Traumatic brain injury (TBI) is a common event in the current extended conflicts by American service members, with estimates that as many as 300,000 have sustained combat-related concussions during Operation Iraqi Freedom and Operation Enduring Freedom. The limited ecological validity of traditional neuropsychological assessment measures presents a challenge to effective postconcussion evaluation of service members in relation to fitness-for-duty decisions or rehabilitation needs. Virtual reality (VR) technology offers a promising opportunity to advance the field of functional assessment for TBI. This article reviews the current professional literature on VR applications for TBI assessment, with special emphasis on those that are particularly relevant to U.S. service members. VR affords several advantages for clinical use. These include assessment of complex sets of cognitive and behavioral functions rather than the isolated components assessed by traditional measures; more precise control over the standardized presentation of task stimuli and the recording of response data; and enhanced ecological validity that can lead to more useful assessment data in the applied contexts faced by the U.S. military.
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http://dx.doi.org/10.1080/09084282.2013.796554 | DOI Listing |
Prim Care Companion CNS Disord
January 2025
Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
The Psychiatric Consultation Service at Massachusetts General Hospital sees medical and surgical inpatients with comorbid psychiatric symptoms and conditions. During their twice-weekly rounds, Dr Stern and other members of the Consultation Service discuss diagnosis and management of hospitalized patients with complex medical or surgical problems who also demonstrate psychiatric symptoms or conditions. These discussions have given rise to rounds reports that will prove useful for clinicians practicing at the interface of medicine and psychiatry.
View Article and Find Full Text PDFJ Urol
January 2025
Department of Population Health, NYU Grossman School of Medicine, New York, New York.
Purpose: We aimed to determine whether implementation of clinical decision support (CDS) tool integrated into the electronic health record (EHR) of a multi-site academic medical center increased the proportion of patients with American Urological Association (AUA) "high risk" microscopic hematuria (MH) who receive guideline concordant evaluations.
Materials And Methods: We conducted a two-arm cluster randomized quality improvement project in which 202 ambulatory sites from a large health system were randomized to either have their physicians receive at time of test results an automated CDS alert for patients with 'high-risk' MH with associated recommendations for imaging and cystoscopy (intervention) or usual care (control). Primary outcome was met if a patient underwent both imaging and cystoscopy within 180 days from MH result.
Ann Neurol
January 2025
School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, New South Wales, Australia.
Unlabelled: Congenital titinopathy has recently emerged as one of the most common congenital muscle disorders.
Objective: To better understand the presentation and clinical needs of the under-characterized extreme end of the congenital titinopathy severity spectrum.
Methods: We comprehensively analyzed the clinical, imaging, pathology, autopsy, and genetic findings in 15 severely affected individuals from 11 families.
Psychopharmacology (Berl)
January 2025
Edith Collins Centre for Translational Research in Alcohol, Drugs and Toxicology, Royal Prince Alfred Hospital, Sydney Local Health District, Sydney, NSW, Australia.
Rationale: Both topiramate and naltrexone have been shown to affect neural alcohol cue reactivity in alcohol use disorder (AUD). However, their comparative effects on alcohol cue reactivity are unknown. Moreover, while naltrexone has been found to normalize hyperactive localized network connectivity implicated in AUD, no studies have examined the effect of topiramate on intrinsic functional connectivity or compared functional connectivity between these two widely used medications.
View Article and Find Full Text PDFJ Head Trauma Rehabil
January 2025
Mental Health Service Line, Minneapolis VA Health Care System, Minneapolis, Minnesota (Tsen); Department of Physical Medicine and Rehabilitation, Rehabilitation & Extended Care, Minneapolis VA Health Care System, Minneapolis, Minnesota (Dr Finn); Department of Psychiatry & Behavioral Sciences, University of Minnesota, Minneapolis, Minnesota (Dr Finn); Department of Research Methodology and Biostatistics, Morsani College of Medicine, University of South Florida, Tampa, Florida (Mrs Klocksieben); Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital, Boston, Massachusetts (O'Neil-Pirozzi); Department of Communication Sciences & Disorders, Northeastern University, Boston, Massachusetts (Dr O'Neil-Pirozzi); H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas (Dr Sander); Brain Injury Research Center, TIRR Memorial Hermann, Houston, Texas (Dr Sander); Department of Research, Craig Hospital, Englewood, Colorado (Drs Agtarap and Finn); Departments of Ophthalmology & Visual Sciences and Physical Medicine & Rehabilitation, University of Alabama at Birmingham, Birmingham, Alabama (Dr Dreer); Research Service, James A. Haley Veterans Hospital, Tampa, Florida (Dr Cotner); Research Service, Traumatic Brain Injury Center of Excellence at James A. Haley Veterans Hospital, Tampa, Florida (Drs Cotner and Nakase-Richardson); Research Department, Central Virginia Veterans Affairs Health Care System, Richmond, Virginia (Mss Vargas, and Dini, and Dr Perrin); Department of Psychology, Virginia Commonwealth University, Richmond, Virginia (Ms Vargas); Department of Psychology, University of Virginia, Charlottesville, Virginia (Ms Dini and Dr Perrin); Mental Health, School of Data Science, University of Virginia, Charlottesville, Virginia (Dr Perrin); Mental Health and Behavioral Services, James A. Haley Veterans Hospital, Tampa, Florida (Drs Finn and Nakase-Richardson); and Department of Internal Medicine, Pulmonary and Sleep Medicine Division, University of South Florida, Tampa, Florida (Dr Nakase-Richardson).
Objective: To describe the self-reported needs of family caregivers of service members and veterans (SMVs) with traumatic brain injury (TBI) at 10 to 15 years post-injury and to identify unique predictors of unmet family needs.
Setting: Five Department of Veterans Affairs Polytrauma Rehabilitation Centers.
Participants: A total of 209 family caregivers of SMVs with TBI from the VA TBI Model Systems national database who completed a 10- or 15-year follow-up assessment.
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