72 research outputs found

    Caregiver Characteristics of Adults with Acute Traumatic Brain Injury in the United States and Latin America

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    Objectives: To compare characteristics of caregivers of adults with acute traumatic brain injury (TBI) in the U.S. and Latin America (Mexico and Colombia). Design: Secondary data analysis of two cohorts. Cohort 1: English-speaking caregivers of adults with TBI in the U.S. (n = 80). Cohort 2: Spanish-speaking caregivers of adults with TBI in Mexico or Colombia (n = 109). Results: Similarities between the U.S. and Latin American caregiver groups, respectively, were: predominantly women (81.3%, 81.7%, respectively); spouses/domestic partners (45%, 31.2%); and motor vehicle accident (41.5%, 48.6%) followed by fall etiologies (40%, 21.1%). Differences between U.S. and Latin American caregivers were: age (49.5 years, 41.5 years, p < 0.001); employment status ((X-5(2) = 59.63, p < 0.001), full-time employment (63.7%, 25.7%), homemaker (2.5%, 31.2%), and retired (17.5%, 1.8%)); violence-related etiology (2.5%, 15.6%); and severity of depressive symptoms (M = 7.9, SD = 5.8; M = 5.8, SD = 5.7; p = 0.014). Conclusions: TBI caregivers in the U.S. were older and employed full-time or retired more often than those in Latin America. Violence-related etiology was nearly five times more common in Latin America, raising concerns for potential implications of post-traumatic stress and family adjustment after injury. Although both groups likely could use mental health support, this was particularly true of the U.S. cohort, maybe due to differential demographics, mechanisms of injury, or family and community support.Data collection was supported by NIDILRR (grant numbers: Kessler 90DPTB0003; NTX-TBIMS 90DPTB0013; JFK 90DPTB0014) and Grant #R21TW009746 from the Fogarty International Center of the National Institutes of Health and in part by the Department of Veterans Affairs. Additional support for coauthors was provided by NIDILRR (grant numbers: Spaulding/Harvard TBIMS: 90DPTB0011; TIRR 90DPTB0016)

    Reply to commentary by R Duggleby (2019)

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    Duggleby (2018) has made a numerical analysis of some aspects of the wide range of phenomena we reviewed in Steele et al. (2018) and asserted " .that panspermia as proposed by Steele et al. (2018) is extremely implausible.” It seems to us that Duggleby has based his viewpoint on a quite narrow and specific model of Panspermia which he supposes to be active in the cosmos. Here we address both his conclusions and his numerical analysis. Our response therefore will be at two levels, his specific analysis and his general conclusions. In the specific section below we show that while Duggleby's numerical analysis appears in part correct it is, in the final analysis, quite irrelevant to Cosmic Panspermia. In the general response which follows we address his unsupported conclusion throughout his critique, namely that … " none of the examples mentioned by Steele et al. (2018) is decisive enough to allow no other explanation.

    Racial/Ethnic Differences in Arrest Probability Trajectories after Traumatic Brain Injury: A Model Systems Study

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    Background: Previous literature has documented racial/ethnic differences in traumatic brain injury (TBI) risk, cause, treatment, and rehabilitation. The purpose of the current study was to investigate potential racial/ethnic differences in arrest probability trajectories over the first 10 years after TBI and whether injury and sociodemographic characteristics accounted for these differences. Methods: The current study included 13,195 participants with moderate-to-severe TBI in the TBI Model Systems National Database who had arrest data from at least one follow-up time point (Years 1, 2, 5, and/or 10). A series of hierarchical linear models assessed racial/ethnic differences in trajectories of arrest probability over these 10 years post-injury and then included socio-demographic and injury-related covariates. Results: White individuals with TBI had lower arrest probability trajectories than Black and Native American individuals, and Asian individuals with TBI had lower arrest probability trajectories than White, Black, Latinx, and Native American persons. In many cases, racial/ethnic disparities persisted even when injury and sociodemographic characteristics were covaried. Conclusion: These results suggest that rehabilitation clinicians should assess for post-injury arrest risk factors such as age, sex, education, pre-injury unemployment, arrest history, and substance abuse, particularly in Black, Latinx, and Native American groups, and integrate programming to lessen post-injury arrest probability and improve overall rehabilitation outcomes
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