Resilience Among Caregivers of Injured Service Members: Finding the Strengths in Caregiving.

OBJECTIVE: To examine the relationships between caregiver resilience and a comprehensive set of sociodemographic and health-related quality of life (HRQOL) predictors among both caregivers and injured service members. DESIGN: Cross-sectional analysis of an observational cohort. SETTING: Community dwelling. PARTICIPANTS: Caregivers (n=87) who provide instrumental or emotional support to injured service members (n=73)(N=160). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: The Connor-Davidson Resilience Scale 25-item version. RESULTS: Higher caregiver resilience scores were related to lower depressive symptom severity, greater health responsibility, physical activity, nutrition, spiritual growth, interpersonal relations, stress management, and problem-solving orientation. A multivariable regression model showed that spiritual growth and aspects of problem-solving orientation were significantly related to resilience. CONCLUSIONS: Results highlight the relationships between resilience and spirituality, problem-solving orientation, and aspects of HRQOL among caregivers of injured service members. These findings have important implications for caregiver behavioral health programs designed to promote resilience and draw upon caregiver strengths when taking on a caregiver role. Approaches that include a more integrative medicine or strengths-based emphasis may be particularly beneficial when working with families of injured military.

Suicide and traumatic brain injury: a review by clinical researchers from the National Institute for Disability and Independent Living Rehabilitation Research (NIDILRR) and Veterans Health Administration Traumatic Brain Injury Model Systems.

Research among a wide range of cohorts (e.g. civilian, military) has increasingly highlighted traumatic brain injury (TBI) as a risk factor for suicidal thoughts and behaviors, including death by suicide. With this recognition, subsequent changes in clinical practice, such as TBI screenings among individuals seeking mental health services, as well as suicide risk assessment among individuals seeking rehabilitation services are essential. Information provided below is aimed at highlighting key and emerging findings regarding suicide and TBI, with the goal of encouraging providers and researchers to explore changing and expanding evidence-based clinical practices to match the needs of those living with a history of TBI.

A review of the literature on pediatric concussions and return-to-learn (RTL): Implications for RTL policy, research, and practice.

OBJECTIVE: While reintegration of concussed youth back into sports has been increasingly studied over the past decade, a noticeably lacking yet growing body of research has begun to focus on issues surrounding return to academics or "return-to-learn" (RTL). The objective of this article was to conduct a comprehensive literature review to identify the full range of themes and gaps in the current body of RTL research. STUDY DESIGN: Researchers analyzed PubMed, PsycINFO, and ERIC databases to identify all recent (January 2000 through May 2016) empirical publications on the RTL process following youth concussions. In addition to the database searches, bibliographies of selected manuscripts were hand-searched for additional sources. RESULTS: A total of 35 articles met inclusion criteria. Key themes identified from the RTL literature centered on academic outcomes, physician recommendations, length of time to complete RTL, concussion-related symptom difficulties, and academic accommodations/guidelines. Across these areas, the research was fairly inconsistent in terms of providing clear conclusions, likely because of the small number of studies conducted within these areas as well as variability in methodology and terminology. Gaps in the research include a lack of the following: consensus on RTL protocols, agreement on prescription of cognitive rest, guidance for RTL legislation, understanding of communication between systems of care, concussion-related education for systems of care, evidence-based programs or interventions for RTL, and the impact on RTL outcomes. CONCLUSIONS: Given the inconsistencies in RTL literature, more rigorous research is needed to inform concussion policy and practice to assist with pediatric concussion management. (PsycINFO Database Record

Examination of Teacher Knowledge, Dissemination Preferences, and Classroom Management of Student Concussions: Implications for Return-to-Learn Protocols.

OBJECTIVES: To determine teacher knowledge of (1) concussion symptomatology, (2) dissemination preferences, and (3) classroom management practices of student concussions. STUDY DESIGN: A cross-sectional survey assessing concussion-related information was completed by teachers/instructors in the state of Alabama. RESULTS: One-hundred and thirty participants completed the survey. Only a quarter perceived they were "very" or "extremely" confident enough to recognize signs related to a concussion (22.3%), and only 12.4% reported they were "very knowledgeable" about concussions. The majority were able to recognize more common concussion symptoms/challenges: headaches (95.4%), trouble concentrating (86.2%), memory (82.3%), balance problems/dizziness (82.3%), changes vision/hearing (76.2%), difficulty completing tasks (70.8%), difficulty making decisions (66.2%), changes in sleep (61.5%), and fatigue (60.8%); only half recognized emotional symptoms (e.g., mood) or symptoms associated with more prolonged recovery. Concussion informants were school nurses (74.4%), followed by parents (46.2%), students (46.2%), and coaches/athletic trainers (45.4%). A little under half of participants received concussion information as part of their job (41.9%). About 14.1% of teachers reported that someone had come to their school to talk with them as a group about concussions, and 82% felt they needed more information. Of the 37% who taught a concussed student, 83% reported they altered the classroom management strategies. CONCLUSIONS: In general, teachers were able to recognize the more commonly experienced concussion symptoms as well as management strategies. However, they appear to want greater concussion information and training. Given the daily influence of teachers on student tasks involving cognitive exertion, incorporation of formal concussion education for teachers is warranted.

Predicting Motor Vehicle Collisions in a Driving Simulator in Young Adults Using the Useful Field of View Assessment.

OBJECTIVE: Being involved in motor vehicle collisions is the leading cause of death in 1- to 34-year-olds, and risk is particularly high in young adults. The Useful Field of View (UFOV) task, a cognitive measure of processing speed, divided attention, and selective attention, has been shown to be predictive of motor vehicle collisions in older adults, but its use as a predictor of driving performance in a young adult population has not been investigated. The present study examined whether UFOV was a predictive measure of motor vehicle collisions in a driving simulator in a young adult population. METHOD: The 3-subtest version of UFOV (lower scores measured in milliseconds indicate better performance) was administered to 60 college students. Participants also completed an 11-mile simulated drive to provide driving performance metrics. RESULTS: Findings suggested that subtests 1 and 2 suffered from a ceiling effect. UFOV subtest 3 significantly predicted collisions in the simulated drive. Each 30 ms slower on the subtest was associated with nearly a 10% increase in the risk of a simulated collision. Post hoc analyses revealed a small partially mediating effect of subtest 3 on the relationship between driving experience and collisions. CONCLUSION: The selective attention component of UFOV subtest 3 may be a predictive measure of crash involvement in a young adult population. Improvements in selective attention may be the underlying mechanism in how driving experience improves driving performance.