Author
Shirin Mollayeva
Other affiliations: Toronto Rehabilitation Institute, University Health Network
Bio: Shirin Mollayeva is an academic researcher from University of Toronto. The author has contributed to research in topics: Traumatic brain injury & Poison control. The author has an hindex of 11, co-authored 22 publications receiving 1041 citations. Previous affiliations of Shirin Mollayeva include Toronto Rehabilitation Institute & University Health Network.
Papers
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TL;DR: The best evidence synthesis for the PSQI showed strong reliability and validity, and moderate structural validity in a variety of samples, suggesting the tool fulfills its intended utility.
872 citations
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373 citations
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TL;DR: Recent research efforts aimed at advancing knowledge on the constructs of sex and gender and their respective influences in the context of TBI are reviewed, and methodological challenges in disentangling the differential impacts of these two constructs are discussed.
Abstract: Over the past decade, traumatic brain injury (TBI) has emerged as a major public health concern, attracting considerable interest from the scientific community, clinical and behavioural services and policymakers, owing to its rising prevalence, wide-ranging risk factors and substantial lifelong familial and societal impact. This increased attention to TBI has resulted in increased funding and advances in legislation. However, many questions surrounding TBI remain unanswered, including questions on sex and gender trends with respect to vulnerability to injury, presentation of injury, response to treatment, and outcomes. Here, we review recent research efforts aimed at advancing knowledge on the constructs of sex and gender and their respective influences in the context of TBI, and discuss methodological challenges in disentangling the differential impacts of these two constructs, particularly in marginalized populations.
161 citations
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TL;DR: The variation in findings supports the idea of fatigue in TBI as a nonhomogeneous entity, with different factors influencing the course of new onset or chronic fatigue, and the need for agreement on a core set of relevant fatigue predictors, definitions and outcome criteria.
98 citations
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TL;DR: Great attention should be given to the diagnosis and management of insomnia in persons with mTBI/concussion, as the odds of reporting higher global disability increased with increasing insomnia and pain.
44 citations
Cited by
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Stanford University1, University of Calgary2, Centers for Disease Control and Prevention3, George Washington University4, Cleveland Clinic5, Johns Hopkins University School of Medicine6, University of California, Los Angeles7, University of Florida Health Science Center8, Kaiser Permanente9, Emory University10, Icahn School of Medicine at Mount Sinai11, Princeton University12, University of Texas Health Science Center at San Antonio13, Harvard University14, Loma Linda University15, Cincinnati Children's Hospital Medical Center16, University of Washington17, St. Louis Children's Hospital18, University of Utah19, Children's Hospital of Philadelphia20, University of North Carolina at Chapel Hill21, John H. Stroger, Jr. Hospital of Cook County22, Vanderbilt University23, University of Pittsburgh24, Nationwide Children's Hospital25, The Ohio State University Wexner Medical Center26, Boston Children's Hospital27, University of Miami28, University of California, San Diego29, American Academy of Neurology30, University of Kansas31, University of Virginia32, Penn State Milton S. Hershey Medical Center33
TL;DR: This guideline identifies the best practices for mTBI based on the current evidence and creates user-friendly guideline implementation materials that are concise and actionable.
Abstract: Importance Mild traumatic brain injury (mTBI), or concussion, in children is a rapidly growing public health concern because epidemiologic data indicate a marked increase in the number of emergency department visits for mTBI over the past decade. However, no evidence-based clinical guidelines have been developed to date for diagnosing and managing pediatric mTBI in the United States. Objective To provide a guideline based on a previous systematic review of the literature to obtain and assess evidence toward developing clinical recommendations for health care professionals related to the diagnosis, prognosis, and management/treatment of pediatric mTBI. Evidence Review The Centers for Disease Control and Prevention (CDC) National Center for Injury Prevention and Control Board of Scientific Counselors, a federal advisory committee, established the Pediatric Mild Traumatic Brain Injury Guideline Workgroup. The workgroup drafted recommendations based on the evidence that was obtained and assessed within the systematic review, as well as related evidence, scientific principles, and expert inference. This information includes selected studies published since the evidence review was conducted that were deemed by the workgroup to be relevant to the recommendations. The dates of the initial literature search were January 1, 1990, to November 30, 2012, and the dates of the updated literature search were December 1, 2012, to July 31, 2015. Findings The CDC guideline includes 19 sets of recommendations on the diagnosis, prognosis, and management/treatment of pediatric mTBI that were assigned a level of obligation (ie, must, should, or may) based on confidence in the evidence. Recommendations address imaging, symptom scales, cognitive testing, and standardized assessment for diagnosis; history and risk factor assessment, monitoring, and counseling for prognosis; and patient/family education, rest, support, return to school, and symptom management for treatment. Conclusions and Relevance This guideline identifies the best practices for mTBI based on the current evidence; updates should be made as the body of evidence grows. In addition to the development of the guideline, CDC has created user-friendly guideline implementation materials that are concise and actionable. Evaluation of the guideline and implementation materials is crucial in understanding the influence of the recommendations.
363 citations
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TL;DR: It is found that overall, human studies report worse outcomes in women than men whereas animal studies report better outcomes in females than males, and closer examination shows that multiple factors including injury severity, sample size, and experimental injury model may differentially interact with sex to affect TBI outcomes.
Abstract: There is growing recognition of the problem of male bias in neuroscience research, including in the field of traumatic brain injury (TBI) where fewer women than men are recruited to clinical trials and male rodents have predominantly been used as an experimental injury model. Despite TBI being a leading cause of mortality and disability worldwide, sex differences in pathophysiology and recovery are poorly understood, limiting clinical care and successful drug development. Given growing interest in sex as a biological variable affecting injury outcomes and treatment efficacy, there is a clear need to summarize sex differences in TBI. This scoping review presents an overview of current knowledge of sex differences in TBI and a comparison of human and animal studies. We found that overall, human studies report worse outcomes in women than men, whereas animal studies report better outcomes in females than males. However, closer examination shows that multiple factors including injury severity, sample size, and experimental injury model may differentially interact with sex to affect TBI outcomes. Additionally, we explore how sex differences in mitochondrial structure and function might contribute to possible sex differences in TBI outcomes. We propose recommendations for future investigations of sex differences in TBI, which we hope will lead to improved patient management, prognosis, and translation of therapies from bench to bedside.
223 citations
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TL;DR: As standardised outcomes will support benchmarking and pooling (meta‐analysis) of trials, one or more of these recommended endpoints should be considered for inclusion in clinical trials assessing patient comfort and pain after surgery.
Abstract: Background Maximising patient comfort during and after surgery is a primary concern of anaesthetists and other perioperative clinicians, but objective measures of what constitutes patient comfort in the perioperative period remain poorly defined. The Standardised Endpoints in Perioperative Medicine initiative was established to derive a set of standardised endpoints for use in perioperative clinical trials. Methods We undertook a systematic review to identify measures of patient comfort used in the anaesthetic, surgical, and other perioperative literature. A multi-round Delphi consensus process that included up to 89 clinician researchers was then used to refine a recommended list of outcome measures. Results We identified 122 studies in a literature search, which were the basis for a preliminary list of 24 outcome measures and their definitions. The response rates for Delphi Rounds 1, 2, and 3 were 100% (n=22), 90% (n=79), and 100% (n=13), respectively. A final list of six defined endpoints was identified: pain intensity (at rest and during movement) at 24 h postoperatively, nausea and vomiting (0–6 h, 6–24 h, and overall), one of two quality-of-recovery (QoR) scales (QoR score or QoR-15), time to gastrointestinal recovery, time to mobilisation, and sleep quality. Conclusions As standardised outcomes will support benchmarking and pooling (meta-analysis) of trials, one or more of these recommended endpoints should be considered for inclusion in clinical trials assessing patient comfort and pain after surgery.
174 citations
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TL;DR: Recent research efforts aimed at advancing knowledge on the constructs of sex and gender and their respective influences in the context of TBI are reviewed, and methodological challenges in disentangling the differential impacts of these two constructs are discussed.
Abstract: Over the past decade, traumatic brain injury (TBI) has emerged as a major public health concern, attracting considerable interest from the scientific community, clinical and behavioural services and policymakers, owing to its rising prevalence, wide-ranging risk factors and substantial lifelong familial and societal impact. This increased attention to TBI has resulted in increased funding and advances in legislation. However, many questions surrounding TBI remain unanswered, including questions on sex and gender trends with respect to vulnerability to injury, presentation of injury, response to treatment, and outcomes. Here, we review recent research efforts aimed at advancing knowledge on the constructs of sex and gender and their respective influences in the context of TBI, and discuss methodological challenges in disentangling the differential impacts of these two constructs, particularly in marginalized populations.
161 citations