Trauma Commons^™

Addressing The Health Of Children In Foster Care, The Rees-Jones Center For Foster Care Excellence

White Papers and Policy Briefs

Studies have shown high rates of physical, developmental and behavioral health concerns along with high rates of health care utilization, among children and adolescents in foster care. In 2016, the Rees-Jones Center for Foster Care Excellence produced a white paper entitled, Addressing the Health and Safety of Children in Foster Care (Children’s HealthSM, 2016), which drew attention to some of these needs and made recommendations for promoting improved health-related outcomes for this population. Much has changed during the last six years, and the purpose of this current white paper is to highlight progress made, draw attention to new and continuing …

Empowering Kinship Caregivers In Texas: A Call To Action For Policy Change, The Rees-Jones Center For Foster Care Excellence

White Papers and Policy Briefs

Kinship care refers to the care of children and adolescents by relatives or close family friends, who are referred to as fictive kin. These relationships can be formal, meaning the child has been removed from a parent and placed by Child Protective Services (CPS) into the care of a relative or family friend, or informal, meaning the relationship occurs without any involvement from CPS. This brief focuses on the former and uses the term kinship care to refer to formal kinship caregiving.

For questions about this publication or others, please email [email protected]

childrens.com/fostercare

Interpersonal Violence Against Women With Spinal Cord Injury: Adding Insult To Injury, Susan Robinson-Whelen, Rosemary B Hughes, Kimberley Aguillard, Diana Gonzalez, Heather B Taylor

Faculty, Staff and Student Publications

BACKGROUND: Mounting empirical evidence suggests that, compared to women without disabilities, women with disabilities are more likely to experience interpersonal violence (IPV). However, there is extremely limited research attention on IPV against women with spinal cord injury (SCI), a particularly understudied and underserved population.

OBJECTIVES: To conduct the first known examination of lifetime IPV experience in women with SCI, to explore demographic and disability-related correlates of IPV, and to examine the health impacts of IPV.

METHODS: The sample included 175 women with traumatic SCI from across the United States who enrolled in a randomized controlled trial of an online psychological …

Disrupted Pancreatic Duct With Necrotic Fluid Collection, Treated With Endoscopic Management, Amir Aghaabdollah, Kelly Volland, Anabel Rodriguez Loya

West Florida Division GME Research Day 2023

No abstract provided.

Volatile Anesthetic And Outcome In Acute Trauma Care: Planned Secondary Analysis Of The Proppr Study, Colleen E Livingston, Dominique T Levy, Sepideh Saroukhani, Erin E Fox, Charles E Wade, John B Holcomb, Sam D Gumbert, Samuel M Galvagno, Olga Y Kaslow, Jean-Francois Pittet, Evan P Pivalizza

Faculty, Staff and Student Publications

BACKGROUND: This retrospective analysis of prospectively collected data from the PROPPR study describes volatile anesthetic use in severely injured trauma patients undergoing anesthesia.

METHODS: After exclusions, 402 subjects were reviewed of the original 680, and 292 had complete data available for analysis. Anesthesia was not protocolized, so analysis was of contemporary practice.

RESULTS: The small group who received no volatile anesthetic (n = 25) had greater injury burden (Glasgow Coma Scale

CONCLUSION: In this acutely injured trauma population, choice of volatile anesthetic did not appear to influence short-term mortality and morbidity. Subjects who received no volatile were more severely injured …

Evaluation Of Communication Sciences And Disorders Graduate Student Attitudes Related To Trauma-Informed Client Interactions, Jenica Joseph

Dissertations

Problem

Communication sciences and disorders (CSD) graduate students may have trauma histories and may be ill-equipped to identify and manage trauma responses in clients. This mixed-methods study examined graduate student attitudes towards implementing trauma-informed educational practice (TIEP) methods and trauma-informed patient care.

Method

The Attitudes Related to Trauma-Informed Care (ARTIC) Scale (Baker et al., 2016) quantitatively measured pretest/posttest changes in CSD graduate student attitudes towards use of trauma-informed care with clients. Participants (n=43) were assigned to non-equivalent experimental and control groups. Groups received the pre/posttest and either an immediate (experimental) or delayed (control) trauma-informed educational session. Twenty-one participants completed focus …

Integrating Feminist Approaches In Counseling Work With Adult Women, Kristen M. Toole

Adultspan Journal

The scope of ‘women’s issues’ in counseling is an ever-evolving landscape. Recent events such as the reversal of Roe v. Wade and the disproportionate impact of COVID-19 on women serve as powerful reminders of the necessity of this focus while underscoring a deep-rooted history of oppressive patriarchal structures. Therefore, counselors must remain informed of the unique considerations surrounding adult women in counseling and acquire proficiency in versatile techniques to meet this population’s nuanced needs. This article examines the complexity of contemporary womanhood and explores the fundamentals of Feminist Counseling Theory (FCT), a holistic, multiculturally conscious, social justice theory in counseling. …

Expandable Intravertebral Implants In Post-Traumatic Vertebral Necrosis - New Classification Suggestion., Diogo Lino Moura, Josué Pereira Gabriel

Trauma and Acute Care Articles

The progressive evolution of post-traumatic vertebral necrosis and consequent loss of structural integrity of the vertebral body along with neurological risk, makes it one of the most feared and unpredictable pathologies in spine traumatology. Several studies have addressed the role of vertebroplasty, kyphoplasty, and corpectomy in its treatment; however, it remains a controversial concept without a defined therapeutic algorithm. The recent emergence of expandable intravertebral implants, which allow, by a percutaneous transpedicular application, the capacity for intrasomatic filling and maintenance of the height of the vertebral body, makes them a viable option, not only in the treatment of acute vertebral …

The Association Between Payer Source And Traumatic Brain Injury Rehabilitation Outcomes: A Tbi Model Systems Study, Anthony H Lequerica, Angelle M Sander, Monique R Pappadis, Jessica M Ketchum, Marissa Jaross, Stephanie Kolakowsky-Hayner, Amanda Rabinowitz, Librada Callender, Michelle Smith

Faculty, Staff and Students Publications

OBJECTIVE: To examine the relationship between payer source for acute rehabilitation, residential median household income (MHI), and outcomes at rehabilitation discharge after traumatic brain injury (TBI).

SETTING: Acute inpatient rehabilitation facilities.

PARTICIPANTS: In total, 8558 individuals enrolled in the Traumatic Brain Injury Model Systems (TBIMS) National Database who were admitted to inpatient rehabilitation between 2006 and 2019 and were younger than 64 years.

DESIGN: Secondary data analysis from a multicenter longitudinal cohort study.

MAIN MEASURES: Payer source was divided into 4 categories: uninsured, public insurance, private insurance, and workers' compensation/auto. Relationships between payer source with residential MHI, rehabilitation length of …

Specialized Intensive Inpatient Rehabilitation Is Crucial And Time-Sensitive For Functional Recovery From Disorders Of Consciousness, Bei Zhang, Katherine O'Brien, Jean Woo, Bradley Chi, Colton Reeh, Sheng Li, Sunil Kothari

Faculty, Staff and Students Publications

BACKGROUND: Disorders of consciousness (DoCs) after severe brain injury are considered to be conditions with dire prognosis. Despite the accumulating evidence, inpatient rehabilitation is often denied by payers referring to the Medicare/Medicaid criteria, under the assumption that such patients will not "

OBJECTIVE: This study aimed to report on the effectiveness and efficiency of a specialized inpatient DoC rehabilitation program based on measurable clinical parameters.

METHODS: A retrospective cohort study was conducted. The cohort comprised 137 patients with DoC admitted to a specialized acute inpatient rehabilitation program between January 2014 and October 2018. Patients were categorized as having been admitted …

Perceived Care Partner Burden At 1-Year Post-Injury And Associations With Emotional Awareness, Functioning, And Empathy After Tbi: A Tbi Model Systems Study, Daniel W Klyce, Kritzianel Merced, Alexander Erickson, Dawn M Neumann, Flora M Hammond, Angelle M Sander, Jennifer A Bogner, Tamara Bushnik, Joyce S Chung, Jacob A Finn

Faculty, Staff and Students Publications

BACKGROUND: People with traumatic brain injury (TBI) can lack awareness of their own emotions and often have problems with emotion dysregulation, affective disorders, and empathy deficits. These impairments are known to impact psychosocial behaviors and may contribute to the burden experienced by care partners of individuals with TBI.

OBJECTIVE: To examine the associations of emotional awareness, emotional functioning, and empathy among participants with TBI with care partner burden.

METHOD: This multisite, cross-sectional, observational study used data from 90 dyads (participants with TBI and their care partner) 1-year post-injury. Participants with TBI completed the Difficulty with Emotional Regulation Scale (DERS; Awareness, …

Modified Early Warning Scoring (Mews) Versus Epic Deterioration Index (Edi): Battle Royale For Which Has The Best Patient Outcomes In The Inpatient Setting, Dirk A. Church

DNP Projects

Abstract

Background: The increased workload bedside nurses face today requires new tools to assist with the identification of deteriorating patients during hospitalization. The Modified Early Warning Score (MEWS) tool has formed the background of early warning tools. Newer, more complex tools, like Epic’s Deterioration Index (EDI), have been developed to identify patient deterioration earlier. There is lack of evidence in the literature comparing different early warning tools, implementation, and patient outcomes.

Objective: The purpose of the study was to examine models for EWS notification for RRT and patient outcomes between the use of the MEWS and EDI in an adult, …

Cerebral Microdialysis And Glucopenia In Traumatic Brain Injury: A Review, Himanshu Sharma, John P Mcginnis, Katherine E Kabotyanski, Shankar P Gopinath, Jerry C Goodman, Claudia Robertson, Jovany Cruz Navarro

Faculty, Staff and Students Publications

Traditionally, intracranial pressure (ICP) and partial brain tissue oxygenation (PbtO2) have been the primary invasive intracranial measurements used to guide management in patients with severe traumatic brain injury (TBI). After injury however, the brain develops an increased metabolic demand which may require an increment in the oxidative metabolism of glucose. Simultaneously, metabolic, and electrical dysfunction can lead to an inability to meet these demands, even in the absence of ischemia or increased intracranial pressure. Cerebral microdialysis provides the ability to accurately measure local concentrations of various solutes including lactate, pyruvate, glycerol and glucose. Experimental and clinical data demonstrate that such …

Evaluating The Impact Of Using A Wound-Specific Oral Nutritional Supplement To Support Wound Healing In A Rehabilitation Setting, Rya K Clark, Argyrios Stampas, Kirk W Kerr, Jeffrey L Nelson, Suela Sulo, Luis Leon-Novelo, Esther Ngan, Dehuti Pandya

Faculty, Staff and Student Publications

Chronic wounds adversely affect patient quality of life, increase the risk of mortality, and impose high costs on healthcare systems. Since protein-energy malnutrition or specific nutrient deficiencies can delay wound healing, nutritionally focused care is a key strategy to help prevent or treat the occurrence of non-healing wounds. The objective of our study of inpatients in a rehabilitation hospital was to quantify the effect of daily wound-specific oral nutritional supplementation (WS-ONS) on healing chronic wounds. Using electronic medical records, we conducted a retrospective analysis of patients with chronic wounds. We identified records for (a) a treatment group who received standard …

Subcortical Functional Connectivity And Its Association With Walking Performance Following Deployment Related Mild Tbi, Mary R Newsome, Sarah L Martindale, Nicholas Davenport, Emily L Dennis, Marlene Diaz, Carrie Esopenko, Cooper Hodges, George R Jackson, Qisheng Liu, Kimbra Kenney, Andrew R Mayer, Jared A Rowland, Randall S Scheibel, Joel L Steinberg, Brian A Taylor, David F Tate, J Kent Werner, William C Walker, Elisabeth A Wilde

Faculty, Staff and Students Publications

INTRODUCTION: The relation between traumatic brain injury (TBI), its acute and chronic symptoms, and the potential for remote neurodegenerative disease is a priority for military research. Structural and functional connectivity (FC) of the basal ganglia, involved in motor tasks such as walking, are altered in some samples of Service Members and Veterans with TBI, but any behavioral implications are unclear and could further depend on the context in which the TBI occurred.

METHODS: In this study, FC from caudate and pallidum seeds was measured in Service Members and Veterans with a history of mild TBI that occurred during combat deployment, …

Pediatric Traumatic Brain Injury In The Middle East And North Africa Region: A Systematic Review And Meta-Analysis To Assess Characteristics, Mechanisms, And Risk Factors, Samar Al-Hajj, Sarah H Farran, Batoul Dekmak, Layal Hneiny, Hussein Abou Abbas, Aya Hassoun, Nadine Youness, Sarah Ghalayini, Nour Abou Khalil, Fiona Lecky, Shima Shahjouieh, Layal Ghamlouche, Zainab Nasrallah, Firas Kobeissy

Faculty, Staff and Student Publications

Pediatric traumatic brain injury (pTBI) represents a major cause of child injuries in the Middle East and North Africa (MENA) region. This review aims to assess pTBIs in the MENA region and reports their clinical severity and outcomes. A search was conducted using major electronic databases, including Medline/Ovid, PubMed, EMBASE, Web of Science, and SCOPUS. Abstracts were screened independently and in duplicate to detect original research. The objective and study findings for each article were recorded, along with the mechanism of pTBI, patient age and sex, injury assessment tool(s) used, and outcome. A total of 1345 articles were retrieved, of …

The Insulin And Igf Signaling Pathway Sustains Breast Cancer Stem Cells By Irs2/Pi3k-Mediated Regulation Of Myc, Manoj Sivan, Stefano Negrini, Carlotte Kiekens, Fary Khan, Gerard E Francisco, Francesca Gimigliano

Faculty, Staff and Student Publications

No abstract provided.

A Comparison Of One Year Outcomes Between Standardized Locomotor Training And Usual Care After Motor Incomplete Spinal Cord Injury: Community Participation, Quality Of Life And Re-Hospitalization, Candace Tefertiller, Meghan Rozwod, Sandra Wojciehowski, Mitch Sevigny, Susan Charlifue, Jessica M Ketchum, Jeffrey Berliner, Heather B Taylor, Andrea L Behrman, Susan Harkema, Gail Forrest, Mary Schmidt Read, Michelle Basso

Faculty, Staff and Student Publications

CONTEXT/OBJECTIVE: Spinal cord injury (SCI) often results in a significant loss of mobility and independence coinciding with reports of decreased quality of life (QOL), community participation, and medical complications often requiring re-hospitalization. Locomotor training (LT), the repetition of stepping-like patterning has shown beneficial effects for improving walking ability after motor incomplete SCI, but the potential impact of LT on psychosocial outcomes has not been well-established. The purpose of this study was to evaluate one year QOL, community participation and re-hospitalization outcomes between individuals who participated in a standardized LT program and those who received usual care (UC).

DESIGN/SETTING/PARTICIPANTS: A retrospective …

Quality Care Is Equitable Care: A Call To Action To Link Quality To Achieving Health Equity Within Acute Care Surgery, Lisa M Knowlton, Tanya Zakrison, Lillian S Kao, Marta L Mccrum, Suresh Agarwal, Brandon Bruns, Kathie-Ann Joseph, Cherisse Berry

Faculty, Staff and Student Publications

Health equity is defined as the sixth domain of healthcare quality. Understanding health disparities in acute care surgery (defined as trauma surgery, emergency general surgery and surgical critical care) is key to identifying targets that will improve outcomes and ensure delivery of high-quality care within healthcare organizations. Implementing a health equity framework within institutions such that local acute care surgeons can ensure equity is a component of quality is imperative. Recognizing this need, the AAST (American Association for the Surgery of Trauma) Diversity, Equity and Inclusion Committee convened an expert panel entitled 'Quality Care is Equitable Care' at the 81st …

Novel Psychiatric Disorder 6 Months After Traumatic Brain Injury In Children And Adolescents, Jeffrey E Max, Imogen Drake, Florin Vaida, John R Hesselink, Linda Ewing-Cobbs, Russell J Schachar, Sandra B Chapman, Erin D Bigler, Elisabeth A Wilde, Ann E Saunders, Tony T Yang, Olga Tymofiyeva, Harvey S Levin

Faculty, Staff and Student Publications

OBJECTIVE: To investigate the factors predictive of novel psychiatric disorders in the interval 0-6 months following traumatic brain injury (TBI).

METHODS: Children ages 5-14 years consecutively hospitalized for mild to severe TBI at five hospitals were recruited. Participants were evaluated at baseline (soon after injury) for pre-injury characteristics including psychiatric disorders, socioeconomic status (SES), psychosocial adversity, family function, family psychiatric history, and adaptive function. In addition to the psychosocial variables, injury severity and lesion location detected with acquisition of a research MRI were measured to develop a biopsychosocial predictive model for development of novel psychiatric disorders. Psychiatric outcome, including occurrence …