Changes in the Corpus Callosum Following Pediatric Traumatic Brain Injury as Assessed by Volumetric MRI and Diffusion Tensor Imaging". BYU ScholarsArchive, 2011. https://scholarsarchive.byu.edu/etd/2996.
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Atrophy of the corpus callosum (CC) is a documented consequence of moderate-to-severe traumatic brain injury (TBI), which has been expressed as volume loss using quantitative magnetic resonance imaging (MRI). Other advanced imaging modalities such as diffusion tensor imaging (DTI) have also detected white matter microstructural alteration following TBI in the CC. The manner and degree to which macrostructural changes such as volume and microstructural changes develop over time following pediatric TBI and their relation to a measure of processing speed is the focus of this longitudinal investigation. As such, DTI and volumetric changes of the CC in participants with TBI and a comparison group at approximately three and 18 months post injury and their relation to processing speed were determined.
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Wells, Carolyn T. "Sleep problems following moderate-to-severe pediatric traumatic brain injury presence, nature, long-term pattern, and relationship to neuropsychological deficits /". Cincinnati, Ohio : University of Cincinnati, 2005. http://www.ohiolink.edu/etd/view.cgi?acc%5Fnum=ucin1116193567.
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Kurowski, Brad G. "Executive Dysfunction after Moderate and Severe Pediatric Traumatic Brain Injury Predicts Clinical Dysfunction on the Child and Adolescent Functional Assessment Scale". University of Cincinnati / OhioLINK, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1342543308.
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Benjamin, Michelle L. "Pilot data on the behavior rating inventory of executive function (brief) and performance measures of executive function in pediatric traumatic brain injury (tbi)". [Gainesville, Fla.] University of Florida, 2004. http://purl.fcla.edu/fcla/etd/UFE0006507.
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Thesis (M.S.)--University of Florida, 2004.Typescript. Title from title page of source document. Document formatted into pages; contains 56 pages. Includes Vita. Includes bibliographical references.
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Chira, Alarcon Patricia Fiorela, i Castillo Natalia Romaña. "Antibiotic prophylaxis for ventilator-associated pneumonia in pediatric patients with moderate to severe traumatic brain injury in a hospital in Lima, Peru". Bachelor's thesis, Universidad Peruana de Ciencias Aplicadas (UPC), 2021. http://hdl.handle.net/10757/656055.
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Introduction: This study evaluates the use of antibiotic prophylaxis for prevention and development of ventilator associated pneumonia (VAP) in pediatric patients with moderate to severe traumatic brain injury (TBI) in order to promote best practices and use the appropriate resources.
Methods: A retrospective cohort study of all pediatric patients, between 1 and 18 years, who were admitted and had moderate or severe TBI diagnosis at the Pediatric Emergency Hospital, Lima-Peru.
Results: One hundred and forty-five patients with diagnosis of traumatic brain injury (TBI), who received mechanical ventilation for at least 48 hours, were evaluated. We obtained an incidence density of 44.60/1000 ventilator days. No relationship was found between antibiotic prophylaxis and the development of VAP. Likewise, it was found that performing oral hygiene with chlorhexidine reduces the risk of developing VAP by 45% (p = 0.03, CI 0.33-0.95).In addition, the presence of purulent secretions (IC 2.23-11.45), solid (, IC 1.67-11.34) or dense ( IC 2.91-16.75) has a 3, 5 and 6 times higher risk of ventilator-associated pneumonia, respectively.
Conclusions: Antibiotic prophylaxis did not show to have a positive effect on the prevention of ventilator associated pneumonia; However, other measures such as oral hygiene with chlorhexidine were associated with reducing the risk of developing VAP. The proportion of patients who received antibiotic prophylaxis was 81 (55.6%) and the incidence density of VAP found in the study is within the standards found in the available literature. Furthermore, the type of discharge was identified as a predictor of increased risk of ventilator-associated pneumonia. Even more studies focused on this population are required.Introducción: Se evaluará el uso de antibióticos profilácticos para prevenir el desarrollo de neumonía asociada a ventilador (NAV) en la población pediátrica admitida con diagnóstico de traumatismo encéfalo craneano (TEC) moderado a grave. Métodos: Se realizó un estudio cohorte retrospectivo de todos los pacientes pediátricos, entre 1 y 18 años, que fueron admitidos con diagnóstico TEC moderado o grave y estuvieron con ventilación mecánica más de 48 horas en el Hospital de Emergencias Pediátricas, Lima-Perú. Resultados: Ciento cuarenta y cinco pacientes con TEC y que recibieron ventilación mecánica fueron evaluados. Se encontró una densidad de incidencia de neumonía asociada a ventilador (NAV) de 44.60/1000 días de ventilador. No se encontró relación entre la profilaxis antibiótica y el desarrollo de NAV. Asimismo, se obtuvo que la realización de higiene oral con clorhexidina disminuye en 45% el riesgo de desarrollar NAV (IC 0.33-0.95). Además, la presencia de secreciones purulentas (IC 2.23-11.45), sólidas (IC 1.67-11.34) o densas (IC 2.91-16.75) tiene 3, 5 y 6 veces más riesgo de neumonía asociada a ventilador, respectivamente. Conclusiones: La profilaxis antibiótica no mostró tener un efecto positivo en la prevención de neumonía asociada a ventilador; sin embargo, otras medidas como la higiene oral con clorhexidina sí estuvieron asociadas disminuyendo el riesgo de desarrollar NAV. La proporción de pacientes que recibieron profilaxis antibiótica fue 81 (55.6%) y la densidad de incidencia de NAV encontrada en el estudio se encuentra dentro de los estándares encontrados en la literatura disponible. Además, el tipo de secreción se identificó como un factor predictor de mayor riesgo de neumonía asociada a ventilador. Se requieren aún más estudios enfocados en esta población.
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Karver, Christine L. "Neurocognitive and socio-demographic predictors of responsiveness to an online intervention for adolescents with TBI". University of Cincinnati / OhioLINK, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1337101388.
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