Reduced community integration in persons following traumatic brain injury, as measured on the Community Integration Measure: An exploratory analysis

Objective: To explore the community integration of individuals who had suffered a Traumatic Brain Injury (TBI) and compare this to members of the general public. Design: Independent groups design. Setting: All participants were resident in Northern Ireland (NI). The brain injured participants were drawn from a Belfast-based social skills programme. Participants: Thirty participants, ten survivors of TBI, ten male and ten female controls from the general public. Main Outcome Measure: The Community Integration Measure (CIM) Results: Analysis of variance showed no significant differences between males and females or between males and brain injured individuals. A significant difference was found between females and brain injured individuals (F(1,18)=4.51, P=0.048). Conclusion: Females were more integrated into their communities than males, who were more integrated than brain injured individuals. It would appear that brain injury survivors are doubly disadvantaged. Their gender (mainly male), and the injury itself, conspires to reduce their integration with the wider community.

Violent, caring, unpredictable: Public views on survivors of brain injury

The purpose of the present work was to investigate how members of the public perceived survivors of brain injury. A twenty-item list of attributes that could be used to describe characteristics of survivors of brain injury were given to three hundred and twenty-three participants. One hundred and sixty-nine psychology students and one hundred and fifty-four members of the public agreed to take part in the study. The effects of group (student and public), gender and socioeconomic status (low, moderate and high) on the attributes were assessed. Multivariate analysis of variance showed a statistically significant difference between the two groups with students holding more positive perceptions on 15 out of the 20 attributes. No effects of gender or socioeconomic status were found. The research suggests that members of the public hold less positive views on survivors of brain injury in respect to intellectual competency, ability to care and trustworthiness when compared to students.

Attitudes of children towards peers with acquired brain injury (ABI).

Research objective: Children with acquired brain injury (ABI) can experience severe problems in establishing peer relationships. The attitudes peers hold toward a child with an ABI can significantly impact on their willingness to befriend. The present work sought to investigate the attitudes peers hold toward a fictional child with ABI. Methods and procedures: Fifty children from a primary school were compared against a similar number from a secondary school. Gender was evenly split across both groups. A vignette describing a young boy acquiring a brain injury, and his subsequent change in behaviour, was presented to the children. The Friendship Activity Scale (FAS) was then used to judge how likely the children were to befriend the fictional character. Outcomes and results: Results showed a statistically significant interaction between gender and age [F(1, 96) 6.285, p = 0.014] with older males expressing more positive attitudes than younger males. Conclusion: The study suggests that children with ABI are more likely to experience negative attitudes in primary school, and concludes in calling for additional research to more fully explore the social experience of children with ABI. Keywords: Children; acquired brain injury; peers; attitudes

Detection of cathepsin S cysteine protease in human brain tumour microdialysates in vivo.

Microdialysis enables the chemistry of extracellular ?uid in body tissues to be measured. Extracellular proteases such as the cysteine protease, cathepsin S (CatS), are thought to facilitate astrocytoma invasion. Microdialysates obtained from human brain tumoursin vivo were subjected to cathepsin S activity and ELISA assays. Cathepsin S ELISA expression was detected in ?ve out of 10 tumour microdialysates, while activity was detected in ?ve out of 11 tumour microdialysates. Cathepsin S expression was also detected in microdialysate from the normal brain control although no activity was found in the same sample. While some re?nements to the technique are necessary, the authors demonstrate the feasibility and safety of microdialysis in human astrocytomasin vivo. Characterisation of the extracellular environment of brain tumoursin vivo using microdialysis may be a useful tool to identify the protease pro?le of brain tumours.

The influence of aetiology and blame on prejudice towards survivors of brain injury.

The purpose of the present work was to investigate if a hierarchy of aetiology exists which would influence attitudes towards survivors of brain injury. An independent groups design utilised four independent variables; aetiology (measured at five levels: ‘Road Traffic Accident’ (RTA), ‘Alcohol’, ‘Drug Use’, ‘Aneurism’ and ‘Recreation’), blame (blame and no-blame), group (psychology students and members of the public) and gender to explore attitudes towards survivors of brain injury. The dependent variables were measured using the Prejudicial Evaluation Scale (PES) and Social Interaction Scale (SIS). Three hundred and twenty-five participants (173 students and 152 members of the public) were randomly allocated to one of ten possible conditions. Among individuals who contributed to receiving their injury greater prejudice was displayed towards those in the ‘Drugs’ condition followed by ‘Recreation’, ‘RTA’, ‘Alcohol’ and ‘Aneurism’. Findings suggest that a hierarchy of aetiology exists, which results in prejudicial attitudes, and is influenced by issues of blame. Key words: prejudice, blame, brain injury

Glycemic State Regulates Brain-Derived Neurotrophic Factor Responsiveness of Neurons in the Paraventricular Nucleus of the Hypothalamus

Brain derived neurotrophic factor (BDNF) is a member of the family of neurotrophins and binds to the tropomyosin-related kinase B (TrkB) receptor. Like other neurotrophic factors, BDNF is involved in the development and differentiation of neurons. Recently, studies have suggested important roles for BDNF in the regulation of energy homeostasis. The paraventricular nucleus (PVN) is critical for normal energy balance contains high levels of both BDNF and TrkB mRNA. Studies have shown that microinjections of BDNF into the PVN increase energy expenditure, suggesting BDNF plays a role in energy homeostasis through direct actions in this hypothalamic nucleus. We used male Sprague-Dawley rats to perform whole-cell current-clamp experiments from PVN neurons in slice preparation. BDNF was bath applied at a concentration of 2nM and caused depolarizations in 54% of neurons (n = 25; mean change in membrane potential: 8.9 ± 1.2 mV), hyperpolarizations in 23% (n = 11; mean change in membrane potential: -6.7 ± 1.4 mV), while the remaining cells tested were unaffected. Previous studies showing effects of BDNF on γ-aminobutyric acid type A (GABAA) mediated neurotransmission in PVN led us to examine if these BDNF-mediated changes in membrane potential were maintained in the presence of tetrodotoxin (TTX) sodium channel blocker (N = 9; 56% depolarized, 22% hyperpolarized, 22% non-responders) and bicuculline (GABAA antagonist) (N = 12; 42% depolarized, 17% hyperpolarized, 41% non-responders), supporting the conclusion that these effects on membrane potential were postsynaptic. We also evaluated the effects of BDNF on these neurons across varying physiologically relevant extracellular glucose concentrations. At 10 mM 23% (n = 11; mean: -6.7 ± 1.4 mV) of PVN neurons hyperpolarized in response to BDNF treatment, whereas at 0.2 mM glucose, 71% showed hyperpolarizing effects (n = 12; mean: -6.3 ± 2.8 mV). Our findings reveal that BDNF has direct impacts on PVN neurons and that these neurons are capable of integrating multiple sources of metabolically relevant input. Our analysis regarding glucose concentrations and their effects on these neurons’ response to other metabolic signals emphasizes the importance of using physiologically relevant conditions for study of central pathways involved in the regulation of energy homeostasis.

Detection of Staphylococcus aureus by 16S rRNA directed in situ hybridisation in a patient with a brain abscess caused by small colony variants.

Kipp F, Ziebuhr W, Becker K, Krimmer V, Höbeta N, Peters G, Von Eiff C. Institute of Medical Microbiology, Hospital and Clinics, University of Münster, Germany. A 45 year old man was admitted to hospital with a right sided facial paralysis and three month history of seizures. Computed tomography showed a left temporal mass including both intracerebral and extracerebral structures. Ten years earlier the patient had undergone a neurosurgical intervention in the same anatomical region to treat a subarachnoid haemorrhage. In tissue samples and pus obtained during neurosurgery, Staphylococcus aureus was detected by a 16S rRNA-directed in situ hybridisation technique. Following long term cultivation, small colony variants (SCV) of methicillin resistant S aureus were identified. The patient was treated successfully with a combination of vancomycin and rifampin followed by prolonged treatment with teicoplanin, with no sign of infection on follow up nine months after discharge. This is the first report in which S aureus SCV have been identified as causative organisms in a patient with brain abscess and in which in situ hybridisation has been used to detect S aureus in a clinical specimen containing SCV. Antimicrobial agents such as rifampin which have intracellular activity should be included in treatment of infections caused by S aureus SCV.

Organs of the human brain, created by the human hand? The social epistemology of information technology

Purpose
– Information science has been conceptualized as a partly unreflexive response to developments in information and computer technology, and, most powerfully, as part of the gestalt of the computer. The computer was viewed as an historical accident in the original formulation of the gestalt. An alternative, and timely, approach to understanding, and then dissolving, the gestalt would be to address the motivating technology directly, fully recognizing it as a radical human construction. This paper aims to address the issues.

Design/methodology/approach
– The paper adopts a social epistemological perspective and is concerned with collective, rather than primarily individual, ways of knowing.

Findings
– Information technology tends to be received as objectively given, autonomously developing, and causing but not itself caused, by the language of discussions in information science. It has also been characterized as artificial, in the sense of unnatural, and sometimes as threatening. Attitudes to technology are implied, rather than explicit, and can appear weak when articulated, corresponding to collective repression.

Research limitations/implications
– Receiving technology as objectively given has an analogy with the Platonist view of mathematical propositions as discovered, in its exclusion of human activity, opening up the possibility of a comparable critique which insists on human agency.

Originality/value
– Apprehensions of information technology have been raised to consciousness, exposing their limitations.