Alicia C. Allan

The role of psychological resilience and mTBI as predictors of postconcussional syndrome symptomatology.

OBJECTIVE Resilience is 1 of several factors that are thought to contribute to outcome following mild traumatic brain injury (mTBI). This study explored the predictors of the postconcussional syndrome (PCS) symptoms that can occur following mTBI. We hypothesized that a reported recent mTBI and lower psychological resilience would predict worse reported PCS symptomatology. METHOD 233 participants completed the Neurobehavioral Symptom Inventory (NSI) and the Brief Resilience Scale (BRS). Three NSI scores were used to define PCS symptomatology. A total of 35 participants reported an mTBI (as operationally defined by the World Health Organization) that was sustained between 1 and 6 months prior to their participation (positive mTBI history); the remainder reported having never had an mTBI. RESULTS Regression analyses revealed that a positive reported recent mTBI history and lower psychological resilience were significant independent predictors of reported PCS symptomatology. These results were found for the 3 PCS scores from the NSI, including using a stringent caseness criterion, p < .05. Demographic variables (age and gender) were not related to outcome, with the exception of education in some analyses. CONCLUSION The results demonstrate that: (a) both perceived psychological resilience and mTBI history play a role in whether or not PCS symptoms are experienced, even when demographic variables are considered, and (b) of these 2 variables, lower perceived psychological resilience was the strongest predictor of PCS-like symptomatology.

Environmental Light Exposure Is Associated with Increased Body Mass in Children

The timing, intensity, and duration of exposure to both artificial and natural light have acute metabolic and physiological effects in mammals. Recent research in human adults suggests exposure to moderate intensity light later in the day is concurrently associated with increased body mass; however, no studies have investigated the effect of light exposure on body mass in young children. We examined objectively measured light exposure and body mass of 48 preschool-aged children at baseline, and measured their body mass again 12 months later. At baseline, moderate intensity light exposure earlier in the day was associated with increased body mass index (BMI). Increased duration of light exposure at baseline predicted increased BMI 12-months later, even after controlling for baseline sleep duration, sleep timing, BMI, and activity. The findings identify that light exposure may be a contributor to the obesogenic environment during early childhood.

Assessment method influences the severity and type of symptoms reported after self-reported mild traumatic brain injury

Objective: To investigate the influence of assessment method (spontaneous report versus checklist) on the report of postconcussive syndrome (PCS) symptoms after mild traumatic brain injury (mTBI). Setting: Community. Participants: Thirty-six participants (58% female) with postacute self-reported mTBI (i.e., sustained 1–6 months prior to participation) and 36 age-, gender-, and ethnicity-matched controls with no history of mTBI. Design: Cross-sectional. Main measures: Spontaneous symptom report from open-ended questions and checklist endorsed symptoms from the Neurobehavioral Symptom Inventory (both measures administered online). Results: Assessment method significantly affected individual symptom item frequencies (small to large effects), the number of symptoms reported, the total severity score, domain severity scores (i.e., somatic/sensory, cognitive, and affective symptom domains), and the number of participants who met a PCS caseness criterion (large effects; checklist > spontaneous report). The types of symptoms that were different between the groups differed for the assessment methods: Compared to controls, the nonclinical mTBI group spontaneously reported significantly greater somatic/sensory and cognitive domain severity scores, whilst no domain severity scores differed between groups when endorsed on a checklist. Conclusions: Assessment method can alter the number, severity, and types of symptoms reported by individuals who have sustained an mTBI and could potentially influence clinical decisions.

Actigraphically Measured Sleep-wake Behavior After Mild Traumatic Brain Injury: A Case-control Study

Objective: To characterize and compare the sleep-wake behavior of individuals following a mild traumatic brain injury (mTBI) with that of noninjured healthy controls. Setting: Community. Participants: Fourteen participants with a recent mTBI (Mage = 28.07; SD = 10.45; n = 10 females) and 34 noninjured controls (Mage = 23.70; SD = 7.30; n = 31 females). Design: Cross-sectional. Main Measures: Battery of subjective sleep measures and 14 days of sleep-wake monitoring via actigraphy (objective measurement) and concurrent daily sleep diary. Results: Participants who had sustained an mTBI self-reported significantly higher sleep-related impairment, poorer nightly sleep quality, and more frequently met criteria for clinical insomnia, compared with controls (d = 0.76-1.11, large effects). The only significant between-group difference on objective sleep metrics occurred on sleep timing. On average, people with a recent history of mTBI fell asleep and woke approximately 1 hour earlier than did the controls (d = 0.62-0.92, medium to large effects). Conclusion: Participants with a history of mTBI had several subjective sleep complaints but relatively few objective sleep changes with the exception of earlier sleep timing. Future research is needed to understand the clinical significance of these findings and how these symptoms can be alleviated. Interventions addressing subjective sleep complaints (eg, cognitive behavior therapy for insomnia) should be tested in this population.

EVALUATING VISUAL COMFORT IN OPEN-PLAN OFFICES: EXPLORATION OF SIMPLE METHODS FOR EVALUATION AND PREDICTION

As changes to building design increase the presence of daylight in the office environment, there is an increased need to account for and manage resulting potential visual discomfort. The efficient and accurate prediction of glare is an ongoing process, and the applicability of thresholds for the classification of glare in field settings is still being evaluated. This study assesses the effectiveness of measured and simulated lighting metrics in distinguishing uncomfortable lighting conditions in a sample of long-term open-plan office occupants in a subtropical setting. Evaluated metrics both under and over-predicted glare. Implications for further examination of thresholds in field settings and the prediction of glare at the design stage are discussed.