Indigenous Theory Building for Māori Children and Adolescents with Traumatic Brain Injury and their Extended Family

2013 ◽  
Vol 14 (3) ◽  
pp. 406-414 ◽  
Author(s):  
Hinemoa Elder
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Extended Family ◽  
Child And Adolescent ◽  
Specific Aspect ◽  
The Body ◽  
Brain Anatomy ◽  
Indigenous Research ◽  
Anatomy And Physiology ◽  
Indigenous Theory

Background: International research identifies indigeneity as a risk factor for traumatic brain injury (TBI). Aotearoa New Zealand studies show that mokopuna (grandchildren; used here to encompass the ages and stages of infant, child and adolescent development and those in young adulthood) are significantly overrepresented in TBI populations. The important role of whānau (family) is also well established in child and adolescent TBI scholarship. Despite awareness of these factors, no studies have been identified that explore whānau knowledge about mokopuna TBI. The aim of this study was to explore two questions: (1) What do Māori people say about mokopuna TBI in the context of the Māori cultural belief that the head is the most sacred part of the body? and (2) How could this information be used to build theory that could inform addressing the rehabilitation needs of this group?Method: Eighteen marae wānanga (culture-specific fora in traditional meeting houses) were held. The wānanga typically lasted approximately 2 hours. Footage and written transcripts were analysed using Rangahau Kaupapa Māori (Māori indigenous research methods).Results: The wairua theory of mokopuna TBI proposes that TBI not only injures brain anatomy and physiology but also injures wairua (defined here as a unique connection between Māori and all aspects of the universe). Injury to wairua means that culturally determined interventions are both indicated and expected. The wairua theory of mokopuna TBI thereby provides a guide to intervention.Conclusion: A Māori theory of mokopuna TBI has been identified which describes a culture-specific aspect of TBI. This theory proposes that pre-existing whānau knowledge salient to TBI is critical to optimising recovery. Further research is needed to test this theory not only in TBI but also in other areas such as in mental illness, neurodegenerative disease and addiction.

Te Waka Oranga: An Indigenous Intervention for Working with Māori Children and Adolescents with Traumatic Brain Injury

2013 ◽  
Vol 14 (3) ◽  
pp. 415-424 ◽  
Author(s):  
Hinemoa Elder
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Extended Family ◽  
Child And Adolescent ◽  
Vital Role ◽  
Cultural Knowledge ◽  
Knowledge Systems ◽  
Leading Role ◽  
Kaupapa Māori

Background: Application of salient cultural knowledge held by families following child and adolescent traumatic brain injury (TBI) has yet to be documented in the literature. While the importance of the family is a well-established determinant of enhanced outcomes in child and adolescent TBI, the emphasis to date has been on the leading role of professional knowledge. The role of whānau (extended family) is recognised as an essential aspect of hauora (wellbeing) for Māori, who are overrepresented in TBI populations. However, whānau knowledge systems as a potent resource for enhancing recovery outcomes have not previously been explored. This paper describes the development of an indigenous intervention, Te Waka Oranga.Method: Rangahau Kaupapa Māori (Māori determined research methods) theory building was used to develop a TBI intervention for working with Māori. The intervention emerged from the findings and analysis of data from 18 wānanga (culturally determined fora) held on rural, remote and urban marae (traditional meeting houses).Results: The intervention framework, called Te Waka Oranga, describes a process akin to teams of paddlers working together to move a waka (canoe, vessel) in a desired direction of recovery. This activity occurs within a Māori defined space, enabling both world views, that of the whānau and the clinical world, to work together. Whānau knowledge therefore has a vital role alongside clinical knowledge in maximising outcomes in mokopuna (infants, children, adolescents and young adults) with TBI.Conclusion: Te Waka Oranga provides for the equal participation of two knowledge systems, that of whānau and of clinical staff in their work in the context of mokopuna TBI. This framework challenges the existing paradigm of the role of families in child and adolescent TBI rehabilitation by highlighting the essential role of cultural knowledge and practices held within culturally determined groups. Further research is needed to test the intervention.

scholarly journals Study of Traumatic Brain Injury Due To Recent Earthquake in Manipal Teaching Hospital

2016 ◽  
Vol 12 (2) ◽  
pp. 63-66
Author(s):  
Bal G Karmacharya ◽  
Brijesh Sathian
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Teaching Hospital ◽  
Brain Injuries ◽  
Injury Severity ◽  
Traumatic Brain Injuries ◽  
The Body ◽  
Mild Head Injury ◽  
Associated Injuries

The objective of this study was to review the demographics, causes injury, severity, treatment and outcome of traumatic brain injuries in victims of the April 2015 earthquake who were admitted in Manipal Teaching Hospital, Pokhara. A total of 37 patients was admitted under Neurosurgery Services. Collapse of buildings was the commonest cause of head injury. The majority of them had mild head injury. Associated injuries to other parts of the body were present in 40.54% patients.Nepal Journal of Neuroscience 12:63-66, 2015

Interventions for Cancer Late Effects and Survivorship

2006 ◽  
Author(s):  
Robert W. Butler ◽  
Donna R. Copeland
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Pediatric Cancer ◽  
Late Effects ◽  
Extended Family ◽  
Family Members ◽  
Current Status ◽  
Major Life ◽  
Term Outcome ◽  
Life Threatening Illness

It is now generally accepted that the diagnosis of many pediatric cancers and their treatments result in significant and long-lasting neurocognitive, psychological, and psychosocial impairments and difficulties. The current status of research in this field has been addressed by other chapters in this text. We would, however, like to emphasize at the onset of our chapter that we firmly believe pediatric cancer is truly a family affair. The effects of the diagnosis of a life-threatening illness and its often-chronic treatment not only result in significant impact on the child’s or adolescent’s neuropsychological and psychological state, but also cause psychological ramifications for the parents, siblings, and extended family members. In healthy, well-functioning families, this major life obstacle can serve as an impetus to rally family members in support of the child. When this happens, interventions for late effects are beginning to be identified as effective and of potential benefit. This field, however, is clearly in its infancy. If the family is chaotic and struggling with relationship issues, the prognosis is less positive. Our clinical observations of these relationships are supported both by preliminary data from studies conducted by our research group and others, and by published manuscripts in the field of pediatric traumatic brain injury (Yeates et al., 1997, 2001). In one of the only studies investigating the impact of familial variables on psychosocial and neuropsychological outcome in pediatric brain tumor patients, the results are extremely consistent with the traumatic brain injury population (Carlson-Green, Morris, & Krawjecki, 1995). Reduced maternal dependence on external coping resources, higher parental socioeconomic status, dual-parent families, and familial cohesion were all identified as improving long-term outcome in this population, as documented by intellectual and behavioral integrity. The late effects of pediatric cancer and its treatment are physical, cognitive, psychological, and social. When multiple effects are present, they can be expected to result in a synergistic impact not only on the child, but also on other family members. The important point is that late effects should not be viewed in isolation or summated but should be appreciated for their interrelatedness.

scholarly journals Cognitive Training in Young Patients With Traumatic Brain Injury: A Fixel-Based Analysis

2019 ◽  
Vol 33 (10) ◽  
pp. 813-824 ◽  
Author(s):  
Helena Verhelst ◽  
Diana Giraldo ◽  
Catharine Vander Linden ◽  
Guy Vingerhoets ◽  
Ben Jeurissen ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
White Matter ◽  
Cognitive Functioning ◽  
Cognitive Training ◽  
Cognitive Assessment ◽  
Cognitive Intervention ◽  
The Body ◽  
Precentral Gyrus ◽  
Time Point

Background. Traumatic brain injury (TBI) is associated with altered white matter organization and impaired cognitive functioning. Objective. We aimed to investigate changes in white matter and cognitive functioning following computerized cognitive training. Methods. Sixteen adolescents with moderate-to-severe TBI (age 15.6 ± 1.8 years, 1.2-4.6 years postinjury) completed the 8-week BrainGames program and diffusion weighted imaging (DWI) and cognitive assessment at time point 1 (before training) and time point 2 (after training). Sixteen healthy controls (HC) (age 15.6 ± 1.8 years) completed DWI assessment at time point 1 and cognitive assessment at time point 1 and 2. Fixel-based analyses were used to examine fractional anisotropy (FA), mean diffusivity (MD), and fiber cross-section (FC) on a whole brain level and in tracts of interest. Results. Patients with TBI showed cognitive impairments and extensive areas with decreased FA and increased MD together with an increase in FC in the body of the corpus callosum and left superior longitudinal fasciculus (SLF) at time point 1. Patients improved significantly on the inhibition measure at time point 2, whereas the HC group remained unchanged. No training-induced changes were observed on the group level in diffusion metrics. Exploratory correlations were found between improvements on verbal working memory and reduced MD of the left SLF and between increased performance on an information processing speed task and increased FA of the right precentral gyrus. Conclusions. Results are indicative of positive effects of BrainGames on cognitive functioning and provide preliminary evidence for neuroplasticity associated with cognitive improvements following cognitive intervention in TBI.

scholarly journals Guilty Molecules, Guilty Minds? The Conflicting Roles of the Innate Immune Response to Traumatic Brain Injury

2012 ◽  
Vol 2012 ◽  
pp. 1-18 ◽  
Author(s):  
Sarah Claire Hellewell ◽  
Maria Cristina Morganti-Kossmann
Keyword(s):  
Traumatic Brain Injury ◽  
Immune Response ◽  
Brain Injury ◽  
Innate Immune Response ◽  
Complex Disease ◽  
Clinical Care ◽  
The Body ◽  
Innate Immune ◽  
Neuroprotective Therapy ◽  
Attractive Therapeutic Target

Traumatic brain injury (TBI) is a complex disease in the most complex organ of the body, whose victims endure lifelong debilitating physical, emotional, and psychosocial consequences. Despite advances in clinical care, there is no effective neuroprotective therapy for TBI, with almost every compound showing promise experimentally having disappointing results in the clinic. The complex and highly interrelated innate immune responses govern both the beneficial and deleterious molecular consequences of TBI and are present as an attractive therapeutic target. This paper discusses the positive, negative, and often conflicting roles of the innate immune response to TBI in both an experimental and clinical settings and highlights recent advances in the search for therapeutic candidates for the treatment of TBI.

scholarly journals An injectable refrigerated hydrogel for Inducing local hypothermia and neuroprotection against traumatic brain injury

2020 ◽  
Author(s):  
yuhan Han ◽  
ZhengZhong Han ◽  
Xuyang Huang ◽  
Feng Qian ◽  
Jun Jia ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Side Effects ◽  
Cyclic Adenosine Monophosphate ◽  
Adenosine Monophosphate ◽  
Controlled Drug Release ◽  
The Body ◽  
Whole Body ◽  
Local Hypothermia ◽  
Whole Body Cooling

Abstract Hypothermia is a promising therapy for Traumatic brain injury (TBI) in the clinic. However, the neuroprotective outcomes of hypothermia-treated TBI are not consistent in clinical studies due to several severe side effects. Here, an injectable refrigerated hydrogel is designed to deliver 3-iodothyronamine (T1AM) to achieve a longer period of local hypothermia for TBI treatment. The hydrogel has four advantages: (1) It can be injected into injured site after TBI, where it forms a hydrogel and avoids the side effects of whole-body cooling. (2) The hydrogel can biodegrade and be used for controlled drug release. (3) Released T1AM can bind to trace amine-associated receptor 1 (TAAR1) to produce cyclic adenosine monophosphate (cAMP), which induces hypothermia. (4) This hydrogel has an increased medical value due to its simple operation and ability to achieve timely treatment. This hydrogel is able to cool the brain to 30.25 ± 2.25 °C for 12 hours while maintaining the body temperature at 36.80 ± 1.75 °C after TBI. More importantly, the hypothermia induced by this hydrogel leads to the maintenance of blood-brain barrier (BBB) integrity, the prevention of cell death, the reduction of the inflammatory response and brain edema, and the promotion of functional recovery after TBI. This cooling method can potentially be developed as a new approach for hypothermia treatment in TBI.

scholarly journals Traumatic Brain Injury and Mountains

2021 ◽  
Vol 7 (9) ◽  
pp. 360-374
Author(s):  
M. Shuvalova ◽  
Yu. Shidakov ◽  
D. Zhanuzakov ◽  
A. Mamytova
Keyword(s):  
Traumatic Brain Injury ◽  
Lactic Acid ◽  
Brain Injury ◽  
Sea Level ◽  
White Male ◽  
Blood Parameters ◽  
The Body ◽  
High Mountain ◽  
Arterial Blood ◽  
Rate Of Oxygen Consumption

Today, the traumatic epidemic is gaining momentum around the world. Having a complex pathogenesis, many aspects of the development and impact of traumatic brain injury (TBI) on the body remain undescribed. In particular, there is practically no information about the state of the body after a traumatic brain injury received in the highlands. The aim of the study is to establish the features of animal behavior, homeostatic blood parameters and functional morphology of the cerebellum in TBI in the highlands. The work was performed on 46 white male mongrel rats. The low-mountain series of experiments was modeled at an altitude of 760 m above sea level (Kyrgyzstan, Bishkek), the high-mountain series — at the Tuya-Ashu pass — 3200 m above sea level (Kyrgyzstan). The Weight Drop Method shock model was used to reproduce a traumatic brain injury. The ethology of animals was evaluated in the Open Field test. The lactic acid level was determined in the AQUA LAB (Bishkek). The microcirculation of the cerebellum was examined under the Olympus B×40 microscope (Japan). Statistical data processing was carried out in the SPSS 16.0 program. The visit to the outer squares of the field during TBI decreases (P<0.001) regardless of the height of the experiments, the number of racks in the highlands decreases by 60% (P < 0.001), the number of peeks into minks — by 76 % (P<0.01). The number of acts of defecation after TBI increases. The biochemical parameters of blood in TBI are characterized by an increase in the deficit of buffer bases to −3.8 mmol/l, a drop in the rate of oxygen consumption to 2.5 ml/min, an increase in the ratio between the rate of oxygen transport by arterial blood and the rate of its consumption to 4.8 rel. unit, and the concentration of lactic acid in the blood is up to 5 mmol/l. The microcirculatory bed of the cerebellum in TBI in the highlands is characterized by increased tortuosity, the appearance of swellings and interceptions along the course of blood vessels, activation of anastomoses, increased vascular porosity, hypercapillarization with erythrocyte sludge, parietal standing of leukocytes, the formation of blood clots in all parts of the vascular bed. There is vasogenic swelling of the cerebellum with the phenomena of dislocation of layers.

scholarly journals A Review of MicroRNA Biomarkers in Traumatic Brain Injury

2019 ◽  
Vol 13 ◽  
pp. 117906951983228 ◽  
Author(s):  
Hamna Atif ◽  
Steven D Hicks
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
The Body ◽  
Symptom Duration ◽  
Public Concern ◽  
Regulate Gene Expression ◽  
Injured Brain ◽  
Patient Reported ◽  
Brain Recovery

There is growing public concern surrounding traumatic brain injury (TBI). TBI can cause significant morbidity, and the long-term sequelae are poorly understood. TBI diagnosis and management rely on patient-reported symptoms and subjective clinical assessment. There are no biologic tools to detect mild TBI or to track brain recovery. Emerging evidence suggests that microRNAs (miRNAs) may provide information about the injured brain. These tiny epigenetic molecules are expressed throughout the body. However, they are particularly important in neurons, can cross the blood-brain barrier, and are securely transported from cell to cell, where they regulate gene expression. miRNA levels may identify patients with TBI and predict symptom duration. This review synthesizes miRNA findings from 14 human studies. We distill more than 291 miRNAs to 17 biomarker candidates that overlap across multiple studies and multiple biofluids. The goal of this review is to establish a collective understanding of miRNA biology in TBI and identify clinical priorities for future investigations of this promising biomarker.

scholarly journals Blast-Related Traumatic Brain Injury: Current Concepts and Research Considerations

2019 ◽  
Vol 13 ◽  
pp. 117906951987221 ◽  
Author(s):  
Daniel W Bryden ◽  
Jessica I Tilghman ◽  
Sidney R Hinds
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Trauma ◽  
Department Of Defense ◽  
Military Service ◽  
The Body ◽  
Us Army ◽  
Blast Overpressure ◽  
Wide Variability ◽  
Injury Severities

Traumatic brain injury (TBI) is a well-known consequence of participation in activities such as military combat or collision sports. But the wide variability in eliciting circumstances and injury severities makes the study of TBI as a uniform disease state impossible. Military Service members are under additional, unique threats such as exposure to explosive blast and its unique effects on the body. This review is aimed toward TBI researchers, as it covers important concepts and considerations for studying blast-induced head trauma. These include the comparability of blast-induced head trauma to other mechanisms of TBI, whether blast overpressure induces measureable biomarkers, and whether a biodosimeter can link blast exposure to health outcomes, using acute radiation exposure as a corollary. This examination is contextualized by the understanding of concussive events and their psychological effects throughout the past century’s wars, as well as the variables that predict sustaining a TBI and those that precipitate or exacerbate psychological conditions. Disclaimer: The views expressed in this article are solely the views of the authors and not those of the Department of Defense Blast Injury Research Coordinating Office, US Army Medical Research and Development Command, US Army Futures Command, US Army, or the Department of Defense.

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