Quasi-stationarity in populations that are subject to large-scale mortality or emigration

We shall examine a model, first studied by Brockwell et al. [Adv Appl Probab 14 (1982) 709.], which can be used to describe the longterm behaviour of populations that are subject to catastrophic mortality or emigration events. Populations can suffer dramatic declines when disease, such as an introduced virus, affects the population, or when food shortages occur, due to overgrazing or fluctuations in rainfall. However, perhaps surprisingly, such populations can survive for long periods and, although they may eventually become extinct, they can exhibit an apparently stationary regime. It is useful to be able to model this behaviour. This is particularly true of the ecological examples that motivated the present study, since, in order to properly manage these populations, it is necessary to be able to predict persistence times and to estimate the conditional probability distribution of population size. We shall see that although our model predicts eventual extinction, the time till extinction can be long and the stationary exhibited by these populations over any reasonable time scale can be explained using a quasistationary distribution. (C) 2001 Elsevier Science Ltd. All rights reserved.

Patterns of community integration 2-5 years post-discharge from brain injury rehabilitation

Outcome after traumatic brain injury (TBI) is characterized by a high degree of variability which has often been difficult to capture in traditional outcome studies. The purpose of this study was to describe patterns of community integration 2-5 years after TBI. Participants were 208 patients admitted to a Brain Injury Rehabilitation Unit between 1991-1995 in Brisbane, Australia. The design comprised retrospective data collection and questionnaire follow-up by mail. Mean follow-up was 3.5 years. Demographic, injury severity and functional status variables were retrieved from hospital records. Community integration was assessed using the Community Integration Questionnaire (CIQ), and vocational status measured by a self administered questionnaire. Data was analysed using cluster analysis which divided the data into meaningful subsets. Based on the CIQ subscale scores of home, social and productive integration, a three cluster solution was selected, with groups labelled as working (n = 78), balanced (n = 46) and poorly integrated (n = 84). Although 38% of the sample returned to a high level of productive activity and 22% achieved a balanced lifestyle, overall community integration was poor for the remainder. This poorly integrated group had more severe injury characterized by longer periods of acute care and post-traumatic amnesia (PTA) and greater functional disability on discharge. These findings have implications for service delivery prior to and during the process of reintegration after brain injury.

Post-traumatic amnesia: Consistency-of-recovery and duration-to-recovery following traumatic brain impairment

The aim of this research was to examine the nature and order of recovery of orientation and memory functioning during Post-Traumatic Amnesia (PTA) in relation to injury severity and PTA duration. The Westmead PTA Scale was used across consecutive testing days to assess the recovery of orientation and memory during PTA in 113 patients. Two new indices were examined: a Consistency-of-Recovery and a Duration-to-Recovery index. a predictable order of recovery was observed during PTA: orientation-to-person recovered sooner and more consistently than the following cluster; orientation-to-time, orientation-to-place, and the ability to remember a face and name. However, the type of memory functioning required for the recall face and name task recovered more consistently than that required for memorizing three pictures. An important overall finding was that the order-of-recovery'' of orientation and memory functioning was dependent upon both the elapsed days since injury, and the consistency of recovery. The newly developed indices were shown to be a valuable means of accounting for differences between groups in the elapsed days to recovery of orientation and memory. These indices also clearly increase the clinical utility of the Westmead PTA Scale and supply an objective means of charting (and potentially predicting) patients' recovery on the different components of orientation and memory throughout their period of hospitalization.