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Deirdre R Dawson

Publications and source records attributed to Deirdre R Dawson.

9 recordsLinked to original sources
PubMed2007

Executive function and coping at one-year post traumatic brain injury.

The purpose of this study was to examine the relationship between executive function and coping at one-year-post traumatic brain injury (TBI). TBI and matched control groups completed a coping questionnaire and a neuropsychological test series. In the TBI group, better executive performance was related to the use of problem focused coping (considered more adaptive). Conversely, lower executive performance was related to the use of emotion focused coping (considered more maladaptive). Planned hierarchical regression showed that executive function contributed significantly to the use of problem focused coping above and beyond pre-morbid intelligence and injury severity. Implications for cognitive rehabilitation are discussed.

Adaptation, Psychological↗
PubMed2006

The case for the development and use of "ecologically valid" measures of executive function in experimental and clinical neuropsychology.

This article considers the scientific process whereby new and better clinical tests of executive function might be developed, and what form they might take. We argue that many of the traditional tests of executive function most commonly in use (e.g., the Wisconsin Card Sorting Test; Stroop) are adaptations of procedures that emerged almost coincidentally from conceptual and experimental frameworks far removed from those currently in favour, and that the prolongation of their use has been encouraged by a sustained period of concentration on "construct-driven" experimentation in neuropsychology. This resulted from the special theoretical demands made by the field of executive function, but was not a necessary consequence, and may not even have been a useful one. Whilst useful, these tests may not therefore be optimal for their purpose. We consider as an alternative approach a function-led development programme which in principle could yield tasks better suited to the concerns of the clinician because of the transparency afforded by increased "representativeness" and "generalisability." We further argue that the requirement of such a programme to represent the interaction between the individual and situational context might also provide useful constraints for purely experimental investigations. We provide an example of such a programme with reference to the Multiple Errands and Six Element tests.

Cognition Disorders↗
PubMed2005

Power mobility driving training for seniors: a pilot study.

This article describes two power mobility training protocols used with seniors and compares posttraining driving performance. Twelve users of power mobility were consecutively recruited from two residential facilities in Toronto, Canada. The aim of training at both sites was to make clients comfortable with and safe at driving power mobility devices. The content of training was similar, but training protocols differed significantly in terms of the number of sessions (means of 3.43 vs. 9.80; p < or = .05) and the time frame over which the sessions were offered (means of 1.57 vs. 5.10 weeks; p < or = .01). Participants at the two sites differed significantly in terms of overall driving performance (p < or = .05), gender (p < or = .01), and type of device used (p < or = .05). Overall, driving performance was significantly associated with facility, gender, type of device used, and training duration (p < or = .05). When these variables were entered into an exploratory hierarchical regression, facility accounted for 64% of the variance in driving performance. When facility was controlled for, the correlations between device and duration of training with driving performance were no longer significant. The determinants of driving performance are difficult to clearly specify as the variable facility encompasses gender as well as all other differences between the two training protocols. Nevertheless, these data provide direction for future research in this area.

Aged↗
PubMed2004

Acute predictors of real-world outcomes following traumatic brain injury: a prospective study.

PRIMARY OBJECTIVE: To determine whether the recovery of acute attention and memory improves the prediction of real-world outcomes over that provided by standard demographic and injury-severity measures. RESEARCH DESIGN: Participants were recruited consecutively at the time of injury and followed prospectively at 1 (time 1, or T1) and 4 years (time 2, or T2). METHODS AND PROCEDURES: Measures of attention and memory and the Galveston Orientation and Amnesia Test (GOAT) were administered to 94 participants daily from the time of injury until the criterion was met. Sixty-three per cent returned at T1 and 53% returned at T2. Outcomes were psychosocial distress, return to work and/or school, and quality of life. MAIN OUTCOMES AND RESULTS: Recovery of attention, memory and orientation did not significantly improve prediction of outcomes at T1, but did so at T2. At T2, recovery of free recall of three words over 24 h was a more sensitive predictor of psychosocial distress and return to productivity than the GOAT. CONCLUSIONS: Free recall of three words may be a useful acute clinical test to enhance prediction of long-term outcomes.

Adolescent↗
PubMed2003

Customized heel pads and soft orthotics to treat heel pain and plantar fasciitis.

We describe the design of a new cost-effective, comfortable orthotic designed to treat heel pain associated with plantar fasciitis. The heel pad is fabricated from a 4 degrees Sorbothane medial wedge with a customized insertion of low-density Plastazote. The orthotic is medium-density Plastazote reinforced with cork in the medial longitudinal arch. One pair of orthotics takes less than 1 hour to make. Pilot data were collected retrospectively to evaluate the efficacy of the orthotic for reducing pain. Ten clients at a hand and foot orthotic clinic with a mean age of 71+/-9.1 years and with unilateral or bilateral heel pain associated with plantar fasciitis were provided with customized heel pads and soft, molded orthotics at their initial visit. Pain levels were recorded with verbal and Likert-type scales. After 5 weeks of heel pad and orthotic use, all patients showed a reduction in pain, with the overall reduction being highly significant (P</=.0001). Customized heel pads and soft molded orthotics are an effective first-line treatment for the heel pain and loss of function associated with plantar fasciitis.

Aged↗
PubMed2002

A comparison of independent living outcomes following traumatic brain injury and spinal cord injury.

This study compares independent living outcomes in persons with traumatic brain injury (TBI) and spinal cord injury (SCI). Both injuries represent life-altering events that are known to have a negative impact on independent living and are predominantly experienced by members of the same demographic group. However, the types of resultant impairments and disabilities experienced by the two populations differ substantially. The TBI participants were recruited consecutively from Canada's largest tertiary care trauma centre and followed prospectively for four years. The SCI participants were recruited via a mailed survey to members of a provincial branch of the Canadian Paraplegic Association. Independent living outcomes were measured using DeJong and Hughes' (1982) classification system of productivity status, the Reintegration to Normal Living Index, and questions on assistance from environmental supports in the form of wheelchair use and paid/unpaid personal assistance. The TBI group was found to be significantly more productive, have higher levels of satisfaction with their current experience of community integration, and use fewer environmental supports than their SCI counterparts (P<or=0.0001). Methodological and demographic differences between the samples are discussed in relation to the results. The results suggest that various aspects of independent living in these two defined groups (TBI and SCI) although highly related require specific attention and that clinicians and researchers working with TBI and SCI might benefit from further collaborative efforts.

Activities of Daily Living↗
PubMedDate not supplied

Community integration status 4 years after traumatic brain injury: participant-proxy agreement.

OBJECTIVES: To measure the level of agreement on community integration outcomes 4 years after traumatic brain injury (TBI) in relation to injury severity, proxy-participant relationship, and type of question. PARTICIPANTS: Thirty-one survivors of TBI (14 with mild TBI and 17 with moderate-severe TBI) and 31 significant other proxies. MEASURES: General and leisure activity scales of the Katz Adjustment Scale (KAS). RESULTS: Agreement was highest between proxies and participants with mild versus moderate-severe TBIs, between spouse proxies and TBI participants compared to nonspouse proxies and on the more objective subscales (frequency of participation) compared to the expectation and satisfaction scales regardless of injury severity or proxy-participant relationship. CONCLUSIONS: For research purposes, proxy data are acceptable but clinicians should assess outcomes and set goals with input from both persons with TBIs and their proxies.

Adaptation, Psychological↗