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N. Shinowara

Bio: N. Shinowara is an academic researcher from National Institutes of Health. The author has contributed to research in topics: Research center & Rehabilitation. The author has an hindex of 1, co-authored 1 publications receiving 4 citations.

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Journal ArticleDOI
TL;DR: This conference, the first of its kind for SCI rehabilitation research in the United States, was organized in response to the changing landscape of SCI care and anticipated advancements and accomplishments over the next 10 years.
Abstract: ‘What's next?’ is a simple question often asked with a mix of anticipation and reluctance, because it may suggest that one knows the present achievements and shortfalls in a given area so that the future can be relatively well-perceived. Over the past few decades, the ‘state-of-the-science’ (SoS) conference framework has provided an opportunity to merge the ‘where we are going’ questions with ‘where we have been’ answers. During the June 2011 joint annual meetings of the International Spinal Cord Society and the American Spinal Injury Association, a State of the Science in Spinal Cord Injury (SCI) Rehabilitation: Informing a New Research Agenda conference was held in Washington, DC. This conference, the first of its kind for SCI rehabilitation research in the United States, was organized in response to the changing landscape of SCI care and anticipated advancements and accomplishments over the next 10 years. Clinicians, researchers, administrators, as well as people with SCI and their families realize that the available interventions and treatments are causing unprecedented and rapid alterations in our view of SCI care and the outcomes from such severe neurologic trauma. The National Institute on Disability and Rehabilitation Research (NIDRR)-funded SCI Model Systems program1,2 grew out of a need to address the unmet rehabilitation needs of people with SCI, including the long-term support needed for return to the community. Incorporated in this model are programs and facilities that address the extensive medical, psychological, social and vocational needs of people with SCI in a focused, coordinated system. The critical elements for the SCI Model Systems programs are conducting research that is meaningful and can have an impact on the lives of people with SCI, collecting data that contributes to a longitudinal national database for epidemiological and research purposes, and providing a system of care and services from injury through lifetime follow-up. Although the incidence of traumatic SCI remains relatively low compared with other neurologic trauma such as brain injury, outcome expectations have grown with the genetics and molecular revolution and emerging technologies. At the same time, lengths of hospital rehabilitation stays are shortening and costs are escalating. ‘What's next?’ is a reasonable question to ask as we consider where SCI rehabilitation research support should be focused. Planning for the SoS conference began in December 2009 with the formation of a steering (planning) committee and initial outreach to federal and private partner organizations for financial and in-kind support. These inaugural steps were funded by the NIDRR to the Shepherd Center in Atlanta, GA. The steering committee consisted of representatives from the NIDRR-funded SCI Model Systems grantees, the NIDRR-funded Rehabilitation Engineering Research Center on SCI, federal agencies, consumer organizations and professional societies. Conference plans required that the steering committee also obtain financing to ensure that the best speakers could be recruited and support post-conference dissemination efforts. The committee also sought to minimize the cost for attendees. Partners were recruited to provide intellectual input and to provide financial support of the SoS infrastructure. The partners eventually involved 37 federal agencies and private organizations whose support made the SoS possible because of shared interests and commitment to improve SCI care, rehabilitation and outcomes through research. The steering committee worked for 18 months to reach a final agreement on the SoS conference content, speakers and format. The committee defined four track themes that cover the broad range of rehabilitation issues encompassing the entire biopsychosocial nature of SCI rehabilitation and research: (1) neurologic and functional recovery; (2) aging and secondary conditions; (3) technology for mobility and function; and (4) psychosocial, vocational and quality of life outcomes. A chairperson with expertise in the topic area was selected for each track and the track chairs, together with the Steering Committee, identified plenary speakers with expertise in each track. In some cases, the plenary presenters were selected from outside the field of SCI rehabilitation research as the issues transcend a particular diagnosis or condition but are relevant to SCI. The plenary presentations provided an opportunity for participants to list: (1) priority goals, (2) barriers to success, (3) research approaches that are essential to progress, and (4) a vision for the achievements that will define the field in 10 years. The plenary speakers also provided paper drafts relevant to their subject matter, which were posted on the conference website before the conference, and subsequently published in this journal issue. Finally, the committee recruited two keynote speakers, one to speak to the importance and relevance of the conference from the lived experience of SCI, and one to highlight the current state of experimental research directed at curing SCI, an important part of the research milieu in which the conference was held. The conference was not focused on advances in experimental procedures to reverse SCI because this topic is the focus of other organizations and conferences. In addition to the plenary speakers, each track identified panel discussants who were charged with responding to the plenary presentations and exploring research topics in greater detail within each track. The panels generated considerable discussion, which continued in concurrent break-out sessions. A leader facilitated these break-out work groups; workgroup volunteers recorded recommendations for research priorities and then the authors of the final manuscript in this issue of Spinal Cord synthesized the recommendations. Conference participants also provided input through a website. The summary recommendations that follow in the final manuscript of this journal issue were formulated by the more than 450 participants from 29 countries and speak to the diversity and depth of the four tracks, and their complimentary nature. The pursuit and achievement of these recommendations are ‘what's next’ in SCI rehabilitation services and research. In conclusion, this SoS was hosted for rehabilitation consumers, providers, researchers, administrators and policy makers, offering a research agenda for the next 10 years and beyond. It is important to these constituents that these recommendations become a basis for future research strategy. Feedback from rehabilitation providers, individuals with SCI, and other colleagues in the health care and policy areas is important to ensure the recommendations of the SoS in 2011 can be implemented. Continuous reassessment of SCI rehabilitation's beginnings, progress and potential are necessary to provide us with the framework for the research design needed to advance this broad field.

4 citations


Cited by
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Journal ArticleDOI
TL;DR: The results from this study have the potential to inform SCI peer mentor training programs about specific leadership behaviors that mentors could be taught to use and could lead to more effective mentoring practices for people with SCI.
Abstract: Objective The purpose of this study was to investigate the leadership behaviors of spinal cord injury (SCI) peer mentors and examine whether behaviors of peer mentors align with the tenets of transformational leadership theory. Method A total of 12 SCI peer mentors aged 28-75 (M = 49.4) who had between 3 and 56 years (M = 13.9) of mentoring experience were recruited for the study. Utilizing a qualitative methodology (informed by a social constructionist approach), each mentor engaged in a semistructured interview about their experiences as a peer mentor. Interviews were transcribed verbatim and subjected to a directed content analysis. Results SCI peer mentors reported using mentorship behaviors and engaging with mentees in a manner that closely aligns with the core components of transformational leadership theory: idealized influence, inspirational motivation, individualized consideration, and intellectual stimulation. A new subcomponent of inspirational motivation described as 'active promotion of achievement' was also identified and may be unique to the context of peer mentorship. Conclusions SCI peer mentors inherently use behaviors associated with transformational leadership theory when interacting with mentees. The results from this study have the potential to inform SCI peer mentor training programs about specific leadership behaviors that mentors could be taught to use and could lead to more effective mentoring practices for people with SCI. (PsycINFO Database Record

20 citations

Journal ArticleDOI
TL;DR: The research strategy roadmap and framework informed discussion at a structured stakeholder dialogue meeting of 23 participants representing key SCI research constituencies, results of which are published in a companion paper.
Abstract: Developing a spinal cord injury research strategy using a structured process of evidence review and stakeholder dialogue. Part II: Background to a research strategy

18 citations

Journal ArticleDOI
TL;DR: This first step in a regionalSCI research strategy has articulated objectives for further development by the wider SCI research community, and reinforced the importance of coordinated, collective action in optimising outcomes following SCI.
Abstract: Developing a spinal cord injury research strategy using a structured process of evidence review and stakeholder dialogue. Part III: outcomes

15 citations

Book ChapterDOI
01 Jan 2015
TL;DR: This research proposes to investigate the life cycle of information generated from SCI and how it can be linked and integrated to collate and make sense of the data relevant to these incidents to see if it could be used predictively to preempt problems and ultimately improve outcomes for patients with SCI.
Abstract: Spinal Cord Injury (SCI) is a traumatic condition where there is a high dependency on medical and social support (ABS, 2013). The average life span after injury is around 40 years and the latest review suggests there has been a significant increase in incidences in the age group over 40 years (AIHW, 2010) . Patients with spinal cord injury have long term treatments and rely heavily on medical and social intervention. Evidence suggests that SCI patients constantly return to hospital for treatment for conditions such urinary tract infections, pneumonia and a range of other conditions (Guilcher et al., 2013; VNI, 2011). The study suggests that a third of traumatic SCI will be hospitalized each year posing a big burden on health expenditure as well as on quality of life (Jaglal et al., 2009). Over the years of medical treatment, patients accumulate a large set of medical data at a public (Commonwealth, State and Community) and private level. This distributed data are difficult to identify and key information may not be available to clinicians or to patients at the right time and place as clinical data are kept at different databases (Banfield et al., 2013; Pang & Hansen, 2006). The aim of this current research is to develop a basis for a systematic approach to working with a mass of health information that is currently not mobilized effectively. This research proposes to investigate the life cycle of information generated from SCI and how it can be linked and integrated to collate and make sense of the data relevant to these incidents to see if it can be used predictively to preempt problems and ultimately improve outcomes for patients with SCI. The focus of this study will be on trauma centres of SCI in Victoria, following through health information generated by patients of SCI from the first injury to discharge. Identifying stake holders, roles they play and the needs of technology to evolve to share information by all concerned (Pinsonneault, Dakshinamoorthy, Reidel, & Tamblyn, 2012; Pluye et al., 2013).

1 citations