Charles Christiansen

Task performance in virtual environments used for cognitive rehabilitation after traumatic brain injury

OBJECTIVE This report describes a reliability study using a prototype computer-simulated virtual environment to assess basic daily living skills in a sample of persons with traumatic brain injury (TBI). The benefits of using virtual reality in training for situations where safety is a factor have been established in defense and industry, but have not been demonstrated in rehabilitation. SUBJECTS Thirty subjects with TBI receiving comprehensive rehabilitation services at a residential facility. METHODS An immersive virtual kitchen was developed in which a meal preparation task involving multiple steps could be performed. The prototype was tested using subjects who completed the task twice within 7 days. RESULTS The stability of performance was estimated using intraclass correlation coefficients (ICCs). The ICC value for total performance based on all steps involved in the meal preparation task was .73. When three items with low variance were removed the ICC improved to .81. Little evidence of vestibular optical side-effects was noted in the subjects tested. CONCLUSION Adequate initial reliability exists to continue development of the environment as an assessment and training prototype for persons with brain injury.

A proposed model of lifestyle balance

The concept of lifestyle balance seems to have widespread acceptance in the popular press. The notion that certain lifestyle configurations might lend to better health, higher levels of life satisfaction and general well‐being is readily endorsed. However, the concept has not been given significant attention in the social and behavioral sciences literature and, as a result, lacks empirical support, and an agreed upon definition. This article presents a proposed model of lifestyle balance based on a synthesis of related research, asserting that balance is a perceived congruence between desired and actual patterns of occupation across five proposed need‐based occupational dimensions seen as necessary for wellbeing. It is asserted that the extent to which people find congruence and sustainability in these patterns of occupation that meet biological and psychological needs within their unique environments can lead to reduced stress, improved health, and greater life satisfaction.

Lifestyle Balance: A Review of Concepts and Research

Abstract The perceived stress of time‐pressures related to modern life in Western nations has heightened public interest in how lifestyles can be balanced. Conditions of apparent imbalance, such as workaholism, burnout, insomnia, obesity and circadian desynchronosis, are ubiquitous and have been linked to adverse health consequences. Despite this, little research has been devoted to the study of healthy lifestyle patterns. This paper traces the concept of lifestyle balance from early history, continuing with the mental hygiene movement of the early twentieth century, and extending to the present. Relevant threads of theory and research pertaining to time use, psychological need satisfaction, role‐balance, and the rhythm and timing of activities are summarized and critiqued. The paper identifies research opportunities for occupational scientists and occupational therapists, and proposes that future studies connect existing research across a common link—the identification of occupational patterns that reduce stress. The importance of such studies to guide health promotion, disease prevention and social policy decisions necessary for population health in the 21st century is emphasized.

Virtual reality in the assessment of selected cognitive function after brain injury

Zhang L, Abreu BC, Masel B, Scheibel RS, Christiansen CH, Huddleston N, Ottenbacher KJ: Virtual reality in the assessment of selected cognitive function after brain injury. Am J Phys Med Rehabil 2001;80:597–604. ObjectiveTo assess selected cognitive functions of persons with traumatic brain injury using a computer-simulated virtual reality environment. Study DesignA computer-simulated virtual kitchen was used to assess the ability of 30 patients with brain injury and 30 volunteers without brain injury to process and sequence information. The overall assessment score was based on the number of correct responses and the time needed to complete daily living tasks. Identical daily living tasks were tested and scored in participants with and without brain injury. Each subject was evaluated twice within 7 to 10 days. A total of 30 tasks were categorized as follows: information processing, problem solving, logical sequencing, and speed of responding. ResultsPersons with brain injuries consistently demonstrated a significant decrease in the ability to process information (P = 0.04–0.01), identify logical sequencing (P = 0.04–0.01), and complete the overall assessment (P < 0.01), compared with volunteers without brain injury. The time needed to process tasks, representing speed of cognitive responding, was also significantly different between the two groups (P < 0.01). ConclusionA computer-generated virtual reality environment represents a reproducible tool to assess selected cognitive functions and can be used as a supplement to traditional rehabilitation assessment in persons with acquired brain injury.

Identity, personal projects and happiness: Self construction in everyday action

Abstract This study reviewed archival data from 120 adults ages 19–79 in order to explore the identity‐related dimensions of their personal projects. Influenced by recent findings in action psychology that suggest a key link between the identity dimensions of projects, and both meaning and happiness or subjective‐well being (SWB), it was hypothesized that project ratings on various dimensions would show the central influence of self‐identity within project systems and significantly predict SWB. Analysis of factors extracted from project dimensions revealed that projects influence happiness based on their beneficial impact and their ability to enable self‐expression, demonstrate social significance, and reflect confidence. The challenge offered by a project and the overall effort required completing it also account for variance in measures of well‐being. For the overall sample, the self‐expression factor emerged as a significant predictor of SWB. When individual sub samples grouped by age were analyzed, different patterns emerged. Only the perceived social significance of projects emerged as a predictor of SWB in all three age groups. Additional analyses designed to explore the project dimensions of integrity (being genuine) and efficacy (getting the job done) were also conducted. These also showed differences among the subgroups, which were interpreted in light of developmental theories of adulthood. Overall, the findings supported a constructionist view that goal directed projects provide important opportunities for shaping identity.

Classification and study in occupation a review and discussion of taxonomies

Abstract This paper identifies classification, or the building of taxonomies, as a fundamental step in the development of knowledge. The history and purposes of taxonomies are briefly reviewed, and extant taxonomies relevant to the study of occupation are examined. These classification systems are found in the psychological, sociological, and vocational literature, and address motivation, meaning, the structure and organization of intentional behaviour, personality, and human performance. The paper concludes that researchers studying occupation will need to become familiar with a diverse theoretical and methodological literature in the social and behavioural sciences before significant advances can be made.

Changing educational paradigms to prepare allied health professionals for the 21st century

CONTEXT Inefficient and ineffective health care delivery has been of recent concern to most stakeholders in the process. Care provision systems will improve when care providers are educated to function as team members and to demonstrate competencies required for practice in diverse, demanding, and ever-changing environments. GOAL In one School of Allied Health Sciences, faculty members from nine departments united to create an interdisciplinary curriculum designed to foster the achievement of common competencies essential for success in the workplace. APPROACH Members of a Curriculum-2000 Task Force collaborated to: (1) review current literature, (2) articulate a set of common competencies across several disciplines, and (3) produce a proposal for achieving and measuring competencies in an interdisciplinary manner. CONCLUSION Individuals from various disciplines can come to consensus about competencies that graduates should achieve. Such consensus is the first step in the direction of implementing a curriculum based on interdisciplinary competencies.

Adolf Meyer Revisited: Connections between Lifestyles, Resilience and Illness

Abstract Adolf Meyer, whose theory of psychobiology represented one of the most insightful and important approaches to understanding mental illness in the early 20th century, insisted that humans could be understood best through consideration of their activities as experienced on a daily basis and over the life course. During Meyers era, changes were occurring at an unprecedented pace including increased cultural diversity, social upheavals and technological advances. These, in turn, were associated with emotional, psychological, and behavioral problems. In many ways, the changes wrought during the early twentieth century parallel the challenges of our current age. This paper argues that Meyers holistic, integrated, and life focused framework provides a timeless context for viewing the inextricable nature of mind and body, explaining the links between stressors of the modern era and illness. I review the emerging literature on psychoneuroimmunology and make the compelling case that lifestyle and daily occupations remain, as Meyer envisioned, important determinants of health and illness. Further, I take the position that lifestyle related stress results from our inability, through daily activity, to meet important and perhaps universal human needs. I discuss empirical evidence that supports this case. I conclude with a call for public efforts to create conditions and opportunities that promote resilience and foster the life balance necessary to sustain health and well‐being.

How Does One Develop and Document the Skills Needed to Assume a Deanship in Higher Education

Senior leadership positions in higher education generally require evidence of demonstrated success in mid-level academic administration, a knowledge of the principal issues influencing governance in universities, a working knowledge of public relations and fundraising, and the ability to transcend one’s current discipline and look objectively at the needs of an academic unit serving many disciplines in relation to the institution at large. It is useful to elaborate on each of these requirements in more detail. First, a viable candidate for a deanship must generally show evidence of demonstrated ability at the administrative level just below the position being sought. For a dean, this would most often mean serving as a successful academic unit head, either as a chairperson of an academic department or as a director of a program. Success would be measured by such factors as years of experience (usually completing at least one typical term of service, 3-5 years) and other measures of administrative effectiveness, such as meeting enroll-