Primary objective: Recent research studies attest to the presence of deficits in emotion perception following severe traumatic brain injury (TBI). Additionally, a growing number of studies report significant levels of alexithymia (disorder of emotional cognition) following TBI. This research aimed to examine the relation between the two, while assessing the influence of posttraumatic stress disorder (PTSD). Design: Cross-sectional study examining levels of alexithymia, emotion perception disorders and PTSD and their association, in 20 people with severe, chronic TBI and 20 adults without brain injuries. Methods: Participants were assessed on the Toronto Alexithymia — 20 Scale, the Posttraumatic Diagnostic Scale and on two emotion perception tasks: matching and labelling of photos depicting the 6 basic emotions. Results: The group with TBI were impaired relative to controls when matching facial expressions. Their performance on ‘fear’ was especially poor. Performance on labelling was similar in pattern, although failed to reach significance. There was no association between poor performance on fear, or other negative expressions, and either PTSD or alexithymia symptoms in the TBI group. Conclusions: Alexithymia, as assessed by the TAS-20, taps a constellation of difficulties that do not appear to include difficulties with emotion perception in people with traumatic brain injuries.

Dysphagia and aspiration pneumonia are prevalent but infrequently studied complications following severe traumatic brain injury (TBI). Aspiration pneumonia is responsible for a significant number of long-term deaths in this population, however, the reported number of deaths attributed to aspiration pneumonia may be inaccurate. This multicentre inception cohort (n = 2545) study analysed consecutive discharges from 3 metropolitan inpatient brain injury rehabilitation units from January 1990 to October 2007 following inpatient rehabilitation following primary TBI. Subject data was linked to national death registries to determine cause of death where relevant. This study aimed to (a) evaluate the prevalence of aspiration pneumonia, percutaneous endoscopic gastrostomy (PEG) insertion and dysphagia following TBI, (b) identify the number of deaths ascribed to aspiration pneumonia, and (c) characterise associated risk factors for long-term aspiration pneumonia related deaths compared to all other causes of death. In-hospital PEG insertion occurred in 18.4% of the sample, two thirds of whom remained dysphagic at discharge. In-hospital aspiration pneumonia was recorded in 3.6% of the sample. Postdischarge, people with TBI were 79 times more likely to die from aspiration pneumonia than the general population. Risks were higher for subjects discharged to a nursing home, with severe ongoing functional disability, dysphagia at discharge, in those who had experienced in-hospital aspiration pneumonia or required PEG insertion. Early identification and risk management of dysphagia and aspiration pneumonia in TBI nursing home populations may maximise these individuals' quality and length of life.

The results of a pilot randomised controlled trial of computerised cognitive training in older adults with mild cognitive impairment (MCI) are reported. Participants (N = 25) were randomised into either the treatment or waitlist training groups. Sixteen participants completed the 30-session computerised cognitive training program using exercises that target a range of cognitive functions including attention, processing speed, visual memory and executive functions. It was hypothesised that participants would improve with practice on the trained tasks, that the benefits of training would generalise to nontrained neuropsychological measures, and that training would result in improved perceptions of memory and memory functioning when compared with waitlist controls. Results indicated that participants were able to improve their performance across a range of tasks with training. There was some evidence of generalisation of training to a measure of visual sustained attention. There were no significant effects of training on self-reported everyday memory functioning or mood. The results are discussed along with suggestions for future research.

Irritability is not uncommon after traumatic brain injury (TBI). Unfortunately, no instruments are available to directly measure this clinical feature. This study thus aimed to develop a specific scale to evaluate the irritability for patients with TBI. A total of 144 participants, which include 80 healthy participants and 64 patients suffering from TBI, were recruited. Irritability was assessed by the National Taiwan University Irritability Scale (NTUIS). Our results showed the NTUIS has good reliability. The factor analysis further revealed 2 different components: annoyance, and verbal aggression. Moreover, both self-reported and family-reported irritability postinjury were significantly higher than the irritability reported by the healthy participants. Indeed patients with TBI have significant problems with irritability after injuries, and thus a more specific assessment tool to carefully evaluate patients' irritability should be used.

There is evidence that individuals with an acquired brain injury (ABI) are at increased risk of developing psychological problems and that they commonly experience difficulties in social communication, associated with poorer long-term outcomes. Although several relevant group interventions have been evaluated, there has been limited exploration of the feasibility of an ABI inpatient intervention. This nonrandomised pilot study tested the feasibility of an inpatient multidisciplinary social communication and coping skills group intervention within 1-year post traumatic/nontraumatic ABI. Seven participants completed a 4-week group program (3 × 1 hour sessions per week) facilitated by a speech pathologist and clinical psychologist and were assessed pre/post intervention and at 3 months with the La Trobe Communication Questionnaire, Correct Information Unit analysis, Hospital Anxiety and Depression Scale, Mini International Neuropsychiatric Interview, Coping Self-Efficacy scale and World Health Organization Quality of Life assessment. Most participants improved between baseline and 3 months post intervention in terms of greater informativeness and efficiency of connected speech and reduced anxiety and they provided positive feedback about the group program. Despite the challenges and limitations of this pilot study, the findings are encouraging and support both the value and feasibility of developing such a program into routine inpatient rehabilitation services.

Stroke is a preventable disease leading to physical, cognitive and emotional disability. Its high prevalence and poor outcome shifts this disease from the clinical, medical realm to a significant public health problem. This article provides an overview of the problem, and the status of stroke prevention in the Australian context. To achieve this, it first examines the recent Australian surveillance data on stroke, identifying the at-risk groups. It then argues for targeted stroke prevention, assesses relevant policies and programs in the international and Australian contexts, and briefly reviews approaches for increased awareness and recognition of stroke symptoms. The article concludes by emphasising the need to account for the at-risk-groups when developing targeted health promotion campaigns for effective prevention of stroke in Australia.

The cognitive symptoms that characterise the Wernicke-Korsakoff's syndrome include anterograde amnesia, confabulation, temporal–spatial disorientation, severe apathy, poor awareness of one's own mental state and changes in executive functions. Such deficits may persist even after the clinical profile stabilises. There are no studies that report an intervention after the acute phase, possibly due to the complexity of these cases. This study provides a descriptive analysis of neuropsychological rehabilitation concomitant to the neurological and psychiatric treatment of a woman who presented the symptoms described by Korsakoff. The intervention focused on reducing the impact caused by the cognitive and behavioural sequelae in the patient's daily life. It described a 25-week neuropsychological program, providing education and compensatory strategies for the patient, and also orientation and support from 2 professional caregivers and family members. Quantitative and qualitative measures were used to evaluate the effect of the intervention on memory efficacy, emotional state and social participation. Both caregivers reported a decrease in the frequency of memory lapses after treatment. Positive changes were also seen in self-care, activities at home, decision-making and participation in social activities. It is concluded that this case achieved results through the collaboration between members of an interdisciplinary team and caregivers providing daily support.