Purpose: To study the association between fatigue and participation and QoL after acquired brain injury (ABI) in adolescents and young adults (AYAs). Materials & Methods: Cross-sectional study with AYAs aged 14–25 years, diagnosed with ABI. The PedsQL™ Multidimensional Fatigue Scale, Child & Adolescent Scale of Participation, and PedsQL™4.0 Generic Core Scales were administered. Results: Sixty-four AYAs participated in the study, 47 with traumatic brain injury (TBI). Median age at admission was 17.6 yrs, 0.8 yrs since injury. High levels of fatigue (median 44.4 (IQR 34.7, 59.7)), limited participation (median 82.5 (IQR 68.8, 92.3)), and diminished QoL (median 63.0 (IQR 47.8, 78.3)) were reported. More fatigue was significantly associated with more participation restrictions (β 0.64, 95%CI 0.44, 0.85) and diminished QoL (β 0.87, 95%CI 0.72, 1.02). Conclusions: AYAs with ABI reported high levels of fatigue, limited participation and diminished quality of life with a significant association between fatigue and both participation and QoL. Targeting fatigue in rehabilitation treatment could potentially improve participation and QoL.
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Since the emergence of modern man some 200,000 years ago, people and technologyhave been inextricably linked to each other. However, unlike traditional technology -such as leverage (and derivative applications such as hammers, wheels and crankshafts),and control of fire - smart technology is equipped with adaptive capacity. Whereas intraditional technology people have to think and handle in terms of technology in orderto apply technology successfully and purposefully, technology with, for example, itsown learning ability adapts to humans. This means that smart technology influencesdevelopment in a different way than traditional technology. Changes in the relationship between human development (brain) and smarttechnology - technology with its own learning capacity and adaptability - have led tothe articulation of 4 requirements technology should meet: 1. it must be sustainable, 2. it must not block development and if it does it must be clear how, 3. there must bea logical argument why the technique can be used and how it can be explained, also in terms of psychological development and, finally, 4. the social and ethical discoursemust be stated in a transparent way. At a fast pace, futurologists and management gurus are presenting “theories” abouthow smart technology will change us permanently as individuals. Requirements 1(sustainability) and 2 (technology influencing human development) are at stake here.However, these ideas cannot be substantiated by scientific research. Psychology(and the other social and human sciences) have not yet been able to generate a convincing interpretation of what is going on in the area of brain and technology (living technology). In fact, there is a need for argumentation. In order to arrive at an argument-based psychology, insight into the non-linearityof processes is indispensable. The Brain & Technology research group is exploring the great possibilities to bridge the distance between people and their limitations by using smart technology, or possibilities, especially when it comes to argument based applied psychology! In this document, mainly the argument requirement is considered, because in the rapidly changing technological processes, the argument often does not sufficiently develop and the argument lies pre-eminently at the level of applied psychology, brain and technology.
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Background: Traumatic brain injury (TBI) is in the developed countries the most common cause of death and disability in childhood. Aim: The purpose of this study is to estimate the incidence of TBI for children and young people in an urbanised region of the Netherlands and to describe relevant characteristics of this group. Methods: Patients, aged 1 month - 24 years who presented with traumatic brain injury at the Erasmus University Hospital (including the Sophia Children's Hospital) in 2007 and 2008 were included in a retrospective study. Data were collected by means of diagnosis codes and search terms for TBI in patient records. The incidence of TBI in the different referral areas of the hospital for standard, specialised and intensive patient care was estimated. Results: 472 patients met the inclusion criteria. The severity of the Injury was classified as mild in 342 patients, moderate in 50 patients and severe in 80 patients. The total incidence of traumatic brain injury in the referral area of the Erasmus University Hospital was estimated at 113.9 young people per 100.000. The incidence for mild traumatic brain injury was estimated at 104.4 young people, for moderate 6.1 and for severe 3.4 young people per 100.000. Conclusion: The ratio for mild, moderate and severe traumatic brain injury in children and young people was 33.7e1.8e1.In the mild TBI group almost 17% of the patients reported sequelae. The finding that 42% of them had a normal brain CT scan at admission underwrites the necessity of careful follow up of children and young people with mild TBI.
