Challenging behaviour profiles of people with acquired brain injury living in community settings

Primary objective: To determine the type and severity of challenging behaviours among a cohort of brain-injured persons referred to a community-based behaviour management service; and to determine whether different behaviour profiles were associated with aetiology of brain injury.
Methods and procedures: A sample of clients (n= 190) referred to the ABI Behaviour Consultancy for assessment and treatment of challenging behaviours was evaluated using the Overt Behaviour Scale (OBS) and other measures of disability and support needs.
Main outcomes and results: The most common challenging behaviour categories were, in order of frequency: verbal aggression, inappropriate social behaviours and lack of initiation. Clients typically exhibited four categories of challenging behaviour and multiple kinds of the behaviours represented by each category. There was some evidence of differences in occurrence of specific behaviours associated with aetiology of brain injury, particularly for hypoxia and alcohol-related brain injury.
Conclusions: A systematic assessment of challenging behaviours in community settings has revealed the profiles of broad behavioural disturbance that can occur following ABI. Assessing the breadth of disturbance is important in understanding a client's presentation and thus planning appropriate behaviour management interventions.

Reconstructing the incidence of human immunodeficiency virus (HIV) in Hong Kong by using data from HIV positive tests and diagnoses of acquired immune deficiency syndrome

The human immunodeficiency virus–acquired immune deficiency syndrome (HIV–AIDS) epidemic in Hong Kong has been under surveillance in the form of voluntary reporting since 1984. However, there has been little discussion or research on the reconstruction of the HIV incidence curve. This paper is the first to use a modified back-projection method to estimate the incidence of HIV in Hong Kong on the basis of the number of positive HIV tests only. The model proposed has several advantages over the original back-projection method based on AIDS data only. First, not all HIV-infected individuals will develop AIDS by the time of analysis, but some of them may undertake an HIV test; therefore, the HIV data set contains more information than the AIDS data set. Second, the HIV diagnosis curve usually has a smoother pattern than the AIDS diagnosis curve, as it is not affected by redefinition of AIDS. Third, the time to positive HIV diagnosis is unlikely to be affected by treatment effects, as it is unlikely that an individual receives medication before the diagnosis of HIV. Fourth, the induction period from HIV infection to the first HIV positive test is usually shorter than the incubation period which is from HIV infection to diagnosis of AIDS. With a shorter induction period, more information becomes available for estimating the HIV incidence curve. Finally, this method requires the number of positive HIV diagnoses only, which is readily available from HIV–AIDS surveillance systems in many countries. It is estimated that, in Hong Kong, the cumulative number of HIV infections during the period 1979–2000 is about 2600, whereas an estimate based only on AIDS data seems to give an underestimate.

Momentary lives : supporting people with acquired brain injury

Personal adjustment following an acquired brain injury is influenced by a comprehensive, complex, and dynamic range of factors. This study found that a useful approach to service provision in the ABI sector would involve a holistic approach that addresses all life domains of the individual within an ecological systems framework.

The purpose of the PhD : theorising the skills acquired by students

In the past decade there has been a marked push for the development of employability skills to be part of the PhD process. This push is generally by stakeholders from above and outside the PhD process, i.e. government and industry, who view skills as a summative product of the PhD. In contrast, our study interviewed stakeholders inside the PhD process – twenty final‐year, full‐time Australian PhD students – to provide a bottom‐up perspective into the skills question. Using grounded theory procedures we theorise the skills students develop during the PhD as a formative developmental process of acquiring intellectual virtues. Drawing on Aristotelian theory, we propose that theorising the PhD as a process of acquiring intellectual virtues offers a more robust and conceptually richer framework for understanding students’ development during the PhD than the instrumental focus on skills evident in contemporary debates.

Pretend play of children with acquired brain injury : an exploratory study

Objective: This exploratory study aimed to describe the self-initiated pretend play of three children who had sustained an acquired brain injury (ABI). No previous research was found.

Methods: Three children aged 3.0–6.0 years were recruited through purposive sampling. Pretend play ability was assessed using the Child-Initiated Pretend Play Assessment.

Results: Two of the three children scored below the range expected for children their age and one child scored above the range, indicating a wide range of pretend play ability for the children. None of the children could sustain their engagement in pretend play to complete the time of the assessment.

Conclusion: Complex pretend play ability is a functional assessment of cognitive ability involving sequential planning, problem-solving, language and social understanding. Cognitive fatigue is argued to explain the children's limited ability to engage in play for the time expected for their ages. More research is required.

Modelling skill acquisition in acquired brain injury

Acquired brain injury (ABI) is a debilitating condition often requiring extensive rehabilitation. Although cognitive rehabilitation is concerned with overcoming a skills deficit, the application of skill acquisition research in this context has been non-existent. Examining post-injury learning in terms of the qualitative variables associated with different phases of skill acquisition is likely to be beneficial in assessing patient status and monitoring progress, as well as identifying changing needs over the course of learning. However, current models of skill acquisition overlook the potential impact of variables such as emotion, implicit learning, metacognition, motivation, and strategies that can be leveraged to improve skill acquisition. The current paper attempts to lay the groundwork for modelling and improving skill acquisition in ABI.

Band-like opacity in the corneas of abattoir-acquired pig eyes

Delayed presentation of retained intraocular foreign body is a diagnostic and therapeutic challenge to the ophthalmologist. Herein a case of a man presenting 25 five years after initial injury with a retained metallic foreign body adjacent to the optic disc is described.