ScI Research Team Newsletter www.sciresearchteam.musc.edu A newsletter of activities of the SCI Research Team (formerly SCIORG)
SPRING 2010
SPINAL CORD INJURY RESEARCH TEAM
Research Highlight: Pressure Ulcers, Race, Socioeconomic Status Pressure ulcers are a serious condition and one of the most common secondary complications which can occur after SCI. We recently completed a study on the relationship of race and socioeconomic status with pressure ulcers. Socioeconomic status is a summary of an individual’s social and economic factors, such as income, education, and employment. We asked participants about their household income and the amount of education they had completed. Thirty-nine percent of participants reported having a pressure ulcer in the past year, 20% reported having a current pressure ulcer, and 23% reported having a surgery to repair a pressure ulcer since their injury. We first looked to see if there was increased risk of pressure ulcers among AfricanAmericans compared with white participants. We found that African-Americans were not at increased risk for pressure ulcers. Next, we looked to see if level of education was related to risk of pressure ulcers. Education was not related to the risk of having a pressure ulcer at all in the previous year.
Inside this issue:
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Research Highlight
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SCI Research Grant Awarded 1 Maintaining Longevity, Part
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You Tube Updates
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Life is Good : A Conversation 3 with Irvin Clark Study Updates
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However, participants with less than a high school education were at increased risk for having a current pressure ulcer compared to participants who had a college education or higher. Last, we wanted to find out if household income was associated with increased risk of pressure ulcers. Persons with a lower household income (<$25,000 per year) compared to those with higher household income (>$75,000 per year) were found to be at increased risk of having had a pressure ulcer in the previous year and also for having a current pressure ulcer. Additionally, participants in the lower household income group were at higher risk for ever having surgery to repair a pressure ulcer at some point since their injury. In the future, we hope to assess other factors related to socioeconomic status, such as access to health care and the use of health care services in relation to the occurrence of pressure ulcers. ***This report is part of a project by one of our 2009 summer students, Bridget Peters. She won the Health Disparities Award at Student Research Day in November for this work.***
Team Receives Award from the American Rehabilitation Counseling Association An article by Dr. Jim Krause and Karla Reed titled, â&#x20AC;&#x153;Obtaining Employment After Spinal Cord Injury: Relationship With Pre-and Postinjury Education" and published in Rehabilitation Counseling Bulletin has been selected to receive first place in the 2009 American Rehabilitation Counseling Association Research Awards competition! As award winners, Dr. Krause and Mrs. Reed received engraved plaques and were invited to attend the ARCA awards reception held on Saturday, March 20th at the American Counseling Association conference in Pittsburgh, PA.
The purpose of this research was to identify the association of educational milestones obtained before and after spinal cord injury with post-injury employment. Survey data were collected from 1,362 adults under the age of 65. The results found that with the exception of a high school certificate, completing educational milestones after injury were associated with substantially higher odds of employment than when they were completed prior to injury. The results illustrate the need for post-injury education, even among individuals who have extensive training and education at the time of injury.
SCI RESEARCH TEAM NEWSLETTER
Maintaining Longevity: Health Behaviors (Part C)
Websites All three of our team websites have recently gotten an updated look. SCIORG: http:// academicdepartments. musc.edu/chp/sciorg/ OR www.sciresearchteam. musc.edu CHORCUP: http:// academicdepartments.mus c.edu/chp/CHORCUP RRTC: http:// academicdepartments. musc.edu/chp/rrtc
There is also some new functionality on all sites, such as links to our abstracts on PubMed, easy links to our YouTube videos, and new bios for our updated team.
How long will I live? This is a major concern among people with SCI. The answer depends on a lot of factors, some of which are directly under an individualâ&#x20AC;&#x2122;s control. In previous newsletters, we have identified the importance of finding purpose in life and maintaining health. In this newsletter, we highlight the importance of individual behavior. We have identified 6 important behaviors related to maintaining longevity. We have found that people who exercise, spend more time out of bed, and who leave their homes on a regular basis to get out in the community have greater longevity. Although there is no magic number, getting out of the home a minimum of 4 times per week is associated with greater longevity. People who are homebound have the lowest average longevity. Three behaviors are associated with shorter life expectancy: smoking, binge alcohol use, and overuse of prescription medication. People who smoke a pack a day or more of cigarettes have on average lower life expectancy than those who smoke less than a pack a day and substantially lower than those who do not smoke. Any regular smoking is associated with
lower life expectancy, but life expectancy improves with time after the person quits smoking. Life expectancy decreases the more frequently the individual has 5 or more drinks per occasion (1 shot of alcohol, 12 ounce beer, 4 ounce glass of wine). This is called binge drinking and is different than other alcohol use that may not be associated with diminished life expectancy. Taking prescription medication weekly for 3 or 4 types of problems (pain, spasticity, sleep, or stress) is also associated with lower life expectancy. Doing more than one of these behaviors at the same time is likely to greatly diminish life expectancy. Respiratory complications are a major reason for mortality after SCI, so any activity that leads to poorer respiratory function will increase risk of mortality. Similarly, there are many deaths after SCI related to unintentional injuries that could be related to alcohol or prescription medication misuse. On the other hand, maintaining an active lifestyle is one of the best ways to maintain longevity. Our purpose in sharing these research findings is not to tell people what they should or should not do, but rather, to inform people with SCI and their families of what we have learned. Ultimately, what you choose to do is up to you. We hope that sharing this information helps you to make informed decisions.
Yo u Tu b e U p d a t e All of our You Tube videos can be viewed at: www.youtube.com/user/SCIResearchTeam You Tube videos for our grant research follow three different tracks: professional directed audience, CHORCUP, and RRTC. The professional track videos, or 'bytes' as they are titled, summarize our research data and findings from the projects for the clinical and research based professional population. The CHORCUP track focuses on videos directly related to the Center on Health Outcomes Research and Capacity Building for Underserved Populations with SCI and TBI. The RRTC videos will focus on activities and research directly related to the Rehabilitation and Research Training Center projects and findings. The following videos are currently available for viewing:
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CHORCUP Volume 1: Introduction to our You Tube CHORCUP Volume 2: Summer Undergraduate Research SCI Research Byte Volume 1: Earnings and SCI SCI Research Byte Volume 2: Depression in Terms of Race SCI Research Byte Volume 3: Injury, Severity, and Education SCI Research Byte Volume 4: Ambulation and Depression
SPRING 2010
L i f e i s G o o d ! A C o nve r s a t i o n w i t h E r v i n C l a r k I recently spoke with Ervin Clark to get his impressions on what it is like to live with an SCI. Ervin expressed, in his always upbeat voice, that “his life changed dramatically as a 15 year old on September 22, 1992 when he stopped his bike to watch a friend doing flips on a mattress.” Ervin had done countless front and back flips in his life so he was easily convinced to join in on the fun. It was a double front flip in which he landed on his neck (C5-6 incomplete). I first met Ervin when he was a junior in high school and have always been impressed by the way he handles any situation which comes his way. When I complimented him on his unwavering positive attitude, Ervin shared with me that his philosophy of life is to always strive to be PM—Positive and Motivated. It does not matter what situations you find yourself in, a person cannot become discouraged. Ervin takes obvious pride in being able to selfmotivate himself. Ervin graduated from North Charleston High School and completed 2 years in Graphic Arts at Trident Technical College while working at a print screening company. For as long as he can remember, Ervin has always enjoyed drawing. He started a company,
Rottweiler Printing, in 1997 and will do any job from portraits to flyers and logos. Another passion, poetry, created a catalyst for his introduction into making music. At a suggestion of a friend, Ervin went into a recording studio to record some songs using several of his poems. Instantly he was bitten by the music bug and has since started a business to assist other artists with engineering, CD arrangement, and song writing. At 33 years old, I asked Ervin what he is most proud of about his life so far. He immediately responded that he is most proud of the man he has become and stated, “I have had to deal with some very challenging situations as result of my SCI and feel that I have finally come out on the other side.” Ervin is a big advocate of peer support and credits his inpatient physical therapist with preparing him for life after SCI.
~Ervin Clark
When asked where he would like to be in five years, Ervin reflected that his goals include owning an artistry business, record label, and finding that special someone to marry and have one or two children. Keep smiling Ervin. ~ Richard Aust
O n g o i n g R e s e a r c h U p d at e s We are currently in the data collection phase of Study 1: “Risk of Adverse Outcomes after SCI: A Longitudinal Study,” and Study 2: “A Longitudinal Study of Risk for Hospitalization, Pressure Ulcers, and Subsequent Injuries after Spinal Cord Injury.” These studies will help rehabilitation professionals better understand how SCI impacts everyday life and will provide a basis for the development of more effective programs for participation and quality of life after SCI. To date we have received over 2450 completed surveys from
“ Always strive to be PM—Positive and Motivated”.
participants. In addition, we are in the data collection phase of the study, “Participation, Subjective Well being, Health, and Spinal Cord Injury: A 35-year Longitudinal Study.” This study is the longest running study of its kind and will continue to provide valuable insight into the patterns of what is occurring post-injury in the areas of secondary conditions, health, and quality of life issues. To date we have
received over 960 completed surveys from participants. Conference Presentations: May 3-4, NARRTC, Alexandria, VA. Presentation: Psychological Factors Affecting Alcohol Use after SCI , Poster: Vocational Interests after Recent Spinal Cord Injury: Comparisons Related to Gender and Race May 25-28, ASIA, Nashville, TN, Presentation: Economic Factors and Risk of Mortality after SCI, Poster: Relationship of Pressure Ulcers, Race, and Socioeconomic Status after SCI
Check out our Facebook pages! ~www.facebook.com/ people/James-Krause/ 100000103684876 ~Spinal Cord Injury: CHORCUP ~Spinal Cord Injury: Rehabilitation Research and Training Center
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DR. JAMES S. KRAUSE MUSC-College of Health Professions Department of Health Sciences and Research 77 President Street, Suite 117 MSC 700 Charleston SC 29425-7000 Toll-free number: 1-866-313-9963 Fax: 843-792-5649 E-mail: krause@musc.edu
Moving or getting a new phone number? Please contact us to update your address or phone #. Email: aust@musc.edu
Toll-free #: 1-866-313-9963
The latest SCI Research Team newsletter is now available online: www.musc.edu/chp/sciorg
Websites To Check Out! Disability Information and Resources: www.makoa.org SCI Information Network: www.spinalcord.uab.edu National Spinal Cord Injury Association: www.spinalcord.org SCI Information Pages: www.sci-info-pages.com Shepherd Center: www.shepherd.org Lumosity Brain Games
Thank you for your support and insight by participating in our studies! Jim Krause, PhD
www.lumosity.com Disabled and Productive www.disabledandproductive.com
Team leader, (C4, 37 years post-injury) Disclaimer: We list these websites for your information only and do not endorse the information posted on these websites.