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A D Moore

Publications and source records attributed to A D Moore.

35 records · Page 2Linked to original sources
PubMed1991

Social role functioning following spinal cord injury.

The Katz Adjustment Scale--Relatives Form was completed by the wives of 27 hospital-discharged spinal cord injured (SCI) patients. Their ratings of the spouses' social adjustment and behaviour were compared to available community and psychiatric norms. Overall, spouses rated their SCI husbands as performing significantly more socially inappropriate behaviours compared to ratings of 'normals' but as engaging in significantly less socially inappropriate behaviours compared to the ratings of psychiatric patients. SCI patients were perceived as performing the same levels of social activities as 'normals', but engaging in less free-time activities compared to both 'normals' and psychiatric patients. These results mirror similar analyses comparing moderate and severe head injury victims with normal and psychiatric norms. The implications for rehabilitation and counselling of families of traumatically disabled patients are discussed.

Adult↗
PubMed1991

Head injury and spinal cord injury: differential effects on psychosocial functioning.

Closed-head injury (CHI) and spinal cord injury (SCI) cause significant permanent alterations in life style, social-role functioning, and psychological status. While the cognitive effects of CHI are well known, there have been questions concerning the psychosocial sequelae from CHI, and whether they are unique to this disability group rather than representing general effects of a life-threatening medical emergency with permanent life-altering consequences. This issue was examined with samples of ambulatory moderate (n = 31) and severe (n = 17) CHI patients and wheelchair-dependent SCI (n = 24) patients. Results indicate that there were no significant differences between the groups on pre- and post injury demographic factors. However, while the moderate CHI and SCI groups were equivalent on many indicators of psychosocial outcome, the severe CHI group was more depressed, angry and hostile, and confused and bewildered. As well, wives of the severe CHI patients rated their husbands as more belligerent, negative, helpless, suspicious, withdrawn and retarded, and with more general psychopathology than did wives of moderate CHI or wives of SCI patients. Implications of these findings for preventative psychosocial rehabilitation are discussed.

Activities of Daily Living↗
PubMed1991

Bleeding gastroesophageal varices: gastric vein embolization after partial portal decompression.

Shunts that decompress the portal vein are effective in the treatment of bleeding esophageal varices. Use of large-caliber portacaval shunts, however, results in the complete decompression of the portal system and the risk of subsequent development of hepatic encephalopathy. Use of small-caliber portacaval shunts results in mild portal hypertension and less frequent hepatic encephalopathy but may increase the risk of recurrent bleeding. Thirty-three patients underwent angiography after partial decompression portacaval shunting (median trans-shunt pressures, 8 mm Hg). Embolization of residual varices, noted in 13 patients, was performed. Results included one complication with no sequelae and no bleeding a mean of 13 months after the procedure was performed. Trans-shunt embolization of esophageal varices effectively prevents bleeding varices after partial portal decompression.

Embolization, Therapeutic↗
PubMed1990

Early metabolic and neurologic predictors of long-term quality of life after closed head injury.

Research has begun to identify early markers that predict survival after traumatic brain injury. In this study, trauma and biochemical indicators of severity were used to predict quality of life in 61 adults with traumatic brain injury and no damage to other organ systems. Severity markers available within 24 hours of injury were predictive of later psychosocial, behavioural and social role functioning. Multiple regression analyses demonstrated that the Glasgow Coma Scale, plasma glucose levels, leukocyte cell count and serum potassium concentration accounted for 12% to 66% of variance in certain measures of later quality of life. The importance of health-care resource allocation and psychosocial and behavioural intervention to the outcome after moderate traumatic brain injury is discussed.

Adult↗
PubMed1989

Pulmonary histiocytosis X: comparison of radiographic and CT findings.

The authors retrospectively evaluated radiographs, computed tomographic (CT) scans, and results of pulmonary function tests (when available) for 17 patients with biopsy-proved pulmonary histiocytosis X. In 11 patients, high-resolution CT was used. In 12 patients, CT demonstrated cystic air spaces, usually less than 10 mm in diameter. In three of these 12, cysts were the only abnormality, but in six others, nodules (usually less than 5 mm in diameter) were also present. Two patients had only nodules and one, only emphysema. CT showed that many lesions that appeared reticular on plain radiographs were actually cysts. CT showed no central or peripheral concentration of lesions, but it did reveal that many small nodules were distributed in the centers of secondary lobules around small airways. CT findings correlated better with the diffusing capacity (rho = -0.71) than did the plain radiographic findings (rho = -0.57). Thus, CT was better than radiography at showing the morphology and distribution of lung abnormalities.

Adult↗
PubMed1967

Spruce budworm mortality as a function of aerial spray droplet size.

The size and number of aerial spray drops impinging on spruce budworm in its conifer forest habitat were determined by means of a new tracer method that uses fluorescent particles in a liquid spray. Examination of 1113 larvae affected by an experimental insecticide that had been applied to a 5000-acre (2024-ha) test area in Montana showed that 93 percent had not been contacted by any droplets larger than 50 micro in diameter. Small numbers of droplets 50 to 100 micro in diameter were found on 7 percent of the larvae, along with lethal numbers of smaller drops. No evidence was found that significant numbers of drops larger than 100 micro reached the target insects. Because about 95 percent of the spray applied to forests by current methods consist of droplets larger than 50 micro, the biologically effective portion of the drop spectrum is only a few percent. The data foreshadow a major potential reduction in insecticide requirements for the successful control of spruce budworm.

Aerosols↗
PubMedDate not supplied

Coping strategies and adjustment after closed-head injury: a cluster analytical approach.

This study examined the effects of coping strategies as moderators of long-term psychosocial and emotional adjustment following closed-head injury. Cluster analysis was used to separate 69 CHI patients into three clinically relevant groups on the basis of responses to the revised Ways of Coping questionnaire. The groups were then compared on a series of validation measures. There were no differences apparent between the three clusters in age, Glasgow Coma Scale score on admission to hospital, or in relatives' ratings of psychiatric symptomatology among the patients. However, the cluster characterized by a generally high use of a wide range of coping strategies had higher ratings of depression, as well as more psychosocial, cognitive and physical difficulties than the other groups. As with other chronic illnesses, it appears that the use of cognitive mechanisms that act as reality 'buffers' may be an important component of improved adjustment to closed-head injury.

Adaptation, Psychological↗
PubMedDate not supplied

Psychosocial sequelae of closed head injury: effects on the marital relationship.

Head injury frequently produces physical and psychological sequelae involving cognitive, behavioural, and personality disturbances which are chronic and perhaps even permanent. Clinically, it is apparent that the marital relationships of head injury patients face initial disruption as well as ongoing challenges in dealing with the physical, neuropsychological, and emotional changes post-injury. However, there is little empirical data to substantiate these observations. In this study, the marital relationships of 55 male head injury patients were assessed, based on the spouse's self-report obtained through interview and questionnaires. The sample was divided into three groups according to the severity of the injury: mild (N = 10), moderate (N = 25) and severe (N = 20). Based on a one-way multivariate analysis of variance, dyadic consensus, affectional expression, and overall dyadic adjustment were significantly lower for wives in the severe group than the moderate group. Affectional expression was also lower in the severe group than the mild group. Stepwise multiple regression analysis determined that 47% of the variance of overall dyadic adjustment could be accounted for by three variables (multiple R = 0.69, p less than 0.001). Dyadic adjustment was greater when wives reported a lower level of financial strain, perceived their spouse to have a relatively low level of general psychopathology or maladjustment, and when the injury was relatively mild based on GCS scores. The implications for intervention in rehabilitation at the marital level are highlighted.

Activities of Daily Living↗
PubMedDate not supplied

Effects of mild, moderate and severe closed head injury on long-term vocational status.

Survival from significant closed head injury (CHI) is frequently associated with cognitive defects, physical impairment, personality change, interpersonal difficulty and, in general, some degree of social dependence. Here we report a multidimensional assessment of quality of life of a sample of 131 male head-injury patients suffering a range of severities of insult with specific emphasis on vocational outcome. Of those patients who sustained a severe injury and were employed full-time prior to the CHI, only 55% were able to return to this level of employment. No differences were found between the moderate and severe groups in pre- or post-CHI occupational status, as measured by the Blishen (1967) quantitative social economic index, although both groups declined from pre- to post-CHI. Lower post-CHI occupational status was associated with lower GCS on admission and longer lengths of post-traumatic amnesia, with patient self-report of physical, cognitive and psychosocial difficulties, including spousal reports of confusion, belligerance, verbal expansiveness and the decreased ability to perform socially-expected activities. Stepwise multiple regression analysis accounted for 38% of variance in post-injury vocational status, with lower pre-injury vocational status, greater age, high physical and psychological difficulties and lower admission Glasgow Coma Scale score variables forming the regression equation. Implications are discussed in terms of rehabilitation issues, including vocational programming and planning.

Adult↗
PubMedDate not supplied

Long-term multi-dimensional outcome following isolated traumatic brain injuries and traumatic brain injuries associated with multiple trauma.

We retrospectively investigated long-term, multi-dimensional quality-of-life outcomes in 68 male patients who suffered pure head injuries and 63 male head-injured patients with associated multiple trauma. Results indicated that patients sustaining associated multiple trauma were significantly younger and more deeply comatose on admission. Trends were found to suggest that patients sustaining associated multiple trauma also remain in coma longer, and experience more difficulties in social interaction and overall psychosocial functioning, but less difficulties in mobility compared with pure-head-injured patients. These findings should be taken into account in the evaluation of results of treatment as well as in the planning and allocation of resources for head-injured patients.

Activities of Daily Living↗
PubMedDate not supplied

Coping strategies and locus of control following traumatic brain injury: relationship to long-term outcome.

Cluster-analytic techniques were used to categorize coping strategies (CS) measured by the Ways of Coping--Revised Scale, and locus of control (LOC) beliefs measured by the Multidimensional Health Locus of Control Scale in 53 male traumatically brain-injured (TBI) persons. A cluster characterized by comparatively higher use of self-controlling and positive reappraisal CS and lower external LOC was associated with significantly lower mood disturbance and physical difficulties and a trend to be less depressed. The age of the neurologically injured patient and Taylor's (1983) cognitive adaptation theory may be important aspects of recovery from TBI and other neurological conditions.

Activities of Daily Living↗
PubMedDate not supplied

Differential effects of spinal cord injury and head injury on marital adjustment.

Central nervous system (CNS) trauma can produce a multitude of physical and psychological sequelae, depending on the neurological level of injury. Clinicians have long recognized the adjustment difficulties posed in marriages of CNS trauma victims, yet there is little research documentation for this observation. The marital relationships of moderate (n = 31) and severe (n = 17) head injury (HI) groups and a spinal cord injury (SCI) group (n = 24) were assessed through spouses' self-reports in interview and through standardized questionnaires. Analyses indicated that the three groups were not statistically different in age, number of months post-injury, pre- and post-injury occupational status, and level of income. In the post-injury marital relationship, the severe HI group was significantly lower than the moderate HI and SCI groups on standardized and validated scales assessing affectional expression (p less than 0.002), dyadic satisfaction (p less than 0.001), dyadic cohesion (p less than 0.01), and total dyadic adjustment (p less than 0.001). On a scale of social role functioning, the severe HI group's performance was significantly lower than the moderate HI and SCI groups (p less than 0.005). These results empirically substantiate the clinical observation that adjustment difficulties may be more intense for wives of the severely head injured than the moderately injured or the SCI, as they must deal with neuropsychological as well as physical fall-out from the injury.

Adaptation, Psychological↗
PubMedDate not supplied

Cognitive moderators of outcome following traumatic brain injury: a conceptual model and implications for rehabilitation.

This paper presents a conceptual model describing the relationships between quality of life outcomes following traumatic brain injury (TBI), coping patterns, and beliefs regarding self-efficacy to assist health-care professionals in understanding the complexity of social and psychological sequelae of TBI. The mode hypothesizes that long-lasting cognitive, behavioural, emotional psychiatric, and interpersonal after-effects of TBI may create a real life 'learned helplessness' with consequent deficits in coping, and altered locus of control beliefs. As a result, TBI patients are at risk for developing self-limiting belief systems about their effectiveness in altering significant events that may result in over-generalizing the effects that TBI has in their day-to-day lives. Subsequently, a feedback loop may be set up where their beliefs in not being able to influence outcomes are not tested, life chances are further restricted, outcomes are suboptimal, and quality of life is reduced. The clinical and theoretical implications of this model are discussed, and an expanded model with future research directions is suggested.

Activities of Daily Living↗