Self-perception of cognitive functions in patients with neurological impairments as measured against a translated Cognitive Change Index.

The primary purpose of the study was to compare the results of neuropsychological assessments with results obtained using a translated Cognitive Change Index (CCI) on patients with diagnosed brain pathology. Our study included 54 patients diagnosed with neurologic pathology (stroke, TBI, or brain tumor) at the University Rehabilitation Institute Soca (average age = 51 years, SD = 15 years). The results of neuropsychological evaluations and anamnestic data were also obtained for the clinical subsample. Confirmatory factor analysis of the translated CCI performed on responses of 151 normative elderly participants supported a one-factor structure of the questionnaire. Cronbach's α was 0.77 in the clinical sample. A significant correlation was found between lower scores for attention and visual abilities using objective measurement tools and a person's self-assessment of impairment in their own cognitive functions (score on CCI). Individuals can perceive that their attention and visual abilities are impaired when those abilities also score low in diagnostic tests.

Consistency of neuropsychological and driving simulator assessment after neurological impairment.

Deficits in attentional and executive functioning may interfere with driving ability and result in a lower level of fitness to drive. Studies show mixed results in relation to the consistency of neuropsychological and driving simulator assessment. The objective of this study was to investigate the consistency of both types of assessment. Ninety-nine patients with various neurological impairments (72 males; M = 48.98 years; SD = 17.27) performed a 30-minute drive in a driving simulation in three different road settings; a (non-)residential rural area, a highway and an urban area. They also underwent neuropsychological assessment of attention and executive function. An exploratory correlational analysis was conducted. We found weak, but significant correlations between attention and executive function measures and more efficient driving in the driving simulator. Distractibility was associated with the most simulator variables in all three simulated road settings. Participants who were better at maintaining attention, eliminating irrelevant information and suppressing inappropriate responses, were less likely to drive above the speed limit, produced a less jerky ride, and used the rearview mirror more regularly. A lack of moderate or strong significant correlations (inconsistency) between traditional neuropsychological and simulator assessment variables may indicate that they don't evaluate the same cognitive processes.

Goal-oriented attentional self-regulation training in individuals with acquired brain injury in a subacute phase: a pilot feasibility study.

The primary aim of this prospective pilot study was to assess feasibility of implementing goal-oriented attentional self-regulation (GOALS) training in Slovenia with patients with multiple cognitive deficits after acquired brain injury in acute phase of recovery. Seven patients with acquired brain injury (i.e. stroke, traumatic brain injury, and subarachnoid hemorrhage) with a mean postinjury time of 4.3 months (SD = 1.25) and mean age of 34.5 years (SD = 18.6) were recruited for the study. The group program consisted of 10 sessions twice a week and included cognitive strategy training, social skills training, and psychoeducation. Structured interviews and neuropsychological tests were used before and after the training to determine the influence of the interventions on daily life tasks and attentional networks performance involving cognitive and behavioral domains. GOALS influenced self-reports of positive effect on the individual goals set by the patients. Training had a positive influence on executive control and memory. The results from the present study suggest that it is feasible to implement GOALS manualized executive function training in Slovenia, with the patients in a somewhat more acute stage than in previous studies, and that GOALS training may be a promising nonpharmacological treatment for cognitive and behavioral difficulties after acquired brain injury. Further research is needed to extend these findings in a larger sample.

A Cloud-Based Virtual Reality App for a Novel Telemindfulness Service: Rationale, Design and Feasibility Evaluation.

BACKGROUND: Worldwide, there has been a marked increase in stress and anxiety, also among patients with traumatic brain injury (TBI). Access to psychology services is limited, with some estimates suggesting that over 50% of sufferers are not accessing the existing services available to them for reasons such as inconvenience, embarrassment, or stigmatization concerns around mental health. Health service providers have increasingly been turning to drug-free therapies, such as mindfulness programs, as complementary treatments. OBJECTIVE: Virtual reality (VR) as a new delivery method for meditation-based stress and anxiety reduction therapy offers configurable environments and privacy protection. Our objective was to design a serious learning-meditation environment and to test the feasibility of the developed telemindfulness approach based on cloud technologies. METHODS: We developed a cloud-based system, which consisted of a Web interface for the mindfulness instructor and remote clients, who had 3D VR headsets. The mindfulness instructor could communicate over the Web interface with the participants using the headset. Additionally, the Web app enabled group sessions in virtual rooms, 360-degree videos, and real interactions or standalone meditation. The mindfulness program was designed as an 8-week Mindfulness-Based Stress Reduction course specifically for the developed virtual environments. The program was tested with four employees and four patients with TBI. The effects were measured with psychometric tests, the Mindful Attention Awareness Scale (MAAS) and the Satisfaction With Life Scale (SWLS). Patients also carried out the Mini-Mental State Examination (MMSE). An additional objective evaluation has also been carried out by tracking head motion. Additionally, the power spectrum analyses of similar tasks between sessions were tested. RESULTS: The patients achieved a higher level of life satisfaction during the study (SWLS: mean 23.0, SD 1.8 vs mean 18.3, SD 3.9) and a slight increase of the MAAS score (mean 3.4, SD 0.6 vs mean 3.3, SD 0.4). Particular insight into the MAAS items revealed that one patient had a lower MAAS score (mean 2.3). Employees showed high MAAS scores (mean 4.3, SD 0.7) and although their SWLS dropped to mean 26, their SWLS was still high (mean 27.3, SD 2.8). The power spectrum showed that the employees had a considerable reduction in high-frequency movements less than 0.34 Hz, particularly with the 360-degree video. As expected, the patients demonstrated a gradual decrease of high-frequency movements while sitting during the mindfulness practices in the virtual environment. CONCLUSIONS: With such a small sample size, it is too early to make any specific conclusions, but the presented results may accelerate the use of innovative technologies and challenge new ideas in research and development in the field of mindfulness/telemindfulness.