Racial/Ethnic Disparities In Longitudinal Trajectories Of Arrest Probability After Traumatic Brain Injury

Traumatic Brain Injury (TBI) is one of the leading causes of disability across the globe, and epidemiological studies have documented a rise in this condition over the recent years. Post-TBI functional impairments can persist beyond the acute phase of the injury, and specific psychosocial and injury-related factors have predicted variability in these outcomes. Previous literature has documented profound racial/ethnic disparities in TBI risk, cause, treatment, and rehabilitation. Prior investigation has revealed an overlap between incarceration and TBI, which showed that incarcerated persons typically endorsed a history of TBI. Criminal justice literature has shown stark racial/ethnic differences in incarceration rates, which are consistent among TBI populations. The current study included participants from the national TBI Model System’s study. An aim of the current study was to evaluate whether racial/ethnic disparities in traumatic brain injury acquisition and rehabilitation, which have been supported by previous literature, occurred within the current study sample. An additional aim of this research was to examine racial/ethnic disparities in arrest probability trajectories and whether injury and sociodemographic characteristics contributed to these longitudinal arrest trajectories. This study utilized a series of hierarchical linear models (HLMs) to assess longitudinal trajectories of arrest probability over the span of ten years post-injury, racial/ethnic disparities longitudinal arrest trajectories, and socio-demographic and injury-related predictors of these identified disparities. Preliminary study results supported previous literature which has shown racial/ethnic disparities in TBI cause and rehabilitation. Arrest probability trajectories generally decreased over the course of ten years post-discharge. White persons with TBI had lower arrest probability trajectories than Black and Native American persons, and Asian individuals with TBI had lower arrest probability trajectories than White, Black, Latinx, and Native American persons. When sociodemographic and injury related characteristics were entered in the models, the racial/ethnic differences in longitudinal arrest probability trajectories were no longer significant for the White vs. Black, Latinx vs. Asian, White vs. Native American, and Latinx vs. Native American comparisons. However, disparities remained in the White vs. Asian, Black vs. Asian, and Asian vs. Native American comparisons. These findings suggest that arrest probability trajectories occur differentially as a function of racial/ethnic group membership, though these differences can only in part be accounted for by injury and sociodemographic considerations. As such, the current study findings yield clinical, public health, and criminal justice implications, aimed to lessen arrest probability outcomes for persons with TBI who possess certain sociodemographic features in addition to racial/ethnic minority group membership

Racism, Healthcare Provider Trust, and Medication Adherence among Black Patients in Safety-Net Primary Care: A Strength-Based Approach

Integrated primary care has been incorporated into a variety of healthcare settings. The benefits of these services are empirically supported by a plethora of studies, which highlight the integration of behavioral and physical healthcare to be beneficial for both patient and healthcare providers. Integrated care models are typically incorporated in Veterans Affairs hospitals, general primary care facilities, and community clinics. Community-based clinics, such as safety-net clinics, typically serve underrepresented populations, and research has shown several mental and physical health disparities to exist among minority populations. Further, the minority stress model posits that distal and proximal minority-based stress processes can result in a cascade of negative health outcomes, such as increased symptomology or poor health-management behaviors. Although minority stressors can lead to this series of consequences, several community and personal strengths may serve as protective factors for marginalized individuals. These processes may occur within safety-net primary care, considering that the populations of interest are underserved. Black patient populations face numerous barriers to healthcare, such as racism, discrimination, and provider bias. Prior literature has shown that prior experiences of racism result in poorer mental and physical health outcomes for Black patient populations. Further, these outcomes have been shown to negatively impact healthcare attitudes and behaviors. The current study aimed to examine how aspects of the minority stress model may operate within safety-net primary care services for Black patient populations. It was hypothesized that racism would predict poorer mental health, which would negatively impact provider trust, and therefore predict lower medication adherence. Using a strengths-based approach, grit and social support were hypothesized to serve as personal and collective buffers to this series of relationship. A path analysis showed that racism significantly predicted mental health, which predicted poorer provider trust; however, the last path of this model, provider trust to medication adherence, was not found to be statistically significant. Thus, the path analysis was broken up into a series of mediations, which explored the relationship between racism and both provider trust and medication adherence through mental health. Mental health was found to mediate the relationship from racism to provider trust and from racism to medication adherence. The moderated mediation effect of social support was found to be non-significant for all mediations, except that grit was moderated the mediation between racism to medication adherence through mental health. These results showed grit served as a personal strength to dampen the associated effects of racism, which may suggest improving intrinsic attitudes and motivation towards long-term health related goals may increase treatment adherence behaviors. Results from this study also confirm the importance of integrated primary care services, as the data suggested high rates of mental health problems, which typically go underreported among Black patients in healthcare settings

A comparative investigation of first and fourth quartile eighth grade students at Colonial Heights Junior High School

It was the purpose of this study (1) to compare the two groups, in certain specific characteristics and abilities; (2) to show that a difference existed between the two groups in such areas as: vita1 statistics, home environment, school record, intelligence, reading ability, and aptitude; (3) to present statistical evidence that a significant difference did exist between the two groups; and (4) to draw conclusions based upon the data which would serve as a basis for decision-making at the junior high level

Design and fabrication of a mid infra-red photonic crystal defect laser in indium antimonide

This paper presents 2D FDTD modelling and prototype fabrication of a mid-infrared photonic crystal defect laser. The device is fabricated using a two stage Focused Ion Beam process which results in improved hole profiles

The development and testing of the Lens Antenna Deployment Demonstration (LADD) test article

The USAF Rome Laboratory and NASA Marshall Space Flight Center, through contract to Grumman Corporation, have developed a space-qualifiable test article for the Strategic Defense Initiative Organization to demonstrate the critical structural and mechanical elements of single-axis roll-out membrane deployment for Space Based Radar (SBR) applications. The Lens Antenna Deployment Demonstration (LADD) test article, originally designed as a shuttle-attached flight experiment, is a large precision space structure which is representative of operational designs for space-fed lens antennas. Although the flight experiment was cancelled due to funding constraints and major revisions in the Strategic Defense System (SDS) architecture, development of this test article was completed in June 1989. To take full advantage of the existence of this unique structure, a series of ground tests are proposed which include static, dynamic, and thermal measurements in a simulated space environment. An equally important objective of these tests is the verification of the analytical tools used to design and develop large precision space structures

RGS9-1 is required for normal inactivation of mouse cone phototransduction

Purpose: To test the hypothesis that Regulator of G-protein Signaling 9 (RGS9-1) is necessary for the normal inactivation of retinal cones. Methods: Mice having the gene RGS9-1 inactivated in both alleles (RGS9-1 -/-) were tested between the ages 8-10 weeks with electroretinographic (ERG) protocols that isolate cone-driven responses. Immunohistochemistry was performed with a primary antibody against RGS9-1 (anti-RGS9-1c), with the secondary conjugated to fluorescein isothiocyanate, and with rhodamine-conjugated peanut agglutinin. Results: (1) Immunohistochemistry showed RGS9-1 to be strongly expressed in the cones of wildtype (WT is C57BL/6) mice, but absent from the cones of RGS9-1 mice. (2) Cone-driven b-wave responses of dark-adapted RGS9-1 -/- mice had saturating amplitudes and sensitivities in the midwave and UV regions of the spectrum equal to or slightly greater than those of WT (C57BL/6) mice. (3) Cone-driven b-wave and a-wave responses of RGS9-1 -/- mice recovered much more slowly than those of WT after a strong conditioning flash: for a flash estimated to isomerize 1.2% of the M-cone pigment and 0.9% of the UV-cone pigment, recovery of 50% saturating amplitude was approximately 60-fold slower than in WT. Conclusions: (1) The amplitudes and sensitivities of the cone-driven responses indicate that cones and cone-driven neurons in RGS9-1 -/- mice have normal generator currents. (2) The greatly retarded recovery of cone-driven responses of RGS9-1 -/- mice relative to those of WT mice establishes that RGS9-1 is required for normal inactivation of the cone phototransduction cascades of both UV- and M-cones

Is Helping Really Helping? Health-Related Quality of Life after TBI Predicting Caregiver Depression Longitudinally in Latin America

Objective: Studies have shown that functional and psychosocial sequelae of traumatic brain injury (TBI) predict emotional well-being of caregivers (Harris, 2000). Previous research examining the mental health of caregivers and the health-related quality of life (HRQoL) of people with TBI have primarily been in the US (Sander, 2012). Very little research has been conducted to uncover the unique relationships between HRQoL of people with TBI and caregiver mental health longitudinally, or in low-middle income Latin American countries. The aim of this study was to evaluate how HRQoL after TBI predict caregiver depression longitudinally in two countries and three data collection sites in Latin America. Design: Multi-site, multinational longitudinal study. Setting: Three hospitals in Neiva and Cali, Colombia, and Mexico City, Mexico (before hospital discharge), as well as in the homes of individuals with TBI and caregivers in these regions (before discharge, at 2 and 4 months after discharge). Participants: A sample of 109 TBI caregiver-patient dyads (n = 218) was included in the study. Main Outcome Measure(s): Caregiver depression (Patient Health Questionnaire-9) and HRQoL in the person with TBI (Short Form-36). Results: Three multiple regressions were conducted to examine which aspects of patient HRQoL at baseline predicted caregiver depression at baseline, 2 months, and 4 months post-discharge. Eight aspects of patient HRQoL were simultaneously entered into each model as predictors: physical functioning, role limitations (physical and emotional), vitality, mental health, social functioning, pain, and general health. At baseline, the overall model significantly predicted caregiver depression, F(8, 105) = 2.62, p = .012, R 2 = .18. Patient mental health was the only significant unique predictor of caregiver depression at baseline, p = .021, β = -.34. The overall model predicting 2-month caregiver depression was significant, F(8, 101) = 3.21, p = .003, R 2 = .22. Only mental health, p = .016, β = -.36, was a significant unique predictor. The overall model predicting 4-month caregiver depression was significant, F(8, 98) = 2.70, p = .010, R 2 = .19, and no factors uniquely predicted caregiver depression, all ps\u3e.05. Conclusions: Results suggest that TBI patient HRQoL can predict caregiver depression among Latin American caregivers before and during the first 4 months after hospital discharge. Across all three time points (baseline, 2 months, and 4 months), caregiver depression was significantly predicted by patient HRQoL. At baseline, patient mental health was the only domain that uniquely predicted caregiver depression. At 2 months, only physical role limitations uniquely predicted caregiver depression, and no unique predictors were detected at 4 months. These findings suggest that within the cultural framework in Latin America, there is a strong relationship between functional and psychological impairments after TBI and depression outcomes in Latin American caregivers. The results highlight the importance of uncovering these relational distinctions and may infer early detection of mental health needs and psychological intervention considerations for Latin American caregivers.https://scholarscompass.vcu.edu/gradposters/1052/thumbnail.jp