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Purpose: To describe the sociodemographic and cognitive profile of participants enrolled in an adapted driving program for individuals with neurological conditions, to explore the association between cognitive functioning and driving program outcome, and to describe driving habits after program completion., Methods: This study combined retrospective chart review and cross-sectional data collection., Results: The sample included 71 participants with neurological disorders (aged 15-56 years, M  = 22.2 ± 8.6; 39% women). Driving program was either successful (47%), failed (7%), discontinued (34%), or ongoing (13%). Among 35 participants with complete neuropsychological and driving program outcome data, those who successfully completed the program showed better attention functioning, and better performance relative to global functioning for attention, executive functions, and working memory, compared to those who discontinued/failed the program. Among 21 participants who completed a telephone questionnaire on average 3.7 years after program enrollment, 67% obtained their driver's license and drove regularly. Participants reported high levels of satisfaction with the program., Conclusion: These results suggest that approximately half of the persons enrolled in a driver training program designed for learners with neurological conditions, obtain a driver's license; and that attention, and to a lesser extent executive functioning and working memory, are related to driving program success.IMPLICATIONS FOR REHABILITATIONIn individual with neurological conditions, learning how to drive can be challenging.An adapted driver training program, involving collaboration between driving instructors and healthcare professionals, simplification of theoretical learning, and increasing driving practice opportunities, can be effective, both in terms of licensing success and client satisfaction.Conducting a pre-driving program neuropsychological assessment, with identification of cognitive strengths and weaknesses, can provide valuable information for clinicians and driving instructors for optimizing training and predicting outcome.Better performance in attention, and better relative to global cognitive functioning in attention, executive functions, and working memory, are related to higher success rate of an adapted driving program.

Objectives: To describe the use of mobile devices after acquired brain injury (ABI), from the perspectives of injured individuals and significant others, and to examine factors associated with mobile device use for cognition., Methods: Cross-sectional study with 50 adults with moderate/severe traumatic brain injury or stroke (42% women; mean of 50.7 years old, 4.6 years post-ABI), and 24 significant others. Participants completed questionnaires on mobile technology, cognitive functioning and the impact of technology., Results: Of 45/50 adults with ABI who owned a smartphone/tablet, 31% reported difficulties in using their device post-injury, 44% had received support, and 46% were interested in further training. Significant others reported motor/visual impairments and the fear of becoming dependent on technology as barriers for mobile device use, and 65% mentioned that their injured relative needed additional support. Mobile device use for cognition was common (64%), predicted in a regression model by lower subjective memory and more positive perception of the psychosocial impacts of technology, and also associated in univariate analyses with younger age, lower executive functioning, and greater use of memory strategies., Conclusion: Using mobile devices for cognition is common post-ABI but remains challenging for a significant proportion. Developing training approaches may help supporting technology use.

Objectives: Individuals with insomnia consistently report difficulties pertaining to their cognitive functioning (e.g., memory, concentration). However, objective measurements of their performance on neuropsychological tests have produced inconsistent findings. This meta-analysis was conducted to provide a quantitative summary of evidence regarding the magnitude of differences between individuals with primary insomnia and normal sleepers on a broad range of neuropsychological measures., Methods: Reference databases (PubMed, PsycInfo, Dissertation Abstracts International) were searched for studies comparing adults with primary insomnia to normal sleepers on neuropsychological measures. Dependent variables related to cognitive and psychomotor performance were extracted from each study. Variables were classified independently by two licensed neuropsychologists according to the main cognitive function being measured. Individual effect sizes (Cohen's d) were weighted by variability and combined for each cognitive function using a fixed effects model. Average effect sizes and their 95% confidence intervals were computed for each cognitive function., Results: Twenty-four studies met inclusion criteria, for a total of 639 individuals with insomnia and 558 normal sleepers. Significant impairments (p<0.05) of small to moderate magnitude were found in individuals with insomnia for tasks assessing episodic memory (ES = -0.51), problem solving (ES = -0.42), manipulation in working memory (ES = -0.42), and retention in working memory (ES = -0.22). No significant group differences were observed for tasks assessing general cognitive function, perceptual and psychomotor processes, procedural learning, verbal functions, different dimensions of attention (alertness, complex reaction time, speed of information processing, selective attention, sustained attention/vigilance) and some aspects of executive functioning (verbal fluency, cognitive flexibility)., Conclusion: Individuals with insomnia exhibit performance impairments for several cognitive functions, including working memory, episodic memory and some aspects of executive functioning. While the data suggests that these impairments are of small to moderate magnitude, further research using more ecologically valid measures and normative data are warranted to establish their clinical significance., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

People with acquired brain injuries (ABI) face financial challenges that affect their daily lives. Managing finances is a crucial activity that can help avoid social isolation. However, this task becomes difficult for people with ABI because of their cognitive impairments. Recent advances in digital technology can help people with ABI manage their finances more effectively. This study aims to identify and describe available digital tools that can help ABI in budget management, and identify their effectiveness, barriers and facilitators to implementation. To address this issue, we conducted a rapid review of academic databases followed by a modified Google/Google Scholar search to identify the digital tools to support budgeting tasks (DBT) used and tested by people with ABI. Our rapid review included only two articles on the use of DBT. The first study showed that common portable electronic devices were acceptable and desirable as memory and organisational aids for people with ABI. The second study documented the development of a DBT and the perception of users (research participants) who found it appealing and user-friendly. However, for both articles, the technologies used are outdated and lack information on barriers and facilitators to using DBT. In conclusion, this literature review revealed that digital technologies have the potential to support budget management in people with ABI, but technology needs to be made available on the market to benefit the users. Further research and development are needed to create new ways to help people with brain injuries manage their budgets. IMPLICATIONS FOR REHABILITATION: Our study showed limited literature involving appropriate digital tools to support budgeting task (DBT) to meet the needs of people with acquired brain injury (ABI) to manage their budgets. Therefore, further research is encouraged to develop digital tools adapted to the budgeting needs and cognitive impairments of people with ABI and their socio-cultural environment. Our paper provides recommendations to develop human-centred digital solutions to help people with ABI manage their budgets, that are accessible, reliable and sustainable. Mixed methods and mix of methods are highly recommended in this regard. [ABSTRACT FROM AUTHOR]

This study aimed to (1) document the profile of individuals with neurological conditions who participated in an adapted training program to obtain their first driver's license, (2) explore the relationship between cognitive functioning and program outcome, and (3) describe the users' experience before, during, and after the adapted driving program. Mixed-methods design including retrospective chart review and prospective cross-sectional data collection. Adapted driver training program in a rehabilitation center (CIUSSS de la Capitale-Nationale, Québec, QC, Canada). The sample included 71 individuals (39% women; mean age = 22.2 +/- 8.6 years) with developmental or acquired neurological conditions who participated in an adapted driving program (Objective 1). Of this number, 35 participants had complete neuropsychological and driving program outcome data (Objective 2), and 12 participated in a qualitative interview (Objective 3). Not applicable. Program outcome (success, failure/discontinuation), neuropsychological data (indices of global cognitive functioning, processing speed, working memory, attention, visuospatial skills, and executive functioning), individual qualitative interviews. Among the 71 participants, the driving program was successfully completed for 47%, failed for 7%, discontinued for 34%, and ongoing for 13%. Participants who successfully completed the program (n=15) showed better attention functioning, and better performance relative to global functioning in attention, executive functioning, and working memory, compared to those who failed/discontinued (n=20). Qualitative data provided enriched information about the participants' motivation to learn to drive (e.g., important personal goal, self-determination, fear of failure), repercussion of program success (e.g., personal and professional development opportunities) or failure (e.g., emotional response, alternative transportation means), and key adaptations of the driving program (e.g., team spirit, individualized teaching). Adapted training is effective in helping individuals with neurological conditions to learn to drive. Attention, and to a lesser extent executive functioning and working memory, play a key role in driving program success. Knowledge on the repercussions of obtaining or failing to obtain their driver's license could help further adapt and support driving training for individuals with neurological conditions. The authors report no conflicts of interest. [ABSTRACT FROM AUTHOR]

The objectives of this study were to compare individuals with traumatic brain injury (TBI) and healthy controls on neuropsychological tests of attention and driving simulation performance, and explore their relationships with participants’ characteristics, sleep, sleepiness, and fatigue. Participants were 22 adults with moderate or severe TBI (time since injury ≥ one year) and 22 matched controls. They completed three neuropsychological tests of attention, a driving simulator task, night-time polysomnographic recordings, and subjective ratings of sleepiness and fatigue. Results showed that participants with TBI exhibited poorer performance compared to controls on measures tapping speed of information processing and sustained attention, but not on selective attention measures. On the driving simulator task, a greater variability of the vehicle lateral position was observed in the TBI group. Poorer performance on specific subsets of neuropsychological variables was associated with poorer sleep continuity in the TBI group, and with a greater increase in subjective sleepiness in both groups. No significant relationship was found between cognitive performance and fatigue. These findings add to the existing evidence that speed of information processing is still impaired several years after moderate to severe TBI. Sustained attention could also be compromised. Attention seems to be associated with sleep continuity and daytime sleepiness; this interaction needs to be explored further. [ABSTRACT FROM PUBLISHER]

Objectives To describe the cognitive functioning of independent community-dwelling elderly adults visiting the emergency department ( ED) for minor injuries and at 3- and 6-month follow-up assessments and to document the occurrence of falls, return to the ED, and hospital visits over time according to cognitive level. Design Prospective cohort study. Setting Three Canadian EDs. Participants Individuals aged 65 and older who were independent in basic activities of daily living, visiting the ED for minor injuries, and discharged home within 48 hours (N = 320). Measurements Participants completed the Montreal Cognitive Assessment ( Mo CA). New falls involving pain and ED or hospital visits were documented at 3 and 6 months. Results At baseline, 62.4% of participants scored below the recommended cutoff of 26 on the Mo CA, suggesting cognitive dysfunction, and 22.9% scored below a more-stringent cutoff of 21. Mo CA scores had improved significantly at 3 and 6 months. Items showing the most improvement were delayed recall and verbal fluency. Persons with Mo CA scores of less than 21 reported significantly more new falls and hospital visits 3 to 6 months after injury. Conclusion Cognition is not optimal in many community-dwelling elderly adults visiting an ED for a minor injury, which may affect their capacity to comprehend, recall, and adhere to medical recommendations after their injury and put them at risk of further negative health events such as falls. [ABSTRACT FROM AUTHOR]