Women’s Gendered Experiences of Traumatic Brain Injury

2020 ◽  
Vol 30 (7) ◽  
pp. 1033-1044
Author(s):  
Alexis M. Fabricius ◽  
Andrea D’Souza ◽  
Vanessa Amodio ◽  
Angela Colantonio ◽  
Tatyana Mollayeva

Despite recognizing that women have worse outcomes after traumatic brain injury (TBI), little is known about how gender influences their experiences of this critical injury. Past research has been dominated by androcentrism and quantitative approaches, leaving the lived experience of women with TBI insufficiently examined. To gain insight into their experiences, this qualitative study interviewed 19 Canadian women with mild and moderate-to-severe TBIs. Applying a thematic analysis, we discerned three themes: Gender prevails considers choosing to do gender over complying with physician advice; Consequences of TBI impeding performativity explores how women frame themselves as terrible people for being unable to do gender post-TBI; and Perceptions of receiving care looks at gendered caregiving expectations. These results broadly align with research on how doing gender influences recovery and health outcomes. We discuss the implications of our findings for knowledge translation, future research on women’s TBI recovery, and clinical practice.

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e052942
Author(s):  
Vincy Chan ◽  
Maria Jennifer Estrella ◽  
Jessica Babineau ◽  
Angela Colantonio

IntroductionRehabilitation is key to improving outcomes and quality of life after traumatic brain injury (TBI). However, individuals experiencing homelessness are rarely represented in research that informs evidence-based rehabilitation guidelines even though TBI is disproportionately prevalent among this population. This protocol is for a scoping review to explore the extent to which rehabilitation, including the types of rehabilitation interventions, is available to, or used by, individuals who experience homelessness and TBI to inform (1) opportunities to integrate rehabilitation for individuals experiencing homelessness and TBI, (2) considerations for existing clinical and practice guidelines for rehabilitation and (3) recommendations for future research.Methods and analysisThe scoping review will be guided by six stages described in scoping review methodology frameworks. Electronic databases (MEDLINE, Embase and Embase Classic, Cochrane CENTRAL Register of Clinical Trials, CINAHL, APA PsycINFO, Applied Social Sciences Index and Abstracts, and Nursing and Allied Health), reference list of included articles and scoping or systematic reviews identified from the search and grey literature, defined as reports from relevant brain injury, housing and rehabilitation organisations, will be searched. Two reviewers will independently screen all articles based on predetermined inclusion and exclusion criteria. A descriptive numerical summary of data items will be provided and qualitative content analytic techniques will be used to identify and report common themes. Preliminary findings will be shared with stakeholders to seek feedback on the implications of the results.Ethics and disseminationEthics review will not be required, as only publicly available data will be analysed. Findings from the scoping review will be published in a peer-reviewed journal and presented at scientific meetings and to stakeholders, defined as service providers in the housing and TBI sectors; health professionals who provide care for individuals with TBI and/or homelessness; health administrators, decision-makers and policy-makers; researchers; and caregivers or family members of individuals with lived experience of TBI and homelessness.


2019 ◽  
Author(s):  
Emily L. Dennis ◽  
Karen Caeyenberghs ◽  
Robert F. Asarnow ◽  
Talin Babikian ◽  
Brenda Bartnik-Olson ◽  
...  

Traumatic brain injury (TBI) is a major cause of death and disability in children in both developed and developing nations. Children and adolescents suffer from TBI at a higher rate than the general population; however, research in this population lags behind research in adults. This may be due, in part, to the smaller number of investigators engaged in research with this population and may also be related to changes in safety laws and clinical practice that have altered length of hospital stays, treatment, and access to this population. Specific developmental issues also warrant attention in studies of children, and the ever-changing context of childhood and adolescence may require larger sample sizes than are commonly available to adequately address remaining questions related to TBI. The ENIGMA (Enhancing NeuroImaging Genetics through Meta-Analysis) Pediatric Moderate-Severe TBI (msTBI) group aims to advance research in this area through global collaborative meta-analysis. In this paper we discuss important challenges in pediatric TBI research and opportunities that we believe the ENIGMA Pediatric msTBI group can provide to address them. We conclude with recommendations for future research in this field of study.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 886-887
Author(s):  
Andrei Irimia ◽  
Ammar Dharani ◽  
Van Ngo ◽  
David Robles ◽  
Kenneth Rostowsky

Abstract Mild traumatic brain injury (mTBI) affects white matter (WM) integrity and accelerates neurodegeneration. This study assesses the effects of age, sex, and cerebral microbleed (CMB) load as predictors of WM integrity in 70 subjects aged 18-77 imaged acutely and ~6 months after mTBI using diffusion tensor imaging (DTI). Two-tensor unscented Kalman tractography was used to segment and cluster 73 WM structures and to map changes in their mean fractional anisotropy (FA), a surrogate measure of WM integrity. Dimensionality reduction of mean FA feature vectors was implemented using principal component (PC) analysis, and two prominent PCs were used as responses in a multivariate analysis of covariance. Acutely and chronically, older age was significantly associated with lower FA (F2,65 = 8.7, p < .001, η2 = 0.2; F2,65 = 12.3, p < .001, η2 = 0.3, respectively), notably in the corpus callosum and in dorsolateral temporal structures, confirming older adults’ WM vulnerability to mTBI. Chronically, sex was associated with mean FA (F2,65 = 5.0, p = 0.01, η2 = 0.1), indicating males’ greater susceptibility to WM degradation. Acutely, a significant association was observed between CMB load and mean FA (F2,65 = 5.1, p = 0.009, η2 = 0.1), suggesting that CMBs reflect the acute severity of diffuse axonal injury. Together, these findings indicate that older age, male sex, and CMB load are risk factors for WM degeneration. Future research should examine how sex- and age-mediated WM degradation lead to cognitive decline and connectome degeneration after mTBI.


Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 586 ◽  
Author(s):  
Hamilton Roschel ◽  
Bruno Gualano ◽  
Sergej M. Ostojic ◽  
Eric S. Rawson

There is a robust and compelling body of evidence supporting the ergogenic and therapeutic role of creatine supplementation in muscle. Beyond these well-described effects and mechanisms, there is literature to suggest that creatine may also be beneficial to brain health (e.g., cognitive processing, brain function, and recovery from trauma). This is a growing field of research, and the purpose of this short review is to provide an update on the effects of creatine supplementation on brain health in humans. There is a potential for creatine supplementation to improve cognitive processing, especially in conditions characterized by brain creatine deficits, which could be induced by acute stressors (e.g., exercise, sleep deprivation) or chronic, pathologic conditions (e.g., creatine synthesis enzyme deficiencies, mild traumatic brain injury, aging, Alzheimer’s disease, depression). Despite this, the optimal creatine protocol able to increase brain creatine levels is still to be determined. Similarly, supplementation studies concomitantly assessing brain creatine and cognitive function are needed. Collectively, data available are promising and future research in the area is warranted.


2021 ◽  
pp. 1-18
Author(s):  
Therese Mulligan ◽  
Suzanne Barker-Collo ◽  
Kerry Gibson ◽  
Kelly Jones

Abstract Background: This research adds to scarce literature regarding adolescent experiences of traumatic brain injury (TBI). Retrospective accounts of young adults who had sustained a TBI in adolescence were analysed to explore the perceived impact this had on their lives and forming identities during this important developmental stage. Methods: Thirteen adults (aged 20–25 years; mean 23 years) who sustained a mild or moderate TBI during adolescence (i.e. aged 13–17 years at injury), approximately 7.7 years (range = 6.7–8.0 years) prior, participated in the research. Semi-structured individual interviews, analysed using thematic analysis, explored participants’ experiences following their TBIs. Results: Thematic analysis of interview data produced two categories of themes: (1) Impacts on Important Areas of Life, which included: schoolwork suffered, career opportunities became limited, struggling with work and missing out socially; and (2) Impacts on Identity: with themes including feeling ‘stupid’, feeling self-conscious, loss of social identity and being dependent. Conclusions: TBI sustained during adolescence can have broad impacts on important areas of life and on developing identity.


BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e016694 ◽  
Author(s):  
Sareh Zarshenas ◽  
Laetitia Tam ◽  
Angela Colantonio ◽  
Seyed Mohammad Alavinia ◽  
Nora Cullen

IntroductionMany studies have assessed the predictors of morbidity/mortality of patients with traumatic brain injury (TBI) in acute care. However, with the increasing rate of survival after TBI, more attention has been given to discharge destinations from acute care as an important measure of clinical priorities. This study describes the design of a systematic review compiling and synthesising studies on the prognostic factors of discharge settings from acute care in patients with TBI.Methods and analysisThis systematic review will be conducted on peer-reviewed studies using seven databases including Medline/Medline in-Process, Embase, Cochrane Database of Systematic Reviews, Cochrane CENTRAL, PsycINFO, CINAHL and Supplemental PubMed. The reference list of selected articles and Google Scholar will also be reviewed to determine other relevant articles. This study will include all English language observational studies that focus on adult patients with TBI in acute care settings. The quality of articles will be assessed by the Quality in Prognostic Studies tool.Ethics and disseminationThe results of this review will provide evidence that may guide healthcare providers in making more informed and timely discharge decisions to the next level of care for patient with TBI. Also, this study will provide valuable information to address the gaps in knowledge for future research.Trial registration numberTrial registration number (PROSPERO) is CRD42016033046.


2013 ◽  
Vol 14 (1) ◽  
pp. 113-129 ◽  
Author(s):  
Angelle M. Sander ◽  
Kacey Little Maestas ◽  
Allison N. Clark ◽  
Whitney N. Havins

The purpose of the current paper was to conduct a systematic review of the literature on predictors of emotional distress in caregivers of persons with traumatic brain injury (TBI), and to provide evidence-based classification for prognostic variables to guide future research and clinical practice. A search was conducted using PubMed, CINAHL and PsycINFO databases. The citations of resulting articles were also reviewed. Twenty-eight articles met inclusion criteria and were retained for review. Reviews were conducted in accordance with the 2011 edition of the American Academy of Neurology (AAN) Guidelines for classifying evidence for prognostic studies. Data abstraction revealed one Class I study, four Class II studies, eight Class III studies, and 15 Class IV studies. Results of the review indicated that caregivers’ report of neurobehavioural problems in the person with injury is a probable predictor of emotional distress for caregivers of persons with complicated mild, moderate or severe TBI (Class B evidence). The level of participation in the person with injury, level of support needed by the person with injury, and family systems functioning are probably predictors of emotional distress for caregivers of persons with severe TBI (Class B evidence). Executive functioning impairment in the person with injury, pre-injury emotional distress in caregivers, caregiver age, caregivers’ use of emotion-focused coping, and social support may possibly be risk factors for caregivers’ emotional distress (Class C evidence). Recommendations for future research and implications for assessment and treatment of family caregivers are discussed.


2021 ◽  
pp. 000841742110342
Author(s):  
Mireille Gagnon-Roy ◽  
Nathalie Bier ◽  
Stéphanie Boulé-Riley ◽  
Heidi Keurentjes ◽  
Priscilla Lam Wai Shun ◽  
...  

Background. Occupational therapists play a major role in identifying the assistance needs of individuals living with a traumatic brain injury. However, to obtain an accurate assessment, verbal assistance should be provided only when necessary, according to the person's needs. Purpose. This study aimed to understand (1) how verbal assistance is provided during an evaluation of Instrumental Activities of Daily Living and (2) why it is provided in this manner. Method. Interviews were conducted with three expert occupational therapists using their own videotaped evaluation and a “think-aloud” method to explore their clinical reasoning when providing verbal assistance. Data were analyzed using thematic analysis. Findings. The process of providing verbal assistance was recognized as flexible and nonlinear, and influenced by various factors including the participants’ level of understanding of the client's abilities. Implications. This information will help therapists better understand how and when to provide verbal assistance when assessing their clients.


Author(s):  
Danielle Toccalino ◽  
Amy Moore ◽  
Sophia Chuon Gutierrez ◽  
Angela Colantonio ◽  
Christine M. Wickens ◽  
...  

Introduction: One in four Canadian women experience intimate partner violence (IPV) in their lifetime. The COVID-19 pandemic has significantly increased rates of IPV globally and the level of violence encountered, exposing IPV survivors to greater risk of physical injury, including traumatic brain injury (TBI). Up to 75% of survivors are suspected of sustaining a TBI and 50-75% experience mental health or substance use challenges (MHSU) as a result of IPV, resulting in extensive personal, social, and economic implications. Objective: The objective of this scoping review was to synthesize what is currently known in the literature about MHSU and TBI among survivors of IPV and identify gaps. Methods: MEDLINE, EMBASE, PsycINFO, CINAHL, Cochrane, Scopus, and Web of Science were searched for relevant articles using a search strategy including text words and subject headings related to TBI, IPV, and MHSU. Two reviewers independently assessed articles for inclusion. Results: The search identified 399 unique articles, 34 of which were included in this study. Of these, 11 articles reported on MHSU in IPV-related TBI and 9 articles reported on both TBI and MHSU in IPV but did not discuss the groups together. The remainder were reviews or theses that noted MHSU in IPV-related TBI. Included articles predominantly focused on cis-gendered women in heterosexual relationships and were conducted in the United States. Only three articles focused on the experiences of Black or Indigenous women and none of the included studies discussed implications of co-occurring TBI and MHSU on survivor’s healthcare-related needs or access to care. Conclusions: Despite the high rates of co-occurring TBI and MHSU among survivors of IPV, there is little research on this intersection and no investigation of the impacts on the health system. Future research should focus on identifying the healthcare-related needs of survivors and identifying and mitigating barriers to access.


2018 ◽  
Vol 24 (1) ◽  
pp. 78-91 ◽  
Author(s):  
Natalie Feary ◽  
Audrey McKinlay

Children do not always receive adequate medical attention following a mild traumatic brain injury (mTBI), despite the necessity of this treatment. Adult mTBI knowledge may be one factor that affects if a child receives medical attention, but little is known about association between mTBI knowledge and help-seeking behaviour. Participants were 212 females and 58 males, including 84 parents, with a mean age of 35.57 years (standard deviation = 10.96). A questionnaire evaluated participants’ understanding of mTBI and vignettes to evaluate behavioural intentions regarding help-seeking behaviour after an mTBI. Only 40.0% of participants were able to recall an adequate number of mTBI symptoms (5+). Surprisingly, mTBI history was not associated with better mTBI knowledge, t(df, 268) = 1.29, p = .20. Similarly, knowing a close friend or family member with mTBI was not associated with higher mTBI knowledge, t(df = 268) = .81, p = .4. Further, neither mTBI symptom knowledge nor vignette child age (young = 5 years, older = 15 years) significantly predicted participants’ cited intentions to perform help-seeking behaviour. Consistent with the existing research, the current study demonstrates a continued lack of mTBI knowledge in the general population. However, this may not be a factor that influences an adult’s decision to take a child to hospital following mTBI. Future research should investigate the association between help-seeking intentions and actual behaviour in relation to paediatric mTBI.


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