Objectives: Participation is considerably restricted in children and adolescents with acquired brain injury (ABI) as compared to their healthy peers. This systematic review aims to identify which factors are associated with participation in children and adolescents with ABI. Methods: A systematic search in Medline and various other electronic databases from January 2001–November 2014 was performed. All clinical studies describing determinants of participation at least 1 year after the diagnosis of ABI by means of one or more pre-defined instruments in patients up to 18 years of age were included. Extracted data included study characteristics, patient characteristics, participation outcome and determinants of participation (categorized into: health conditions (including characteristics of ABI), body functions and structures, activities, personal factors and environmental factors). The methodological quality of the studies was evaluated based on three quality aspects (selection, information and statistical analysis bias) and scored as low, moderate or high. Results: Eight studies using an explicit participation outcome measure were selected after review, including a total of 1863 patients, with a follow-up ranging from 1 up to 288 months. Three studies included patients with a traumatic or a non-traumatic brain injury (TBI or NTBI) and five studies with only TBI patients. Factors consistently found to be associated with more participation restrictions were: greater severity of ABI, impaired motor, cognitive, behavioural and/or sensory functioning, limited accessibility of the physical environmentand worse family functioning. Fewer participation problems were associated with a supportive/nurturing parenting style, higher household income, acceptance and support in the community and availability of special programmes. The overall methodological quality of the included studies was high in two and moderate in six studies. Conclusion: This systematic review shows that only a few, moderate quality, studies on the determinants of participation after paediatric ABI using recommended explicit measurement instruments are available. Various components of the ICF model: health condition, body functions and structures and environmental factors were consistently found to be associated with participation. More methodologically sound studies, using the recommended explicit outcome measures, a standardized set of potential determinants and longterm follow-up are suggested to increase the knowledge on participation in children and youth with ABI.
We examined the neural correlates of facial attractiveness by presenting pictures of male or female faces (neutral expression) with low/intermediate/high attractiveness to 48 male or female participants while recording their electroencephalogram (EEG). Subjective attractiveness ratings were used to determine the 10% highest, 10% middlemost, and 10% lowest rated faces for each individual participant to allow for high contrast comparisons. These were then split into preferred and dispreferred gender categories. ERP components P1, N1, P2, N2, early posterior negativity (EPN), P300 and late positive potential (LPP) (up until 3000 ms post-stimulus), and the face specific N170 were analysed. A salience effect (attractive/unattractive > intermediate) in an early LPP interval (450–850 ms) and a long-lasting valence related effect (attractive > unattractive) in a late LPP interval (1000–3000 ms) were elicited by the preferred gender faces but not by the dispreferred gender faces. Multi-variate pattern analysis (MVPA)-classifications on whole-brain single-trial EEG patterns further confirmed these salience and valence effects. It is concluded that, facial attractiveness elicits neural responses that are indicative of valenced experiences, but only if these faces are considered relevant. These experiences take time to develop and last well beyond the interval that is commonly explored.
MULTIFILE
Obesity is a fast-growing societal threat, causingchronic conditions, physical and psychological health problems,as well as sickness absence and heavy healthcare costs. Despitenumerous attempts to promote physical activity and healthydiet, existing interventions do not focus on the commonemotional causes of obesity. There is a need for self-managementsupport of this vulnerable target group: emotional eaters. Thispaper presents the results of the design case study focusing on aholistic design and evaluation of a personalised virtual mHealthcoach that provides self-management training ‘Denk je zèlf!’(Dutch for ‘Develop a wise mind and counsel yourself’). Thetarget group are young adults with an emotional eating disorderand who are obese. The contextual inquiry study was conductedto gain insights into the needs and experiences of the targetusers, including interviews and questionnaires with emotionaleaters, patients undergoing obesity treatment, and healthcarepractitioners. Personas and the use-case scenario were derivedfrom these results and translated into the new ‘Denk je zèlf!’virtual coach, based on Dialectical Behaviour Therapy andexperience sampling measures to capture user experience andemotional state. The main contributions of this paper are: (a)combining holistic eHealth design, behavior chain analysis, anddialectic behaviour therapy in one personalised virtual mHealthcoaching application for emotional eaters; (b) applying emotionenrichedPersonas to guide the design; (c) the results of theinitial user evaluation. Preliminary results suggest that the‘Denk je zèlf!’ virtual coach is useful for helping the targetgroup. Future research will be aimed at further iterative (re)-design and evaluation, as well as development of the dialecticaldialogues for the virtual coach and content for the education andinstruction modules.
