Fall 2014
Longevity after Injury Project
Spinal column with vertebrae Cervical Vertebrae (7) C1-C7
News & Updates
Research Highlight Suicide Mortality After Spinal Cord Injury in the United States: Injury Cohorts Analysis
Thoracic Vertebrae (12) T1-T12
According to the Center for Disease Control, suicide was the 10th leading cause of death in the United States in 2013. Sadly, suicide is a huge issue among persons with spinal cord injuries (SCI). Earlier research found those with SCI are three times more likely than the general population to die from suicide. Since suicide is preventable, understanding risk factors and promoting suicide prevention is very important.
Lumbar Vertebrae (5) L1-L5
The Longevity after Injury Project completed a study to learn more about suicide risk factors and deaths in those with SCI. We looked at three different groups of people with SCI , those who were injured from 1973-1979, those injured from 1980-1989, and those injured from 1990-1999. Below are some of our findings.
Sacrum (5 - fused) Coccyx (4 - fused) Inside this issue National Disability Employment Awareness Month, World Suicide Prevention Day .................. 2
Injuries from 1973-1979 had the highest suicide deaths at 6.72% Odds of committing suicide were reduced by 20% for the 1980-1989 group and 46% for the 1990-1999 group Non-Hispanic whites were more likely to commit suicide T1-S3 injuries had higher suicide odds Suicide risks decline around 7 years post-injury Our study found that risk of suicide is greatest among the following groups: nonHispanic whites, males, those in the first 6 years after SCI, and those with TI-S3 injury levels. Also, we noticed a decline in suicide in these 3 groups over time. However, although there was a trend of a decrease in suicide over time, those with SCI are still 3 times more likely to die from suicide compared to the general population. Our research cannot provide evidence on why this trend occurred, but we will continue to study the risk across different groups. Suicide or experiencing suicidal thoughts can be hard to talk about, but know that help is available. For information and resources, visit page 2 of this newsletter.
MS Study, CAP ................... 3 Student Perspective ........... 4 Videos ................................ 5 Open House, RRTC Grand Rounds .............................. 6 Facebook Giveaway, Recent Publications ....................... 7 Contact Information ........... 8
National Disability Employment Awareness Month National Disability Employment Awareness Month (NDEAM) is a campaign held every October. This campaign aims to increase awareness regarding employment issues among those who have a disability, in hopes of developing more inclusive work places.
“Expect. Employ. Empower.”
NDEAM’s theme for this year is “Expect. Employ. Empower.” As stated by the Assistant Secretary of Labor for Disability Employment Policy, Kathy Martinez, "We all have a role to play in — and benefit to gain from — increasing opportunities for meaningful employment for people with disabilities. This year's theme encapsulates this in three powerful words. It conveys that advancing disability employment is about much more than just hiring. It's about creating a continuum of inclusion. And the first step on this continuum is expectation."
In celebration of NDEAM, below are some facts about disability and employment we have discovered through our research. As employment is a big predictor of overall quality of life and of getting the health care one needs, we are continually dedicated to studying how disabilities and employment affect one another.
For those with SCI, the employment rate is around 30%.
Education is the biggest facilitator to employment, which also helps lower one’s chance of poverty.
Loss of financial or medical benefits is the biggest barrier to employment
What can you do to Expect, Employ, and Empower? Find out and learn more by visiting their website: www.dol.gov
World Suicide Prevention Day September 10th marked World Suicide Hotlines and support: Prevention Day. As our article on page 1 National Suicide Prevention Line: discussed, suicide is a huge issue in the 1-800-273-TALK (1-800-273-8255) world, especially among those with SCI. Chat online World Suicide Prevention Day serves to National Hopeline Network: raise awareness, provide support to 1-800-SUICIDE (1-800-748-2433) survivors and families, and provide suiWebsite cide prevention resources. Trident United Way’s 2-1-1 Hotline: For more information, click here. *211 If you or someone you know is in crisis, Website please know that help is available 24/7 TTY Mode: at the following hotlines. 1-800-799-4889
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New Multiple Sclerosis Study Starting next year, we will have a new study focused on successful employment and quality of life after multiple sclerosis (MS). To prepare for our study, we conducted four focus group meetings in Ohio on August 11 and 12, 2014. Our four meetings allowed us to meet with different groups of people, all of whom have MS. We met with college educated individuals with white collar jobs, high school/ technical school educated individuals with blue collar jobs, minorities with white collar jobs, and minorities with blue collar jobs. Meeting with these individuals allowed us to gain a wide array of perspectives.
Topics covered in the meetings included the following:
As we aim to fill the gap in research concerning MS and employment, we focused on discussing and sharing employment experiences within the group. All of the participants were employed at the time of their MS diagnosis or had worked sometime post-diagnosis. The majority of the meetings consisted of questions designed to elicit information about the personal, environmental, and policy-related factors that influence job retention, satisfaction, and longevity after MS diagnosis. Participants were also asked if they felt their employment status was influenced by gender, race, age at diagnosis, functional ability, environment, and resources.
(h) Any other issues
“ ...we aim to fill the gap in research concerning MS and employment...”
(a) Types of jobs/employment (b) Maintenance of employment following diagnosis or return to work process (c) Barriers and challenges at different points during their work life (d) Job accommodations and resources (e) Impact of policies on their work life (f) Factors which attributed to retirement, temporary leave, or securing another job (g) Managing health and secondary conditions after diagnosis
All four focus groups were very passionate about the topic at hand and gave us great insight. The information discussed in the meeting will be utilized for the development of the study survey. Our team looks forward to the opportunity of conducting this invaluable research. To stay up-to-date on the progress of this study, please visit our blog at: http://sciandtbiresearch.blogspot.com
CAP Outings
FOCUS POINT
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To show gratitude for our consumer advisory panel (CAP) members, our team hosted several outings for them over the summer. On June 19, July 17, and August 14, team members and CAP members met up at Joseph P. Riley Stadium to enjoy an evening of watching Charleston’s baseball team, The RiverDogs. Everyone who came out to these games enjoyed a great evening of baseball.
Our research team would like to thank the Charleston RiverDogs for their continued generosity in providing tickets to our group. If you have an SCI and are interested in providing feedback on our research assessments and activities, consider joining our CAP. If you are interested, please contact our consumer advocate, Richard Aust, at 843-792-2605 or at aust@musc.edu.
Student Perspective: Summer Experience with the Longevity after Injury Project
Hello, my name is Taylor Hutt and I am a senior at Spelman College, where I am pursuing a bachelor’s degree in biology. During the summer, I was lucky to intern at MUSC, where I participated in research for the Longevity after Injury Project. As a student researcher, I worked on my summer project titled, “Health Disparities and Neighborhood Impacts after Traumatic Spinal Cord Injury”. Working alongside Drs. Cao, Krause, and Saunders, we conducted a study that looked into the role of neighborhood disadvantages in racial/ethnic health disparities among people with spinal cord injury (SCI). To help develop my research skills, I attended multiple lectures, labs, and patient panels with physical therapy (PT) and occupational therapy (OT) students. The tools I developed from the patient panels helped me better understand what life is like and the everyday challenges faced by those living with SCI. I was able to observe different techniques used to help people adjust to life after injury. I was also given the opportunity to meet multiple individuals who have overcome their challenges, yet lead very active lifestyles. Many of the people I met participate in local sports teams; one is even in the process of qualifying for the US Paralympics!
Throughout the summer, I was able to participate in events within the research team. In June, our team took its community advisory panel members to the Charleston RiverDogs game. This was my first time at a Minor League baseball game. After a rough start, the RiverDogs made an exciting comeback to beat the Kannapolis Intimidators 10-7. From June through July, I was also able to participate in the MUSC summer basketball league with other staff members and students. As I return to Spelman to embark upon my senior year, I will never forget the tools I learned working with the research team. After graduation, I plan on continuing my education to pursue a Master of Public Health Degree, as well as a Doctor of Medicine degree. I will always remember the challenges faced by those with disabilities. I am hopeful that, one day, I can help positively impact policy and ignite change in our healthcare system. I had a great time working with the patients, staff, and students this summer. I am grateful for the time I spent with the Longevity after Injury Project, and I look forward to sharing my experiences with others in the future.
“The tools I developed from the patient panels helped me better understand what life is like, and the everyday challenges faced, by those living with SCI.” -Taylor Hutt
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Check out these videos... Check out the two videos below about The Power of Disability Blogging and Disability and Employment: Job Application Process.
Check out our professional
Nicole DiPiro We sat down with one of our PhD students, Nicole DiPiro, to discuss her manuscript, Pain and fatigue as mediators of the relationship between mobility aid usage and depressive symptomatology in ambulatory individuals with SCI.
The Power of Disability Blogging
and community videos!
In the individuals Nicole studied, pain and fatigue were significantly related to depressive symptoms and were shown to be mediators of mobility aid usage. Nicole will be presenting her research findings in-depth for her dissertation next year. To find out more about her research, please click here.
Disability and Employment: Job Application Process
Summer Student Program
Summer student video This summer, we welcomed Taylor Hutt as our summer intern. Taylor is an upcoming senior at Spelman College, where she is pursuing a Bachelor’s degree in Biology. During her 10-week internship, Taylor assisted with doing research on the community effects on health for those with SCI. On July 29, 2014,Taylor presented her findings during MUSC’s Student Research Day. Taylor discussed “Health Disparities and Neighborhood Impacts After Traumatic Spinal Cord Injury.” To listen to her discuss her project and research findings, please click here.
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Fall Open House On Thursday, November 6th, our team will be participating in an Open House Celebration. This celebration will showcase our work and accomplishments, along with the work of several other researchers at MUSC.
If you would like more information about this event, please send an e-mail to jarnecke@musc.edu.
Without our participants, our research would not be possible.
RRTC Grand Rounds James S. Krause, PhD
On Wednesday, July 23, 2014, the Longevity after Injury Project hosted our quarterly SCI Grand Rounds for the RRTC on Secondary Health Conditions grant. Our speaker was our founder, Dr. James S. Krause, Professor and Director for MUSC’s Center for Rehabilitation Research in Neurological Conditions. Dr. Krause presented on “Secondary health conditions and SCI: What have we learned over the past five years?” Dr. Krause reviewed the progress of our research over the past five years, as well as our research findings. The success of our research and of our Grand Rounds allows us to continue hosting Grand Rounds.
Our next SCI Grand Rounds will take place on November 11, 2014, with Dr. Yue Cao presenting. Make sure to regularly visit our website, Facebook, and LinkedIn pages for updates!
To view Dr. Krause’s presentation, click here (please use an updated media player to view).
To view Dr. Krause’s PowerPoint slides, click here.
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Facebook Giveaway!
To show our appreciation for all of you, we are doing a $25 Visa gift card giveaway on our Facebook page. If you would like a chance at winning the gift card, please make sure to “like� us on Facebook. Then, be on the lookout for a status regarding the gift card giveaway. When you see that status, comment on it, share it, or like it to be entered for a chance to win.
Recent Publications DiPiro, N.D., Krause, J.S., Saunders, L.L., Brotherton, S., & Kraft, S. (2014). Pain and fatigue as mediators of the relationship between mobility aid usage and depressive symptomatology in ambulatory individuals with SCI. Spinal Cord, 52(4),316-321. Abstract Krause, J.S., Saunders, L.L., DiPiro, N.D., Newman, S., Banik, N.L., & Park, S. (2014). Allostatic load and spinal cord injury: Review of existing research and preliminary data. Topics in Spinal Cord Injury Rehabilitation, 20(2),137146. Abstract Cao, Y., DiPiro, N.D., Xi, J., & Krause, J.S. (2014). Unmet expectations of adjustment and depressive symptoms among people with traumatic spinal cord injury. Rehabilitation Psychology, 59(3), 313-320. Abstract Cao, Y., J.F. Massaro, J.S. Krause, Y. Chen, & M.J. DeVivo. (2014). Suicide mortality after spinal cord injury in the United States: Injury cohorts analysis. Archives of Physical Medicine and Rehabilitation, 95, 230-235. Abstract Cao, Y., J.S. Krause, L.L. Saunders, & W. Bingham. 2014. Household income and subjective well-being after spinal cord injury: A longitudinal study. Topics in Spinal Cord Injury Rehabilitation, 20(1), 40-7. Abstract Krause, J.S., Dismuke, C.E., Acuna, J., Sligh-Conway, C., Washington, K., & Reed, K.S. (2013). Race-ethnicity and poverty after spinal cord injury. Spinal Cord, 52(2), 1-6. Abstract Saunders, L.L., DiPiro, N., Krause, J.S., Brotherton, S., & Kraft, S. (2013). Risk of fall related injuries among ambulatory participants with spinal cord injury. Topics of Spinal Cord Injury Rehabilitation, 19(4), 259-266. Abstract Selassie, A., Snipe, L., & Focht, K. (2013). Baseline prevalence of heart diseases, hypertension, diabetes, and obesity in persons with acute traumatic spinal cord injury: Potential threats in the recovery trajectory. Topics of Spinal Cord Injury Rehabilitation, 19(3), 172-182. Abstract Saunders, L.L., Krause, J.S., DiPiro, N., Kraft, S., & Brotherton, S. (2013). Ambulation and complications related to assistive devices after spinal cord injury. Journal of Spinal Cord Medicine, 36(6), 652-659. Abstract
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Message from Dr. Jim Krause We would like to take this opportunity to thank those of you who have participated in our research. Our goal is to help improve the health, function, quality of life, employment outcomes, and longevity of people with disability through research and education. We have made great progress together this year and will let you know about future SCI research studies as they become available. RRTC is funded by the National Institute on Disability and Rehabilitation Research (NIDRR#H133B090005)
Websites Longevity After Injury Project: www.longevityafterinjury.com Beyond 90 Days (under construction): www.beyond90days.com Facebook: www.facebook.com/LongevityAfterInjuryProject Blog: www.sciandtbiresearch.blogspot.com/
CHORCUP is funded by the Nation-
LinkedIn: http://www.linkedin.com/company/musc-longevity
al Institute on Disability and Reha-
-after-injury-project
bilitation Research (NIDRR -
CHORCUP: http://academicdepartments.musc.edu/chp/
#H133A080064).
longevity_after_injury/funded_projects/chorcup/index.htm
RRTC: http://academicdepartments.musc.edu/chp/ longevity_after_injury/funded_projects/rrtc/
The Longevity after Injury Project College of Health Professions 77 President St. MSC 700 Charleston, SC 29425-7000 WEBSITE: www.longevityafterinjury.com
PHONE: (843) 792-2605
TOLL FREE: 1-866-313-9963
FAX: (843) 792-5649
OFFICE HOURS: 8 a.m. to 5 p.m. EST