Traumatic Brain Injury A Roadmap for Accelerating Progress (2022) / Chapter Skim
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1 Introduction
1 Introduction
Pages 15-26
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. Traumatic brain injury (TBI)
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And in 2005, the De partment of Veterans Affairs designated a network for rehabilitation after polytrauma, establish ing its Polytrauma System of Care. A National Trauma Care System: Integrating Military and Civilian Trauma Systems to Achieve Zero Preventable Deaths After Injury (NASEM, 2016)
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A number of TBI definitions are collected in Appendix B of the report Evaluation of the Disability Determination Process for Traumatic Brain Injury in Veterans (NASEM, 2019)
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One study found that even among those who had experienced an injury considered a mild TBI, 53 percent reported continued impairment a year later (Nelson et al., 2019)
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Adult patients sustaining moderate or severe TBI, such as from a motor vehicle crash, may find themselves transported by emergency medical services to the ED of a trauma center, with subsequent admission to the intensive care unit of the hospital, perhaps after urgent surgical intervention. This may be followed by an inpatient hospital stay and subsequent inpatient and outpatient rehabilitation, potentially over the course of months or even years.
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Now is the time to advance military and civilian TBI research and care, and this report is intended to contribute to those strategic planning efforts. 4 Based on a search for traumatic brain injury or TBI in the federal RePORTER database, available at https:// federalreporter.nih.gov (accessed August 25, 2021)
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International Initiative NIH, European 2011–2019 Civilians, International effort to reduce for Traumatic Brain Commission, military TBI burden by leveraging and Injury Research Canadian personnel, coordinating TBI research (InTBIR) Institutes of athletes, and Health Research pediatric populations Long-term Impact of DoD, VA, 2019– Military Further research for TBI military Military-relevant Brain universities, present (Veterans)
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civilians care gaps Education and Awareness HEADS UP CDC 2003– Youths and the Educational initiatives to improve present elderly TBI awareness and prevention among youths and the elderly NOTE: CDC = Centers for Disease Control and Prevention; DoD = Department of Defense; DOE = Department of Energy; FDA = Food and Drug Administration; HHS = Department of Health and Human Services; NCAA = National Collegiate Athletic Association; NFL = National Football League; NIDILRR = National Institute on Disability Independent Living and Rehabilitation Research; NIH = National Institutes of Health; NINDS = National Institute of Neurological Disorders and Stroke; PPP = public–private partnership; TBI = traumatic brain injury; UCSF = University of California, San Francisco; VA = Department of Veterans Affairs. STUDY PURPOSE, SCOPE, AND APPROACH Recognizing the importance of and opportunities for improving TBI care and research, DoD's Combat Casualty Care Research Program asked the National Academies to convene an ad hoc committee of experts to consider the challenges entailed in achieving such improvements and recommending steps that can be taken to overcome those challenges.
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Presentations and discussions will address the following topics: • Fostering biomedical research on TBI; • Accelerating translational and clinical research on TBI; • Delivering breakthroughs in TBI treatments; and • Improving TBI systems of clinical care from acute care through rehabilitation. The study, including the workshop, will address a range of populations affected by TBI and related goals, including improving readiness, retention, return to service, and prevention of long term sequelae in military populations; and improving return to play and work, and prevention of long-term sequelae in sports participants, older adults who have fallen, individuals affected by traffic/vehicle injuries, and other civilian populations.
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The opportunities identified include implementing a new clinical classification system for TBI; using emerging biomarkers as part of an expanded TBI toolkit; learning from and building on existing care systems and networks; increasing patient, family, and stakeholder engagement; and employing additional types of study designs. Finally, Chapter 8 details the essential elements of an optimized system for accelerating progress in the TBI field, emphasizing the need for a coordinated system capable of more effectively connecting current programs and networks and providing a locus for efforts to advance TBI care and research.
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2017. A narrative literature review of depression following traumatic brain injury: Prevalence, impact, and management challenges.
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