Harmonization of Databases: A Step for Advancing the Knowledge About Spinal Cord Injury.

The objectives of this article are to (1) provide an overview of existing spinal cord injury (SCI) clinical research databases-their purposes, characteristics, and accessibility to users; and (2) present a vision for future collaborations required for cross-cutting research in SCI. This vision highlights the need for validated and relevant data for longitudinal clinical trials and observational and epidemiologic SCI-related studies. Three existing SCI clinical research databases/registries are reviewed and summarized with regard to current formats, collection methods, and uses, including major strengths and weaknesses.

Associations between perceptions of evidence and adoption of H1N1 influenza infection prevention strategies among healthcare workers providing care to persons with spinal cord injury.

Aim: To examine associations between perceptions of evidence (research evidence, clinical expertise, patient preferences) and outcomes of a nationwide programme to implement H1N1 influenza prevention guidelines.

Background: Healthcare workers do not consistently adhere to recommended infection control practices and this may be associated with their perceptions of evidence sources.

Design: Cross-sectional mailed survey.

Use of implementation theory: a focus on PARIHS.

Background: Limited understanding and application of theory in implementation research contributes to variable effectiveness of implementation studies. Better understanding of direct experiences with theory could improve implementation research and the potency of interventions.

Aims: This study was a conceptual exercise aimed at characterizing experiences with and applications of the Promoting Action on Research Implementation in Health Services (PARIHS) framework.

Depression, healthcare utilization, and comorbid psychiatric disorders after spinal cord injury.

Background: Depression is often comorbid with other psychiatric conditions in the general population, with resultant impact on severity of conditions and healthcare utilization. It is unclear to what degree this is also true among persons with spinal cord injury (SCI).

Objective: This study examined rates at which psychiatric conditions were comorbid with depression after SCI, and the association between a depression diagnosis and healthcare and pharmaceutical drug use.

Pain, depression, and health care utilization over time after spinal cord injury.

Objective: The aim of this research was to examine comorbid pain and depression after spinal cord injury (SCI) in terms of: frequency, longitudinal course, and associations with medical conditions and use of SCI specialty care.

Method: Three consecutive standardized annual psychological evaluations were reviewed for 286 persons with SCI receiving care at an SCI specialty care center. Chart abstraction included medical and demographic information, a depression scale, and a pain scale.

Pain and post-traumatic stress disorder symptoms during inpatient rehabilitation among operation enduring freedom/operation iraqi freedom veterans with spinal cord injury.

Objective: To examine the frequency of post-traumatic stress disorder (PTSD) symptoms and pain, and how PTSD symptoms were associated with pain severity ratings and the longitudinal course of pain during inpatient rehabilitation for spinal cord injury (SCI) among veterans of the Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) conflicts.

Design: Longitudinal analysis of data gathered from electronic medical records.

Setting: SCI specialty care centers within the Department of Veterans Affairs.

Activity and participation after spinal cord injury: state-of-the-art report.

The importance of activities and community participation for persons with spinal cord injury (SCI) has been recognized for decades and yet theoretical and empirical advances have been limited. This report summarizes the recommendations for researchers on the topic of measuring activity and participation among persons with SCI formulated by the Spinal Cord Injury workgroup at the State-of-the-Art Conference on Outcome Measures in Rehabilitation held in January 2010. Activity and participation were defined as independent constructs ideally measured in reference to personal values and environmental influences.

Smoking behavior and delivery of evidence-based care for veterans with spinal cord injuries and disorders.

Objective: Little is known about those veterans with spinal cord injuries and disorders (SCI/D) who smoke cigarettes. This study identified the factors associated with smoking in this population, motivations for smoking, and the readiness for smoking cessation. Current practices for the delivery of evidence-based tobacco cessation were also examined.

Using VA data for research in persons with spinal cord injuries and disorders: lessons from SCI QUERI.

The Department of Veterans Affairs (VA) provides integrated services to more than 25,000 veterans with spinal cord injuries and disorders (SCI/D). VA data offer great potential for providing insights into healthcare utilization and morbidity, and these capabilities are central to efforts to improve healthcare for veterans with SCI/D. The objective of this article is to introduce researchers to the use of VA data to examine questions related to SCI/D using examples from Spinal Cord Injury (SCI) Quality Enhancement Research Initiative studies.

A critical synthesis of literature on the promoting action on research implementation in health services (PARIHS) framework.

Background: The Promoting Action on Research Implementation in Health Services framework, or PARIHS, is a conceptual framework that posits key, interacting elements that influence successful implementation of evidence-based practices. It has been widely cited and used as the basis for empirical work; however, there has not yet been a literature review to examine how the framework has been used in implementation projects and research. The purpose of the present article was to critically review and synthesize the literature on PARIHS to understand how it has been used and operationalized, and to highlight its strengths and limitations.

Pain, depression, and physical functioning following burn injury.

Objective: Little is known about how pain and depression after burn injury may influence long-term outcomes such as physical functioning. This prospective study examined associations between pain, depression, and physical functioning in a sample of burn injury survivors.

Design And Participants: Questionnaires assessing pain, depression, and physical functioning were completed by 64 (52% of original sample) adult burn survivors shortly after discharge from burn care and at 1- and 2-year follow-ups.

Pain among veterans with spinal cord injury.

The Department of Veterans Affairs Veterans Health Administration cares for approximately 15% of persons with spinal cord injury (SCI) in the United States. However, the nature and characteristics of pain among veterans with SCI are not well understood. This study used a postal survey to compare veterans with SCI and nonveterans with SCI on pain intensity; pain interference; functioning; and other pain, demographic, and medical characteristics.

Adjustment and discussion of cancer: a comparison of breast and prostate cancer survivors.

Supportive conversations may facilitate adjustment among cancer patients early in treatment. However, little is known about how cancer discussion is related to adjustment among long-term survivors of cancer or how gender differences may influence associations between cancer discussion and adjustment. The purpose of this study was to examine possible moderator effects of gender on associations between cancer discussions and adjustment among survivors of breast or prostate cancer.

Physiologic reactivity to a laboratory stress task among men with benign prostatic hyperplasia.

Objectives: The sympathetic nervous system and hypothalamic-pituitary-gonadal axis are involved in the pathophysiology of benign prostatic hyperplasia (BPH). The sympathetic nervous system and hypothalamic-pituitary-gonadal axis are also highly reactive to psychological stressors, yet associations between prostate function and reactivity to a psychological stressor have not been examined using standardized psychological stress paradigms. The objective of this study was to examine the associations between psychological stress reactivity and BPH disease parameters.

Prevalence of depression diagnoses and use of antidepressant medications by veterans with spinal cord injury.

Objectives: The objectives of this study were to examine the prevalence of depression diagnoses among veterans with spinal cord injuries and disabilities (SCI&D) for a 3-yr period, and to characterize patterns of antidepressant medication use in this population.

Design: This study was a retrospective analysis of clinical and administrative data. The sample consisted of 3678 veterans with SCI&D who had received any health care at a Department of Veterans Affairs facility between fiscal years 1999 and 2001, a depression diagnosis, and complete data.

Pain following spinal cord injury.

Pain is one of the most common, severe, and treatment-resistant complications that follows SCI. Recent years have seen a surge of research on methods for assessing and treating spinal cord injury pain. In this article, pain after SCI is reviewed in terms of nature, scope, assessment techniques, and treatment strategies.

Cold pressor pain sensitivity in monozygotic twins discordant for chronic fatigue syndrome.

Objective: Individuals with chronic fatigue syndrome (CFS) experience many pain symptoms. The present study examined whether pain and fatigue ratings and pain threshold and tolerance levels for cold pain differed between twins with CFS and their cotwins without CFS.

Design: Cotwin control design to assess cold pain sensitivity, pain, and fatigue in monozygotic twins discordant for CFS.

Early unplanned transfers from inpatient rehabilitation.

Objective: To identify characteristics of patients who transfer off inpatient rehabilitation to a surgical or medical unit before completion of their rehabilitation program.

Design: A retrospective 9-yr chart review of patients transferred off the rehabilitation unit at a regional level 1 trauma center due to medical complications.

Results: Of 3072 patient admissions, 250 (8%) were transferred to an acute medical or surgical unit, and 55 (22%) of those transfers were within 3 days.

Stress is associated with subsequent pain and disability among men with nonbacterial prostatitis/pelvic pain.

Background: Nonbacterial prostatitis is a syndrome characterized by persistent pelvic area pain in men with or without voiding symptoms. Its causes are poorly understood, and evidence-based treatments are lacking. Although psychological stress has been proposed as an etiological factor, the literature lacks prospective studies using standardized measures to examine associations between stress and male pelvic pain problems over time.

Stress, hostility, and disease parameters of benign prostatic hyperplasia.

Objective: Psychological factors such as stress are known to influence activity in the sympathetic nervous system and hypothalamic-pituitary-gonadal axis, systems that in turn have been implicated in the development of benign prostatic hyperplasia (BPH). Associations between psychological stress and prostate function have not been directly examined. The objective of this study was to examine associations among stress, hostility, and BPH disease parameters.

Religious participation, interleukin-6, and mortality in older adults.

This study prospectively examined the relationship between religious attendance, interleukin-6 (IL-6) levels, and mortality rates in a community-based sample of 557 older adults. Attending religious services more than once weekly was a significant predictor of lower subsequent 12-year mortality and elevated IL-6 levels (> 3.19 pg/mL), with a mortality ratio of.

Cancer fear and mood disturbance after radical prostatectomy: consequences of biochemical evidence of recurrence.

Purpose: Biochemical recurrence of prostate cancer often precedes any clinical sign or symptom of disease recurrence by several years. Thus, patients may have laboratory evidence of recurrence and do not know what it portends in terms of the future disease course. Little is known about the emotional consequences of biochemical recurrence.

Concealment of homosexual identity, social support and CD4 cell count among HIV-seropositive gay men.

Objective: Previous research has indicated that the concealment of homosexuality is related to poorer health among gay men with HIV. This study explored mechanisms by which concealment of homosexuality may be related to HIV disease status by examining associations between concealment of homosexuality, social support, social constraints, depressive symptoms and CD4 count among HIV-seropositive gay men.

Method: Questionnaires assessing concealment of homosexuality, social support, depressive symptoms and social constraints were administered to 73 HIV-seropositive gay men.