Ethnographic analysis of traumatic brain injury patients in the national Model Systems database

Burnett, Derek M.; Kolakowsky-Hayner, Stephanie A.; Slater, Dan; Stringer, Anthony Y.; Bushnik, Tamara; Zafonte, Ross; Cifu, David X.

doi:10.1053/apmr.2003.50091

“…As ethnic minority groups have been found to be at increased risk of TBI internationally [24], those identified as being part of an ethnic minority group may also be at increased risk within the international prison population. In contrast to other findings, which reveals that falls are the main cause of TBI in the general population [19], assaults were identified as the main cause of TBI in this study.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Traumatic Brain Injury in a Male Adult Prison Population and Its Association with the Offence Type

Mitchell¹,

Theadom²,

Preez

³

2017

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Background: The prevalence of traumatic brain injury (TBI) in prison populations has been found to vary considerably. This study aimed to determine the prevalence of TBI in a prison population in New Zealand and to identify whether age, ethnicity, offence type, security classification and sentence length were linked to TBI prevalence. Methods: All offenders admitted to a new Corrections Facility over a 6-month period (May-November 2015) were screened to understand their history of TBI. Data was merged with demographic information, details of the offence type, sentence length and security classification from the prison database. Binary logistic regression was used to identify the contribution of predictors on TBI history. Results: Of the 1,061 eligible male prisoners, 1,054 (99.3%) completed a TBI history screen. Out of the 672 (63.7%) who had sustained at least one TBI in their lifetime, 343 (32.5%) had experienced multiple injuries. One in 5 participants experienced their first TBI injury before the age of 15 years. A regression model was able to correctly classify 66.9% of cases and revealed that belonging to Māori ethnicity or being imprisoned for violent, sexual or burglary offences were independently predictive of TBI (χ² = 9.86, p = 0.28). Conclusions: The high prevalence of TBI within male prisoners and a high proportion of injuries sustained in childhood suggest the need for routine screening for TBI to identify prisoners at risk of persistent difficulties. Interventions to support those experiencing persistent difficulties post-TBI are needed to optimise functioning and prevent reoffending.

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“…9,27,28 Adult Hispanic patients exhibit higher levels of disability measured according to lower levels of integration into the community, 29 lower standard of living, lower engagement in leisure activities, and return to work. 9 In our study, Hispanic children compared with NHW children had lower scores in participation in social activities in the community and at school.…”

Section: Discussionmentioning

confidence: 99%

“…32,33 Studies in adult patients with TBI have documented an association between access to rehabilitation services and better outcomes. 8,9,29 We do not have specific information on the intensity, type, and time of rehabilitation services for these patients, and it is therefore unknown if the Hispanic children in our study faced barriers in accessing rehabilitation services. Previous studies have linked limited English proficiency, lower education levels, and underinsurance to lower access to rehabilitation services.…”

Section: Discussionmentioning

confidence: 99%

Disparities in Disability After Traumatic Brain Injury Among Hispanic Children and Adolescents

Jimenez

¹

,

Ebel

²

,

Wang

³

et al. 2013

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WHAT'S KNOWN ON THIS SUBJECT: Previous studies report Hispanic adults have lower access to rehabilitation services, especially among those who only speak Spanish, and higher disability after traumatic brain injury (TBI) compared with nonHispanic white subjects. No studies have examined disparities in disability after TBI for Hispanic children.WHAT THIS STUDY ADDS: Hispanic children experience disparities in long-term disability after TBI. Compared with nonHispanic white children, Hispanic children report significantly larger reductions in health-related quality of life, participation in activities, and ability to communicate and care for themselves 3 years after injury. abstract OBJECTIVE: To compare the extent of disability in multiple areas of functioning after mild, moderate, and severe traumatic brain injury (TBI) between Hispanic and non-Hispanic white (NHW) children. METHODS:This was a prospective cohort study of children aged ,18 years treated for a TBI between March 1, 2007, and September 30, 2008. Hispanic (n = 74) and NHW (n = 457) children were included in the study. Outcome measures were disability in health-related quality of life, adaptive skills, and participation in activities 3, 12, 24, and 36 months after injury compared with preinjury functioning. We compared change in outcome scores between Hispanic and NHW children at each follow-up time. All analyses were adjusted for age, gender, severity and intent of injury, insurance, family function at baseline, parental education, and income. RESULTS:The health-related quality of life for all children was lower at all follow-up times compared with baseline. Although NHW children showed some improvement during the first 3 years after injury, Hispanic children remained significantly impaired. Significant differences were also observed in the domains of communication and self-care abilities after TBI. Differences between groups in scores for participation in activities were also present but were only significant 3 months after injury.CONCLUSIONS: Hispanic children with TBI report larger and long-term reductions in their quality of life, participation in activities, communication, and self-care abilities compared with NHW children. The reasons for these differences need to be better understood and interventions implemented to improve the outcomes of these children. Pediatrics

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“…9,27,28 Adult Hispanic patients exhibit higher levels of disability measured according to lower levels of integration into the community, 29 lower standard of living, lower engagement in leisure activities, and return to work. 9 In our study, Hispanic children compared with NHW children had lower scores in participation in social activities in the community and at school.…”

Section: Discussionmentioning

confidence: 99%

“…32,33 Studies in adult patients with TBI have documented an association between access to rehabilitation services and better outcomes. 8,9,29 We do not have specific information on the intensity, type, and time of rehabilitation services for these patients, and it is therefore unknown if the Hispanic children in our study faced barriers in accessing rehabilitation services. Previous studies have linked limited English proficiency, lower education levels, and underinsurance to lower access to rehabilitation services.…”

Section: Discussionmentioning

confidence: 99%

Disparities in Disability After Traumatic Brain Injury Among Hispanic Children and Adolescents

2013

PEDIATRICS

0

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WHAT'S KNOWN ON THIS SUBJECT: Previous studies report Hispanic adults have lower access to rehabilitation services, especially among those who only speak Spanish, and higher disability after traumatic brain injury (TBI) compared with nonHispanic white subjects. No studies have examined disparities in disability after TBI for Hispanic children.WHAT THIS STUDY ADDS: Hispanic children experience disparities in long-term disability after TBI. Compared with nonHispanic white children, Hispanic children report significantly larger reductions in health-related quality of life, participation in activities, and ability to communicate and care for themselves 3 years after injury. abstract OBJECTIVE: To compare the extent of disability in multiple areas of functioning after mild, moderate, and severe traumatic brain injury (TBI) between Hispanic and non-Hispanic white (NHW) children. METHODS:This was a prospective cohort study of children aged ,18 years treated for a TBI between March 1, 2007, and September 30, 2008. Hispanic (n = 74) and NHW (n = 457) children were included in the study. Outcome measures were disability in health-related quality of life, adaptive skills, and participation in activities 3, 12, 24, and 36 months after injury compared with preinjury functioning. We compared change in outcome scores between Hispanic and NHW children at each follow-up time. All analyses were adjusted for age, gender, severity and intent of injury, insurance, family function at baseline, parental education, and income. RESULTS:The health-related quality of life for all children was lower at all follow-up times compared with baseline. Although NHW children showed some improvement during the first 3 years after injury, Hispanic children remained significantly impaired. Significant differences were also observed in the domains of communication and self-care abilities after TBI. Differences between groups in scores for participation in activities were also present but were only significant 3 months after injury.CONCLUSIONS: Hispanic children with TBI report larger and long-term reductions in their quality of life, participation in activities, communication, and self-care abilities compared with NHW children. The reasons for these differences need to be better understood and interventions implemented to improve the outcomes of these children. Pediatrics

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Ethnographic analysis of traumatic brain injury patients in the national Model Systems database

Cited by 70 publications

References 11 publications

Prevalence of Traumatic Brain Injury in a Male Adult Prison Population and Its Association with the Offence Type

Prevalence of Traumatic Brain Injury in a Male Adult Prison Population and Its Association with the Offence Type

Disparities in Disability After Traumatic Brain Injury Among Hispanic Children and Adolescents

Disparities in Disability After Traumatic Brain Injury Among Hispanic Children and Adolescents

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