No abstract

Sleep disturbance after mild traumatic brain injury (mTBI) is commonly reported as debilitating and persistent. However, the nature of this disturbance is poorly understood. This study sought to characterize sleep after mTBI compared with a control group. A cross-sectional matched case control design was used. Thirty-three persons with recent mTBI (1-6 months ago) and 33 age, sex, and ethnicity matched controls completed established questionnaires of sleep quality, quantity, timing, and sleep-related daytime impairment. The mTBI participants were compared with an independent sample of close-matched controls (CMCs; n = 33) to allow partial internal replication. Compared with controls, persons with mTBI reported significantly greater sleep disturbance, more severe insomnia symptoms, a longer duration of wake after sleep onset, and greater sleep-related impairment (all medium to large effects, Cohen's d > 0.5). No differences were found in sleep quantity, timing, sleep onset latency, sleep efficiency, or daytime sleepiness. All findings except a measure of sleep timing (i.e., sleep midpoint) were replicated for CMCs. These results indicate a difference in the magnitude and nature of perceived sleep disturbance after mTBI compared with controls, where persons with mTBI report poorer sleep quality and greater sleep-related impairment. Sleep quantity and timing did not differ between the groups. These preliminary findings should guide the provision of clearer advice to patients about the aspects of their sleep that may change after mTBI and could inform treatment selection.

Verbal behavior plays a fundamental role in the development of complex social and communication skills. Many children diagnosed with autism spectrum disorder exhibit profound deficiencies in intraverbal repertoires and the development of social relationships. Recent studies that investigated the effects of intraverbal training on the emergence of reverse intraverbals produced mixed results (e.g., Perez-Gonzalez et al., Journal of Applied Behavior Analysis 40: [697][698][699][700][701] 2007)). In the current study, a multiple-probe design across four participants with autism was used to evaluate the effects of intraverbal training on the emergence of reverse intraverbals. Intraverbal training consisted of multiple exemplars taught concurrently, bidirectional stimulusresponse teaching formats, general case analysis, reinforcement, and a constant prompt delay (CPD) procedure. Participants were trained on intraverbal targets and probes were conducted to assess emergence of untaught reverse intraverbals. Three participants demonstrated the emergence of reverse intraverbals as a result of the intraverbal training procedures. Social validity and maintenance of target responses and emergent reverse intraverbals were assessed.

Lighting is an important component of indoor environmental quality that can affect occupant satisfaction, well-being and productivity. Lighting quality is a broad abstract concept and this has implications for its assessment. Subjective evaluations of lighting are an important complement to objective photometric information; however, there is limited existing guidance for the selection of such measures. We review and highlight the advantages and limitations associated with measures of general lighting quality and discomfort glare. Existing measures of lighting quality have broad coverage of individual lighting features but do not always clearly form cohesive scales measuring an underlying construct. Questions used in experimental glare research focus narrowly on glare severity, with ambiguous response rating scales. There is a need for the development of reliable and valid tools to assess lighting quality and its components, with clearly defined definitions and constructs, and explicit reporting of psychometric scale properties. The development of rigorous self-report tools will improve the understanding and design of quality lighting environments. ARTICLE HISTORY

The primary objective was to determine if poor sleep predicts postconcussion symptoms in the subacute period after mild traumatic brain injury (TBI). The impact of poor sleep pre- and post-injury was examined. The research design was cross-sectional. After screening to detect response invalidity, 61 individuals with a self-reported history of mild TBI 1-to-6 months prior answered an online fixed order battery of standardized questionnaires assessing their sleep (current and preinjury) and persistent postconcussion symptoms (Neurobehavioral Symptom Inventory, minus sleep, and fatigue items). The sleep measures were the Insomnia Severity Index, Epworth Sleepiness Scale, a single Likert-scale pre-injury sleep quality rating, and two PROMIS™ measures (sleep-related impairment and sleep disturbance). After controlling for the effects of preinjury sleep quality and demographics, the combination of the sleep measures made a significant contribution to the outcome (F[8,58] = 4.013, p = .001, [Formula: see text]). Only current sleep-related impairment (ß = .60, p < .05) made a significant and unique contribution to neurobehavioral symptoms. Preinjury sleep was not a predictor (ß = -.19, p > .05), although it contributed 3% of the variance in NSI scores after controlling for demographics. Sleep-related impairment is a modifiable factor. As a significant contributor to neurobehavioral symptoms, treatment for post-injury sleep-related impairment warrants further attention.