The educational needs of Canadian homeless shelter workers related to traumatic brain injury

Work ◽  
2021 ◽  
pp. 1-11
Author(s):  
Amanda Formosa ◽  
Isabelle Dobronyi ◽  
Jane Topolovec-Vranic
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Educational Needs ◽  
Homeless Population ◽  
Care Providers ◽  
Frontline Workers ◽  
Level Of Confidence ◽  
Educational Initiatives ◽  
Shelter Workers ◽  
Positive Effect

BACKGROUND: Traumatic brain injury (TBI) has a higher prevalence in the homeless population. Caregivers to individuals who have TBIs may require better education surrounding screening, diagnosis and management of this disease to tailor interventions to their clients’ needs. OBJECTIVE: To assess the insight and educational needs of homeless care providers in recognizing and dealing with clients who had experienced a TBI. METHODS: A survey assessing the point of views of homeless care providers across Canada regarding their level of confidence in identifying and managing symptoms of TBI. RESULTS: Eight-eight completed surveys were included. Overall, frontline workers expressed a moderate level of confidence in identifying and managing TBI, stating that educational initiatives in this context would be of high value to themselves and their clients. CONCLUSIONS: Frontline workers to homeless clients rate their educational needs on the identification and management of TBI to be high such that educational initiatives for shelter workers across Canada may be beneficial to increase their knowledge in identifying and managing the TBI-related symptoms. Improved education would not only benefit frontline workers but may also have a positive effect on health outcomes for their clients.

scholarly journals Community Integration After Traumatic Brain Injury and Related Factors: A Study in the Nepalese Context

2020 ◽  
Vol 6 ◽  
pp. 237796082098178
Author(s):  
Sumana Lama ◽  
Jintana Damkliang ◽  
Luppana Kitrungrote
Keyword(s):  
Social Support ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Health Care Providers ◽  
Physical Environment ◽  
Community Integration ◽  
Sampling Technique ◽  
Care Providers ◽  
Related Factors ◽  
High Level

Introduction Community integration is an essential component for rehabilitation among traumatic brain injury (TBI) survivors, which yields positive outcomes in terms of social activities, community participation, and productive work. A factor that usually facilitates community integration among TBI survivors is social support, whereas physical environment and fatigue are most often found as barriers. Objectives This study aimed to (1) describe the level of community integration, fatigue, physical environment, and social support of persons after TBI, and (2) examine the relationship between community integration and these three factors. Methods This is a descriptive correlational study. One hundred and twenty TBI survivors living in the communities of Province Number Three, Nepal were enrolled using the stratified sampling technique. The data were collected using the Community Integration Questionnaire, Modified Fatigue Impact Scale, Craig Hospital Inventory of Environmental Factors, and the Multidimensional Scale of Perceived Social Support. Descriptive statistics and Pearson’s correlation were used to analyze the data. Results Community integration, fatigue, and physical environment showed a moderate level, while social support revealed a high level. Fatigue was significantly correlated with overall community integration, whereas physical environment was found to correlate with two subscales of community integration, home integration and productive activities. Conclusion To enhance the level of community integration among TBI survivors, health care providers, in particular rehabilitation nurses and community nurses, should plan and implement strategies such as follow-up appointments or continued rehabilitation at home.

Postural neurologic deficits after decompressive craniectomy: A case series of sinking skin flap syndrome in traumatic brain injury

2020 ◽  
pp. 1-10
Author(s):  
Emma A. Bateman ◽  
Jordan VanderEnde ◽  
Keith Sequeira ◽  
Heather M. MacKenzie
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Rare Complication ◽  
Skin Flap ◽  
Case Series ◽  
Cognitive Outcome ◽  
Definitive Treatment ◽  
Care Providers ◽  
Neurologic Deficits ◽  
The Impact

BACKGROUND: Hemicraniectomy to manage raised intracranial pressure following traumatic brain injury (TBI) has improved survival but may increase the incidence of Sinking Skin Flap Syndrome (SSFS). SSFS is a clinical syndrome in which patients with craniectomy develop objective neurologic abnormalities due to the pressure of the atmosphere on the unprotected brain, often presenting with postural headaches and neurologic deficits that localize to the craniectomy site. Previously thought to be a rare complication of craniectomy after TBI, evidence suggests SSFS is under-recognized. OBJECTIVE: To describe the clinical and radiographic features leading to diagnosis and the impact of temporizing and definitive management of SSFS on outcomes in inpatients with moderate/severe TBI. METHODS: Two patients’ symptoms, qualitative behaviour observation, physical and cognitive outcome measures, and neuroimaging pre- and post-temporizing measures and cranioplasty are presented. RESULTS: Both patients demonstrated partial improvements with temporizing measures and substantial improvements in functional, cognitive, physical, and rehabilitation outcomes from the cranioplasty and resolution of SSFS. CONCLUSIONS: Rehabilitation care providers are critical to the timely diagnosis and management of SSFS, including the use of temporizing measures and advocacy for definitive treatment with cranioplasty. These cases highlight the diverse clinical presentations and importance of SSFS diagnosis to improve patient outcomes.

scholarly journals Critical Update on the Third Edition of the Guidelines for Managing Severe Traumatic Brain Injury in Children

2020 ◽  
Vol 29 (1) ◽  
pp. e13-e18
Author(s):  
Karin Reuter-Rice ◽  
Elise Christoferson
Keyword(s):  
Traumatic Brain Injury ◽  
Critical Care ◽  
Brain Injury ◽  
Severe Traumatic Brain Injury ◽  
Current Evidence ◽  
Care Providers ◽  
The Third ◽  
Guideline Document ◽  
Severe Tbi ◽  
Pediatric Tbi

Background Severe traumatic brain injury (TBI) is associated with high rates of death and disability. As a result, the revised guidelines for the management of pediatric severe TBI address some of the previous gaps in pediatric TBI evidence and management strategies targeted to promote overall health outcomes. Objectives To provide highlights of the most important updates featured in the third edition of the guidelines for the management of pediatric severe TBI. These highlights can help critical care providers apply the most current and appropriate therapies for children with severe TBI. Methods and Results After a brief overview of the process behind identifying the evidence to support the third edition guidelines, both relevant and new recommendations from the guidelines are outlined to provide critical care providers with the most current management approaches needed for children with severe TBI. Recommendations for neuroimaging, hyperosmolar therapy, analgesics and sedatives, seizure prophylaxis, ventilation therapies, temperature control/hypothermia, nutrition, and corticosteroids are provided. In addition, the complete guideline document and its accompanying algorithm for recommended therapies are available electronically and are referenced within this article. Conclusions The evidence base for treating pediatric TBI is increasing and provides the basis for high-quality care. This article provides critical care providers with a quick reference to the current evidence when caring for a child with a severe TBI. In addition, it provides direct access links to the comprehensive guideline document and algorithms developed to support critical care providers.

First-Line Health Care Providers' Reported Knowledge of and Referrals to Speech-Language Pathologists for Clients With Mild Traumatic Brain Injury

2021 ◽  
pp. 1-14
Author(s):  
Kelly Knollman-Porter ◽  
Jessica A. Brown ◽  
Tracey Wallace ◽  
Shelby Spitz
Keyword(s):  
Health Care ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Health Care Providers ◽  
Multidisciplinary Teams ◽  
Care Providers ◽  
First Line ◽  
Speech Language Pathologists

Purpose People with mild traumatic brain injury (mTBI) may experience deficits in cognition or communication that go unnoticed by first-line health care providers (FHPs). Speech-language pathologists (SLPs) assess and treat these domains yet are often underrepresented on mTBI multidisciplinary teams. This study's aim was to evaluate FHPs' reported knowledge of and referral practices to SLPs for individuals across the life span with mTBI. Method Physicians, physician assistants, nurse practitioners, nurses, and athletic trainers ( n = 126) completed an online survey, including two Likert scale questions and one free response question relating to SLPs' role in mTBI. Results More than half of FHPs rate their knowledge of the SLP's role in mTBI management as low (somewhat knowledgeable, 29%; not very knowledgeable, 23%). Similarly, nearly two thirds of FHPs indicated rarely (19%) or never (44%), referring to SLPs for management of patients with mTBI. The majority of FHPs' open responses on the role of the SLP in mTBI management were incomplete, with many including domains that were not relevant to an SLP's role in the management of mTBI (e.g., dysphagia). Within the article, we provide results overall and according to individual profession. Conclusions Results suggest a majority of FHPs lack knowledge in the role of the SLP in the management of mTBI, which may underpin the low referral patterns reported by FHPs for SLP services. Future educational efforts for FHPs regarding the role of SLPs in mTBI care are necessary.

scholarly journals When Basic Research Doesn't Translate to the Bedside—Lessons from the Magnesium Brain Trauma Study

2007 ◽  
Vol 7 (5) ◽  
pp. 133-135 ◽  
Author(s):  
John W. Miller ◽  
Raimondo D'Ambrosio
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Severe Traumatic Brain Injury ◽  
Primary Outcome ◽  
Brain Injuries ◽  
Controlled Trial ◽  
Serum Magnesium ◽  
Trauma Centre ◽  
Double Blind ◽  
Positive Effect

Magnesium Sulfate for Neuroprotection After Traumatic Brain Injury: A Randomised Controlled Trial. Temkin NR, Anderson GD, Winn HR, Ellenbogen RG, Britz GW, Schuster J, Lucas T, Newell DW, Mansfield PN, Machamer JE, Barber J, Dikmen SS. Lancet Neurol 2007;6(1):29–38. BACKGROUND: Traumatic brain injuries represent an important and costly health problem. Supplemental magnesium positively affects many of the processes involved in secondary injury after traumatic brain injury and consistently improves outcome in animal models. We aimed to test whether treatment with magnesium favourably affects outcome in head-injured patients. METHODS: In a double-blind trial, 499 patients aged 14 years or older admitted to a level 1 regional trauma centre between August, 1998, and October, 2004, with moderate or severe traumatic brain injury were randomly assigned one of two doses of magnesium or placebo within 8 h of injury and continuing for 5 days. Magnesium doses were targeted to achieve serum magnesium ranges of 1 0–1·85 mmol/L or 1·25–2·5 mmol/L. The primary outcome was a composite of mortality, seizures, functional measures, and neuropsychological tests assessed up to 6 months after injury. Analyses were done according to the intention-to-treat principle. This trial is registered with Clinicaltrials.gov, number NCT00004730. FINDINGS: Magnesium showed no significant positive effect on the composite primary outcome measure at the higher dose (mean = 55 average percentile ranking on magnesium vs. 52 on placebo, 95% CI for difference – 7 to 14; p = 0·70). Those randomly assigned magnesium at the lower dose did significantly worse than those assigned placebo (48 vs. 54, 95% CI −10·5 to −2; p = 0007). Furthermore, there was higher mortality with the higher magnesium dose than with placebo. Other major medical complications were similar between groups, except for a slight excess of pulmonary oedema and respiratory failure in the lower magnesium target group. No subgroups were identified in which magnesium had a significantly positive effect. INTERPRETATION: Continuous infusions of magnesium for 5 days given to patients within 8 h of moderate or severe traumatic brain injury were not neuroprotective and might even have a negative effect in the treatment of significant head injury.

scholarly journals Rehabilitation Intervention in Animal Model Can Improve Neuromotor and Cognitive Functions After Traumatic Brain Injury: Pilot Study

2011 ◽  
pp. 367-375 ◽  
Author(s):  
M. LIPPERT-GRÜNER ◽  
M. MÄGELE ◽  
O. ŠVESTKOVÁ ◽  
Y. ANGEROVÁ ◽  
T. ESTER-BODE ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Cognitive Functions ◽  
Search Time ◽  
Study Groups ◽  
Clinical Results ◽  
Brain Trauma ◽  
Positive Effects ◽  
Therapeutic Procedures ◽  
Positive Effect

The aim of the present study was to quantify the effect of multisensory rehabilitation on rats’ cognition after an experimental brain trauma and to assess its possible clinical implications. The complex intermittent multisensory rehabilitation consisted of currently used major therapeutic procedures targeted at the improvement of cognitive functions; including multisensory and motor stimulation and enriched environment. We have confirmed this positive effect of early multisensory rehabilitation on the recovery of motor functions after traumatic brain injury. However, we have been able to prove a positive effect on the recovery of cognitive functions only with respect to the frequency of efficient search strategies in a Barnes maze test, while results for search time and travelled distance were not significantly different between study groups. We have concluded that the positive effects of an early treatment of functional deficits are comparable with the clinical results in early neurorehabilitation in human patients after brain trauma. It might therefore be reasonable to apply these experimental results to human medical neurorehabilitation care.

scholarly journals Factors associated with strain among informal care providers of patients with traumatic brain injury in Malaysia

2020 ◽  
Vol 9 (6) ◽  
pp. 2990
Author(s):  
MohammadAbrar Shareef ◽  
AmenaAwadh Bamatraf ◽  
AbdulhadiA AlAmodi ◽  
MeryamAbdella Ali ◽  
ChongMei Chan ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Informal Care ◽  
Care Providers ◽  
Factors Associated

scholarly journals Clinical Outcomes of MLC601 (NeuroAiDTM) in Traumatic Brain Injury: A Pilot Study

2020 ◽  
Vol 10 (2) ◽  
pp. 60 ◽  
Author(s):  
Asra Al Fauzi ◽  
Krisna Tsaniadi Prihastomo ◽  
I. G. M. Aswin R. Ranuh ◽  
Tedy Apriawan ◽  
Joni Wahyuhadi ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Ischemic Stroke ◽  
Brain Injury ◽  
Pilot Study ◽  
Adverse Effects ◽  
Clinical Outcomes ◽  
Controlled Trial ◽  
Control Group ◽  
Product Formulation ◽  
Positive Effect

Background: MLC601 is a natural product formulation from Chinese medicine that is extensively studied in ischemic stroke. Traumatic brain injury (TBI) shares pathophysiological mechanisms with ischemic stroke, yet there are few studies on the use of MLC601 in treating TBI. This Indonesian pilot study aimed to investigate clinical outcomes of MLC601 for TBI. Methods: This randomized controlled trial included subjects with nonsurgical moderate TBI allocated into two groups: with and without MLC601 over three months in addition to standard TBI treatment. Clinical outcomes were measured by the Glasgow Outcome Scale (GOS) and Barthel Index (BI) observed upon discharge and at months (M) 3 and 6. Results: Thirty-two subjects were included. The MLC601 group (n = 16) had higher GOS than the control group (n = 16) at all observation timepoints, though these differences were not statistically significant (p = 0.151). The BI values indicated a significant improvement for the MLC601 group compared to the control group at M3 (47.5 vs. 35.0; p = 0.014) and at M6 (67.5 vs. 57.5; p = 0.055). No adverse effects were associated with MLC601 treatment. Conclusion: In this cohort of nonsurgical moderate TBI subjects, MLC601 showed potential for a positive effect on clinical outcome with no adverse effects.

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