Conference Schedule
Conference schedule of events and times.
Please note these may be subject to change.
2024 International Traumatic Brain Injury Conference
Day 1 - 21st March 2024
7:45 AM - 8:45 AM
Registration and Check-In
8:45 AM - 9:30 AM
Mihi Whakatau with Tupoho iwi
9:30 AM – 10:00 AM
Meet your Emcee and some Conference Housekeeping
10.00 AM - 10.30 AM
Official Conference opening and Welcome by the Hon. Marama Davidson
10:30 AM – 11:00 AM
Paramanawa / Morning Tea
Keynote Session 1 –
Dr Debbie Hager
11:00 AM – 12:00 PM
Setting the scene of tbi (the context of disability/ invisibility/ violence) and why we should care.
Traumatic brain injury in women occurs against a backdrop of power disparities inherent in men’s violence against women. Debbie will explore how this context influences who is perceived as credible and provided with skilled diagnosis and treatment, and why there is so little research, response and support for women harmed by TBI. The session will also explore the stigma and resulting discrimination caused by the disabling effects of TBI for women.
Keynote Session 2 -
Dr Hinemoa Elder
12:00 PM – 1:00 PM
Kaupapa Māori understanding of tbi’s and tools to support wellbeing in tamariki, rangatahi, wāhine and tane with tbi caused by ipv.
Ka mua, ka muri. Learning from the past to ensure a better future.
Working with whānau to improve outcomes in Māori traumatic brain injury.
The role of whānau is recognised as an essential aspect of hauora for Māori, who are over represented in traumatic brain injury populations. Whānau knowledge systems are a potent resource for enhancing recovery outcomes as used in Te Waka Oranga and Te Waka Kuaka.
These two interwoven approaches locate the whānau within their own culturally-determined knowledge systems and this optimises their integral role in the healing journey. In this way the experience is enhanced, there is a sense of ease and self-determination. When whānau bring their own unique cultural knowledge forward to adddress the culturally defined injury, outcomes are improved. The development of this approach has been previously published (Elder, 2013a, 2013b; Elder & Kersten, 2015, Elder 2017).
Te Waka Oranga, describes a process of bringing whānau knowledge, skills and emotions, and whānau leading the collaboration with health workers’ knowledge, skills, and emotions in the context of identifying recovery destinations they prioritise.
Te Waka Kuaka is a Māori cultural needs assessment tool that has been developed to identify and guide this work. The four subscales on Te Waka Kuaka help identify and navigate whānau needs at any given time, and at repeated points on the journey.
These are:
- Wairua (a pivotal component of hauora and wellbeing, concerned with unique connection between Māori and all elements of the universe),
- Tangata (people),
- Wā (time) and
- Wāhi (place).
This keynote describes the use of these tools, illustrating practical ways of bringing whānau resources to the fore to promote whānau healing and self-determination. This way of working is already being used in TBI rehabilitation. Wider application of the approach has led to use in mental health services where other aspects of cultural injuries such as in mental illness and trauma as well as addictions and neurodegenerative disorders are present.
1:00 PM - 1:45 PM
Tina / Lunch
Keynote Session 3 –
Dr Eve Valera
1:45 PM – 3:15 PM
Concussion: A complex and hidden epidemic for women experiencing intimate partner violence.
This talk will present data on brain injuries, from both blunt force trauma and strangulation, sustained by woman who have experienced intimate partner violence (IPV). It will provide an overview of prevalence data as well as cognitive, psychological and neural correlates of such brain injuries. Finally, it will touch upon ways to interact with women who may have experienced IPV-related brain injuries as well as the importance of raising awareness about this highly overlooked issue.
3:15 PM – 3:30 PM
Paramanawa / Afternoon Tea
Workshop Session 1
3:30 PM – 4:30 PM
Breakout Session 1A: Sandy Shultz: A Translational Approach to Understanding the Pathophysiology, Biomarkers, and Functional Consequences of Intimate Partner Violence-Related Brain Injury.
This talk will present data on brain injuries, from both blunt force trauma and strangulation, sustained by woman who have experienced intimate partner violence (IPV). It will provide an overview of prevalence data as well as cognitive, psychological and neural correlates of such brain injuries. Finally, it will touch upon ways to interact with women who may have experienced IPV-related brain injuries as well as the importance of raising awareness about this highly overlooked issue.
Intimate partner violence-related brain injury (IPV-BI) is unique (e.g., often a combination of traumatic brain injury, strangulation, and/or high levels of stress; predominantly affects women; repetitive in nature). The pathophysiological profiles and functional consequences of different forms of IPV-BI are poorly understood, which ultimately makes it difficult to detect and treat IPV-BI patients. This represents a significant knowledge gap that requires urgent attention. In 2022, we were awarded a $2M NHMRC Ideas grant for an Australian-first research study to characterise the pathophysiology, biomarkers, and functional consequences of IPV-BI. In the proposed research presentation we will outline the unique challenge of IPV-BI and the philosophy behind our translational research program, which involves both rodent and human studies, and provide an update of our exciting findings to date.
Presentation #1 (Professor Sandy Shultz): Translational Research to Address the Complex Problem of IPV-BI and a New Rat Model of IPV-BI
IPV-BI is a complex issue that involves different forms of brain insult that occur in the presence of different confounding variables. This makes it difficult to comprehensively study and understand IPV-BI in human patients alone. Professor Sandy Shultz will provide an overview of this challenge and discuss why a translational research approach that incorporates both animal model and human patient approaches can be harnessed to provide insights into the pathophysiology, biomarkers, functional consequences, and treatments for IPV-BI. Shultz will then present data from the world’s first rat model of combined TBI, strangulation, and/or stress (i.e., the different forms of brain insults that occur in human IPV) that can provide complementary insights into questions that are difficult to address in humans. These new findings demonstrate a synergistic effect of different IPV brain insults on neuropathophysiological, blood biomarker, and behavioural measures. Shultz will also present novel findings related to the use of psilocybin to improve long-term outcomes in rats with IPV-BI.
Presentation #2 (Dr. Stuart McDonald): Understanding the Acute Consequences of IPV-BI in Humans
Our research program also involves multi-site clinical studies investigating the acute effects of IPV-BI in patients from Emergency Departments. Participants complete a brief symptom and cognitive assessment and blood is collected to analyse blood biomarkers. Dr. McDonald will present initial results indicating that IPV-BI patients have worse symptoms and higher concentrations of blood biomarkers compared to patients who have had a concussion unrelated to IPV.
Presentation #3 (Dr. Georgia Symons): Understanding the Chronic Consequences of IPV-BI in Humans
Last, Dr. Symons will present our studies into the chronic (i.e., history of IPV but not within the past 6 months) consequences of IPV-BI. This project involves a more comprehensive neuropsychological and cognitive assessment, advanced neuroimaging (MRI and PET), and blood biomarkers. Results to date indicate that the majority of IPV-BI patients have persisting post-concussion symptoms and probable PTSD.
At the conclusion of these talks we will have time for open discussion related to research approaches, findings, and potential expansion of the clinical research to additional sites that will foster collaboration in this vital area of study.
Breakout Session 1B: Katie Hodge and Peta Murphy: The Impact of Strangulation on the Brain-– Practical Solutions and Accessing Timely Support
By the end of this practical workshop, you will have an increased understanding of the symptoms of a brain injury, how this might present in different individuals and helpful tools to enable you to provide appropriate support for those accessing your service (including barriers and facilitators). This workshop will also cover navigating the referral pathway to access more specialised input.
Synopsis:
Traumatic Brain injury (TBI) is a significant problem that can arise from interpersonal violence including strangulation, suffocation, assault, falls and other mechanisms. TBI is an invisible injury and can result in lifelong impairments. Diagnosis of a TBI (particularly mild TBI / concussion) may be missed in individuals with alcohol and drug misuse, mental health conditions, Intellectual Disability, Fetal Alcohol Syndrome, Attention Deficit Hyperactive Disorder, and those experiencing trauma. Over the past 5 years, only 2-5% of strangulation / suffocation claims caused by domestic violence have resulted in a related brain injury claim. This is a significant disparity that warrants further discussion.
Untreated cognitive difficulties following strangulation and other mechanisms of brain injury, places the individual at risk of not accessing necessary treatment and potentially being labelled as non-compliant, forgetful, unmotivated, lazy, disorganised and / or a poor parent. In the absence of appropriate support, the individual may be exposed to added risks including another TBI, involvement in anti-social or illegal behaviour, family estrangement / social isolation, further harm (domestic violence), job loss and / or homelessness.
This practical workshop will enable you to recognise signs of a brain injury, tools to assist individuals accessing your service, and a plan for accessing further support. The workshop aims to be interactive and provide opportunities for discussion and real-life application of these tools.
Learning Objectives / Outcomes:
- Understand the impact of strangulation and interpersonal violence on the brain and everyday functioning.
- Knowledge and access to a Tool kit that includes resources to assist you when working with people following a suspected brain injury.
- Knowledge of referral pathways and how to access specialist services.
Kelly Jones
4:30 PM – 5:00 PM
Violence related TBI – the facts (AUT research) Violence-related Traumatic Brain Injury (TBI) incidence in New Zealand: Findings from the Bionic Study
Research Presentation:
Background: Violence is a problem of international significance, with global data suggesting that 10-24% of all TBI are violence-related. TBI due to violence is distinct from other mechanisms of injury, involving unique means of force transmission and single or multiple mechanisms of trauma (e.g., sharp or blunt force, one or more perpetrators). Our ‘Brain Injury Incidence and Outcomes New Zealand in the Community’ (BIONIC 2010-2011) study found that 17% of TBI in New Zealand (NZ) were due to assault. Using methods consistent with BIONIC, our recently completed BIONIC2 study will provide updated violence-related TBI incidence figures for NZ.
Aims: Specific aims are to determine: 1) violence-related TBI incidence in NZ from 2021 to 2022 by age, sex, and ethnicity; area (urban, rural), location (place), activity, and injury mechanism; and 2) any changes in violence-related TBI incidence and aetiology over time and by age, sex, and ethnicity by comparing BIONIC2 2021-2022 with corresponding BIONIC 2010-2011 data. Methods: BIONIC2 was a prospective, population-based register of TBI epidemiology from 01/05/2021 to 30/04/2022 in the Hamilton and Waikato Districts (being the same applied boundaries in BIONIC 2010-2011) using proven methods. BIONIC2 data will be compared to existing BIONIC data, focusing on violence-related TBI across all ages and all TBI severities.
Results: Data analyses are currently underway and due for completion end of 2023. Discussion: Findings will enable policy, service budgets, and strategic action plans based on the most upto-date information to meet the specific realities of violence-related TBI in NZ. Longer-term beneficiaries will be adults, children, and whānau impacted by violence-related TBI, especially groups that could be better served by more responsive health services and trauma prevention approaches.
5:00 PM – 5:15 PM
Closing remarks
Canapes
5:30 PM – 6:00 PM
Please note – bar will remain open for the evening.
Dinner
7:00 PM – 9:30 PM
Day 2 - 22nd March 2024
7:45 AM – 8:00 AM
Registration and Check-In
8:00 AM - 8:15 AM
Welcome/Karakia
Keynote Session 4 –
Katherine Snedaker
8:15 AM – 9:15 AM
Sex/Gender Differences in Brain Injury and why it matters!
This presentation provides an overview of sex and gender differences in brain injury between men and women based on scientific research and Katherine’s experience working with housands of women. While these differences matter in sport, accidents, and military service injuries, those who are injured from violence are rarely seen by the medical community.
Katherine will address why these differences are important for patients, families, and clinicians to consider in care plans for women and girls. The lack of education and awareness can lead to a patient’s unrealistic expectations of recovery time and an underestimation of the need for support from family and school/work. In addition, a lack of screening and training in a medical professional can inhibitdiagnosis and delivery of healthcare service.
“If brain injury is the “invisible illness” of our time, then within this invisible injury, women have been the invisible patients,” says Katherine Snedaker, Founder and Executive Director of PINK Concussions. “Over the last decade, we have been able to raise general awareness of brain injuries in women athletes and veterans, and with the #PINKBrainPledge recruit hundreds of women to pledge their brains. Now it is time for effort to redouble our efforts for those who suffer from Domestic Violence/IPV
“Beyond sports, there is a far greater number of repetitive brain injuries are still hidden and endured by the invisible women who suffer violence inflicted by partners in every social economic group of society.”
Objectives:
- Describe three ways in which brain injuries (including concussion) in women differ from males.
- Articulate factors that may account for sex and gender differences in TBI incidences, severity, and recovery
- Understand the urgent need to develop “better” practices in the care and education of women with brain injury to facilitate recovery and positive long-term outcomes.
Workshop Session 2
9:15 AM – 10:15 AM
Breakout Session 2A: Tee Whiting: Incubated in Terror- the lived experience of childhood abuse and neglect and the long-term effects of TBI.
This presentation is from the perspective of the eldest of six children of a single mother- herself a victim of child abuse. Her children raised in an environment of extreme, unpredictable, and irrational physical violence, gross emotional neglect and psychological + verbal abuse.
- The impact of TBI caused by familial violence on children’s learning, development- specifically neurodevelopment, and other outcomes in the short/ long-term.
- TBI caused by familial violence- barriers to seeking help for children, the intersection with trauma into adulthood, the lack of understanding of childhood trauma and the impact of this intersection with medical and mental health and addictions services in Aotearoa New Zealand.
- Attachment and neurodevelopment, what happens when the ‘nurturer/caregiver’ is the source of unpredictable violence and neglect.
Breakout Session 2B: An integrated response- Porirua Family Harm/ CCDHB/ Concussion Clinic.
The Family Harm Team of Porirua Police and the Concussion Team of Wellington Hospital describe a collaborative pilot seeking to improve access to brain injury care for victim-survivors of intimate partner violence
Presenters:
Detective Sergeant Gary Fowler
26 ½ Years in Police
8 Years as a CIB investigator and Family violence portfolio holder for Kapiti
6 years CIB Trainer RNZPC
10 years Supervisor of FH in Kapiti Mana
Karen Kyne is a neuropsychologist trained at Massey University and now contracting to a variety of DHB and ACC services. She has worked in Concussion Clinic’s off and on since 2009.
Rebecca Jewell – background is in Occupational Therapy, with a clinical focus on neurorehab and concussion for 10 years. She is now working for Te Whatu Ora Southern as the Violence Intervention Programme Team Leader, seeking to ensure that those impacted by violence receive appropriate assessment, support and intervention from staff in health.
Mel Brazier is Team Leader for the Community Older Adults and Rehabilitation Service in Wellington – a large multidisciplinary service provided assessment and intervention for people 16 and above with acquired health conditions. The ORA service ran a Concussion Clinic for 10 years, working alongside ACC to provide Concussion Services to the Wellington region. Mel is a speech-language therapist by background, qualified in 1998 and has worked in community services for the last 20 years of her career.
Breakout Session 2C: Michelle Fitts and Jennifer Cullen “It’s been like a spiritual awakening for me:” The impacts of traumatic brain injury education with women in the prison system.
Aboriginal and Torres Strait Islander women in prison often have histories of experiencing head injuries from assault. Despite the association between assault and harms to the brain, there is limited research with Aboriginal and Torres Strait Islander women in prison who have experience traumatic brain injury (TBI) from violence. TBI education for people who experience TBI as well as frontline professionals in other settings (e.g., health) has shown to support people who experience TBI to implement strategies to manage TBI symptoms as well as lead to service policy and practice updates to consider and respond to TBI. In August 2023, two Aboriginal facilitators delivered a three-session workshop on acquired brain injury (with a primary focus on TBI) to two groups of women involved in a peer mentor group at one regional Australian prison. The peer mentor group disseminated the TBI resources to Aboriginal and Torres Strait Islander women at the prison. Feedback was collected from Aboriginal and Torres Strait Islander women who attended the workshops or received the information resources during semi-structured interviews. With developing an understanding and awareness of TBI and how it appears in everyday life in the workshops, women reported developing deeper sense of insight and compassion for both themselves and other women at the prison. With a high proportion of women in the prison community with TBI, knowledge holders identified opportunities for the prison community to better respond to as well as support women at the prison generally including: (1) education workshops for women as well as frontline correctional and probation and parole officers; (2) TBI screening and referral pathways; (3) consideration of TBI in prison policies and programs, and, (4) pathways for support through the prison and post-discharge.
10:15 AM – 10:45 AM
Paramanawa / Morning Tea
Keynote Session 5 –
Dr Kim Gorgens
10:45 AM – 12:15 PM
The Injury to Prison Pathway: The short and long-term effects of TBI among youth and the US criminal legal system.
This presentation will highlight data from adult and youth US correctional, court and treatment facilities and outline a new model developed with the CDC brain injury team. This presentation will also highlight psychosocial vulnerabilities that characterize young people with TBI in the criminal legal system and a novel model in the US that is designed to disrupt the trajectory of youth in the criminal legal system. The Colorado Brain Injury Model is used to identify brain injury history, assess cognitive functioning and psychosocial vulnerabilities and to make recommendations and referrals that support the youth through (and out of) the system.
12:15 PM - 1:00 PM
Tina / Lunch
Keynote Session 6 –
Dr Alice Theadom and Sam Guy
1:00 PM - 2:00 PM
TBI within the prison sector and tools
Workshop Session 3
2:00 PM – 3:00 PM
Breakout Session 3A: Michelle Fitts and Elaine Wills: Aboriginal and Torres Strait Islander women’s perceptions of traumatic brain injury from family violence: Voices from regional and remote Australia.
Background and Objectives: Aboriginal and Torres Strait Islander women experience high rates of head injuries as a result of family violence. This study explored the barriers that affect access to healthcare and assessment for a potential traumatic brain injury for Aboriginal and Torres Strait Islander women as an outcome of family violence in one regional and one remote region in Australia.
Method: Between January and November 2022, semi-structured interviews and discussion groups were conducted with 28 women, 30 hospital staff and 90 professionals from health, housing and disability services as well as specialised family violence and legal services from one regional town in Queensland and one remote town in the Northern Territory, Australia. Interviews and discussion groups were audiotaped and transcribed verbatim. Transcripts were analysed using thematic analysis.
Results: While service workers described high ‘suspected head injury’ among the clients they work with and support, very few women had been assessed for TBI. Various workforce barriers prevent pre-screening and assessment including limited access to specialist neuropsychology services and stable remote primary health care professionals with remote expertise. There were also low levels of training and knowledge among community-based service providers of head injury. Other key factors influencing women’s access to health care included fear of child removal; fear of escalating violence; prioritisation of other competing demands; and insufficient awareness of the signs of brain injury. While some service professionals were able to address some of the system barriers, lack of healthcare and assessment generated uncertainty for service providers about how to support and respond to the needs of women living with long-term disabilities from TBI.
Conclusions: Needs-based investment in the primary healthcare and specialist service systems together with professional training on head injury would benefit how systems in remote areas respond through a more integrated approach to support women following family violence. There is a need for further research to understand how assessment, screening and follow-up care for Aboriginal and Torres Strait Islander women is best implemented into regional and remote settings.
Breakout Session 3B: Debbie Hager and Olivia Bloom: Safeguarding Adults Toolkit.
Safeguarding Adults from Abuse: A Toolkit
One consequence of a disabling traumatic brain injury is that affected adults may no longer be able to safely identify and remove themselves from abusive, harmful situations. International governments have already begun to assume the mandate to protect and safeguard adults such as those with disabling traumatic brain injury, who are at risk of violence, abuse and neglect, as seen in the UK’s Care Act of 2014. In stark contrast, adults in this precarious situation are invisible in New Zealand. This gap creates critical situations of risk due to a lack of safeguarding adult’s agencies and responses; there is no government funded lead agency charged with the responsibility for protection and prevention of harm for this invisible demographic.
This interactive workshop will explain a Te Tiriti o Waitangi and rights-based twin-track approach to the prevention, identification, and management of people disabled by brain injury – and will explain the use, in this context of the term Adult at Risk.
The workshop will explore:
- the Safeguarding Framework, using the established Safeguarding Adults from Abuse (SAFA) integrated community response in the Waitematā District as the case study.
- discuss a fundamental toolkit of knowledge and skills for safeguarding adults at risk of abuse, including Supported Decision Making, Independent Advocacy, and co-ordination of Interagency safeguarding adults responses.
- how access to these tools is influenced by current legislature and policy.
Closing Remarks and Poroporoaki
3:00 PM – 3:30PM
Closing Remarks and Poroporoaki
Tickets
You can purchase your tickets now for the 2024 Conference. Tickets are $550 for two days excluding dinner and $600 for two days dinner inclusive.
Dinner only tickets
Tickets are also available to purchase to attend the Buffet Dinner on Thursday 21st March 2024 at the War Memorial Hall. Alison Mau will be speaking about her new venture : TIKA. For more information on this please refer to Latest News Page.