Dataset Information

A Multidisciplinary Model to Guide Employment Outcomes Among People Living With Spinal Cord Injuries in South Africa: A Mixed Methods Study Protocol.

ABSTRACT: BACKGROUND:Spinal cord injury (SCI) often results in complete or partial loss of functioning of the upper and/or lower limbs, leading to the affected individual experiencing difficulties in performing activities of daily living. This results in reduced participation in social, religious, recreational, and economic activities (employment). The South Africa legal framework promotes the employment and assistance of people with disabilities. However, rehabilitation interventions focus mainly on impairments and activity limitations, with few attempts to prepare those with SCI to return to gainful employment. There is therefore a need for a well-coordinated, multidisciplinary rehabilitation initiative that will promote the employment of people living with spinal cord injuries (PLWSCI) in South Africa. OBJECTIVE:This study aims to develop a multidisciplinary model to guide employment outcomes amongst PLWSCI in South Africa. METHODS:This study will utilize explanatory mixed methods during 3 phases. The first phase will explore the current rehabilitation practices, and the second will establish the factors that influence employment outcomes among PLWSCI. A multidisciplinary team consisting of health care professionals, representatives from the departments of Labour, Education, Social Development, and Health, and nongovernment organizations representing PLWSCI will provide feedback for the model development of phase 3, along with results from the previous 2 phases, using a multistage Delphi technique. RESULTS:It is estimated that the results of phases 1 and 2 will be completed 11 months after data collection commencement (November 2015). Phase 3 results will be finalized 4 months after phases 1 and 2. CONCLUSIONS:Developing a multidisciplinary model to guide the employment outcomes of PLWSCI will ensure a coordinated response to integrate them into a productive life and will assist them to achieve economic self-sufficiency, personal growth, social integration, life satisfaction, and an improved quality of life. This can be achieved by active inclusion of PLWSCI to ensure that their concerns and recommendations are addressed. CLINICALTRIAL:ClinicalTrials.gov NCT02582619; https://clinicaltrials.gov/ct2/show/NCT02582619 (Archived by WebCite at http://www.webcitation.org/6mBgcj6z7).

SUBMITTER: Pefile N

PROVIDER: S-EPMC5174725 | biostudies-literature | 2016 Dec

REPOSITORIES: biostudies-literature

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A Multidisciplinary Model to Guide Employment Outcomes Among People Living With Spinal Cord Injuries in South Africa: A Mixed Methods Study Protocol.

Pefile Ntsikelelo N Mothabeng Joyce J Naidoo Saloshni S

JMIR research protocols 20161206 4

<h4>Background</h4>Spinal cord injury (SCI) often results in complete or partial loss of functioning of the upper and/or lower limbs, leading to the affected individual experiencing difficulties in performing activities of daily living. This results in reduced participation in social, religious, recreational, and economic activities (employment). The South Africa legal framework promotes the employment and assistance of people with disabilities. However, rehabilitation interventions focus mainly ...[more]

PMID: 27923779

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Project description:ObjectivesRugby-related spinal cord injuries (SCIs) are rare but life altering and traumatic events. Little is known about the long-term consequences and outcomes of players who have sustained these injuries. This study investigated current quality of life (QoL) and factors associated with QoL, among individuals with rugby-related SCI in South Africa, by using the International Classification of Functioning, Disability and Health (ICF) framework.DesignDescriptive cross-sectional study.SettingRugby-related SCI population of South Africa, as captured in the BokSmart/Chris Burger Petro Jackson Players' Fund database.ParticipantsNinety (n=90) of the 102 eligible players on the database agreed to participate in the study.Main outcome measureThe relationship between QoL, as measured with the WHO Quality of Life questionnaire (WHOQOL-BREF) and specific independent variables (demographic information, level of independence and participation in various activities and life roles) was investigated. Variables that were significantly associated with QoL in bivariate analyses were included in multiple linear regression analyses.ResultsThe mean score and SD of the WHOQOL-BREF was 15.1±2.3?arbitrary units. Participation (an ICF framework construct) and income were significantly associated with overall QoL (p<0.001). Participation was the only variable significantly associated with all QoL subdomains (p<0.001). Additionally, number of health concerns, type of healthcare (public vs private) and level of education were significantly associated with various QoL domains (p<0.001).ConclusionsOn average, these individuals with rugby-related SCI presented with higher QoL scores than other comparable SCI studies. However, lower levels of participation and income, certain levels of education, increased health concerns and use of public healthcare were associated with lower levels of QoL. Sporting bodies have a responsibility to optimise player welfare, by acting on the modifiable factors associated with QoL.

Project description:Directing the organization of cells into a tissue with defined architectures is one use of biomaterials for regenerative medicine. To this end, hydrogels are widely investigated as they have mechanical properties similar to native soft tissues and can be formed in situ to conform to a defect. Herein, we describe the development of porous hydrogel tubes fabricated through a two-step polymerization process with an intermediate microsphere phase that provides macroscale porosity (66.5%) for cell infiltration. These tubes were investigated in a spinal cord injury model, with the tubes assembled to conform to the injury and to provide an orientation that guides axons through the injury. Implanted tubes had good apposition and were integrated with the host tissue due to cell infiltration, with a transient increase in immune cell infiltration at 1?week that resolved by 2?weeks post injury compared to a gelfoam control. The glial scar was significantly reduced relative to control, which enabled robust axon growth along the inner and outer surface of the tubes. Axon density within the hydrogel tubes (1744 axons/mm2) was significantly increased more than 3-fold compared to the control (456 axons/mm2), with approximately 30% of axons within the tube myelinated. Furthermore, implantation of hydrogel tubes enhanced functional recovery relative to control. This modular assembly of porous tubes to fill a defect and directionally orient tissue growth could be extended beyond spinal cord injury to other tissues, such as vascular or musculoskeletal tissue. STATEMENT OF SIGNIFICANCE: Tissue engineering approaches that mimic the native architecture of healthy tissue are needed following injury. Traditionally, pre-molded scaffolds have been implemented but require a priori knowledge of wound geometries. Conversely, hydrogels can conform to any injury, but do not guide bi-directional regeneration. In this work, we investigate the feasibility of a system of modular hydrogel tubes to promote bi-directional regeneration after spinal cord injury. This system allows for tubes to be cut to size during surgery and implanted one-by-one to fill any injury, while providing bi-directional guidance. Moreover, this system of tubes can be broadly applied to tissue engineering approaches that require a modular guidance system, such as repair to vascular or musculoskeletal tissues.

Dataset Information

A Multidisciplinary Model to Guide Employment Outcomes Among People Living With Spinal Cord Injuries in South Africa: A Mixed Methods Study Protocol.

Publications

A Multidisciplinary Model to Guide Employment Outcomes Among People Living With Spinal Cord Injuries in South Africa: A Mixed Methods Study Protocol.

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