An Overview of Traumatic Brain & Spinal Cord Injuries (TBI/TSCI) Among Indigenous Populations in Canada, United States, Australia, and New Zealand
Bibliographic record
Abstract
Background: Indigenous populations across Canada, the United States (US), Australia, and New Zealand (NZ) are disproportionately affected by traumatic brain injury (TBI) and traumatic spinal cord injury (TSCI), both of which can lead to a lifetime of ongoing treatment as well as physiological and psychological impacts. Despite this, a paucity of data exists related to the healthcare experiences within the pathways of care specific to Indigenous populations with TBI/TSCI. This scoping review aims to identify the types of research conducted for, with, and about Indigenous populations, while comparing existing knowledge gaps concerning TBI/TSCI among Indigenous populations across Canada, US, Australia, and NZ. Methods: This review was guided by a five-stage scoping review methodology. It was conducted by a collaborative team of Indigenous and non-Indigenous researchers and a Traditional Knowledge Keeper. We searched 9 databases for peer-reviewed articles related to TBI and/or TSCI and Indigenous populations across all four countries, published between 2000-2021. The initial search resulted in 2,110 sources, and two independent reviewers (EK & LR) screened all citations for inclusion. Overall, 75 articles were selected for the final review.
 Results: A total of 75 articles were included in the final review. 68 studies were focused exclusively on TBI, and 7 studies focused on TSCI. 23 of the included studies were from Australia, 24 from US, 15 from Canada, and 12 from NZ, and one paper was a commentary led by researchers in more than one country. The studies were focused across 5 main subject areas: epidemiology (n=33), rehabilitation (n=25), physician perspectives (n=5), patient knowledge (n=5), and full pathway of care (n=7). Across these themes, three sub-themes also emerged: patient experience (n=11), development of culturally appropriate tool/program (n=10), and cultural understandings of neurotrauma (n=3). Moreover, only 20 of the 75 studies included some form of Indigenous community engagement.
 Implications & Conclusion: Overall, this scoping review highlighted the types of research being done about TBI/TSCI within Indigenous populations, the current knowledge gaps, and how communities are involved within the research process. Global healthcare systems operate differently, and consequently, result in varying health outcomes. The results highlight that there is a lack of Indigenous-driven projects, and a gap within Indigenous-specific data collection strategies. This calls for future research to be driven by community-specific priorities and prioritize Indigenous data governance strategies.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".