Executive dysfunction is common following brain injury, with impairments involving attention, social pragmatics, higher-order thinking, judgment, and reasoning. Executive function impairments may have a direct impact on an individual's ability to return to instrumental activities of daily living (IADL), including employment, money management, driving, and maintaining a residence. Research has shown that neuropsychological executive function measures may be able to predict daily-living skills. There is limited research evaluating the relationship between executive functions and IADLs in adults with acquired brain injuries (ABI), with none investigating levels of proficiency as related to specific test scores. We hypothesize that neuropsychological executive function measures will have significant and moderate-to-strong correlations with participant-rated proficiency on functional tasks as measured by the Mayo-Portland Adaptability Inventory. Results support that IQ and some of the executive function measures (Processing Speed, Working Memory, and Trail-Making Test-Part B) correlated significantly and strongly and explained unique variance in all IADLs in this study. Data suggest that individuals with ABI who performed in the higher end of the low-average range or higher on measures of executive functioning tend to require little or no assistance to be independent with transportation, money management, living without support, and employment. Results also suggest that individuals with less executive dysfunction are likely to have greater overall community participation.
Gestational diabetes is a common complication of pregnancy and occurs in approximately 7% of all pregnancies. It has been associated with an increased rate of congenital anomalies including disturbances of intrauterine growth, delayed brain maturity, and neurobehavioral abnormalities in the offspring. The resulting maternal and fetal metabolic dysfunction leads to diminished iron stores (which can affect red blood cell [RBC] production and subsequent organogenesis), a metabolism-placental perfusion mismatch, increased FFA, increased lactic acidosis, and potential hypoxia. Though most newborns born in the context of gestational diabetes are not significantly affected by it, empirical research suggests gestational diabetes has been associated with lower general intelligence, language impairments, attention weaknesses, impulsivity, and behavioral problems. In extreme cases, it may essentially function as a gestational brain insult. Children who are exposed to poorly controlled gestational diabetes may benefit from some form of tracking or follow-up assessments. Additionally, clinicians evaluating children with developmental learning or cognitive dysfunction may want to seek appropriate gestational diabetes-related information from the parents. A greater understanding of this significant gestational risk may help foster improved prenatal diabetes management and may help reduce the neurodevelopmental effects of gestational diabetes.
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