Results suggest that both, level of disability and injury chronicity, should be considered when determining LOS. Data also show an association between LOS and changes in the MPAI and CIQ.

Traumatic brain injury (TBI) results in disruption of information processing via damage to primary, secondary, and tertiary cortical regions, as well as, subcortical pathways supporting information flow within and between cortical structures. TBI predominantly affects the anterior frontal poles, anterior temporal poles, white matter tracts and medial temporal structures. Fundamental information processing skills such as attention, perceptual processing, categorization and cognitive distance are concentrated within these same regions and are frequently disrupted following injury. Information processing skills improve in accordance with the extent to which residual frontal and temporal neurons can be encouraged to recruit and bias neuronal networks or the degree to which the functional connectivity of neural networks can be re-established and result in re-emergence or regeneration of specific cognitive skills. Higher-order cognitive processes, i.e., memory, reasoning, problem solving and other executive functions, are dependent upon the integrity of attention, perceptual processing, categorization, and cognitive distance. A therapeutic construct for treatment of attention, perceptual processing, categorization and cognitive distance deficits is presented along with an interventional model for encouragement of re-emergence or regeneration of these fundamental information processing skills.

Background:The Haitian orphanage sector receives more than 70 million United States Dollars (USD) in foreign aid annually and continues grow; there are over 500 orphanages in Port-Au-Prince alone. An estimated 80% of the 30,000 children living in Haitian orphanages have at least one living parent.Objectives:This research seeks to identify factors contributing to maternal-child separation in Port-Au-Prince to understand motivations and attitudes surrounding maternal-child separation. We hypothesized that poverty, health status, and current state of the family unit are influential in the mother’s decision to separate from her child.Methods:From June to August 2017, a chain referral sampling study was conducted in Port-Au-Prince and the surrounding metropolitan area. Seventy interviews were conducted with (1) Mothers – separated (n = 8) and non-separated (n = 48) – and (2) Community leaders exposed to maternal-child separation (n = 18). The semi-structured interview consisted of questions about (1) exposure to maternal-child separation, (2) circumstances surrounding maternal-child separation, and (3) factors contributing to maternal-child separation. Additionally, all mothers completed a survey including demographic information and multiple validated surveys: Maternal Postpartum Quality of Life, Patient Health Questionnaire (PHQ-9), and PTSD Checklist (PCL) to address quality of life, depression, and PTSD, respectively.Findings:This study found separation to be associated with poor economic means compounded with other factors, most notably access to education, ability to care for disabled children, insufficient support, and poor maternal mental health. Additional themes identified include negative stigma towards maternal-child separation and sparse education surrounding family planning. Quantitative findings revealed separated mothers experienced significantly higher rates of PTSD compared to non-separated, small but statistically worse quality of life, and no difference in rates of major depression.Conclusion:This research finds economic means to be insufficient in predicting maternal-child separation, with access to education being the most salient contributing factor mentioned after economics. Findings from this study will inform development of programming focusing on education, family planning, and social support in Port-Au-Prince.

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