Knowledge Of Traumatic Brain Injury Research Articles

Zebrafish аs а Promising Experimental Model of Traumatic Brain Injury

Traumatic brain injury (TBI) involves various types of physical injuries to brain tissue. TBI is a highly heterogeneous clinical condition, whose symptoms include cognitive, motor and emotional deficits, as well as neurodegeneration and neuroinflammation. Animal modeling plays a key role in studying TBI, expanding our knowledge of TBI and its temporal dynamics, and to develop new drugs for its treatment. Recently, the use of the bony zebrafish (Danio rerio) as an aquatic model organism has attracted particular interest in translational neurobiology. Zebrafish are presently second (after mice) laboratory animal species most used in biomedicine. Here, we discuss the prospects of using zebrafish to model TBI, as well as problems and new directions of research in this area. We also emphasize the importance of zebrafish as a highly translational model for studying the molecular mechanisms and neurological disorders in TBI, as well as screening for potential therapeutic agents.

Who is seeking information about traumatic brain injury? Characterizing online course participants.

Accessible, up-to-date information on traumatic brain injury (TBI) can be challenging to find and is needed to address TBI knowledge gaps and improve outcomes for people who experience a TBI. The Understanding TBI Massive Open Online Course (TBI MOOC) was developed to increase TBI knowledge across a diverse global audience. We sought to characterize the TBI MOOC participant cohort, to understand the reach of the course among this target audience. Examining the characteristics of TBI MOOC enrollees showed that participants came from a wide range of demographic backgrounds, had a variety of TBI experiences and had multiple reasons for enrolling in the MOOC. The majority of course participants shared some characteristics with other groups of health information seekers. Four distinct demographic profiles were identified among TBI MOOC participants (education seekers, TBI-aware participants, TBI care providers and retirees) using a novel approach combining chi-squared tests and network modularity. Participants assigned to the TBI-aware and retiree profiles were most likely to complete all modules of the MOOC, and the TBI-aware profile was more highly represented in more recent iterations of the MOOC. Together, these data indicate that the TBI MOOC provided information to a wide range of people, and particularly engaged participants with personal or family experience of TBI. However, engagement with this course was minimal among some hard-to-reach populations, including men and people with low levels of education, indicating that additional strategies are needed to ensure equity in health promotion.

In-vivo and In-vitro Investigations to Assess Traumatic Brain Injury.

Traumatic brain injury (TBI) is a major source of death and disability worldwide; however, its pathogenesis is no longer regarded as an immediate, irreversible process that occurs at the time of injury. Long-term alterations in personality, sensory-motor function, and cognition are common among trauma survivors. The pathophysiology of brain injury is very complex, so it is difficult to understand. Establishing models such as weight drop, controlled cortical impact, fluid percussion, Accelerationdeceleration, hydrodynamic and cell line culture, etc</i>., to simulate the event within controlled conditions has been a critical step in better understanding traumatic brain injury and enabling improved therapy. Establishing effective in vivo and in vitro</i> models of traumatic brain injury and mathematical models is described here as part of the discovery of neuroprotective techniques. Some models, such as weight drop, fluid percussion, and cortical impact, help us understand the pathology of brain injury and provide suitable and effective therapeutic doses of the drug. A chemical mechanism such as prolonged or toxic exposure to chemicals and gases causes toxic encephalopathy, an acquired brain injury that may or may not be reversible. This review provides a comprehensive overview of numerous in-vivo</i> and in-vitro</i> models and molecular pathways to advance the knowledge of TBI. It covers traumatic brain damage pathophysiology, including apoptosis, the function of chemicals and genes, and a brief discussion on putative pharmacological remedies.

Invited Symposium 1: Traumatic Brain Injury: Highlighting the Contributions of Dr. Harvey S. Levin Ph.D., ABPP-CN, FACSM 1946 - 2022

Invited Symposium 1: Traumatic Brain Injury: Highlighting the Contributions of Dr. Harvey S. Levin Ph.D., ABPP-CN, FACSM 1946 - 2022

Measuring vibrations on a biofidelic brain using ferroelectret nanogenerator

Our knowledge of traumatic brain injury has been fast growing with the emergence of new markers pointing to various neurological changes that the brain undergoes during an impact or any other form of concussive event. In this work, we study the modality of deformations on a biofidelic brain system when subject to blunt impacts, highlighting the importance of the time-dependent behavior of the resulting waves propagating through the brain. This study is carried out using two different approaches involving optical (Particle Image Velocimetry) and mechanical (flexible sensors) in the biofidelic brain. Results show that the system has a natural mechanical frequency of sim 25 oscillations per second, which was confirmed by both methods, showing a positive correlation with one another. The consistency of these results with previously reported brain pathology validates the use of either technique, and establishes a new, simpler mechanism to study brain vibrations by using flexible piezoelectric patches. The visco-elastic nature of the biofidelic brain is validated by observing the the relationship between both methods at two different time intervals, by using the information of the strain and stress inside the brain from the Particle Image Velocimetry and flexible sensor, respectively. A non-linear stress-strain relationship was observed and justified to support the same.

Workplace Barriers to Return-to-Work Processes

This study identified workplace barriers to return-to-work (RTW) processes through a multiple case study consisting of 38 cases. Sixty-four interviews with employees with mild traumatic brain injury (TBI) and 45 interviews with their managers were conducted in 2017–2020 at T1 (1–3 months after the employees returned to work) and T2 (12–16 months after T1). Workplace barriers were associated with the organizational and psychosocial work environments, TBI knowledge, and char- acteristics of the employee. The role of management was a key aspect across all barriers. Workplace barriers often co-occurred and became increasingly important at T2. At T2, most employees increased their workload, but some still experienced unsupportive management, workplace conflicts, and a low degree of job control. The psychosocial work environment is a main area for workplace barriers. The managers’ knowledge of RTW processes and TBI-related challenges potentially reduce barriers and thereby contribute to balance the needs of the organization and the individual.

"I Don't Think It's on Anyone's Radar": The Workforce and System Barriers to Healthcare for Indigenous Women Following a Traumatic Brain Injury Acquired through Violence in Remote Australia.

Aboriginal and Torres Strait Islander women experience high rates of traumatic brain injury (TBI) as a result of violence. While healthcare access is critical for women who have experienced a TBI as it can support pre-screening, comprehensive diagnostic assessment, and referral pathways, little is known about the barriers for Aboriginal and Torres Strait Islander women in remote areas to access healthcare. To address this gap, this study focuses on the workforce barriers in one remote region in Australia. Semi-structured interviews and focus groups were conducted with 38 professionals from various sectors including health, crisis accommodation and support, disability, family violence, and legal services. Interviews and focus groups were audiotaped and transcribed verbatim and were analysed using thematic analysis. The results highlighted various workforce barriers that affected pre-screening and diagnostic assessment including limited access to specialist neuropsychology services and stable remote primary healthcare professionals with remote expertise. There were also low levels of TBI training and knowledge among community-based professionals. The addition of pre-screening questions together with professional training on TBI may improve how remote service systems respond to women with potential TBI. Further research to understand the perspectives of Aboriginal and Torres Strait Islander women living with TBI is needed.

‘I had nothing. It’s just life experience that helped me through that situation’: Australian audiologists’ perspectives on audiological clinical practice for traumatic brain injury and rehabilitation

ABSTRACT Objective Australian Audiologists’ perspectives on standard non-specialized clinical practice in the context of Traumatic Brain Injury (TBI) were examined, including the perceived barriers to optimal service provision. Design A qualitative research design utilizing semi-structured interviews was conducted using purposive sampling. Nine participants were interviewed about their understanding of the impact of TBI on hearing and balance; identification, diagnosis and management of auditory and vestibular dysfunction following TBI; barriers to service delivery; training relating to complex clients (i.e., TBI); and awareness of referral pathways. Results Three major themes, each with subthemes, were evident in the data. The major themes reflected general considerations of audiological professional culture and specific issues related to knowledge of TBI and clinical practice with patients. Analysis revealed that professional culture seemed to act as a contextual barrier and interacted with the perceived lack of TBI related knowledge to hinder optimal clinical practice in this patient population. Conclusion Application of the biopsychosocial model, including interdisciplinary care in the management of patients with TBI, is needed. An improvement in theoretical and practical knowledge encompassing the wide-ranging effects of TBI is critical for the optimal audiological service delivery.

Supporting Employment and Mental Health for Women Survivors of Intimate Partner Violence & Traumatic Brain Injury: A Community-Based Participatory Research Study

<h3>Research Objectives</h3> Explore employment and mental health related barriers and facilitators, service needs, and priorities for women survivors of intimate partner violence (IPV) with traumatic brain injury (TBI) and develop stakeholder informed knowledge translation (KT) materials and implement them through the Abused & Brain Injured Toolkit. <h3>Design</h3> Two sequential projects: one exploring knowledge and service gaps, and the second to develop KT materials to address those gaps. Data were collected via focus groups and semi-structured interviews. Reporting shall follow the consolidated criteria for reporting qualitative research. <h3>Setting</h3> Community-based, participatory research model with data collection taking place online via phone or videoconference interviews, online surveys, and email. <h3>Participants</h3> A convenience sample of key stakeholders including frontline workers, executive directors/program managers in the IPV sector, women survivors of IPV, health care professionals, and employers. 24 stakeholders participated in interviews or focus groups to inform development of the KT materials and were invited to provide feedback mid-design. <h3>Interventions</h3> N/A. <h3>Main Outcome Measures</h3> We engaged in member checking to seek feedback on the prototype KT materials. <h3>Results</h3> Based on identified gaps and stakeholder input, two KT modules, one for employment and one for mental health, were developed for our existing online educational toolkit (Abused and Brain Injured Toolkit, abitoolkit.ca). Survivors' employment needs fell into two main categories, maintaining employment and obtaining employment. Mental health related challenges centred on difficulties parsing impacts of brain injury from mental health. <h3>Conclusions</h3> TBI knowledge among IPV service providers is increasing. As it does, additional education and resources will be needed to support survivors in various aspects of their lives. The development of KT modules directly addresses this, broadening available educational material in this area. <h3>Author(s) Disclosures</h3> The authors have no disclosures to report.

Video-consulting to address mental health needs after traumatic brain injury: evaluation of a training workshop to build capacity among psychologists

ABSTRACT Background Traumatic brain injury (TBI) can lead to significant psychological distress, but few psychologists in Australia are trained in working with this complex clinical group. Despite government funding to provide video-consulting (VC) services in Australia, uptake before COVID-19 was limited. Objective This mixed methods study evaluated whether training in eHealth and evidence based TBI psychological therapies increased provider uptake of VC in clinical practice, and delivery of mental health services to individuals with TBI. Methods Mental health professionals completed a range of self-report measures before (n = 50), after (n = 48), and four months following (n = 30) a one-day workshop. Participants’ TBI knowledge, client-base and levels of access, confidence, motivation and attitudes toward VC were assessed. Knowledge did not increase after training but participants had significant increases in their confidence and motivation to using VC at follow up. Significant reductions in pragmatic barriers to using VC were reported post training and at follow up, all barrier categories indicated significant reductions. There was no significant change in clinical practice of the participants. Conclusions Training to increase TBI knowledge requires specific assessment tools and although training appears to reduce barriers to using VC, uptake in clinical practice may require additional supervision and warrants further research.

Informal carer's knowledge of traumatic brain injury questionnaire: Initial development and validation.

AimTo develop and psychometrically test the instrument for measuring the knowledge of traumatic brain injury of informal carers.DesignInstrument development.MethodFocus group discussions were conducted among informal carers and healthcare specialists in March 2017. The content validity was determined by the mean of the item content validity index. A reliability test was performed by the Kuder‐Richardson 20 and Pearson's correlation coefficient among 40 informal carers of patients with a traumatic brain injury in the rehabilitation medicine department of a tertiary hospital from August–September 2017.ResultsThe final 34‐item questionnaire covers the nature of traumatic brain injury, the consequences of traumatic brain injury, the rehabilitation process, and the role of the caregiver. The item content means ranged from 0.8–1.00, and the difficulty of knowledge items ranged from 0.18–0.98. The internal consistency reliability and correlation coefficient were 0.70 and 0.84, respectively.

Traumatic brain injury in the acute care setting: assessment and management practices of speech-language pathologists

ABSTRACT Primary Objective To characterize current knowledge, beliefs, confidence, and practice patterns of acute care speech-language pathologists (SLPs) in assessing and managing cognitive-communication disorders following traumatic brain injury (TBI). Research Design We developed an online survey to learn more about current TBI knowledge and practice patterns of acute care SLPs, with the goal of establishing a baseline upon which changes in SLP training and practice standards may be measured. Methods and Procedures We distributed the survey to 1800 SLPs in 18 states via postal mail, in addition to posting it to relevant online groups. One hundred and eighty-two practicing acute care SLPs responded to the survey. Main Outcomes and Results Respondents were highly variable in their training and knowledge about TBI, their beliefs about cognitive-communication rehabilitation, and their practice patterns in assessing, managing, and communicating about TBI during the acute stage of injury. Conclusions These results highlight the need for more consistent training about cognitive-communication deficits during and after graduate school, as well as the development of sensitive, specific, and standardized assessment tools, education protocols, and shared language for describing patients with TBI along the continuum of care.

Current status of traumatic brain injury research in Malaysia: A systematic review

Traumatic brain injury (TBI) is a major cause of death and disability worldwide. In 2009, the National Trauma Database Malaysia reported that nearly 80% of traumas in the population were caused by road traffic accidents, with 64% of these cases related to TBI. Despite these concerning reports, TBI reporting systems and research are still limited in Malaysia. Thus, this systematic review aimed to identify and evaluate the available literature on TBI in Malaysia in order to uncover the status of TBI research in Malaysia. A comprehensive literature search was performed on four databases (PubMed, Embase, Medline and Scopus) regarding TBI in Malaysia. Critical evaluation of 60 relevant articles after application of inclusion and exclusion criteria have indicated that TBI research in Malaysia may have significant limitations in representing the actual TBI population and was lacking in basic TBI research. Thus, there is a dire need for government and private institutions to provide support for the advancement of TBI reporting and the progression of basic, clinical and translation TBI research in Malaysia. This will create a deeper understanding of TBI, contributing to global TBI knowledge, and advancing the development of efficient interventions for Malaysians with its population heterogeneity taken into consideration.

Traumatic Brain Injury and Its Relationship to Previous Convictions, Aggression, and Psychological Functioning in Dutch Detainees

ABSTRACT Objective: Higher prevalence of traumatic brain injury (TBI) has been reported for detained individuals. TBI may result in erroneously interpreting situations in everyday life, impair problem-solving abilities through dialogue, or negotiation, which may increase aggressive behavior. Knowledge of TBI and its consequences in Dutch penitentiaries is lacking, as virtually no screening, supervision, or treatment is currently provided. Method: The current manuscript assesses differences in self-reported aggression, impulsivity, indication for mild intellectual disability, history of childhood trauma, and emotion regulation in detainees (n = 283) and non-incarcerated controls (NIC; n = 51), with and without a history of TBI. Result: A total of 45.2% of detainees reported a TBI, compared to 29.4% in the NIC group. ANCOVA results revealed no interaction between group and TBI history, indicating that TBI history did not affect behavior in detainees and NIC differently. The main effects revealed higher levels of aggression in detainees compared to NICs, and in participants with TBI compared to those without. Separate ANCOVA’s per group reveal that TBI history in detainees was associated with more aggression – also when correcting for violence as the cause of TBI. A logistic regression revealed that detainees with TBI have a higher chance (odds ratio = 3.3) of having at least one prior conviction. Conclusions: TBI history was related to aggressive behavior in Dutch inmates, future studies should assess if TBI history is predictive of in-prison infractions and recidivism rates, and if screening and providing neuro-rehabilitative measures or improved supervision may improve TBI related deficits.

Factors associated with strain among informal care providers of patients with traumatic brain injury in Malaysia.

Purpose:This study aims to investigate the level of strain and various influencing factors among informal care providers of traumatic brain injury (TBI) patients.Methods:A cross-sectional study was conducted in a single center in Malaysia via recruiting care providers of patients with TBI. The modified caregiver strain index (MCSI) questionnaires were utilized to ascertain the level of strain. The demographic data of informal care providers were also obtained. Independent sample t-test, analysis of variance (ANOVA), and a linear regression model were processed for data analysis.Results:A total of 140 informal care providers were included in the study. More than half of informal care providers claimed to have strain (54.3%). Factors associated with increased strain include receiving tertiary education, being of Chinese background, and employed experience higher strain level. Informal care providers with characteristics such as being single, retired and provided care for 5 years experienced a lower level of strain.Conclusion:Guidance on integrating the TBI knowledge into practice, assessing the care provider's level of strain regularly and providing supportive measures may aid in supporting informal care providers at risk.

Characteristics of traumatic brain injury during Operation Enduring Freedom-Afghanistan: a retrospective case series.

Traumatic brain injury (TBI) is a significant cause of morbidity and mortality, especially among members of the armed services. Injuries sustained in the battlefield are subject to different mechanisms than those sustained in civilian life, particularly blast and high-velocity injury. Due to the unique nature of these injuries and the challenges associated with battlefield medicine, surgical interventions play a key role in acute management of TBI. However, the burden of chronic disease posed by TBI is poorly understood and difficult to investigate, especially in the military setting. The authors report the case logs of a United States Navy neurosurgeon, detailing the acute management and outcomes of 156 patients sustaining TBI between November 2010 and May 2011 during the war in Afghanistan. By demographics, more than half of the patients treated were local nationals. By mechanism of injury, blunt trauma (40.4%) and explosive injury (37.2%) were the most common contributors to TBI. Decompressive craniectomies (24.0%) and clot evacuations (14.7%) were the procedures most commonly performed. Nearly one-quarter of patients were transferred to receive further care, yet only 3 patients were referred for rehabilitative services. Furthermore, the data suggest that patients sustaining comorbid injuries in addition to TBI may be predisposed to worse outcomes. Improvements in documentation of military patients may improve knowledge of TBI and further identify potential variables or treatments that may affect prognosis. The increased survivability from TBI also highlights the need for additional research expenditure in the field of neurorehabilitation specifically.

School Psychologists’ Knowledge of Traumatic Brain Injuries and Willingness to Lead a Concussion Team

Within a school there is not typically one person assigned to aid students who have experienced a traumatic brain injury (TBI). Symptoms following a TBI may hinder a students’ academic performance suggesting a need for “return-to-learn” protocols to be implemented as students return to the rigors of school. Previous literature suggests school psychologists are the most appropriate school personnel to aid these students. The purpose of this study was to examine school psychologists’ knowledge regarding TBIs and gauge their interest in aiding with school reintegration. Results implied knowledge of TBI is not a significant predictor of willingness to be a ‘concussion team leader’. Qualitative analyses revealed school psychologists perceived school nurses to be the most qualified. Implications for practice, including changes in training programs, are discussed.

A Comparison of Student and Parent Knowledge and Perceived Confidence About Brain Injury and Concussion

Purpose:The public has long had misconceptions about traumatic brain injury (TBI) and its effects. Concussion education targeted toward athletes has been increasing with passage of return-to-play laws in all 50 states. The current study examined differences in public knowledge about TBI and concussion, and the extent to which students and parents in the general public may have benefited from increased availability of education around concussion.Methods:At a public fair, 246 students, parents, and other adults completed a survey adapted from existing TBI and concussion knowledge surveys. Participants also rated their confidence in accuracy of their responses.Results:There were no group differences on TBI knowledge or confidence. Parents scored slightly higher on concussion knowledge than students, and knowing someone with a TBI or concussion was also associated with higher scores. Confidence was only weakly related to concussion knowledge. Overall concussion knowledge scores were higher than TBI knowledge scores. Knowledge and confidence were not associated with sports participation.Discussion:Given similarities in TBI knowledge across groups, but that parents outpace students in concussion knowledge, parents may have greater exposure or heightened awareness of concussion information education opportunities. Lower confidence in students suggests an openness to education and opportunities for prevention of injuries.

Battered and Brain Injured: Assessing Knowledge of Traumatic Brain Injury Among Intimate Partner Violence Service Providers.

Background: Traumatic brain injury (TBI) as a result of intimate partner violence (IPV) is a significant health concern; yet, little is known about the intersection between the two. Existing research is scarce, limiting the ability of health care providers to develop effective supports. This pilot project surveyed the IPV support community in Toronto, Canada to understand the degree of existing TBI-specific knowledge and relevant services available among these service providers and to seek to bridge the divide between research and practice by developing a national knowledge-to-practice network to support brain-injured women survivors of IPV.Materials and Methods: In phase 1, 68 agencies providing IPV support services were invited to complete an anonymous online survey. In phase 2, 22 stakeholders attended a workshop held to disseminate existing knowledge, develop a national knowledge-to-practice network, and determine next steps in research and practice.Results: The results highlighted a general lack of TBI awareness and understanding among IPV service providers. In addition, participants stated that frontline workers and women survivors of IPV alike do not recognize signs or symptoms of TBI. Recommendations addressing research gaps, professional and public education, and service development were identified and are discussed herein.Conclusions: The identified lack of TBI knowledge among IPV service providers highlights the immediate need to increase education among management and frontline workers. Further investigation identifying best practices for knowledge transfer are suggested. The development of a national strategy addressing education, research, and funding is critical for successful uptake and integration of TBI-sensitive services within the IPV sector.

Knowledge, Awareness, and Attitudes Regarding Concussion Among Middle Schoolers.

Introduction: Given the widespread prevalence of concussions in children under the age of 19, the adolescent perspective, as well as an understanding of the mechanisms behind traumatic brain injury (TBI), is extremely important. The authors sought to assess the knowledge, awareness, and attitudes regarding concussion among middle school children and whether a brief educational intervention based on clinical data and science resulted in a change of their knowledge or attitudes towards concussions.Methods: A 20-question survey design was administered before and after an educational intervention. The surveys were anonymous, but they were paired so that it was possible to correlate the pre- and post-test answers to the respondents. An eighth-grader at a Florida middle school conducted this study after school hours after the student and their parent or legal guardian signed informed consent. This project was approved by the Science Department at Howard Bishop Middle School in Alachua County, Florida. JMP® 14.0 (SAS Institute Inc., Cary, NC) was used for statistical analyses.Results: The cohort was 64% female, age range: 13 - 15, and consisted of local eighth-grade students. Forty-three percent never wore a helmet when riding a bicycle or skateboard. Only 68% knew that the state had a helmet law for kids. Participants were significantly more likely to feel they had good TBI knowledge after the intervention (p = 0.0005, 95% confidence interval (CI) 0.1937 to 0.6863) and that the didactic lectures changed the way they thought about safety (p = 0.0034, 95% CI 0.1025 to 0.5175). Students reported that their mothers (vs. fathers) were significantly more likely to wear seatbelts (p = 0.05, 95% CI 0.0036 to 0.5036), and they themselves reported wearing seatbelts more often after the survey.Conclusions: There still exists a knowledge gap when it comes to pediatric concussion. Expanding awareness is important in order to bolster safety measures among adolescents.