Jane Topolovec-Vranic1, Naomi Ennis2, Mackenzie Howatt2, Donna Ouchterlony2, Alicja Michalak2, Cheryl Masanic3, Angela Colantonio4, Stephen W Hwang5, Pia Kontos6, Vicky Stergiopoulos7, Michael D Cusimano8. 1. Trauma and Neurosurgery Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ont. ; Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ont. 2. Head Injury Clinic, St. Michael's Hospital, Toronto, Ont. 3. Head Injury Clinic, St. Michael's Hospital, Toronto, Ont. ; Toronto Rehabilitation Institute, University Health Network, Toronto, Ont. 4. Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ont. ; Toronto Rehabilitation Institute, University Health Network, Toronto, Ont. ; Dalla Lana School of Public Health, University of Toronto, Toronto, Ont. 5. Centre for Research on Inner City Health, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ont. ; Division of General Internal Medicine, Department of Medicine, University of Toronto, Toronto, Ont. 6. Toronto Rehabilitation Institute, University Health Network, Toronto, Ont. ; Dalla Lana School of Public Health, University of Toronto, Toronto, Ont. 7. Centre for Research on Inner City Health, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ont. ; Department of Psychiatry, University of Toronto, Toronto, Ont. 8. Dalla Lana School of Public Health, University of Toronto, Toronto, Ont. ; Injury Prevention Research Office, Trauma and Neurosurgery Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ont. ; Division of Neurosurgery, University of Toronto, Toronto, Ont.
Abstract
BACKGROUND: Little empiric research has investigated the interrelationship between homelessness and traumatic brain injury. The objectives of this study were to determine the rate, mechanisms and associated outcomes of traumatic brain injury among men in an urban homeless shelter. METHODS: We recruited participants from an urban men's shelter in Toronto, Ontario. Researchers administered the Brain Injury Screening Questionnaire, a semistructured interview screening tool for brain injury. Demographic information and detailed histories of brain injuries were obtained. Participants with positive and negative screening results were compared, and the rates and mechanisms of injury were analyzed by age group. RESULTS: A total of 111 men (mean age 54.2 ± standard deviation 11.5 yr; range 27-81 yr) participated. Nearly half (50 [45%]) of the respondents had a positive screening result for traumatic brain injury. Of these, 73% (35/48) reported experiencing their first injury before adulthood (< 18 yr), and 87% (40/46) reported a first injury before the onset of homelessness. Among those with a positive screening result, 33 (66%) reported sustaining at least one traumatic brain injury by assault, 22 (44%) by sports or another recreational activity, 21 (42%) by motor vehicle collision and 21 (42%) by a fall. A positive screening result was significantly associated with a lifetime history of arrest or mental illness and a parental history of substance abuse. INTERPRETATION: Multiple mechanisms contributed to high rates of traumatic brain injury within a sample of homeless men. Assault was the most common mechanism, with sports and recreation, motor vehicle collisions and falls also being reported frequently by the participants. Injury commonly predated the onset of homelessness, with most participants experiencing their first injury in childhood. Additional research is needed to understand the complex interactions among homelessness, traumatic brain injury, mental illness and substance use.
BACKGROUND: Little empiric research has investigated the interrelationship between homelessness and traumatic brain injury. The objectives of this study were to determine the rate, mechanisms and associated outcomes of traumatic brain injury among men in an urban homeless shelter. METHODS: We recruited participants from an urban men's shelter in Toronto, Ontario. Researchers administered the Brain Injury Screening Questionnaire, a semistructured interview screening tool for brain injury. Demographic information and detailed histories of brain injuries were obtained. Participants with positive and negative screening results were compared, and the rates and mechanisms of injury were analyzed by age group. RESULTS: A total of 111 men (mean age 54.2 ± standard deviation 11.5 yr; range 27-81 yr) participated. Nearly half (50 [45%]) of the respondents had a positive screening result for traumatic brain injury. Of these, 73% (35/48) reported experiencing their first injury before adulthood (< 18 yr), and 87% (40/46) reported a first injury before the onset of homelessness. Among those with a positive screening result, 33 (66%) reported sustaining at least one traumatic brain injury by assault, 22 (44%) by sports or another recreational activity, 21 (42%) by motor vehicle collision and 21 (42%) by a fall. A positive screening result was significantly associated with a lifetime history of arrest or mental illness and a parental history of substance abuse. INTERPRETATION: Multiple mechanisms contributed to high rates of traumatic brain injury within a sample of homeless men. Assault was the most common mechanism, with sports and recreation, motor vehicle collisions and falls also being reported frequently by the participants. Injury commonly predated the onset of homelessness, with most participants experiencing their first injury in childhood. Additional research is needed to understand the complex interactions among homelessness, traumatic brain injury, mental illness and substance use.
Authors: Satu Winqvist; Maria Lehtilahti; Jari Jokelainen; Heikki Luukinen; Matti Hillbom Journal: Neuroepidemiology Date: 2007-11-07 Impact factor: 3.282
Authors: Gabriela Ilie; Edward M Adlaf; Robert E Mann; Anca Ialomiteanu; Hayley Hamilton; Jürgen Rehm; Mark Asbridge; Michael D Cusimano Journal: J Neurotrauma Date: 2015-04-28 Impact factor: 5.269
Authors: Jacob L Stubbs; Allen E Thornton; Kristina M Gicas; Tiffany A O'Connor; Emily M Livingston; Henri Y Lu; Amiti K Mehta; Donna J Lang; Alexandra T Vertinsky; Thalia S Field; Manraj K Heran; Olga Leonova; Charanveer S Sahota; Tari Buchanan; Alasdair M Barr; G William MacEwan; Alexander Rauscher; William G Honer; William J Panenka Journal: Can J Psychiatry Date: 2021-03-15 Impact factor: 5.321
Authors: Gabriela Ilie; Edward M Adlaf; Robert E Mann; Angela Boak; Hayley Hamilton; Mark Asbridge; Angela Colantonio; Nigel E Turner; Jürgen Rehm; Michael D Cusimano Journal: PLoS One Date: 2014-09-30 Impact factor: 3.240
Authors: Seth A Seabury; Étienne Gaudette; Dana P Goldman; Amy J Markowitz; Jordan Brooks; Michael A McCrea; David O Okonkwo; Geoffrey T Manley; Opeolu Adeoye; Neeraj Badjatia; Kim Boase; Yelena Bodien; M Ross Bullock; Randall Chesnut; John D Corrigan; Karen Crawford; Ramon Diaz-Arrastia; Sureyya Dikmen; Ann-Christine Duhaime; Richard Ellenbogen; V Ramana Feeser; Adam Ferguson; Brandon Foreman; Raquel Gardner; Joseph Giacino; Luis Gonzalez; Shankar Gopinath; Rao Gullapalli; J Claude Hemphill; Gillian Hotz; Sonia Jain; Frederick Korley; Joel Kramer; Natalie Kreitzer; Harvey Levin; Chris Lindsell; Joan Machamer; Christopher Madden; Alastair Martin; Thomas McAllister; Randall Merchant; Pratik Mukherjee; Lindsay Nelson; Florence Noel; Eva Palacios; Daniel Perl; Ava Puccio; Miri Rabinowitz; Claudia Robertson; Jonathan Rosand; Angelle Sander; Gabriella Satris; David Schnyer; Mark Sherer; Murray Stein; Sabrina Taylor; Nancy Temkin; Arthur Toga; Alex Valadka; Mary Vassar; Paul Vespa; Kevin Wang; John Yue; Esther Yuh; Ross Zafonte Journal: JAMA Netw Open Date: 2018-05-18