TRAUMA RESEARCH METHODS AND PRACTICE
WORKSHOP - UNIVERSITY OF MELBOURNE, 2008
It’s never just about
the numbers, but…
Nick Rushworth
Executive Officer Brain Injury Australia
“…peak of peaks”
BIA
member
organisations
members’ members
“Brain Injury Australia works to ensure that all people living with
an ABI have access to supports and resources each person
requires to optimise their social and economic participation.”
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subtitle
“…advocacy for Australian
Government
allocations
 A
and policies that reflect the needs and prioritiesstyle
of people with
an ABI and their families.”
“…the provision of effective and timely input into policy,
legislation and program development through active contact
with Australian Government ministers, parliamentary
representatives, Australian Government departments and
agencies, and national disability organisations.”
3/18/2016
Brain Injury Network of South
Australia AGM, 2008
3
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style
It’s
never
just
about
the
In 2003, 432,700
people
(2.2%
of
the
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style
numbers,
population)
hadbut…
an Acquired
Brain
Injury with “activity limitations” or
“participation restrictions”
- Australian Bureau of Statistics’ 2003
Survey of Disability, Ageing and Carers
Nick Rushworth
3/18/2016
Executive Officer Brain Injury Australia
4
Brain Injury Network of South
Australia AGM, 2008
Almost 3 out of every 4 PWABI were aged less than 65
years, half of them
between
15Discussion
andMaster
34 years title
of age
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toof
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Topics
2 out of every 3style
said that they acquired their brain
to
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toideas
edityears
Master
subtitle
State
theClick
main
you’ll besubtitle
talking
injury when they were
aged
under
25
style
style
about
9 out of every 10 said their ABI was caused by
accident or injury (more than half of them said the
accident or injury occurred on a “street, road or
highway”)
3 out of every 4 were men
3/18/2016
3/18/2016
Brain
Brain Injury
Injury Network
Network of
of South
South
Australia
AGM,
2008
Australia AGM, 2008
5
5
27,300 people with an ABI aged under 65 years experiencing
“activity limitations” or “participation restrictions” said their
Click
to condition…the
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ABI was their “main
disabling
onetitle
reported as
causing the moststyle
problems”. A traffic injury was the main
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to edit Master subtitle
cause for more than half of these
people
It’s never just aboutstylethe
Onenumbers,
in four reportedbut…
four or more disability
groups,
compared with one in eighteen of all people with disability
One in three reported 5 or more health conditions,
compared with about one in eight of all people with disability
3/18/2016
Nick Rushworth
Brain Injury Network of South
Australia AGM, 2008
6
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11,866
people with an ABI
style
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accessed Commonwealth
style
State/Territory Disability
Agreement (CSTDA)-funded
services in 2004-05
3/18/2016
Brain Injury Network of South
Australia AGM, 2008
7
“outcomes”1?
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to
edit
Master
title
What
This
Means
20-26 year follow-up of 100 men with TBI admitted to Sydney’s Lidcombe Hospital
between 1976 and 1981: style
Clickstatement
to edit Master
subtitle
Add
a
strong
that
 “…85% had used at least one service in the preceding
12 months, most
style
summarizes
how
or think
commonly financial (69%),
transport (64%)
and you
homefeel
support
(52%). Unmet
about
topic
needs were high, especially
in thethis
social
participation (73%), vocational (67%),
and respite (38%) areas…”
 Summarize key points you want your
audience
to
remember
 “Significant proportions of the series continued to experience activity

limitations in mobility (25%) and basic self-care tasks (21%), although
restrictions in social participation were much more prevalent (e.g., 66% for
employability, 54% for interpersonal relationships)…”
3/18/2016
- “Long-Term Outcomes After Traumatic Brain Injury: Following up a
Consecutive Series at 20-26 Years Post-Trauma - Final Report to the
Brain Injury
Network
of South
Motor Accidents
Authority
Of New
South Wales”, R Tate et al. Rehabilitation8
Australia AGM, 2008
Studies Unit, Faculty of Medicine, University of Sydney, 2004
“outcomes”2?
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to
editMeans
Master title
Next Steps
What
This
Brain Injury Outcomesstyle
Study (BIOS) - 198 clients with severe TBI sustained
between 1999 and 2001:
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toactions
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subtitle
Add
Summarize
a
strong
any
statement
that
required
of
“…good recovery in the Physical domain, with onlystyle
10% continuing to have
your
summarizes
audience
youfunctioning
feel or think
significant impairments that
interfered
withhow
everyday
in mobility at
this topic
three years post trauma…”
 about
Summarize
any follow up action items
requiredimpairments
Summarize
of you
key points
you
want
your and
“By contrast, clinically significant
persisted
in the
Cognitive
Behavioural domains for audience
many clients:toforremember
example, 61% for memory, 52% for

problem solving and 20% for social interaction…”
“ At three years, the longest PTA [Post-Traumatic Amnesia] group had
significantly lower levels of [community] participation…”
3/18/2016
- Brain Injury Outcomes Study (Final report) May 2004, Robyn Tate, Ian
Cameron, Julie Winstanley, Bridget Myles, Ross Harris, Rehabilitation Studies
BrainClinical
Injury Network
Southof Medicine, The University of Sydney.
Unit, Northern
School, of
Faculty
9
Australia AGM, 2008
injury
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to prone:
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People with an ABI arestyle
drawn from the same populations as those at the
greatest risk of any injury:
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style
low levels of education
low workforce participation rates
poor housing
large family size
histories of marital breakdown, of neglect, physical and sexual
abuse
parental drug or alcohol abuse and substance abuse
mental illness
3/18/2016
Australian Institute of Health and Welfare, Key National Indicators of Children’s
Health, Development
and Wellbeing:
Brain Injury Network
of South Indicator Framework for a Picture of
10
Australia’s Children
2009,
Canberra,
Australia
AGM,
2008 2008.
prisoners - “research priority”?
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to
edit
Master
title
2003-04 survey of 200 New South Wales prisoners: 82% had
experience of TBI style
with over half reporting ongoing effects
(headaches, memory loss, personality
behavioural
change,
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edit
Master subtitle
anxiety, depression etc.) 22% had sustained four
styleor more TBIs
2003 Young People in Custody Health Survey (NSW): 40% of
young men had sustained an ABI resulting in “significant loss
of consciousness”
NSW Prison Injury Surveillance Program: assaults accounted
for 80% of violence in prisons - the second most common
injury treated in prison clinics
3/18/2016
- “Prison Violence: Perspectives And Epidemiology”, Tony Butler and Azar Kariminia,
Centre for Health Research in Criminal Justice, NSW Justice Health and School of
Public Health and Community Medicine, University of New South Wales NSW Public
Injury
of South
Health Bulletin Vol.Brain
17 No.
1–2,Network
and Peter
Schofield et. al, “Traumatic brain injury 11
Australia AGM, 2008
among Australian prisoners: rates, recurrence and sequelae”, Brain Injury, May 2006.
homelessClick
- “research
priority”?
to
edit
Master
title
10% of people using inner-city Sydney hostels and refuges
style
had cognitive impairment as a result of alcohol-related brain
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style
injury or TBI
Two Victorian studies of pension-only Supported Residential
Services found between 13 per cent and 17 per cent of
residents had a history of ABI
Three-year study of outreach service use found 33% of clients
had a diagnosed alcohol-related brain injury
3/18/2016
- Hatzitaskos., P. (1995) “Crime Times”, Vol. 1, No.1-2, p.5., Byrne, B. (1997) SRS Socialization
Facilitation Project (Caulfield General Medical Centre, Melbourne) and Community (Residential
Services) Visitors’ Board, Annual Report of Community Visitors, 1996, Health Services Act 1988
(Office of the Public Advocate, Melbourne) cited in HACC Program Development & Access
SRS/Rooming House Project, Final Report December 1998, McGregor, Robb (2000) “Comparative
Brain Injury Network of South
data between clients with alcohol related brain injuries and other clients, Ozanam Community 12
Australia AGM, 2008
Support Services Outreach Program.
Indigenous - “research priority”?
to edit
Master
the transport injuryClick
rate for Indigenous
Australians
is up totitle
three times that
of non-Indigenous Australians
style
the rate of “head injury” due to assault
in the
populations of
Click to
editIndigenous
Master subtitle
QLD, WA, SA and the NT was more than 20 timesstyle
that of non-Indigenous
populations. The rate of head injury due to assault in Indigenous women
was almost 70 times that for non-Indigenous women
the median age for stroke in the Northern Territory is 20 years below the
national average
between 1999 and 2006, 60 Indigenous Australians in the Northern Territory
have died from petrol-sniffing and a further 120 have suffered permanent
“brain damage”
3/18/2016
- Australian Institute of Health and Welfare, “Hospitalisation for head injury due to
assault among Indigenous and non-Indigenous Australians, July 1999-June 2005”,
Jamieson et al., Medical Journal of Australia, May 2008; Australasian Consortium
of Rehabilitation Outcomes;l “Beyond Petrol Sniffing: Renewing Hope for
Brain Injury Network of South
13
Indigenous Communities”, report of the Australian Senate’s Community Affairs
Australia AGM, 2008
Reference Committee
"trimodal age structure"
incidence
(per 100,000)
age
falls-related Click
TBI –to“research
priority”?
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title
style
22,710 hospitalisations for TBI in 2004–05
most common causes ofTBIClick
were falls
(42%),
transportation (29%) and assault
to edit
Master
(14%)”
subtitle style
“while traffic accidents and assault are the main mechanisms of injury in younger
people, falls are the foremost mechanism of TBI in older people, followed by traffic
accidents as pedestrians, drivers or passengers…”
rates of TBI due to falls…were highest in the 85 plus age bracket
the proportion of hospitalisations with TBI as Principal Diagnosis that resulted in
death were highest for falls (63%) followed by transportation (27%) and assault (4%)
3/18/2016
- Helps Y, Henley G and Harrison JE. 2008. Hospital separations due to traumatic brain
Brain Injury
Injury Network
South
injury, Australia 2004–05.
researchofand
statistics series number 45, Adelaide:
15
Australia AGM, 2008
AIHW
falls-relatedClick
TBI –to“research
priority”?
edit Master
title
style
United States: “geriatric TBI” costs $2.2 billion per annum
to of
edit
Master aged care admissions
“Major reason” forupClick
to 40%
residential
subtitle
style to 70 million by 2030
Population 65+
- to double
“…the costs of caring for older adults with a TBI in monetary and human
terms will be staggering…”
Australia: older demographic profile than US
Falls-related TBI: rates triple by 2050 = 750,000 additional hospital bed
days, 3,320 additional residential aged care places
3/18/2016
- Helps Y, Henley G and Harrison JE. 2008. Hospital separations due to traumatic brain
Brain Injury
Injury Network
South
injury, Australia 2004–05.
researchofand
statistics series number 45, Adelaide:
16
Australia AGM, 2008
AIHW
stroke – “research priority”?
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Between 40,000
and 48,000 strokes each year (and
growing)
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70% are first-ever strokes
cause 7% of all deaths in Australia
highly preventable
highly costly ($1.3 billion in 1997)
3/18/2016
Brain Injury Network of South
Australia AGM, 2008
17
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www.braininjuryaustralia.org.au
3/18/2016
Brain Injury Network of South
Australia AGM, 2008
18