Rehabilitation Needs at 5 Years Post-Traumatic Brain Injury: A VA TBI Model Systems Study

Journal of Head Trauma Rehabilitation, Год журнала: 2020, Номер 36(3), С. 175 - 185

Опубликована: Ноя. 13, 2020

Describe rehabilitation needs and factors associated with unmet at 5 years post-traumatic brain injury (TBI).Five Veterans Affairs (VA) polytrauma centers (PRCs).VA TBI Model Systems participants (N = 283; 96% male, 75%, 57% severe TBI).Prospective observational cohort.Rehabilitation Needs Survey (21-item survey that assesses cognitive, emotional, social, functional needs); Craig Hospital Inventory of Environmental Factors (25-item potential environmental barriers).Participants endorsed a mean 8 (SD: 6.2) ongoing 3 4.7) post-TBI. Approximately 65% reported least 1 need remained unmet. The number nature differed across severity groups. In unadjusted adjusted linear regression models, Black race barriers (Craig total score) were predictive (P < .001). Those greater the physical environment (54%-63%), informational sources (54%), social attitudes (55%), healthcare access (40%), public policy (32%-37%), transportation availability (33%), in-home assistance (32%) as most frequent post-TBI.Veterans Service Members continue to have programs address support them are needed.

Язык: Английский

---

Estrogen Alleviates Sex-Dependent Differences in Lung Bacterial Clearance and Mortality Secondary to Bacterial Pneumonia after Traumatic Brain Injury

Journal of Neurotrauma, Год журнала: 2020, Номер 38(8), С. 989 - 999

Опубликована: Ноя. 18, 2020

Traumatic brain injury (TBI) is the leading cause of injury-related death and disability in patients under age 46 years. Survivors initial often endure systemic complications such as pulmonary infection, Pseudomonas aeruginosa one most common causes nosocomial pneumonia intensive care units. Female are less likely to develop secondary after TBI, pre-clinical studies have revealed a salutary role for estrogen trauma. Therefore, we hypothesized that female mice would experience mortality post-TBI with P. aeruginosa. We employed mouse model TBI followed by pneumonia. Male had greater impaired lung bacterial clearance compared mice. This was confirmed difference sex hormones, oophorectomized wild-type similar male There were differences tumor necrosis factor-α secretion alveolar macrophages infection. Finally, injection or restored prevented mortality. Our among first reveal dimorphism secondary, long-term complications.

Язык: Английский

---

Statistical Models and Implant Customization in Hip Arthroplasty: Seeking Patient Satisfaction through Design

Heliyon, Год журнала: 2024, Номер 10(20), С. e38832 - e38832

Опубликована: Окт. 1, 2024

Язык: Английский

---

Unmet Rehabilitation Needs Indirectly Influence Life Satisfaction 5 Years After Traumatic Brain Injury: A Veterans Affairs TBI Model Systems Study

Archives of Physical Medicine and Rehabilitation, Год журнала: 2020, Номер 102(1), С. 58 - 67

Опубликована: Сен. 16, 2020

Язык: Английский

---

Early Factors Predictive of Extreme High and Low Life Satisfaction 10 Years Post–Moderate to Severe Traumatic Brain Injury

Journal of Head Trauma Rehabilitation, Год журнала: 2023, Номер 38(6), С. 448 - 457

Опубликована: Фев. 28, 2023

Objective: To identify demographic, injury-related, and 1-year postinjury clinical functional predictors of high low life satisfaction at 10 years after moderate to severe traumatic brain injury (TBI) using an extreme phenotyping approach. Setting: Multicenter longitudinal database study. Participants: A total 3040 people from the National Institute on Disability, Independent Living, Rehabilitation Research TBI Model Systems with data post-TBI. Design: Multicenter, cross-sectional, observational design. Main Measures: Satisfaction With Life Scale (outcome), Glasgow Coma Scale, Disability Rating Functional Independence Measure, Participation Assessment Recombined Tools-Objective, Patient Health Questionnaire-9, General Anxiety Disorder-7 (standardized predictors). Results: Greater cognitive motor independence, more frequent community participation, less depressive symptoms 1 year post–moderate predicted later. Non-Hispanic White Hispanic individuals were significantly likely than Black have Conclusions: Extreme analysis complements existing knowledge regarding TBI. From a chronic disease management perspective, future studies are needed examine feasibility impact early medical rehabilitative interventions targeting function, mood maintenance/enhancement long-term

Язык: Английский

---

Rehabilitation in the Department of Veterans Affairs Polytrauma System of Care

Physical Medicine and Rehabilitation Clinics of North America, Год журнала: 2018, Номер 30(1), С. 1 - 12

Опубликована: Ноя. 21, 2018

Язык: Английский

---

Factors Associated With High and Low Life Satisfaction 10 Years After Traumatic Brain Injury

Archives of Physical Medicine and Rehabilitation, Год журнала: 2022, Номер 103(11), С. 2164 - 2173

Опубликована: Фев. 22, 2022

Язык: Английский

---

Factors associated with employment and work perception in combat-exposed veterans.

Rehabilitation Psychology, Год журнала: 2020, Номер 65(3), С. 279 - 290

Опубликована: Апрель 16, 2020

The purpose of this study was 2-fold: (a) to evaluate whether perception work ability is associated with employment status in a sample combat-exposed veterans, and (b) determine the same sets variables that are also ability. Research Method/Design: In cross-sectional study, veterans (N = 83) underwent neuropsychological assessment completed questionnaires assessing demographic characteristics, combat-related experiences, psychiatric neurobehavioral/health-related symptoms. Primary outcomes interest were (unemployed vs. employed) veterans' their has declined due an ongoing condition (yes no).

Язык: Английский

---

Refining understanding of life satisfaction in elderly persons with traumatic brain injury using age-defined cohorts: a TBI model systems study

Brain Injury, Год журнала: 2021, Номер 35(10), С. 1284 - 1291

Опубликована: Авг. 24, 2021

Objective: Examine effects of age cohort on post-injury life satisfaction in elderly persons with TBIDesign: Retrospective cohortSetting: TBI Model Systems centers.Participants: 5,109 participants the National DatabaseInterventions: Not applicableMain Outcome Measures: Demographics, injury characteristics and cause, outcomes, at time analysis, to follow commands, maximum follow-up period, scores Satisfaction With Life Scale (SWLS) Participation Assessment Recombined Tools-Objective (PART-O) 1, 2, 5, or 10 years post-injury.Results: post-TBI across groups increased age. The young-old sub-group demonstrated poorest while oldest experienced greatest satisfaction. In contrast, participation decreased age.Conclusions: Findings show diversity following moderate severe for three age-cohorts. Differences may be due variations generation-based lived experience, perceived meaningfulness participation, could echo prior evidence greater resilience group, reflect bias within study sample. Further research into between- within- differences cohorts is needed more precisely meet their needs physical functional rehabilitation as well psychological supports.

Язык: Английский

---

Cognitive Performance is Associated With 1-Year Participation and Life Satisfaction Outcomes: A Traumatic Brain Injury Model Systems Study

Journal of Head Trauma Rehabilitation, Год журнала: 2024, Номер unknown

Опубликована: Сен. 23, 2024

Objective: To determine, in persons with traumatic brain injury (TBI), the association between cognitive change after inpatient rehabilitation discharge and 1-year participation life satisfaction outcomes. Design: Secondary analysis of prospectively collected TBI Model Systems (TBIMS) data. Setting: Inpatient community. Participants: 499 individuals requiring who completed Brief Test Adult Cognition by Telephone (BTACT) at (ie, baseline) postinjury. Main Outcome Measures: Participation Assessment Recombined Tools-Objective (PART-O) Satisfaction Life Scale (SWLS) Results: Of 2,840 TBIMS participants baseline BTACT, met inclusion criteria (mean [standard deviation] age = 45 [19] years; 72% male). Change BTACT executive function (EF) was not associated (PART-O; β 0.087, 95% CI [−0.004, 0.178], P .061) when it sole model predictor. episodic memory (EM) (β 0.096, [0.007, 0.184], .035), but adjusting for demographic, clinical, functional status covariates 0.067, [−0.010, 0.145], .089). EF total scores predictor 0.091, [−0.001, 0.182], .0503). EM before 0.114, [0.025, 0.202], .012) 0.103, [0.014, 0.191], .023). In secondary analyses, PART-O Social Relations Out About subdomains (Social Relations: 0.127, [0.036, 0.217], .006; About: 0.141, [0.051, 0.232], .002) 0.168, [0.072, 0.265], < .002; 0.156, [0.061, 0.252], further [0.040, 0.214], .004; 0.136, [0.043, 0.229], .004). However, only models remained significant multiple comparison correction Bonferroni-adjusted alpha level 0.002). Conclusion: gains during first year were related to social community participation. Gains satisfaction. These results highlight potential benefit need interventions targeting specific functions that may contribute TBI.

Язык: Английский

---