Results: One hundred seventy-five patients (20.9%) were diagnosed with SCI clinical syndromes. CCS was the most common (44.0%), followed by CES (25.1%) and BSS (17.1%). Significant differences (P 0.01) were found between groups with regard to age, race, etiology, total admission FIM, motor admission FIM, self-care admission and discharge FIM, and LOS. Statistical analysis between tetraplegic BSS and CCS revealed significant differences (P 0.01) with respect to age (39.7 vs 53.2 years) and a trend toward significance (P 0.05) with regard to self-care admission and discharge FIM. No significant differences (P 0.01) were found when comparing CMS to CES.Conclusions: SCI clinical syndromes represent a significant proportion of admissions to acute SCI rehabilitation, with CCS presenting most commonly and representing the oldest age group with the lowest admission functional level of all SCI clinical syndromes. Patients with cervical BSS seem to achieve higher functional improvement by discharge compared with patients with CCS. Patients with CMS and CES exhibit similar functional outcomes. Patients with ACS and PCS show functional gains with inpatient rehabilitation, with patients with ACS displaying the longest LOS of the SCI clinical syndromes. These findings have important implications for the overall management and outcome of patients with SCI.J Spinal Cord Med. 2007;30:215-224

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Persons who drink post-injury are unlikely to be 'light' or social drinkers. Either people choose to abstain completely or appear to use alcohol frequently.

This study demonstrates the beneficial outcomes of use of HAs in reducing the probability of any ED visits and any hospitalizations and in reducing the number of nights in the hospital. Although use of HAs reduced total Medicare costs, it significantly increased total and out-of-pocket health care spending. This information may have implications for Medicare regarding covering HAs for patients with HL.

Traumatic brain injury (TBI) is a leading cause of death and disability worldwide. Accidents are a major cause of brain injury, and many accidents are alcohol or drug related. Evidence indicates that a vast majority of victims test positive for alcohol or illicit drugs at the time of hospital admission. Research also suggests that a majority of TBI survivors were moderate to heavy drinkers pre-injury. This manuscript reviews literature on pre- and post-injury substance use patterns, abuse risk factors, and dangers of post-injury use. Assessment is discussed in detail with information provided on the need for quantitative assessment, records review, corroboration, and long-term monitoring. Information is also provided on critical features of treatment, prevention, and education, and on the role of psychologists in substance abuse assessment and treatment. The manuscript concludes with a section addressing issues, questions, and concerns commonly encountered by clinicians.

We analyzed models of access to care and disparities in healthcare to be able to have an integrated and cohesive conceptual framework that could potentially address issues related to access to healthcare among individuals with disabilities. The Model of Healthcare Disparities and Disability (MHDD) provides a framework for conceptualizing how healthcare disparities impact disability and specifically, how a mismatch between personal and environmental factors may result in reduced healthcare access and quality, which in turn may lead to reduced functioning, activity and participation among individuals with impairments and chronic health conditions. Researchers, health providers, policy makers and community advocate groups who are engaged in devising interventions aimed at reducing healthcare disparities would benefit from the discussions. Implications for Rehabilitation Evaluates the main models of healthcare disparity and disability to create an integrated framework. Provides a comprehensive conceptual model of healthcare disparity that specifically targets issues related to individuals with disabilities. Conceptualizes how personal and environmental factors interact to produce disparities in access to healthcare and healthcare quality. Recognizes and targets modifiable factors to reduce disparities between and within individuals with disabilities.

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