bluuebunny/crossref_metadata_2025_split huggingface dataset:
Student Competition (Knowledge Generation) ID 1984770
Authors: Parameswaran Shajaky , Walden Thomas P. , Brisbois Louise , Craven B. Catharine 
Published: December 2023

Background
Following a traumatic spinal cord injury (tSCI), patients prioritize being able to manage their bowels independently. A reduction of independence can impact an individual’s quality of life. The current study investigates the relationships between sphincter control, level of independence and quality of life. We hypothesized that sphincter control would relate strongly to levels of independence and quality of life.

Methods
Adults with tSCI who consented to participate in the Rick Hansen Spinal Cord Injury Registry at the Lyndhurst Rehabilitation Centre completed community follow-up interviews from 2014-2021. Data was collected at baseline, year 1, 2 and 5 (n = 330). Descriptive data and neurological level of injury (NLI) were collected, along with the Life Satisfaction Questionnaire (LiSAT-11), 36-item Short Form Survey Quality of Life measures (SF-36v2) and the Spinal Cord Independence Measure III (SCIM). Separate analyses were conducted for NLI C1-T10 (upper motor neuron [UMN] [n=280]), and T11-S5 (lower motor neuron [LMN] [n=50]). Associations between sphincter management and life satisfaction were calculated using Spearman’s correlation coefficient, adjusted for age and sex.

Results
SCIM had a moderate, yet significant relationship with LiSAT-11 (r2=0.48, p&lt;0.001) for LMN, but no relationship for UMN (r2= 0.17, p&lt;0.001). A weak relationship was observed between SCIM and SF-36v2 for LMN (r2=0.30, p=0.014) but no relationship for UMN (r2=0.01, p=0.59).

Conclusion
Sphincter management scores after rehabilitation discharge are not a strong predictor of life satisfaction following tSCI suggesting that a multifaceted approach is required to assess an individuals’ quality of life post tSCI.
Poster (Clinical/Best Practice Implementation) ID 1984775
Authors: Chase Andrea , Sreenivasan Vidya , Curran Dorothyann , Robichaud Monica , Maddigan Lorraine , Bowman Tory 
Published: December 2023

Background/Objectives
Monitoring skin integrity is a critical issue for patients with spinal cord injury. Damage to the skin can go unnoticed due to sensory loss or diminution and can result in pressure injuries or wounds that can be difficult to heal. A team of inpatient clinicians and people with lived experience worked together to create a ‘SkIn-fo-Graphic’ that would be used to teach all new inpatients how to do a full body skin check.

Methods
A full picture of the body, contributed by Spinal Cord Injury Ontario (SCIO), was marked with the names of specific bony prominences and areas which should be viewed daily to ensure a skin check is complete. Staff at our Centre modified the graphic and created step-by-step instructions. Patients provided feedback on terminology and placement of words/ arrows for clarity. Further refinement was completed by SCIO and clinical staff to create the final tool and instructions.

Results
A graphic was developed iteratively by a community organization, physicians, allied health professionals and patients to provide a tool with instructions that can be used by both clinical staff (to teach daily skin check) and patients (as a reference for doing their own checks). A QR Code link was also created to directly link patients to more in-depth skin education on the community partner website.

Conclusion
Engaging all stakeholders in the development of a key tool for instruction of skin check in patients with spinal cord injury is important to ensure complete clarity and utility.
Workshop (Clinical/Best Practice Implementation) ID 1984795
Authors: Kaiser Anita , Donkers Sarah , Rademeyer Hope Jervis , Walden Kristen , Wolfe Dalton L. 
Published: December 2023

Background/Objectives
Following an initial summit in March 2019, various Canadian stakeholders have collaborated within a Community of Practice (CoP) with a vision to increase the access to, and quality of activity-based therapies (ABT) for persons with spinal cord injury/disease (SCI/D). This workshop will describe key knowledge products and study findings emanating from working groups of the ABT CoP as well as a study initiated through the Canadian SCI Standing and Walking Module Group.

Design/Methods
Priority areas were identified by consensus across the ABT CoP, leading to several studies and development of specific knowledge products. Key challenges included defining and standardizing ABT, gaps in knowledge/training and practice variation with a focus on achieving optimal timing, dosage and intensity of ABT. Various knowledge products and study findings related to these challenges will be presented, with audience interaction encouraged through polls and open discussion.

Results
Presentation highlights include a framework for structured reporting of ABT and a series of videos, pod-casts and information cards promoting ABT. In addition, a mixed methods study of Canadian physiotherapists demonstrated that ABTs were a much desired, yet not fully available treatment option. Therapists identified needs for more fulsome research partnerships, improved and more creative staffing models, enhanced training methods and the importance of a strong therapeutic alliance.

Conclusion
The work of the ABT CoP will continue to focus on these and other priorities, with the ultimate goal of universal access and identification of approaches that will enhance outcomes for persons with SCI/D.
Poster (Clinical/Best Practice Implementation) ID 1984967
Authors: Kangatharan Suban , Amiri Mohammadreza , Brisbois Louise , Farahani Farnoosh , Craven Beverley C. 
Published: December 2023

Background
Assessment of physical activity (PA) prescription recall and serum screening for dyslipidemia are critical to describe and mitigate Cardiometabolic Disease (CMD) risk among adults with spinal cord injury or disease (SCI/D).

Objectives
To report: 1) the frequency of PA prescription recall; and, 2) the frequency of lipid profile assessment and interpretation recall among inpatients with SCI/D during rehabilitation.

Methods
Adults with SCI/D completed the SCI-HIGH CMD intermediary outcome indicators. A Kinesiologist collected data via interview and chart abstraction among UHN inpatients. Survey responses were scored using Reachlite’s optical character recognition software. Descriptive statistics were used to characterize the participant’s age, sex, impairment characteristics, and report recall rates and the frequency of lipid screening/interpretation. Based on the participant’s needs, either educational materials to increase future adherence to PA guidelines and/or a Mediterranean diet were provided.

Results
Adult inpatients (n=124), mean age 59 years, 64% paraplegic, and 36% female participated. In total, 14% of participants (16/117) reported being taught the benefits of PA for their heart health; of whom 69% (11/16) recalled exercise instruction. Similarly, 15% of inpatients (17/114) recalled lipid screening during rehabilitation, although chart abstraction revealed that 30% (37/124) had completed lipid screening. Clinical interpretation of their lipid values was recalled by 30% of inpatients.

Conclusion
There is a significant opportunity to advance PA instruction and lipid profile education and management among inpatients with SCI/D to reduce CMD risk. Inclusion of PA and lipid management instructions in patient-oriented discharge summaries may enhance patient recall/adherence.
Poster (Clinical/Best Practice Implementation) ID 1984972
Authors: Amiri Mohammadreza , Kangatharan Suban , Brisbois Louise , Farahani Farnoosh , Khasiyeva Natavan , Burley Meredith , Casemore Sheila , Murphy Margaret , Walker Stacy-Ann , Craven Beverley C. 
Published: December 2023

Background
Heart disease is the most common cause of death after spinal cord injury or disease (SCI/D), with Cardiometabolic Disease (CMD) risk a primary contributor.

Objectives
1) To report the frequency of Physical Activity guideline adherence; 2) To report the frequency of serum lipid screening recall and their recollection of the result interpretation; among adults living with SCI/D in the community.

Methods
A Kinesiologist collected the SCI-High outcome data via in person or phone 1:1 interviews, and chart abstraction among UHN outpatients. A Provincial Intake Coordinator collected data via phone interview among outpatients affiliated with SCI Ontario. Survey responses were scored using Reachlite’s optical character recognition software. Descriptive statistics characterize the participant’s age, sex, impairment characteristics, and adherence to physical activity guidelines and the frequency of lipid screening/interpretation recall. Best practice education materials were used to increase future PA guideline adherence, prompt lipid screening, and healthy food choices.

Results
Adult outpatients (n=127, 67% male), mean age 61 years, and 55% paraplegic consented to participate. In total, 48% (60/126) of outpatients reported engaging in some form of aerobic exercise; of whom 50% (30/60) of these individuals were meeting current PA guidelines. About 51% of outpatients recalled lipid screening within the last year, 33% indicated they had not had an assessment. Clinical interpretation of lipid values was recalled by 71% (53/75) of outpatients.

Conclusion
Physical activity guideline adherence and routine lipid assessments are integral to CMD risk modification – substantial education resources and recall aids may help to modify CMD risk after SCI/D.
Poster (Clinical/Best Practice Implementation) ID 1985003
Authors: Seliman Merna , Giurleo Charlie , Elliott Stacy , Carlson Marie , Kras-Dupuis Anna , Wolfe Dalton L. , McBride Kate 
Published: December 2023

Background
Sexual health is an important component of overall health. Yet, sexuality is often neglected in rehabilitation. Studies indicate that typically clinicians do not address the sexual health concerns of patients because of lack of adequate training, comfort, and knowledge in this area.

Objectives
The purpose of this initiative was to develop and implement an e-learning module to address the current gap in rehabilitation practice.

Methods
In 2021, an interdisciplinary team of rehab clinicians worked with an Instructional Designer based at Parkwood Institute to develop e-Learning modules aimed to introduce rehab teams to sexual health rehab and application to practice. The modules were launched at Parkwood Institute in January 2022 and were compulsory education for all rehabilitation staff in Spinal Cord, Acquired Brain Injury and Stroke programs. They were subsequently launched more broadly at Vancouver Coastal Health in March 2022. Surveys were conducted to assess the impact of the modules on clinical application.

Results
To date,186/209 (89%) of rehabilitation staff at Parkwood Institute and a total of 55 clinicians from Vancouver Coastal Health have completed the modules. Preliminary results show improvement in confidence, knowledge, and ability to address the sexual health needs of rehabilitation patients.

Conclusions
The e-Learning modules help fill the current practice gap and facilitate sustainability of sexual health practice in clinical settings. Accessible educational opportunities such as the e-modules are valuable tools in enhancing self-efficacy of staff when addressing sexual health concerns of patients.
Student Competition (Knowledge Generation) ID 1985014
Authors: Cadel Lauren , Hitzig Sander L , McCarthy Lisa M , Hahn-Goldberg Shoshana , Packer Tanya L , Ho Chester H , Lofters Aisha K , Patel Tejal , Cimino Stephanie R , Guilcher Sara JT 
Published: December 2023

Background
Adults with spinal cord injury/dysfunction (SCI/D) are commonly prescribed multiple medications to manage secondary complications. Significant challenges managing medications have been highlighted, with the need for more support with medication self-management.

Objective
The objective of this study is to co-develop a toolkit to assist with medication self-management for persons with SCI/D.

Methods
Adults with SCI/D, caregivers, and healthcare providers will participate in the three steps of concept mapping – brainstorming, sorting and rating, and mapping to identify key components of the toolkit. Participants will generate statements about what should be incorporated into a toolkit to help persons with SCI/D manage their medications. Participants will rate the final list of statements on importance and feasibility and sort the statements into thematic piles. A visual map will be developed by a subset of participants, representing the thematic piles.

Findings
To date, participants have generated over 500 statements. Ideas generated around the content of the toolkit focus on information about: pharmacological and non-pharmacological options for managing secondary complications, side effects, communicating with providers, and medication access. Ideas specific to the delivery of the toolkit focus on: ensuring an individualized approach, accessibility, and the use of visuals. Statements will be synthesized for sorting and rating and mapping.

Conclusion
Subsequent phases of this research will refine the toolkit through interviews and input from our working group. A mixed methods pilot evaluation will then be conducted to assess the feasibility, acceptability, and appropriateness of the toolkit, as well medication knowledge, self-efficacy, and quality of life.
Post Doc Competition (Health Services, Economics and Policy Change) ID 1985179
Authors: Senthinathan Arrani , Tadrous Mina , Hussain Swaleh , Craven B. Catharine , Jaglal Susan B. , Moineddin Rahim , Shepherd John , Cadel Lauren , Noonan Vanessa K. , McKay Sandra , Tu Karen , Guilcher Sara 
Published: December 2023

Background/Objectives
The COVID-19 pandemic has significantly impacted healthcare utilization; however, research has not investigated the impact in the spinal cord injury/dysfunction (SCI/D) population in Canada. To examine healthcare utilization and delivery during the COVID-19 pandemic in individuals with SCI/D.

Methods/Overview
A repeated-cross sectional retrospective longitudinal cohort study design was conducted using health administrative database in Ontario, Canada. In 5,754 individuals with SCI/D, healthcare utilization and delivery (in-person, and virtual) were determined at the 1) pre-pandemic (March 2015 to February 2020), 2) initial pandemic onset (March 2020-May 2020), and 3) pandemic (June 2020 to March 2022) phases. Autoregressive integrated moving average (ARIMA) modelling were conducted to determine pandemic impact on monthly healthcare utilization and delivery.

Results
The initial pandemic onset period had a significant reduction of 24% in physician (p=0.0081), 35% in specialist (p&lt;0.0001), and 30% in urologist (p&lt;0.0001) visits, compared to pre-pandemic levels, with a partial recovery as the pandemic progressed. In April 2020, compared to the pre-pandemic period, a significant increase (p&lt;0.0001) for virtual visits for physician, specialist, urologist, and primary care was found. The initial pandemic onset period had a 46% decrease in ED visits (p=0.0764) and 58% decrease in hospital admissions (p=0.0011), compared to the pre-pandemic period.

Conclusion
Healthcare utilization dropped in the initial pandemic onset period as physician, specialist, urologist, and ED visits, as well as hospitalization decreased significantly (p&lt;0.05) versus pre-pandemic levels. Virtual visit increases compensated for in-person visit decreases as the pandemic progressed to allow for total visits to partially recover.
Workshop (Health Services, Economics and Policy Change) ID 1985330
Authors: Craven B. Catharine , Farahani Farnoosh , Wiest Matheus J. , Gargaro Judith , Bayley Mark T. 
Published: December 2023

Background
Spinal cord injury or disease (SCI/D) are complex chronic conditions associated with multiple morbidities and many social and emotional challenges. Understanding the current gaps in care, the health services and policy priorities of Ontarians with SCI/D is integral to transforming services and meeting their needs over time.

Objectives
Workshop participants will gain: 1) Insight into the current inequities in SCI care; 2) A shared understanding of the current gaps, regional service priorities, and policy needs of people with lived experience in the community.

Design/Methods
The intended audience includes people with lived experience, family/friends, clinicians, community service providers, funders, advocacy groups, health system planners, administrators, and policymakers. Synthesized results from the Neurotrauma Care Pathways Project (neurotraumapathways.ca) and the SCI Implementation and Evaluation Quality Care Consortium (sciconsortium.ca) will be shared using infographics and lay language. These Ontario Ministry of Health funded projects are intended to inform practice and drive innovations in care. Participants will have an opportunity to discuss priorities regarding inclusion and service equity. The dilemmas of marginalized groups and special populations will be highlighted and the planned next steps shared with workshop attendees.

Results/Findings
Our hope is that participants will take away a shared understanding that might influence their near term health policy, advocacy, and health behaviours.
Poster (Knowledge Generation) ID 1985362
Authors: Craven B. Catharine , Blencowe Lindsie , Giangregorio Lora , Carbone Laura , Weaver Frances M. , Jaglal Susan , Munro Barry , Boag Lynn , Noonan Vanessa K. , Humphreys Suzanne , Alavinia Mohammad 
Published: December 2023

Objective
To develop a lower extremity (LE) fragility fracture risk score estimation method among adults with chronic spinal cord injury (SCI).

Methods
Adults (≥18) with chronic traumatic SCI (n=90, C2-T12, AIS:A-D) participated in a 2-year prospective cohort study. We used a literature search and practice expertise to identify LE fracture predictors. Reference categories (i.e., risk score = 0) were: no prior fracture, 0-9 years post-injury, AIS-CD, no parental history of osteoporosis, and no opioid use. Using logistic regression coefficients, we calculated how far each category is from the base category and computed βi (Wij-WiREF) for each risk factor. In this model, B was the increase in risk associated with each year post injury. The point value for each fracture risk category was calculated by Pointsij=βi (Wij-WiREF)/B. The total points range from 0-21, and the probability of LE fracture is calculated for each point to determine the probability of developing a LE fracture using the formula:

Results
Most participants had an AIS-A impairment (60.0%), the mean time post-injury=15.23 years (SD=9.58). For the points system (0-17), prior fracture, years post-injury, AIS, Benzodiazepine use, Opioid use, and parental osteoporosis were defined risk factors. An individual’s risk profile can estimate LE fracture risk. A score of 11 equates to 20% or high fracture risk over a 5-year time period.

Conclusion
We describe our preliminary model to estimate LE fracture risk among those with chronic SCI. We plan to apply statistical and machine learning algorithms using Canadian RHSCIR data and US VHA data to validate the model, and increase the model’s predictability.
Poster (Health Services, Economics and Policy Change) ID 1985397
Authors: Farahani Farnoosh , Craven B. Catharine ,   SCI-IEQCC
Published: December 2023

Background
The Spinal Cord Injury Implementation and Evaluation Quality Care Consortium (SCI-IEQCC) is a quality improvement initiative (began in 2019) with a mission to provide optimal and equitable rehabilitation services for all Canadians regardless of where they live, and to ensure the functional recovery, health and well-being for individuals living with spinal cord injury and disease (SCI/D).

Objective
To highlight the growing needs of an expanding multisite network and the importance of governance and organizational structures to support the execution of current deliverables while addressing emerging challenges.

Design/Methods
The SCI-IEQCC has a central team for network management. Administrators/leaders, clinicians with implementation science training, local site implementation teams, and individuals with lived experience comprise the SCI-IEQCC. Implementation and evaluation of indicators and best practices across 10 participating organizations requires: operational oversite; monitoring of project milestones; adherence to regulatory requirements; sustained data quality with linkage for analyses; report card dissemination; information sharing and network updates; strategic planning to map future directions; identification of priorities; and, meeting academic/funding deliverables.

Results/Findings
SCI-IEQCC has driven improvements in rehabilitation service delivery, performance, utilization of best practices, and increments in staff engagement, training, and knowledge exchange. SCI-IEQCC challenges are derived from the diversity of participating organizations, turnover in leaders, staff shortages, reducing variation in documentation and data management, and ensuring resource continuity.

Conclusion
The growing complexity of this multisite network necessitate innovative approaches to streamline processes across sites, ensure uniform adherence to regulatory requirements, disseminate innovations in informatics, and assure dedication to its mission and vision.
Post Doc Competition (Knowledge Generation) ID 1986617
Authors: Oh Jeonghoon , Scheffler Michelle S. , Martin Catherine A. , Dinh Jenny , Steele Alexander G. , Sayenko Dimitry G. 
Published: December 2023

Background
Transcutaneous spinal stimulation (TSS) is emerging as a valuable tool for electrophysiological and clinical assessments.

Objective
The objectives of this study were to investigate: (1) TSS above and below a spinal cord injury (SCI) lesion results in different recruitment pattern of upper limb (UL) motor pools compared to neurologically intact subjects (NIS), and (2) the relationship between recruitment pattern of UL motor pools and neurological and functional status in individuals with SCI. Methods: Eleven NIS and six participants with cervical SCI were recruited in this study. We compared spinally evoked motor potentials in UL muscles during TSS delivered to the cervical spinal cord between the spinous process of C3-C4 and C7-T1 vertebrae.

Results
As expected, TSS delivered over the cervical spinal cord in NIS can preferentially activate proximal and distal muscles along the rostrocaudal axis, as well as ipsilateral UL muscles along the mediolateral axis. However, in participants with SCI, the responses registered in UL muscles innervated by motor pools above and below the lesion demonstrated different recruitment compared to NIS, and were dependent on the level, extent, and side of SCI.

Conclusions
The spatial map obtained from assessing evoked potentials above and below the lesion contributes to the comprehensive understanding of the viability and function of specific UL motor pools, and can be utilized to monitor changes in recruitment patterns of the UL motor pools during neurorehabilitation interventions after SCI.