scholarly journals P.188 Neurotrauma in Indigenous populations of Canada: challenges and future directions: A Scoping Review

Author(s):  
Z Salaheen ◽  
A Moghaddamjou ◽  
MG Fehlings

Background: Neurotrauma accounts for over 24 000 hospitalizations annually in Canada. Among those affected, Indigenous peoples are disproportionately impacted. The goal of this scoping review is to identify factors underlying these disparities. Methods: A scoping review was conducted to collect papers pertaining to neurotrauma in Indigenous populations of Canada. Using MEDLINE, 676 articles were screened with MeSH terms including ‘Indigenous’, ‘spinal cord injuries’, ‘brain injuries, traumatic’ and ‘Canada’ as of April 2021. Results: Studies report over twice the incidence of traumatic brain injury and traumatic spinal cord injury in Indigenous populations compared to non-Indigenous populations. The burden of neurotrauma is attributable to infrastructure disparities in rural communities and reserves, elevated rates of substance use and violence, and inequities in treatment and rehabilitation following injury. These issues are deeply rooted in the trauma endured by Indigenous peoples through the course of Canadian history, owing to government policies that severely impacted their socioeconomic conditions, culture, and access to healthcare services. Conclusions: Systems-level interventions guided by Indigenous community members will help to address the disparities that Indigenous peoples face in the care and rehabilitation of neurotrauma. This study will inform further research of culturally appropriate approaches to reduce neurotrauma burden among Indigenous peoples.

2020 ◽  
Author(s):  
Geoffrey S.F. Ling ◽  
Mohit Datta

Traumatic brain and spinal cord injuries are significant causes of permanent disability and death. In 2010, 823,000 traumatic brain injuries were reported in the United States alone; in fact, the actual number is likely considerably higher because mild traumatic brain injuries and concussions are underreported. The number of new traumatic spinal cord injuries has been estimated at 12,000 annually. Survival from these injuries has increased due to improvements in medical care. This review covers mild traumatic brain injury and concussion, moderate to severe traumatic brain injury, and traumatic spinal cord injury. Figures include computed tomography scans showing a frontal contusion, diffuse cerebral edema and intracranial air from a gunshot wound, a subdural hematoma, an epidural hematoma, a skull fracture with epidural hematoma, and a spinal fracture from a gunshot wound. Tables list requirements for players with concussion, key guidelines for prehospital management of moderate to severe traumatic brain injury, key guidelines for management of moderate to severe traumatic brain injury, brain herniation brain code, key clinical practice guidelines for managing cervical spine and spinal cord injury, and the American Spinal Injury Association’s neurologic classification of spinal cord injury. This review contains 6 highly rendered figures, 12 tables, and 55 references.


2021 ◽  
Author(s):  
Ntsikelelo Pefile ◽  
Joyce Diphale Mothabeng ◽  
Saloshni Naidoo

Abstract Background Unemployment among persons with spinal cord injury (PWSCI) is high and often leads to poverty (including their families). Modifiable and unmodifiable factors that influence employment among PWSCI are known and are addressed throughout the rehabilitation process. The overall aim of rehabilitation of PWSCI is quality of life and community integration (including employment). Interventions that seek to improve employment outcomes among PWSCI are well documented. However, no integrated reviews clearly describe the resources utilised, interventions utilised, duration of interventions and the outcomes (and tools used) to improve employment outcomes among PWSCI. Policymakers and rehabilitation professionals require this information to develop models or strategies to improve employment outcomes for PWSCI. This review aims to map evidence on interventions and approaches that aim to enhance the employment of PWSCI. Methodology This review will map evidence on interventions that improve employment outcomes among PWSCI, using the Arksey and O'Malley framework and the Donabedian model as the guiding lens. The first stage includes the development of the research question and will be reviewed throughout the review process. The PCC framework will be utilised to determine the inclusion and exclusion criteria and develop the search terms. Peer-reviewed primary studies will be identified using the Boolean search terms on PubMed, MEDLINE, Ebscohost, Google Scholar, CINAHL, Cochrane databases. Two independent reviewers will identify primary studies and charting data, and one reviewer will act as a supervisor and arbitrator. Data charting tool will be utilised to gather the required information from the selected studies. Nvivo software version 25 will be used to develop themes for summarising and reporting the data. The quality of the courses selected will be evaluated using the Mixed Methods Appraisal Tool (MMAT). DiscussionData from the selected studies will be discussed in relation to the research questions and the Donabedian model. Information gathered from this scoping review will enable policymakers, rehabilitation professionals and other stakeholders to use this as a foundation in an attempt to develop strategies or models that seek to improve employment outcomes among PWSCI. Moreover, a gap in current practice will be identified, and further research needed in the field will be described.


Author(s):  
Seo Yeon Yoon ◽  
Ja-Ho Leigh ◽  
Jieun Lee ◽  
Wan Ho Kim

Central-nervous-system (CNS) injuries constitute a significant cause of morbidity (often resulting in long-term disability) and mortality. This cross-sectional study compared the activity and participation of community-dwelling people with severe disability from acquired brain injuries (ABI) (n = 322) and spinal-cord injuries (SCI) (n = 183) to identify risk factors related to disability. Data were collected through a questionnaire survey of community-dwelling people with severe disability attending 65 healthcare centers. The survey included the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) and sociodemographic factors. We categorized a registered grade of disability of 1 or 2 as severe disability. WHODAS 2.0 domain and summary scores were compared between the ABI and SCI groups, and risk factors associated with disability were identified through regression analysis. ABI participants had significantly higher disability in cognition and relationships, whereas patients with SCI had higher disability in mobility (p < 0.05). Onset duration was negatively correlated with cognition, relationships, participation, and summary scores in ABI participants (p < 0.05). Neither group’s socioeconomic factors were associated with WHODA 2.0 scores. Understanding the different patterns of disability between SCI and ABI in community-dwelling people with severe disability helps establish future plans for the management of health resources.


2019 ◽  
Vol 8 ◽  
Author(s):  
Thato M.M. Paulus-Mokgachane ◽  
Surona J. Visagie ◽  
Gubela Mji

Background: People with spinal cord injury (SCI) often have great need for healthcare services, but they report access challenges. Primary care access to people with SCI has not been explored in Botswana.Objective: This study aimed to identify barriers and facilitators that users with spinal cord injuries experience in accessing primary care services in the greater Gaborone area, Botswana.Methods: A quantitative, cross-sectional, observational study was conducted. Data were collected with a structured questionnaire from 57 participants with traumatic and non-traumatic SCI. Descriptive and inferential analysis was performed.Results: The male to female ratio was 2.8:1. The mean age of participants was 40 years (standard deviation 9.59). Road traffic crashes caused 85% of the injuries. Most participants visited primary care facilities between 2 and 10 times in the 6 months before the study. Participants were satisfied with the services (63%) and felt that facilities were clean (95%) and well maintained (73.5%). Preferential treatment, respect, short waiting times and convenient hours facilitated satisfaction with services. Availability was hampered by insufficient provider knowledge on SCI as indicated by 71.9% of participants, and shortage of consumables (80.7%). Structural challenges (42.1% could not enter the facility by themselves and 56.5% could not use the bathroom) and lack of height-adjustable examining couches (66.7%) impeded accessibility. Cost was incurred when participants (64.9%) utilised private health services where public services failed to address their needs.Conclusion: Primary care services were mostly affordable and adequate. Availability, acceptability and accessibility aspects created barriers.


2020 ◽  
Author(s):  
Geoffrey S.F. Ling ◽  
Mohit Datta

Traumatic brain and spinal cord injuries are significant causes of permanent disability and death. In 2010, 823,000 traumatic brain injuries were reported in the United States alone; in fact, the actual number is likely considerably higher because mild traumatic brain injuries and concussions are underreported. The number of new traumatic spinal cord injuries has been estimated at 12,000 annually. Survival from these injuries has increased due to improvements in medical care. This review covers mild traumatic brain injury and concussion, moderate to severe traumatic brain injury, and traumatic spinal cord injury. Figures include computed tomography scans showing a frontal contusion, diffuse cerebral edema and intracranial air from a gunshot wound, a subdural hematoma, an epidural hematoma, a skull fracture with epidural hematoma, and a spinal fracture from a gunshot wound. Tables list requirements for players with concussion, key guidelines for prehospital management of moderate to severe traumatic brain injury, key guidelines for management of moderate to severe traumatic brain injury, brain herniation brain code, key clinical practice guidelines for managing cervical spine and spinal cord injury, and the American Spinal Injury Association’s neurologic classification of spinal cord injury. This review contains 6 highly rendered figures, 12 tables, and 55 references.


2020 ◽  
Author(s):  
Geoffrey S.F. Ling ◽  
Mohit Datta

Traumatic brain and spinal cord injuries are significant causes of permanent disability and death. In 2010, 823,000 traumatic brain injuries were reported in the United States alone; in fact, the actual number is likely considerably higher because mild traumatic brain injuries and concussions are underreported. The number of new traumatic spinal cord injuries has been estimated at 12,000 annually. Survival from these injuries has increased due to improvements in medical care. This review covers mild traumatic brain injury and concussion, moderate to severe traumatic brain injury, and traumatic spinal cord injury. Figures include computed tomography scans showing a frontal contusion, diffuse cerebral edema and intracranial air from a gunshot wound, a subdural hematoma, an epidural hematoma, a skull fracture with epidural hematoma, and a spinal fracture from a gunshot wound. Tables list requirements for players with concussion, key guidelines for prehospital management of moderate to severe traumatic brain injury, key guidelines for management of moderate to severe traumatic brain injury, brain herniation brain code, key clinical practice guidelines for managing cervical spine and spinal cord injury, and the American Spinal Injury Association’s neurologic classification of spinal cord injury. This review contains 6 highly rendered figures, 12 tables, and 55 references.


2019 ◽  
Vol 8 (3) ◽  
pp. 143-148
Author(s):  
Maryam Shabany ◽  
Alireza Nikbakht Nasrabadi ◽  
Nooredin Mohammadi ◽  
Keyvan Davatgaran ◽  
MirSaeed Yekaninejad

Introduction: Empowering an individual with spinal cord injury as far as possible is an experience with various social and cultural aspects. This study investigated health professionals' experiences of barriers in empowering individuals with spinal cord injuries. Methods: This was a qualitative inquiry with a conventional content analysis approach. A number of 11 healthcare professionals who were members of Iran Spinal Cord Injuries Research National Network or had been working in a related research center for at least three years participated in the study. A purposive sampling method was applied until reaching data saturation. The data were collected by semi-structured interviews. The collected data were managed with MAXQDA software version 10. Results: Three main themes as barriers in empowering people with spinal cord injury emerged: 1) Lack of patient-and-family-centered education, 2) Failure in providing sufficient healthcare services and 3) Inappropriate setting for using rehabilitation services. Conclusion: These finding can help policymakers to provide better social facilities and more support services for people with spinal cord injuries and their families. Further research is needed to investigate barriers to empowerment from the perspective of individuals with SCI and their families.


2020 ◽  
Author(s):  
Geoffrey S.F. Ling ◽  
Mohit Datta

Traumatic brain and spinal cord injuries are significant causes of permanent disability and death. In 2010, 823,000 traumatic brain injuries were reported in the United States alone; in fact, the actual number is likely considerably higher because mild traumatic brain injuries and concussions are underreported. The number of new traumatic spinal cord injuries has been estimated at 12,000 annually. Survival from these injuries has increased due to improvements in medical care. This review covers mild traumatic brain injury and concussion, moderate to severe traumatic brain injury, and traumatic spinal cord injury. Figures include computed tomography scans showing a frontal contusion, diffuse cerebral edema and intracranial air from a gunshot wound, a subdural hematoma, an epidural hematoma, a skull fracture with epidural hematoma, and a spinal fracture from a gunshot wound. Tables list requirements for players with concussion, key guidelines for prehospital management of moderate to severe traumatic brain injury, key guidelines for management of moderate to severe traumatic brain injury, brain herniation brain code, key clinical practice guidelines for managing cervical spine and spinal cord injury, and the American Spinal Injury Association’s neurologic classification of spinal cord injury. This review contains 6 highly rendered figures, 12 tables, and 55 references.


2021 ◽  
Vol 9 (Spl-1- GCSGD_2020) ◽  
pp. S10-S22
Author(s):  
Anita Prem ◽  
◽  
K Mohanraj ◽  
A Rajan Samuel ◽  
◽  
...  

Technological innovations are now an integral part of healthcare. Brain-computer interface (BCI) is a novel technological intervention system that is useful in restoring function to people disabled by neurological disorders such as attention deficit hyperactivity disorder (ADHD), amyotrophic lateral sclerosis (ALS), cerebral palsy, stroke, or spinal cord injury. This paper surveys the literature concerning the effectiveness of BCI on attention in subjects under various conditions. The findings of this scoping review are that studies have been made on ADHD, ALS, ASD subjects, and subjects recovering from brain and spinal cord injuries. BCI based neurofeedback training is seen to be effective in improving attention in these subjects. Some studies have also been made on healthy subjects.BCI based neurofeedback training promises neurocognitive improvement and EEG changes in the elderly. Different cognitive assessments have been tried on healthy adults. From this review, it is evident that hardly any research has been done on using BCI for enhancing attention in post-stroke subjects. So there arises the necessity for making a study on the effects of BCI based attention training in post-stroke subjects, as attention is the key for learning motor skills that get impaired following a stroke. Currently, many researches are underway to determine the effects of a BCI based training program for the enhancement of attention in post-stroke subjects.


2021 ◽  
Author(s):  
Hsu-Wen Tseng ◽  
Dorothee Girard ◽  
Kylie Alexander ◽  
Susan Millard ◽  
Frederic Torossian ◽  
...  

The cells-of-origin of neurogenic heterotopic ossifications (NHO), which develop frequently in the periarticular muscles following spinal cord injuries (SCI) and traumatic brain injuries, remain unclear because the skeletal muscle harbors two progenitor cell populations: satellite cells (SCs) which are myogenic, and fibro-adipogenic progenitors (FAPs) which are mesenchymal. Lineage-tracing experiments using the Cre recombinase /LoxP system were performed in two mouse strains with the fluorescent protein ZsGreen specifically expressed in either SCs or FAPs in the skeletal muscles under the control of the Pax7 or Prrx1 gene promotors respectively. These experiments demonstrate that following a muscle injury, SCI causes the upregulation of PDGFRα on FAPs but not SCs and the failure of SCs to regenerate myofibers in the injured muscle, with instead reduced apoptosis and continued proliferation of muscle resident FAPs enabling their osteogenic differentiation into NHO. No cells expressing ZsGreen under the Prrx1 promoter were detected in the blood after injury suggesting that the cells-of-origin of NHO are locally derived from the injured muscle. We validated these findings in the human pathology using human NHO biopsies. PDGFRα+ mesenchymal cells isolated from the muscle surrounding NHO biopsies could develop ectopic human bones when transplanted into immunocompromised mice whereas CD56+ myogenic cells had a much lower potential. Therefore, NHO is a pathology of the injured muscle in which SCI reprograms FAPs to uncontrolled proliferation and differentiation into osteoblasts.


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