The objective of the present study was to develop a scale designed to assess the consequences of working memory deficits in everyday life. The Working Memory Questionnaire (WMQ) is a self-administered scale, addressing three dimensions of working memory: short-term storage, attention, and executive control. The normative sample included 313 healthy participants. The patient group included 69 brain injured patients, who were compared to a subsample of 69 matched healthy controls. The questionnaire was found to have a good internal consistency, both in healthy participants and in patients with brain injury (Cronbach's alpha = .89 and .94, respectively). In healthy participants, significant effects of age (p < .0001) and education (p < .01) were found, due to more complaints in participants aged 60 or more and (unexpectedly) in those aged below 30, and for less educated participants, below high school level. The WMQ was found to have the sensitivity to discriminate patients from matched controls, in the three domains (p < .0001). A good concurrent validity was found with the Cognitive Failure Questionnaire and the Rating Scale of Attentional Behaviour (Spearman's Rho = .90 and .81, respectively, both ps < .0001). In addition, the total complaint score significantly correlated with neuropsychological measures of working memory (visual spans and short-term memory with interference) and with global intellectual efficiency (Raven's Matrices) but not with digit spans. Further studies are needed to measure the internal structure of the scale, and to compare self- and proxy-ratings.
Les deficits de l’attention, de la memoire de travail et des fonctions executives font partie des sequelles cognitives les plus invalidantes des lesions cerebrales. Plusieurs etudes recentes ont montre que des programmes de reentrainement cognitif specifique pouvaient reduire ces deficits, avec une amelioration dans la vie quotidienne. Les traitements de l’anosognosie et des troubles du comportement ont ete moins evalues.
The objective of this study was to evaluate the level of healing of chronic neuropathic plantar ulcers, using an irremovable windowed fibreglass cast boot, which is only opened after healing. A single-centre prospective study of a cohort of 177 diabetic patients with chronic neuropathic plantar ulcers was carried out. The duration of neuropathic plantar ulcers was 604 ± 808 days, with a mean surface area of 4.6 ± 6.5 cm(2) , a mean depth of 1.04 ± 1.08 cm and a mean volume of 5.9 ± 17.7 cm(3) . After a mean of 96 days of wearing a windowed fibreglass cast boot (min 9 days, max 664 days and median 68 days), the level of healing reached 83.6%, although 29 patients did not heal (16.4%). The compliance was at 95%. NPUs with bigger volumes (p = 0.037) and those located at the heels ( p = 0.004) had significantly lower healing levels. Twenty-one patients had moderate peripheral arterial disease (12%), and 24 patients were ostectomized for underlying osteomyelitis (14%), before inclusion. Moderate peripheral arterial disease (p = 0.970) or operated osteomyelitis (p = 0.128) did not modify the level of healing significantly, which were of 81% and 70.8%, respectively. Complications include 12 ulcers due to the windowed fibreglass cast boot (i.e. 7%) and two other ulcers being moderately infected, resulting in 2% of toe amputation, but there was no major amputation or phlebitis. The treatment of old and deep NPUs of the diabetic foot by wearing a windowed fibreglass cast boot without opening the boot prior to healing offers very high ulcer recovery levels. Windowed fibreglass cast boots were changed in only 26 cases (14.6%). In addition, compliance was excellent and of the order of 95%. Furthermore, moderate peripheral arterial disease or a recent ostectomy did not affect the efficacy of windowed fibreglass cast boot.
Purpose: People with traumatic brain injury are frequently involved in a litigation because another person was at fault for causing the accident. A compensation amount will often be settled to compensate the victim for the past, present, future damages and losses suffered. We report descriptive data about the full and final personal compensation amount and investigated its association with patient's outcomes. Methods: We used a longitudinal prospective study of severe TBI patients injured in 2005-2007 (PariS-TBI). Questions regarding involvement in a litigation were asked concurrently with 4 and 8-year outcomes. Results: Among 160 participants assessed 4 and/or 8 years post-injury, a total of 67 persons declared being involved in a litigation, among which 38 people reported a compensation amount of a mean €292,653 (standard deviation = 436,334; interquartile 25-50-75 = 37,000-100,000-500,000; minimum = 1,500-maximum = 2,000,000). A higher compensation amount was associated with more severe disability and cognitive impairment in patients, and with more informal care time provided by caregivers. However, no significant association related to patient's gender, age, years of education, motor/balance impairment, return to work status, mood and related to caregiver's subjective burden was found. Conclusion: Financial compensation was related to victims' long-term severity of impairment, although some extreme cases with severe disability were granted very poor compensation.
