“The Impact of Gun Violence: Understanding Surgical Intervention for Spinal Cord Injury from Gunshot Wounds”
Speaker: Alicia Seeds, MD
Mentor: Heather Barnett, MD, PhD
Authors: Alicia Seeds and Heather Barnett
Abstract: Surgical management of GSW-related SCIs remains controversial. Time to surgery and indications in this group are not well understood; these factors may impact prior data suggesting patients with GSW-SCI have worse outcomes.
Patients with traumatic SCI from July 2012-July 2022 (n=1569) were identified from our level 1 trauma center Trauma Registry. Patients with GSW-SCI were less likely to undergo surgery compared to other etiologies (24.3% vs. 70.2%, p<0.0001). Time to surgery for GSW-SCI was longer than for other etiologies (49.2±92.9 vs. 30.6 hours±46.0, p=0.012). The most common reason for delay in spinal surgery was other emergent surgery (52%). The most common indications for surgery were retained bullet (20%) and unstable spine (20%).
Surgery was delayed in patients with GSW-SCI compared to other etiologies with average time to surgery >48 hours and high variability in both timing and indication. These details should be considered in interpretation of surgical outcomes after GSW-SCI.
“Remote Exercise Risks and Risk Mitigation in Lymphangioleiomyomatosis (LAM): A Delphi Study”
Speaker: Claire E. Child, DPT, MPH
Mentors: Mary Beth Brown, PT, PhD and Anne M. Turner, MD, MPH, MLIS
Authors: Claire E. Child, Anne M. Turner, Tracy L. Jirikowic, Joshua M. Liao, Mary Beth Brown
Abstract: Patients with the rare interstitial lung disease lymphangioleiomyomatosis (LAM) have unique disease-specific risks during exercise, which must be mitigated to optimize safety during exercise. We conducted a two-round modified Delphi study to synthesize expert opinions related to exercise preparticipation screening in LAM. A Delphi study is an acceptable methodology for generating consensus when there is a paucity of available literature and an urgent need to develop guidelines and products. Purposive sampling was used to engage a diverse, international panel of 15 professionals with clinical and research expertise in LAM in a first round online survey and a second round, in-person meeting. An anonymous survey was also sent to patients with LAM to obtain patient perspectives on risks during exercise training. A tool was developed for LAM-specific exercise preparticipation screening prior to initiation of a remote, asynchronously monitored exercise program.
“Environmental Impact on Community Participation Experienced by People with Multiple Sclerosis: A Community-Engaged Mixed Methods Study Protocol”
Speaker: Melody (Bishan) Yang, MS, PhC
Mentor: Danbi Lee, OTD, PhD, OTR/L
Authors: Bishan Yang, Danbi Lee, Ivan Molton, Carolyn Baylor, Dawn Ehde, Andrew Humbert, Sarah Iribarren
Abstract: While full participation is an important goal for people with MS (PwMS), they are often dissatisfied with their ability to participate in what they want and need to do. Factors contributing to restricted participation are multifaceted; however, most existing MS research primarily focused on documenting the significant impact of impairments but less so on external barriers. This dissertation project aims to conduct a community-engaged sequential mixed methods study to understand how environments influence community participation among PwMS and engage stakeholders to co-identify actions needed to support their participation. A community advisory board will be involved throughout the project to ensure its relevance to the MS community’s needs. This study will include (1) a quantitative secondary analysis of GPS-measured and self-reported participation and environment data, (2) focus groups exploring perspectives on the focused topic, and (3) a town hall meeting inviting stakeholders’ input to identify collective actions and next steps.
