RehabWire: Volume 4, Number 7, October 2002.


October is National Disability Employment Awareness Month. It is also the beginning of the new TBI Model Systems funding period. RehabWire for October combines these topics to look at TBI and employment.

NIDRR Projects: Research in the New Millennium.

Some highlights of the new TBI Model Systems research projects: Northern California Traumatic Brain Injury Model System of Care, Santa Clara Valley Medical Center (SCVMC) (H133A020524) led by Tamara Bushnik, PhD. Theresa San Agustin, MD, Project Officer.
Abstract: This model system supports two studies which are designed to better characterize the type and impact of fatigue on the TBI population: (1) a cross-sectional study of people up to ten years post-TBI and (2) a longitudinal study that focuses on the evolution of fatigue over the first two years post-injury. Two additional studies characterize the impact of late posttraumatic seizures on recovery.
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The Rocky Mountain Regional Brain Injury System (RMRBIS), Craig Hospital (H133A020510) led by Gale G. Whiteneck, PhD. Theresa San Agustin, MD, Project Officer.
Abstract: The RMRBIS conducts three research projects: Study 1 is a randomized clinical trial used to study the effects of Modafinil on fatigue and excessive sleepiness after TBI. Study 2 assesses the effectiveness of a group therapy intervention for social pragmatic communication. Study 3 investigates the environmental and clinical factors that influence outcome over a 40-year time frame to understand the process of living and aging with a TBI.
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Southeastern Michigan Traumatic Brain Injury System (SEMTBIS), Wayne State University and Rehabilitation Institute of Michigan (H133A020515) led by Robin A. Hanks, PhD. Delores Watkins, Project Officer.
Abstract: Three studies evaluate (1) a peer-mentoring intervention, (2) a dynamic system of survivor and significant-other well-being, and (3) resumption of driving after brain injury.
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Mayo Clinic Traumatic Brain Injury Model System, Mayo Medical Center (H133A020507) led by James F. Malec, PhD. Kristi E. Wilson, PhD, Project Officer.
Abstract: Within the Mayo TBI Model System (TBIMS), three local research projects focus on: (1) decision-making and outcomes of inpatient and outpatient rehabilitation pathways, (2) very long term (5-15+ years post-injury) process and outcome for people with TBI identified through the Rochester Epidemiology Project, and (3) telehealth-based (Internet) cognitive rehabilitation.

Traumatic Brain Injury Model System of Mississippi (TBIMSM), Methodist Rehabilitation Center(H133A020514) led by Mark Sherer, PhD. Kristi E. Wilson, PhD, Project Officer.
Abstract: The TBI Model System of Mississippi involves three studies: (1) investigating two medications in a parallel group, double blind, placebo controlled, randomized assignment design; (2) developing and conducting a trial of an intervention to improve the therapeutic alliances between persons with TBI and family members and professional staff serving persons with TBI in a post-acute brain injury neurorehabilitation program; and (3) investigating the use of transcranial magnetic stimulation to improve the characterization of motor disorders after TBI.
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New York Traumatic Brain Injury Model System (NYTBIMS), Mount Sinai School of Medicine(H133A020501) led by Wayne Gordon, PhD. Constance Pledger, EdD, Project Officer.
Abstract: The NYTBIMS focuses on depression and fatigue, impairments that limit participation in community and vocational activities: (1) treatment of Post-TBI Depression to examine the efficacy of sertraline (Zoloft) in the treatment of depression and anxiety after traumatic brain injury; and (2) a study of post-TBI fatigue and its treatment investigates the components, consequences, and correlates of post-TBI fatigue and evaluates the benefits of Modafinil (Provigil) to treat fatigue in individuals with TBI.
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Carolina’s Traumatic Brain Injury Rehabilitation and Research System (CTBIRRS), Charlotte Mecklenburg Hospital Authority (H133A020522) led by Flora M. Hammond, MD. Constance Pledger, EdD, Project Officer.
Abstract: A comprehensive, rigorous approach is used to study post-traumatic irritability, the project investigates the relationship to the caregiver as a component of the environment, the response to amantadine hydrochloride, and the nature of the problem as experienced by those in the community.
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Moss Traumatic Brain Injury Model System, Albert Einstein Healthcare Network (H133A020505) led by Tessa Hart, PhD. Ruth Brannon, Project Officer.
Abstract: This model system includes three research studies: (1) the use of assistive technology for cognitive and behavioral disabilities; (2) validation of an observational rating scale of attention dysfunction in a psychostimulant treatment trial; and (3) and use of botulinum toxin for treating severe spasticity caused by TBI.

University of Pittsburgh Brain Injury Model System (UPBI), University of Pittsburgh (H133A020502) led by Ross D. Zafonte, DO. Kristi E. Wilson, PhD, Project Officer.
Abstract: The UPBI's research projects: (1) evaluate the impact of selected innovations in technology on service delivery, functional outcome, and as a therapeutic intervention; (2) address the shortcoming in wheelchair design for persons with brain injury by evaluating a unique personalized powered mobility system; (3) perform a randomized trial evaluating the efficacy of virtual reality and robotics for persons with TBI; and (4) implement and evaluate a web based virtual case manager support structure for persons with TBI and their families.

North Texas Traumatic Brain Injury Model System (NT-TBIMS), The University of Texas Southwestern Medical Center (H133A020526) led by Ramon R. Diaz-Arrastia, MD, PhD. Theresa San Agustin, MD, Project Officer.
Abstract: The NT-TBIMS conducts two research projects regarding outcome after TBI: (1) to determine whether the inheritance of particular alleles in certain candidate genes is associated with a greater risk of poor outcome after TBI; and (2) to determine whether functional magnetic resonance imaging of the brain is predictive of functional recovery after TBI.

Traumatic Brain Injury Model System, Virginia Commonwealth University (H133A020516) led by Jeffrey S. Kreutzer, PhD. Theresa San Agustin, MD, Project Officer.
Abstract: Projects in two major research areas focus predominantly on TBI survivors: (1) examining pharmacological approaches to the treatment of depression; (2) examining a structured approach to the treatment of acute cognitive and neurobehavioral problems, and (3) examining the benefits of intervention programs for family members.
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University of Washington Traumatic Brain Injury Model System, University of Washington(H133A020508) led by Kathleen R. Bell, MD. Ruth Brannon, Project Officer.
Abstract: Research Project 1 seeks to combat depression and emotional distress in persons with stable TBI, by employing exercise as a positive approach to improved emotional and physical functioning and socialization. Project 2 examines what characterizes TBI survivors who are able to return to employment and to hold jobs that are stable and complex in nature. Project 3 examines the impact of the Medicare prospective payment system for inpatient rehabilitation on TBI survivors receiving access to acute rehabilitation efforts.
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Did You Know...?

Thousands of additional resources on these topics are available from NARIC’s Browse by Subject pages at Find Resources.

New Research: Selections from REHABDATA

Kreutzer, J. S., Kolakowsky-Hayner, S. A. (2001) Family aspects of return to work after brain injury.Brain Injury Source, 5(1), 20-21, 45. RTC on Severe Traumatic Brain Injury, Virginia Commonwealth University, Medical College of Virginia; Department of Physical Medicine. Accession Number: J41602.
Abstract: Article with suggestions for family, friends, and caregivers of persons with TBI on ways they can help increase the likelihood of employment success as their family member with TBI returns to work.

West, M. D. (2001) The changing landscape of return to work: Implications for Supplemental Security Income and Social Security Disability Insurance beneficiaries with TBI. Brain Injury Source, 5(1), 24-27, 48. Brain Injury Association. Accession Number: J41604.
Abstract: Article describing work incentives available to persons with TBI who receive disability benefits through Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI), and discussing improvements to work incentive programs under the Ticket to Work and Work Incentives Improvement Act of 1999 (TWWIIA).

Wehman, P. (ed.) (2001) Supported employment in business: Expanding the capacity of workers with disabilities. Training Resource Network, Inc. Accession Number: R08193.
Abstract: Volume providing up-to-date information on supported employment. It focuses on three major areas: (1) clinical foundations, or how supported employment works; (2) applications for different end users such as workers with mental retardation, physical disabilities, TBI, or psychiatric disabilities; and (3) cutting edge issues such as conversion, policy, rural programs, and business alliances.

Targett, P. S., Yasuda, S., West, M. D. (2001) Lessons in return to work following TBI: Case studies in long-term job retention. Brain Injury Source, 5(1), 28-30. Virginia Commonwealth University, Medical College of Virginia. Accession Number: J41605.
Abstract: Article presenting two case studies of individuals who achieved long term job retention in a supported employment program following TBI. Aspects of the supported employment program that facilitated their success are identified.

Ericksen, J., Cifu, D. X., Burnett, D. (2001) The role of neuropharmacologic agents in return to work after traumatic brain injury. Brain Injury Source, 5(1), 32-34. Virginia Commonwealth University, Medical College of Virginia. Accession Number: J41606.
Abstract: Article discussing the potential impact on return to work efforts of medications commonly used after TBI.

Kolakowsky-Hayner, S. A., Kreutzer, J. S. (2001) Return to work after brain injury: A self-directed approach. NeuroRehabilitation, 16, 41-47. Virginia Commonwealth University Medical College of Virginia, IOS Press. Accession Number: J43724.
Abstract: Presents ideas and questions to help brain injury survivors sort through the options of returning to their same job, finding a new job, or not going back to work at all. Rehabilitation professionals are encouraged to use the information to facilitate discussions with their clients.

Johnstone, B., Mount, D., Schopp, L. H. (2002) Financial and vocational outcomes one year post-traumatic brain injury. University of Missouri/Columbia. Accession Number: O14321.
Abstract: Study to determine the financial and vocational outcomes in terms of employment status, earned income, and public assistance received one year after traumatic brain injury. Thirty-five individuals with new TBI were assessed at the time of injury and one year later. Results showed the number of persons employed fell from 69 percent to 31 percent, the number unemployed increased from 11 percent to 49 percent, the average earned income per month declined 51 percent and the mean total public assistance received increased 275 percent