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Murphy LF, Bryce TN, Coker J, Scott M, Roach MJ, Worobey L, Botticello AL. Medical, dental, and optical care utilization among community-living people with spinal cord injury in the United States. J Spinal Cord Med 2024; 47:64-73. [PMID: 35993789 PMCID: PMC10795619 DOI: 10.1080/10790268.2022.2110817] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
Abstract
CONTEXT/OBJECTIVE Information about patterns of healthcare utilization for people living with spinal cord injury (SCI) is currently limited, and this is needed to understand independent community living after SCI. This study investigates self-reported healthcare utilization among community-living people with SCI and assesses disparities across demographic, socioeconomic, and injury-related subgroups. DESIGN Secondary analysis of cross-sectional survey data administered via telephone interview. SETTING 6 SCI Model Systems centers in the United States (California, Colorado, New Jersey, New York, Ohio, and Pennsylvania). PARTICIPANTS Adults with chronic, traumatic SCI who were community-living for at least one year after the completion of an inpatient rehabilitation program (N = 617). INTERVENTIONS Not applicable. OUTCOME MEASURES Utilization of a usual source of 4 types of health care in the past 12 months: primary, SCI, dental, and optical. RESULTS 84% of participants reported utilizing primary care in the past year. More than half reported utilizing SCI (54%) and dental (57%) care, and 36% reported utilizing optical care. There were no significant differences across key subgroups in the utilization of primary care. Participants who had been injured for 5 years or less and participants with greater educational attainment were more likely to report utilizing SCI care. Participants with higher household income levels were more likely to report using dental care. Female participants and older age groups were more likely to report using optical care. CONCLUSION Rates of healthcare utilization among people with SCI are below recommended rates and vary across demographic, socioeconomic, and injury-related subgroups. This information can inform future research to target barriers to using healthcare services among community-living people with SCI.
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Affiliation(s)
- Lauren F. Murphy
- Center for Spinal Cord Injury Research and Center for Outcomes and Assessment Research, Kessler Foundation, West Orange, New Jersey, USA
- Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Thomas N. Bryce
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | - Michael Scott
- Rancho Los Amigos National Rehabilitation Center, Downey, California, USA
| | - Mary Joan Roach
- Case Western Reserve University, Cleveland, Ohio, USA
- MetroHealth System, Cleveland, OH, USA
| | - Lynn Worobey
- Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA
| | - Amanda L. Botticello
- Center for Spinal Cord Injury Research and Center for Outcomes and Assessment Research, Kessler Foundation, West Orange, New Jersey, USA
- Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ, USA
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Botticello AL, Murphy LF, Boninger M, Bryce TN, Charlifue S, Coker J, Roach MJ, Scott M, Worobey L. Residential Mobility and Reasons for Moving Among People Living With Spinal Cord Injury: Results of a Multisite Survey Study. Top Spinal Cord Inj Rehabil 2023; 29:108-121. [PMID: 38076496 PMCID: PMC10704213 DOI: 10.46292/sci23-00030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Background Residential mobility after spinal cord injury (SCI) has not been extensively examined despite a growing interest in investigating the relationship between neighborhood exposures and community living outcomes. Objectives This study explores residential mobility patterns, the annual move rate, and reasons for moving among a community-living sample of adults with SCI. Methods A survey was conducted with 690 people at six SCI Model Systems centers in the United States between July 2017 and October 2020. The outcomes included move status in the past 12 months, move distance, and the primary reason for moving. A sample from the 2019 American Community Survey (ACS) 5-year pooled estimates was obtained for comparative analysis. Descriptive statistics were used to summarize the distributions of the outcomes and differences between the samples. Results The annual move rate for adults with SCI was 16.4%, and most moves were within the same county (56.6%). Recent movers were more likely to be young adults, be newly injured, and have low socioeconomic status. Housing quality, accessibility, and family were more frequently reported motivations for moving compared to employment. Young adults more commonly moved for family and accessibility, whereas middle-aged adults more commonly moved for housing quality. No notable difference was observed in the annual move rate between the SCI and the general population samples. Conclusion These findings suggest an age-related pattern of residential relocation after SCI, which may be indicative an extended search for optimal living conditions that meet the housing and accessibility needs of this population.
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Affiliation(s)
- Amanda L. Botticello
- Kessler Foundation, West Orange, New Jersey
- Rutgers New Jersey Medical School, Newark, New Jersey
| | - Lauren F. Murphy
- Kessler Foundation, West Orange, New Jersey
- Rutgers New Jersey Medical School, Newark, New Jersey
| | - Michael Boninger
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Thomas N. Bryce
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York
| | | | | | - Mary Joan Roach
- Case Western University, Cleveland, Ohio
- MetroHealth System, Cleveland, Ohio
| | - Michael Scott
- Rancho Los Amigos National Rehabilitation Center, Downey, California
| | - Lynn Worobey
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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Murphy LF, Kalpakjian C, Charlifue S, Heinemann AW, Slavin M, Rohrbach T, Tulsky DS, Botticello AL. Greener on the other side? an analysis of the association between residential greenspace and psychological well-being among people living with spinal cord injury in the United States. Spinal Cord 2022; 60:170-176. [PMID: 35022532 DOI: 10.1038/s41393-021-00736-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 11/29/2021] [Accepted: 12/02/2021] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Secondary analysis of cross-sectional data from a multisite survey study. OBJECTIVES To describe associations between residential greenspace and psychological well-being among adults living with chronic spinal cord injury (SCI). SETTING Community. METHODS Participants were from the Spinal Cord Injury-Quality of Life (SCI-QOL) Calibration Study (N = 313). Geographic Information Systems (GIS) analysis was used to define five- and half-mile buffer areas around participants' residential addresses to represent community and neighborhood environments, respectively, and to create measures of natural and developed open greenspace. Associations of greenspace measures with two SCI-QOL psychological well-being domains (positive affect and depressive symptoms) were modeled using ordinary least squares (OLS) regression, adjusted for demographic, injury-related, and community socioeconomic characteristics. RESULTS People living in a community with a moderate amount of natural greenspace reported less positive affect and more depressive symptoms compared to people living in a community with low natural greenspace. At the neighborhood level, a moderate amount of developed open space was associated with less positive affect and more depressive symptoms than a low amount of developed open space. CONCLUSIONS Contrary to expectations, residential greenspace had a negative relationship with psychological well-being in this sample of adults with SCI. Understanding how and why natural spaces are associated with quality of life for people with mobility disabilities can influence public policy and urban planning designs to ensure that residential greenspaces are accessible and beneficial to all.
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Affiliation(s)
- Lauren F Murphy
- Kessler Foundation, West Orange, NJ, USA. .,Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ, USA.
| | | | | | - Allen W Heinemann
- Northwestern University Feinberg School of Medicine and Shirley Ryan AbilityLab, Chicago, IL, USA
| | | | - Tanya Rohrbach
- Department of Science and Engineering, Raritan Valley Community College, Branchburg, NJ, USA
| | - David S Tulsky
- Center for Health Assessment Research and Translation and Departments of Physical Therapy and Psychological and Brain Sciences, University of Delaware, Newark, DE, USA
| | - Amanda L Botticello
- Kessler Foundation, West Orange, NJ, USA.,Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ, USA
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Kendall JA, Haberl JK, Hartsgrove C, Murphy LF, DeLuca R, Diaz-Segarra N, Kirshblum SC. Surveillance for Pressure Injuries on Admission to Inpatient Rehabilitation Hospitals During the COVID-19 Pandemic. Arch Phys Med Rehabil 2021; 102:1932-1938. [PMID: 34252395 PMCID: PMC8270737 DOI: 10.1016/j.apmr.2021.06.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 06/06/2021] [Accepted: 06/11/2021] [Indexed: 11/29/2022]
Abstract
Objective To determine if the incidence of pressure injuries (PIs) on admission to an inpatient rehabilitation hospital (IRH) system of care was increased during the early coronavirus disease 2019 (COVID-19) pandemic period. Design Retrospective survey chart review of consecutive cohorts. Admissions to 4 acute IRHs within 1 system of care over the first consecutive 6-week period of admitting patients positive for COVID-19 during the initial peak of the COVID-19 pandemic, April 1-May 9, 2020. A comparison was made with the pre–COVID-19 period, January 1-February 19, 2020. Setting Four acute IRHs with admissions on a referral basis from acute care hospitals. Participants A consecutive sample (N=1125) of pre–COVID-19 admissions (n=768) and COVID-19 period admissions (n=357), including persons who were COVID-19–positive (n=161) and COVID-19–negative (n=196). Main Outcome Measures Incidence of PIs on admission to IRH. Results Prevalence of PIs on admission during the COVID-19 pandemic was increased when compared with the pre–COVID-19 period by 14.9% (P<.001). There was no difference in the prevalence of PIs in the COVID-19 period between patients who were COVID-19–positive and COVID-19–negative (35.4% vs 35.7%). The severity of PIs, measured by the wound stage of the most severe PI the patient presented with, worsened during the COVID-19 period compared with pre–COVID-19 (χ2 32.04%, P<.001). The length of stay in the acute care hospital before transfer to the IRH during COVID-19 was greater than pre–COVID-19 by 10.9% (P<.001). Conclusions During the early part of the COVID-19 pandemic time frame, there was an increase in the prevalence and severity of PIs noted on admission to our IRHs. This may represent the significant burden placed on the health care system by the pandemic, affecting all patients regardless of COVID-19 status. This information is important to help all facilities remain vigilant to prevent PIs as the pandemic continues and potential future pandemics that place strain on medical resources.
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Affiliation(s)
- Jamila A Kendall
- Department of Physical Medicine and Rehabilitation, Rutgers-New Jersey Medical School, Newark, NJ; Kessler Institute for Rehabilitation, West Orange, NJ.
| | | | - Caitlin Hartsgrove
- Department of Physical Medicine and Rehabilitation, Rutgers-New Jersey Medical School, Newark, NJ; Kessler Institute for Rehabilitation, West Orange, NJ
| | | | - Robert DeLuca
- Kessler Institute for Rehabilitation, West Orange, NJ; Kessler Foundation, West Orange, NJ
| | - Nicole Diaz-Segarra
- Department of Physical Medicine and Rehabilitation, Rutgers-New Jersey Medical School, Newark, NJ; Kessler Institute for Rehabilitation, West Orange, NJ
| | - Steven C Kirshblum
- Department of Physical Medicine and Rehabilitation, Rutgers-New Jersey Medical School, Newark, NJ; Kessler Institute for Rehabilitation, West Orange, NJ; Rutgers New Jersey Medical School, Newark, NJ; Kessler Foundation, West Orange, NJ; Select Medical Corporation, Mechanicsburg, PA
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Abstract
Here we investigate the maximum sustainable yield problem for an age-structured population whose dynamics are density dependent. We use the nonlinear version of the McKendrick model of population dynamics that was introduced by Gurtin and MacCamy and do not constrain the magnitude of the harvesting term. We show that this problem has an optimal solution and that the optimum is attainable by a bimodal harvesting policy. This result is consistent with the results obtained by Grey for the nonlinear Leslie model.
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Affiliation(s)
- L F Murphy
- Department of Mathematics, Oregon State University, Corvallis 97331
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Murphy LF. Woman's Auxiliary: Husband-Wife Membership. Calif Med 1965; 102:333. [PMID: 18729943 PMCID: PMC1515734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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Murphy LF. WOMAN'S AUXILIARY: THE IMPORTANCE OF AUXILIARY MEMBERSHIP. Calif Med 1962; 97:196. [PMID: 18732559 PMCID: PMC1575219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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Murphy LF. WOMAN'S AUXILIARY. Calif Med 1961; 95:131. [PMID: 18732430 PMCID: PMC1574575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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