Cognitive predictors of medical decision-making capacity in traumatic brain injury.

Objective: To identify cognitive predictors of medical decision-making capacity (MDC) in participants with moderate to severe traumatic brain injury (TBI). Participants: At baseline, participants were 34 adults with TBI and 20 healthy adults. At 6-month follow-up, participants were 24 adults with TBI and 20 healthy adults. Main Outcome Measures: Participants were administered the Capacity to Consent to Treatment Instrument (CCTI) and neuropsychological test measures. Multivariate cognitive predictor models were developed for CCTI consent abilities/standards (S) of understanding (S5); reasoning (S4); and appreciation (S3). Results: At baseline, short-term verbal memory and semantic fluency predicted TBI group performance on understanding (S5); short-term verbal memory and attention predicted performance on reasoning (S4); and working memory predicted performance on appreciation (S3). At 6 month follow-up, executive function, verbal processing speed, and working memory predicted TBI performance on understanding (S5); working memory and short-term memory predicted reasoning (S4); and basic executive functioning predicted appreciation (S3). Conclusions: Multiple cognitive functions are associated with acute impairment and partial recovery of MDC in patients with TBI. Short-term verbal memory predicted consent capacity of TBI participants at the time of acute inpatient hospitalization, while executive functioning and working memory predicted improved capacity at six-month follow-up. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Family caregivers of persons with spinal cord injury: Predicting caregivers at risk for probable depression.

Objective: To determine the percentage of family caregivers of persons with spinal cord injury (SCI) with probable depression and to test the hypothesis that dysfunctional problem-solving abilities would be significantly predictive of risk status after taking into account important demographic characteristics and caregiver health. Design: Correlational and logistic regression analyses of data collected in a cross-sectional design. Participants: Eighteen men and 103 women caregivers (mean age of caregivers = 45.66 years, SD = 12.88) of individuals with SCI. Main Outcome Measure: The Inventory to Diagnose Depression. Results: Nineteen caregivers (15.7%) met criteria on the Inventory to Diagnose Depression for a major depressive disorder. A dysfunctional problem-solving style was significantly predictive of caregiver depression, regardless of the severity of physical impairment of the care recipient or the physical health of the caregiver and caregiver demographic variables. Conclusions: The percentage of caregivers with probable depressive disorder may parallel that observed among persons with SCI, using a more conservative self-report measure designed to assess symptoms associated with a depressive syndrome. Family caregivers with a dysfunctional problem-solving style and assisting individuals with more severe injuries may have probable depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Development of an integrated information model for computer integrated manufacturing

The development of an FDBS is integrate existing CIM components by using a bottom-up development process. The components used in this paper do not support any kind database management. The integration of those components into a federation may be done by using two general approaches [3]:

• • Migration of the files to a DBMS

• • Extend the file system to support DBMS-like features

Both migration and extension of the file system are costly solutions and actually depend on existing capabilities of the components. Problems may occur when the federated schema becomes too large. The schema might be split up into smaller federated schemes (loosely coupled FBDS).     

Focus groups with persons who have age-related macular degeneration: Emotional issues.

Objective: To identify content areas characterizing emotional issues faced by persons with age-related macular degeneration (AMD). Design and Participants: Six focus groups (N = 53) were conducted with persons having AMD, with discussion addressing feelings about vision. Discussion was audiotaped, transcribed, and subjected to content analysis. Results: Twice as many comments conveyed negative as compared with positive affect. Negative comments communicated feelings of frustration, fear, sadness, and inadequacy. Positive comments addressed gratitude and hope. Positive and negative comments were just as likely regardless of disease severity. The tendency to make positive versus negative comments was related to participants' mental health score on the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25) but unrelated to other psychosocially oriented subscales of the NEI VFQ-25 and the presence of probable depression as defined by the 10-item Center for Epidemiological Studies-Depression Scale. Conclusions: When persons with AMD are given the opportunity to frame the emotional accompaniments of vision impairment from their own perspectives, predominantly negative issues were expressed, yet positive emotions were also mentioned. This information can be used for psychoeducational interventions for this population and the selection of emotional outcome measures when evaluating interventions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social Problem-Solving Abilities and Psychological Adjustment of Persons in Low Vision Rehabilitation.

Objective: Tested the relations of social problem-solving abilities to distress, depression, and well-being and impairment reported by persons participating in a low vision rehabilitation program. Study Design: Correlational and multiple regression analyses. Setting: Outpatient low vision rehabilitation clinic. Participants: 25 men (M = 73.88 years old, SD = 11.94 years) and 29 women (M = 68.79 years old, SD = 17.25 years) participating in a comprehensive admitting examination. Main Outcome Measures: Emotional distress specific to the condition, depressive behavior, satisfaction with life, and functional ability. Results: A negative problem orientation significantly predicted depression and emotional distress; rational problem-solving skills predicted life satisfaction. Conclusions: A negative problem orientation toward problem solving predicts poor emotional adjustment reported by persons with low vision, and proactive problem-solving skills appear to promote optimal adjustment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)