Objective. To study the prevalence, nature and determinants of aggression among inpatients with acquired brain injury. Background. Patients with acquired brain injury often have difficulty in controlling their aggressive impulses. Design. A prospective observational study design. Methods. By means of the Staff Observation Aggression Scale-Revised, the prevalence, nature and severity of aggressive behaviour of inpatients with acquired brain injury was assessed on a neuropsychiatric treatment ward with 45 beds. Additional data on patient-related variables were gathered from the patients’ files. Results. In total, 388 aggressive incidents were recorded over 17 weeks. Of a total of 57 patients included, 24 (42%) patients had engaged in aggressive behaviour on one or more occasions. A relatively small proportion of patients (n = 8; 14%) was found to be responsible for the majority of incidents (n = 332; 86%). The vast majority of aggression incidents (n = 270; 70%) were directly preceded by interactions between patients and nursing staff. In line with this, most incidents occurred at times of high contact intensity. Aggressive behaviour was associated with male gender, length of stay at the ward, legal status and hypoxia as the cause of brain injury. Conclusion. Aggression was found to be highly prevalent among inpatients with acquired brain injury. The results suggest that for the prevention of aggression on the ward, it may be highly effective to develop individually tailored interventions for the subgroup with serious aggression problems. Relevance to clinical practice. Insight into the frequency, nature and determinants of aggressive behaviour in inpatients with acquired brain injury provides nurses with tools for the prevention and treatment of aggressive behaviour.
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Purpose: Physical interventions during subacute rehabilitation have potential to improve functional recovery. This study explored the perspectives of children and adolescents with acquired brain injury (ABI) and their parents with respect to physical rehabilitation during the subacute phase. Methods: Thirteen children and adolescents with ABI and their parents were included and interviewed using semi-structured interviews. Interview transcripts were analysed using inductive thematic analysis approach. Results: Six themes were identified: 1) beliefs of physical rehabilitation, 2) content of physical rehabilitation, 3) tailored care, 4) impact of context, 5) communication and 6) transition. The importance of intensive physical practice was widely supported. The positive can-do mentality was emphasised to create an atmosphere of hope, meaning that every effort would be made to achieve maximum recovery. Intensive involvement of parents is considered essential during subacute rehabilitation including an open and mutual dialogue about the focus of rehabilitation, therapy goals and future participation in their own environment. Conclusions: Our findings highlight the need for an intensive rehabilitation approach, tailored to the individual’s needs. The perspectives of children and adolescents and their parents in our study contribute to a better understanding of factors that are important for optimal recovery through physical rehabilitation during the subacute phase.
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Titel: The Exodus from the Netherlands or Brain Circulation: Push and Pull Factors of Remigration among Highly Educated Turkish Dutch Auteurs: Gürkan Çelik and Ton Notten In: European Review, 22 (3), 2014, pp. 403-413 The exodus from the Netherlands or brain circulation: Push and pull factors of remigration among highly educated Turkish-Dutch An increasing number of Turks, the Netherlands’ largest ethnic minority, are beginning to return to their country of origin, taking with them the education and skills they have acquired abroad, as the Netherlands faces challenges from economic difficulties, social tension and increasingly powerful right wing parties. At the same time Turkey’s political, social and economic conditions have been improving, making returning home even more appealing for Turkish migrants at large. This article gives explanations about the push and pull factors of return migration. The factors influencing return to one’s country of origin are “pulls”. It is assumed that remigration is more affected by positive developments in the country of origin than by negative developments in the country of residence. Civil society, business world and the Dutch government can develop policies to bind these capable people to the Netherlands, at least in the form of “brain circulation” so that they can serve as “bridge builders” between the two countries. Keywords Return migration, integration, Turkish-Dutch, Turkish migrants, brain circulation =============================================================================== SAMENVATTING De uittocht uit Nederland of breincirculatie: Push- en pull-factoren van remigratie onder hoogopgeleide Turkse Nederlanders. In Nederland zien we een lichte toename van het aantal Turken, de grootste etnische minderheidsgroep in Nederland, die terugkeren naar hun land van herkomst. Ze exporteren daarmee goede opleidingen en vaardigheden die ze in Nederland verwierven. De oorzaken: de economische neergang, sociale spanningen en de groeiende invloed van extreemrechtse partijen. Tegelijkertijd verbeteren in Turkije de politieke, sociale en economische omstandigheden die steeds meer aantrekkingskracht uitoefenen op immigranten in dat land. Dit artikel gaat in op de push- and pull-factoren voor remigranten. Pull-factoren beinvloeden iemands terugkeer naar zijn land van herkomst. Aangenomen wordt dat zo’n remigratie sterker wordt bevorderd door positieve ontwikkelingen in het land van herkomst dan door negatieve (push-factoren) in het land waar men op dat moment woont. De civil society, het bedrijfsleven en de Nederlandse overhead kunnen een beleid ontwikkelen dat verdienstelijke inwoners weet te behouden, hen op z’n minst kan inschakelen als bruggenbouwers en aldus kenniscirculatie mogelijk maakt tussen beide landen. Trefwoorden Retourmigratie, integratie, Turkse Nederlanders, Turkse migranten, kenniscirculatie, breincirculatie
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Given the substantial increase in children attending center-based childcare over the past decades, the consequences of center-based childcare for children’s development have gained more attention in developmental research. However, the relation between center-based childcare and children’s neurocognitive development remains relatively underexplored. The aim of this study was therefore to examine the relations between quantity of center-based childcare during infancy and the neurocognitive development (both functional brain networks and self-regulation) of 584 Dutch children. Small-world brain networks and children’s self-regulation were assessed during infancy (around 10 months of age) and the preschool period (2–6 years of age). The findings revealed that the quantity of center-based childcare during infancy was unrelated to individual differences in children’s functional brain networks. However, spending more hours per week in center-based childcare was positively related to the development of self-regulation in preschool age children, regardless of children’s sex or the levels of exposure to risk and maternal support in the home environment. More insight into the positive effects of center-based childcare on children’s development from infancy to toddlerhood can help to increase our insight into a better work–life balance and labor force participation of parents with young children. Moreover, this study highlights that Dutch center-based childcare offers opportunities to invest in positive child outcomes in children, including self-regulation.
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Purpose/objective: Stereotactic radiosurgery of brain metastases requires highly conformal dose distributions. Besides beams setup, characteristics of the linear accelerator collimator may also play a role. In this study we compared the impact of leaf width on the dose outside the target for stereotactic radiosurgery of single brain metastases. Results: The mean dose was evaluated in the first 2 rings of 5 mm around the PTV(table 1). The difference in mean dose for the small lesions(Dpres=24 Gy) of the first ring of 5 mm is 1.8 Gy in favor of the Agility and 0.9 Gy for the larger lesions(Dpres=18 Gy)also in favor of the Agility. The difference is smaller for the larger lesions (figure1). Also for the second ring of 5 mm, adjacent to the first ring, the difference is is 1.1 Gy vs 0.8 Gy also in favor of the Agility. Conclusion: For the small lesions with a volume smaller than 4 cm³ the Agility shows a steeper gradient in the two surrounding rings than the MLCi1. Therefore we recommend the use of the Agility for treating the smaller lesions.
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This article examines the possibility of the futuristic assumption that the human mind will converge with artificial intelligence technology to create an enhancement of consciousness. By studying how a correlation between consciousness and the brain is made through visual tools that are used in neuroscience, this article elaborates on how these findings affect research that is done in philosophy on the concept of consciousness. This article proposes a new approach on studying the brain, by examining it as a theoretical object, which gives every research field the possibility to argue over the truth in the images that are created of the brain.
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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.
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The principle of minimum relative entropy is proposed as a general fundamental principle that could be used by the brain to do inference and update beliefs about the world. It originates from information and probability theory, but we relate it it to the brain, to the concept of surprise and to a minimum free-energy principle that has already been proposed for the brain. The measure of surprise that is based on relative entropy (Bayesian surprise) is compared with another definition of surprise (Shannon surprise) that is used by Friston for a minimum free-energy principle. Theoretical and experimental justifi cations are given to propose to use Bayesian surprise as a better and more natural definition of surprise. It can be used as a novel way to quantify surprise or related concepts in developmental robotics. This can then be used in implementations of intrinsic motivations like curiosity to drive exploration, interactive learning and autonomous mental development.
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AIM: To synthesize the evidence about the characteristics (frequency, intensity, time, type) and effects of physical rehabilitation interventions on functional recovery and performance in daily functioning in children and young people with acquired brain injury (ABI), including traumatic brain injuries (TBI) and non-TBI, during the subacute rehabilitation phase.METHOD: Using scoping review methodology, a systematic literature search was performed using four databases. Articles were screened by title and abstract and data from eligible studies were extracted for synthesis.RESULTS: Nine of 3009 studies were included. The results demonstrated a variety of intervention characteristics: frequency varied between 1 and 7 days per week; time of intervention varied between 25 minutes and 6 hours a day; intervention types were specified in seven studies; and none of the included studies reported details of intensity of intervention. All studies reported positive results on the International Classification of Functioning, Disability and Health: Children and Youth (ICF-CY) levels of body function and activities after the intervention period, with study designs of included studies being cohort studies without concurrent controls (n=7) or case reports (n=2).INTERPRETATION: Inconsistency in results hampers generalizability to guide clinical practice. Physical interventions during subacute rehabilitation have potential to improve functional recovery with intervention characteristics as an important factor influencing its effectiveness. Future well-designed studies are indicated to gain knowledge and optimize rehabilitation practice in paediatric ABI and high-quality research including outcomes across all ICF-CY domains is needed.
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In this chapter it is argued that self-direction is currently well above the head of the majority of youngsters and even of many adults. Evidence for this conclusion stems from developmental and brain research. However, for various reasons it is important that people develop the competences that are necessary for self-direction. To what degree is it possible to develop these competences? Are they 'learnable'? What can education contribute?
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