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Jack Sisson's TBI Blog
A hug is duct tape for the soul.
Sunday, April 28, 2013
Call to test inmates for brain injury
First Scotland, now Australia! The Australian state of Victoria's public advocate is now calling for all prisoners to be checked for cognitive impairments, including brain injuries. This has caused me to wonder if we've missed something and if any U.S. states routinely scan prisoners for TBI. Will make a note to check on this. Jack's been pushing for it for years!
From The Age:
(Victoria, Australia) The state's public advocate is calling for all prisoners to be routinely checked for all cognitive impairments, including acquired brain injuries and intellectual disabilities, when they enter jail.
Colleen Pearce heads the independent body the Victorian government set up to protect the rights of people with a disability. She said it was critical to identify impairments early on to ensure prisoners received effective support and to prevent them from reoffending when released, because there were higher and more severe rates of cognitive impairments in prisons than in the community.
''Without [routine screening], people with cognitive impairments can get trapped in a revolving door of endless contact with police and prisons with attendant costs to the community and, worse, the loss of their potential as contributing community members,'' she said.
Fairfax Media reported last month that up to half of state prisoners have an acquired brain injury, many undiagnosed.
Dr Hutchens said the tool was more effective because it included questions about not only previous assaults and car accidents, but also alcohol and drug use, suicide attempts and overdoses.
''Those risk factors actually came out as being more prevalent than traumatic brain injury and are currently being ignored as real risks of causing acquired brain injury in the prison system,'' she said.
Arbias chief executive John Eyre said that while some prison officers had undergone the two-hour training course required to use the tool at the time of the study, the Department of Justice had not approached Arbias for further training since then.
''That leads me to suspect that if they are using the tool they may not be using it correctly, or alternatively they're not using it,'' Mr Eyre said.
A Department of Justice spokeswoman said that different screening tests were available, but most prisoners were tested with the Victorian Intervention and Screening Assessment Tool.
This identified potential impairments, which were then confirmed by a neuropsychologist or clinician. She would not say whether people on remand were similarly tested.
Margot Powell, a senior solicitor at the Mental Health Legal Centre, which provides free representation for mentally ill people, said the greatest difficulty the centre's clients faced was obtaining appropriate psychiatric treatment and medication.
The Department of Justice spokeswoman said that everyone who entered prison was screened by a mental health care professional within 24 hours. Those shown to have a mental health problem were given a treatment plan that was reviewed regularly.
Thursday, April 25, 2013
How Poetry Can Help People with Dementia
From CARE 2:
For 20 minutes, silence blankets the room, punctuated only by the soft breathing of two women who are seated, facing one another.
The eldest of the two struggles to speak—she has dementia and talking has recently become difficult for her.
A single word, “life,” finally ekes its way out of her mouth.
The other woman, a poet named Susanna Howard, makes a notation in her notebook. Once she’s finished, she takes her eyes off the page and resumes waiting.
Sometime later, thanks to Howard’s ministrations, the elderly woman’s remarks have, almost magically, become woven into a new pattern, at once familiar and unique:
Lived a Life
Nobody here asks what you did
In your life
It seems they seem to think
We were put on earth with broken legs
And have come here for sympathy
Nobody wants to listen
I’ve had a stroke
Words don’t come out
And they say ‘Yes, yes’—
Don’t really want to know
It sounds silly
But it’s quite true
We have all lived a life
Giving a voice to those silenced by dementia
Howard, whose motto is “All words are okay,” is the creative force behind “Living Words,” an innovative form of art therapy aimed at giving people with dementia a new voice.
Too often, says Howard, people with cognitive impairment are written off by society.
Even close friends and family can become unsure of how to communicate with loved ones who have lost their ability to form coherent thoughts and sentences. Most hesitate to speak to dementia-stricken people for fear that they will upset them by asking a question that can’t be answered, or say something that unintentionally offends them.
Of course, not speaking only serves to further alienate the individual living with cognitive impairment. “I find it very sad when people say the essence of a person goes when they have dementia,” says Howard. “The person you loved is still there, operating from their essential self.”
We all just want to be heard
Different dementias can affect different people in different ways.
For example, the early stages of Alzheimer’s disease are often marked by progressive memory loss, while individuals suffering from Lewy-body dementia often experience vivid hallucinations and delusions.
It’s no wonder that most outsiders become easily baffled and thus hesitant to engage a cognitively impaired friend or family member.
But avoiding interactions only isolates that individual further, making him feel unheard and almost in-human.
That’s what makes the poetry sessions are so helpful.
According to Howard, going through the process of writing a poem, and then hearing the finished verse spoken back to them, can help people with dementia feel connected. “When a person hears their words, they resonate with them; even if they don’t recall saying them. This resonation prompts a feeling of being heard on some level,” she says.
The chair—it’s so dirty feeling
I’m not in running order
Where do you go to when you
I keep out of walking mode
With the mainframe
In the convoy—don’t go around much
Wish I could drive in a big car
Drive away in a car, oh
Oh I, I wish, wish I could
Fly just fly right away
To number 65—Not
Drifting along at nothing
Continue reading for more poetry by people living with dementia.
Sunday, April 21, 2013
NIH-funded study to develop measure of quality of life specific to caregivers of persons with TBI
From The George Washington University School of Public Health and Health Services:
Dr. Chiaravalloti receives $526,206 National Institutes of Health grant to study challenges faced by caregivers of persons with TBI
Kessler Foundation is one four sites participating in "Quality of Life in Caregivers of Traumatic Brain Injury: The Development of the TBI-CareQOL", a multi-site 5-year study funded by the National Institutes of Health/National Institute of Nursing Research (1R01NR013658-01). Nancy Chiaravalloti , PhD, co-investigator of the Kessler site, is also project director of the Northern New Jersey Traumatic Brain Injury System and director of TBI Research at Kessler Foundation.
The University of Michigan is the lead center for the study; Noelle Carlozzi, PhD, is principal investigator. The goal is to develop a measure of quality of life that is specific to caregivers of persons with traumatic brain injury (TBI). Although these caregivers have been identified as an underserved population in both civilian and in military life, there is a lack of measures of health-related quality of life (HRQOL) that are specific to these caregivers. "This study will result in a new tool that will help clinicians understand the issues these caregivers face," said John DeLuca, PhD, VP for Research and Training, "and identify the need for additional treatment and resources both the patients with TBI and their families."
This study has 3 phases. In the first phase, caregivers of persons with documented TBI participate in focus groups to discuss issues related to their quality of life. To assess the impact of TBI on quality of life, data are collected from the patient medical records on type of injury, cause of injury, severity of injury, lengths of stay, and possibly associated injuries. During the second phase, caregivers complete a draft measurement tool and the various questions are evaluated for appropriateness and utility, as well as other statistical properties. In the third phase, caregivers who completed the draft assessment tool are interviewed to evaluate their experience.
The TBI-CareQOL is targeted for use in caregivers of both civilian and military TBI. This will be utilized as a primary assessment measure in the congressionally mandated 15-year longitudinal study of caregivers in the military, and is a potential measure for inclusion in the TBI Model System (TBIS).
Link to Medical News at The George Washington University School of Public Health and Health Services.
Friday, April 19, 2013
A Serious Bump On The Head Turned This Mother Of Two Into A Best-selling Author
From Marlo Thomas.com:
This week's story is about a history professor who experienced a traumatic brain injury that unleashed a hidden talent -- writing fiction. Laura pursued her new passion fervently and has become a wildly successful romance author. What a fascinating way to heal! -– Marlo, MarloThomas.com
When Laura Kaye and her family set out for a July 4th holiday, she expected to see fireworks. But she had no idea that their summer vacation would begin with a bang that would change the course of her life.
“We were at our beach house,” Laura recalled, “and the girls were eating lunch. I was unloading the dishwasher and as I stood up, I caught the corner of my head on an open cabinet door. It hurt, but I didn’t think much about it. I just had a headache. So we went off to the amusement park and watched the fireworks that night.”
But over the next couple days, that headache would become crippling. So much so, that the Annapolis, Maryland mother of two ended up in the emergency room. What appeared to be a simple hit on the head was actually a traumatic brain injury.
“There was no physical damage that could be picked up on a scan. But I couldn’t sleep. I lost my appetite. I even began playing guitar for the first time! They could tell from the behavioral changes I began to experience that something serious had happened.”
Laura’s doctor explained that when tissue is injured, the brain re-routes the neural connections around the injury, often activating parts of the brain that weren’t being used.
Thursday, April 18, 2013
Brain Injuries From Boston Bombings May Resemble Those In War Veterans, NFL Players
From Huffington Post:
It's one of the heart-wrenching images now etched into our minds: A Boston Marathon runner blown off his feet by a bomb blast -- one of two explosions on Monday that killed three people and injured more than 170 others.
"Shock waves just hit my whole body and my legs just started jittering around. I knew I was going down," 78-year-old Bill Iffrig of Lake Stevens, Wash., told CNN on Monday. Iffrig walked away on his own. He later told reporters that he felt fine, with the exception of a scraped knee and ringing in his ears.
For runners and bystanders near the bombings, however, an absence of obvious physical injury may not guarantee an escape from bodily harm. Recent research on Gulf War veterans and NFL football players highlights the dangers posed by even mild brain trauma. Exposure to shock waves from the powerful explosions near the marathon finish line, experts warned, may result in initially silent yet potentially serious long-term effects on the brain.
A bomb blast's short-lived supersonic wave "packs a wallop," said Dr. Lee Goldstein, a biomedical engineer at Boston University. "It can knock you off your feet." He added that it's the second component of a blast that raises the biggest concern for the brain.
"Right behind that is this blast wind that goes back-and-forth, causing the head to swing back-and-forth on the neck, like a bobblehead, very quickly," Goldstein explained.
While health experts have long believed that one explosion exposure is unlikely to cause long-term damage, Goldstein pointed to emerging evidence that suggests otherwise. In a study published in May, Goldstein and his colleagues found that soldiers exposed to a single roadside bomb blast had brain trauma similar to football players who had suffered multiple concussions.
"One blast is really like getting multiple head injuries over a compressed period of time," Goldstein said, comparing each slug of alternating air to a hard-hitting tackle from a 300-pound linebacker.
Autopsies of both military veterans and former athletes showed signs of chronic traumatic encephalopathy, or CTE. Over time, the degenerative disease can resemble Alzheimer's, with symptoms that include irritability, memory and attention-span problems, dementia and suicidal thoughts. In the same study, Goldstein's team also found that animals developed evidence of the disease just two weeks after exposure to a single simulated blast.
Goldstein emphasized that much remains to be learned about CTE, and that we can't say whether anyone at the bomb site will actually develop the disease. The bombs used in Boston appear to have been made with relatively low-grade explosives. Still, he said, the possibility "certainly raises concern."
Dr. Linda C. Degutis, director of the Centers for Disease Control and Prevention Injury Center, also expressed concern.
"We know based on a lot of research done that with any explosive device there is a possibility of having some traumatic brain injury even if you're not actually hit with pieces of the bomb itself," said Degutis. Brain injuries frequently go undiagnosed after blasts, she said.
The CDC and the National Institute of Neurological Disorders and Stroke list potential early symptoms of a moderate or severe traumatic brain injury: repeated vomiting or nausea, convulsions or seizures, an inability to awaken from sleep, dilation of one or both pupils, slurred speech, weakness or numbness in the extremities, loss of coordination and increased confusion, restlessness, or other abnormal behavior.
The difficulty in recognizing milder injuries, generally accompanied by subtle symptoms such as headaches or a ringing in the ears, worry Degutis. Such minor damage can still lead to major problems in the future, particularly if the victim goes undiagnosed and untreated.
"Just like other injuries you might have, such as a sprained ankle, resting the brain is important," Degutis said, noting that a secondary injury while the brain is recovering may be more likely to cause devastation.
Dr. Jeff Bazarian, a brain injury expert at the University of Rochester Medical Center, referred to lessons from 9/11.
"People went to hospitals with fractures and internal organ injuries," Bazarian said. "But long after those bones healed and internal organs were fixed, it was the overlooked concussions that ultimately interrupted their ability to go back to what they were doing before.
"Concussions often get missed because other injuries are more life-threatening," added Bazarian, who, has studied impacts of head injuries on athletes and soldiers. Some people never go to the hospital, he said. They may feel fine at the time.
So just how many of these people, which Bazarian refers to as the "walking wounded," might there from the Boston bombings? That, of course, depends on how far the damaging waves travelled from the blast. And that, too, depends.
The U.S. military uses a bomb blast threshold of 50 meters as a rough radius within which it will classify someone as brain-injured. The military requires these soldiers to rest for 24 hours, regardless of symptoms.
While 50 meters is a good "rule of thumb," according to Bazarian, the strength and location of the blast is also key. A blast on the side of an urban street, where tall buildings can concentrate and reflect shock waves, would look very different than one detonated in the desert.
In fact, depending on the geometry of building walls and streets, it's possible that someone 10 feet from the blast may have greater injury than someone standing just three feet away, noted Goldstein.
Vulnerability to the blast also depends on the person. Young children, whose brains have not fully developed, and the elderly tend to be at greatest risk.
Bazarian noted that a pair of promising blood tests could one day help first responders identify people who have sustained brain injuries. The tests are not yet approved by the Food and Drug Administration.
For now, experts agreed that health professionals and victims should watch carefully for brain injury symptoms.
Of course, some of the symptoms can overlap with those of post-traumatic stress disorder, another serious concern after an emotionally-charged event like the Boston bombings.
"That's another reason for folks to see their doctor," said Bazarian. "If not recognized and treated early, PTSD can also become more of a long-term problem."
Link to Huffington Post.
Wednesday, April 17, 2013
Dementia makes communication difficult, but some steps can make it easier
From The Washington Post:
My grandmother, who is 92, recently reported that she’d seen three giraffes in her Midwest back yard. She is otherwise sharp (and also kind and funny), but the giraffe episode was further evidence of the mild cognitive impairment that has been slowly creeping into her life.
The question for my family has become: How should we respond? One of my sisters tried humor. (“Grandmom, I didn’t know you drank in the middle of the day!”) My father suggested that they were deer (to which she replied, “I’m 92 years old, and I know a giraffe when I see one.”) I tried to learn more about what, exactly, the giraffes were doing out there. (She didn’t seem to know, saying only that “the light shimmered.”)
Communicating with a family member who has cognitive impairment can be frustrating and disheartening, even downright depressing for patient and caregiver alike. And it’s a problem faced by a growing number of Americans. According to a report published last week, about 4.1 million Americans have dementia. Alzheimer’s, one of the many forms of dementia, is the most expensive disease in the United States, costing $157 billion to $215 billion a year — more than heart disease and cancer, according to the study, which was sponsored by the National Institute on Aging. As baby boomers reach old age, these numbers are expected to increase dramatically.
A number of techniques can not only reduce the frustration but also create new ways of connecting. Among the most effective and popular among experts is the “validation method,” a practice pioneered by geriatric social worker and researcher Naomi Feil in the 1980s.
As its name suggests, the practice is based on the idea of validating a patient’s experience — to empathize, even if what the person is expressing doesn’t seem to make sense.
In my grandmother’s case, that might have been to ask how tall the giraffes were or how my grandmother felt upon seeing them.
“You match her emotions,” Feil says. You communicate that you “know that it’s real and meaningful for her, [that] she’s not psychotic or hallucinating.”
Feil, the daughter of a nursing home director and a social worker, studied psychiatric group work at Columbia University, then came home to work in her father’s facility in Ohio. There, her family established units for people experiencing memory loss. Today, Feil’s method is used around the world.
“Validation was one of the first approaches,” says Mary A. Corcoran, an associate dean at George Washington University School of Medicine and Health Sciences. There have been many since, she adds, but “validation is one of the better known approaches to addressing the emotional needs of people with Alzheimer’s disease.” Clinical study results on its effectiveness have been inconclusive, she says, but the technique has nonetheless become widely used. Alice Bonner, director of the Division of Nursing Homes at the Centers for Medicare and Medicaid Services, says that validation “was the foundation for our teaching about person-centered, individualized care over the past year.” It is also the basis for a series of six training DVDs for health-care workers that CMS developed and distributed to each of the nation’s more than 15,000 nursing homes.
Monday, April 15, 2013
Don't forget to mail your taxes
Sunday, April 14, 2013
Dementia care costs more than treating heart disease or cancer
From Los Angeles Times:
Caring for patients with dementia in the U.S. costs at least $159 billion a year, according to a new study. Bills for nursing homes and home health aides are a big part of the expense.
The financial toll of caring for Americans with dementia adds up to at least $159 billion a year, making it more expensive than treatments for patients with heart disease or cancer, according to a new report in the New England Journal of Medicine.
Dementia is characterized by a group of symptoms that prevent people from carrying out the tasks of daily living. Reduced mental function makes it impossible for them to do things like keep track of their medications or their finances. In more severe case cases, patients lose the ability to handle basic tasks like bathing and dressing. Dementia is considered a chronic disease of aging, and there is no cure.
Medical bills for dementia patients are comparatively small, amounting to 16% to 25% of the total tally, according to researchers from RAND Corp. in Santa Monica and their collaborators. By far, the most expensive part of dementia care is the cost of caring for patients, either in nursing homes or their own homes.
In 2010, the annual tab for care in nursing homes and other institutions for dementia patients came out to $13,900 per patient. The bill for professional home health aides was an additional $5,700 per patient.
And then there’s the “informal care” provided by family members and friends who help loved ones with dementia do things like pay their bills and buy their groceries. The research team used two methods to calculate the value of all this care. In one, they estimated the “replacement cost” — what it would have cost to hire a professional to do the same work. In the other, they estimated the size of the paycheck these volunteers could have earned if they spent the same amount of time working at a paying job.
The two methods yielded quite different results. When using replacement costs as a guide, the total bill per dementia patient worked out to $41,689 per year, on average. When passed-up paychecks were used, the total rose to $56,290, according to the study.
The researchers used data from a nationally representative survey called the Health and Retirement Study to estimate that 14.7% of Americans over the age of 70 suffered from dementia. Combining that with U.S. census data, they calculated that the amount of money spent caring for Americans with dementia was about $109 billion in 2010. Adding in the value of unpaid informal care pushed the total up to between $159 billion and $215 billion. By comparison, direct spending adds up to about $102 billion a year for patients with heart disease and $77 billion a year for patients with various types of cancer, they wrote.
Spending related to dementia will only grow as Americans get older. If present trends continue, the total cost of dementia care will more than double by 2040, according to the report.
People with dementia are likely to have other health problems, such as a history of stroke, heart disease or a psychiatric condition — all of which add to their medical bills. (They are statistically less likely to have cancer.) In the study, the researchers did their best to exclude those other medical costs to arrive at a number that represented the economic value of dementia-related care.
The study was funded by a grant from the National Institute on Aging.
Link to the Los Angeles Times.
Saturday, April 13, 2013
Margaret Thatcher's battle with dementia
From The Australian News:
It is a sad irony that, during her time in power, Margaret Thatcher was renowned for her razor-like intellect and power-house memory.
No one at that time could have foreseen her later mental decline, least of all her daughter Carol.
In her memoir, A Swim-On Part in a Goldfish Bowl, Carol Thatcher told of her mother's "blotting paper brain" that effortlessly absorbed information.
But in a cruel twist of fate, Thatcher was destined to become one of the more than 820,000 people in the UK whose lives are blighted by dementia.
Although it has often been reported that she suffered from Alzheimer's disease, this has never been confirmed.
Alzheimer's is the most common of four principal kinds of dementia, affecting about two thirds of all those with the condition.
The second most common is vascular dementia, caused by reduced blood flow to the brain, followed by dementia with Lewy bodies and frontotemporal dementia.
All forms of dementia result in symptoms of memory loss, confusion, and mood changes that can be devastating not only for those affected but also the loved ones around them. In some cases, dementia can also lead to altered personality and hallucinations.
For more than a decade, Thatcher struggled with the cruel draining away of her mental faculties.
Carol broke the news that her mother had been suffering from dementia in 2008.
She first noticed her mother's memory failing over lunch in 2000, relating in her book how she "almost fell off her chair" with surprise.
As dementia tightened its grip, Thatcher frequently forgot that her husband, Denis, had died.
Thatcher's descent into dementia was dramatically - and some say, unfairly - depicted in the film The Iron Lady, with Meryl Streep playing the former British PM.
In her book, Carol Thatcher describes how the tell-tale signs of dementia slowly began to emerge.
"Whereas previously you would never had had to say anything to her twice, because she'd already filed it away in her formidable memory bank, Mum started asking the same questions over and over again, unaware she was doing so," she wrote.
After Denis Thatcher died from cancer in 2003, her mother continually had to be reminded that her husband had gone.
"I had to keep giving the bad news over and over again," said Carol Thatcher. "Every time it finally sank in that she had lost her husband of more than 50 years, she'd look at me sadly and say 'oh', as I struggled to compose myself."
On bad days her mother could "hardly remember the beginning of a sentence by the time she got to the end," she recalled.
Thatcher became patron of Alzheimer's Research UK, Britain's leading charity dedicated to dementia research, in 2001.
Rebecca Wood, the charity's chief executive, said: "The loss of Baroness Thatcher will resonate across the world, but in particular with the 820,000 people living with dementia in the UK. Irrespective of personal politics, few would dispute Lady Thatcher's profound influence, the power of her presentation and strength of her convictions.
"That dementia could affect such a forceful personality is a lesson that this cruel condition does not discriminate. As patron to Alzheimer's Research UK, her support of our research could not have been more important, helping draw attention to a condition so frequently swept under the carpet.
"Thanks to Lady Thatcher, we have made inroads with our research to defeat dementia. The answers will come too late for her, but they will come, and this will be another important part of our collective memory of her life and work."
Thursday, April 11, 2013
When to Worry About a Bump on the Head
Head injury signs in babies
Two weeks ago we took a trip to San Diego so my husband could attend a conference and Eli and I could play by the ocean. On the last day we were there, I was hanging out in our hotel room, trying to keep Eli awake just a little while longer when it happened. We were sitting on the hotel bed, I bent over to get his pacifier and before I could blink, Eli hit the floor head first.
It was apparent from the moment of the injury that he wasn’t okay. He couldn’t hold his head up, wouldn’t open his eyes, and was moaning in pain. We ended up going to a local children’s hospital by ambulance, which is a situation I never thought we’d be in. Once at the hospital, they looked at Eli’s head and neck, took a neck x-ray and said he was fine, but that he might have a sore neck. We were told that kids fall off furniture all the time and to not worry, just give him some Motrin and he’d be okay.
But he wasn’t.
Later that day, Eli began profusely vomiting and having trouble staying awake. We went to a different hospital where a CT scan showed that he had a subdural hematoma. It’s a fancy way of saying that he was bleeding on his brain. It’s true that kids fall off beds and changing tables every day and the majority of them are fine, but my son got much more than a bump on the head- he got a mild traumatic brain injury. Since being discharged from the hospital last week he’s had a few mild seizures and continues to vomit periodically, but thankfully, he’s otherwise pretty much back to normal. We were lucky.
Thankfully we knew when to return to the hospital because this particular injury, and several other types of head injuries, have a high rate of morbidity and mortality when left untreated. In light of what we learned, I thought I’d share a few signs that you should take very seriously when it comes to head injuries in people of all ages so that hopefully none of you face that period of uncertainty that we did.
Wednesday, April 10, 2013
NFL brain-injury panel a "sham," former players say
From CBS News:
Former NFL players trying to sue the league over concussion-linked injuries argued in court Tuesday that the NFL "glorified" violence and profited from damaging hits to the head.
Players' lawyer David Frederick also accused the league of concealing the emerging science about concussions over several decades, even after creating a Mild Traumatic Brain Injury committee in 1994.
"It set up a sham committee designed to get information about neurological risks, but in fact spread misinformation," Frederick argued at a pivotal federal hearing to determine if the complaints will remain in court or be sent to arbitration.
U.S. District Judge Anita Brody's decision could be worth billions to either side.
About 4,200 of the league's 12,000 former players have joined the litigation. Some are battling dementia, depression or Alzheimer's disease, and fault the league for rushing them back on the field after concussions. Others are worried about developing problems and want their health monitored.
A handful, including popular Pro Bowler Junior Seau, have committed suicide.
NFL lawyer Paul Clement insisted that teams bear the chief responsibility for health and safety under the players' collective bargaining agreement, along with others.
"The one thing constant throughout is these agreements put the primary role and responsibility on some combination of the players themselves, the unions and the clubs," Clement argued.
"The clubs are the ones who had doctors on the sidelines who had primary responsibility for sending players back into the game," he added at a news conference after the 40-minute hearing.
U.S. District Judge Anita Brody appeared most interested in whether the contract is sufficiently specific about health and safety issues to keep the matter in arbitration.
"The thing that concerns me is you say it talks about it `all over,"' Brody said to Clement. "It has to be really specific. That's what I have to wrestle with."
Frederick said the contract is "silent" on latent head injuries, making the lawsuits appropriate.
Brody is not expected to rule for several months, and the cases could take years to play out if her ruling is appealed, as expected.
Players' family members on hand for the hearing included Kevin Turner, a former Philadelphia Eagles running back now battling Lou Gehrig's disease; Dorsey Levens, a veteran running back who made a 2012 documentary on concussions called "Bell Rung" and Mary Ann Easterling, whose husband, former Atlanta safety Ray Easterling, was the lead plaintiff in the litigation before he committed suicide last year.
Attendees might have momentarily thought they were on the playing field, as a power problem at the federal courthouse caused muggy conditions in the courtroom. The judge insisted that the well-heeled crowd of lawyers remove their suit jackets. Frederick did so, while Clement declined.
Both more typically find themselves at the U.S. Supreme Court, where Clement has fought gay marriage laws and state health care mandates, and Frederick has pursued consumer protection cases.
Their very presence signaled the importance of the litigation to both sides, on both a financial and public-relations grounds.
Mounting scientific evidence links head injuries to brain damage
Recent studies of the brains of dead athletes and others shows that most had signs of brain damage after suffering repeated head injuries.
In January, UCLA researchers claimed to find evidence of the degenerative brain disease chronic traumatic encephalopathy (CTE) in the brains of five retired NFL players.
And a study published in December by the Boston University School of Medicine reported on the autopsies of 85 brain donors.
The autopsies revealed extensive evidence of protein tangles clogging brain tissue and causing the destruction of brain cells in football players, wrestlers, hockey players, boxers, and military combat veterans.
The researchers reported in the journal Brain that 68 of the 85 individuals they examined, all of whom had experienced repeated head trauma, had evidence of chronic traumatic encephalopathy.
Co-author Dr. Robert Cantu told The Boston Globe the study should convince doubters that CTE is a real condition caused by repeat head injuries.
Cantu's colleague, Dr. Ann McKee, told CBSNews.com in July that CTE can only be detected after death by staining tau protein deposits in brain tissue - a complex, several-month process that she compared to developing a photograph.
Last year, McKee concluded that Dave Duerson, a former NFL player who committed suicide, had "moderately advanced" brain damage related to blows to the head. In January, the the National Institutes of Health announced that Seau had CTE when he committed suicide last May.
Another study, published Jan. 7 in JAMA Neurology, found retired NFL players were more likely to report cognitive impairment and depression and show physical brain changes on an MRI scan compared to healthy individuals.
In September, the NFL announced a donation of $30 million for medical research to the Foundation for the National Institutes of Health, the fundraising arm of the NIH.
Goodell said the research could benefit athletes and potential areas of study may include CTE, concussion management and treatment and disorders from later in life such as Alzheimer's.
Link to CBS News.
Tuesday, April 09, 2013
NFL Lawsuit Sheds Light on Concussion Risks
From Huffington Post Sports:
[Today,] April 9, 2013, marks the date for oral argument in the United States District Court in Philadelphia, Pennsylvania, on the National Football League's motion to dismiss the lawsuit brought by brain damaged professional football players. The players allege that the league intentionally concealed the risks of concussion and permanent brain injury. It is essential and necessary that the district court allow these law suits to proceed to expose the reprehensible pattern of deception and intentional misconduct committed by the league, whose management exalts profits over player safety.
The suit spotlights players who have sustained brain damage while playing professional football, while the league knew and intentionally obscured the known risks of serious brain injury. If this theme sounds familiar, it is. Similar successful claims have forced the tobacco industry to be accountable to seriously injured individuals for intentionally misleading them and the general public by hiding the known risks of smoking. So, too, the asbestos industry was found responsible for its intentional cover-up of the dangers of asbestos exposure and the serious pulmonary consequences. The NFL, like tobacco companies and asbestos manufacturers, has concealed relevant and crucial evidence from those whose very lives depend on the league's behaving in a responsible manner to protect them from these dangers.
The popular appeal of professional football and the inherent violent nature of the game, encouraged by the league to garner a larger fan base, make it imperative that the truth be revealed. The public not only has a right to know, they have a need to know that these deceptions and misrepresentations have nurtured both a professional and amateur culture that condones and celebrates violence. Over the years, the NFL staunchly refused to acknowledge the accumulating body of impartial medical evidence highlighting the risk of permanent brain damage from repeated blows to the head. More than 40 years ago, the prestigious Congress of Neurological Surgeons repudiated the misconception that concussions are not brain injuries.
The NFL, however, hid behind the inaccurate statements made by its own Committee on Mild Traumatic Brain Injury. The committee's inaccurate statements include their unsupported assertion that "mild TBIs in professional football are not serious injuries;" their questionable studies which reach the suspicious conclusion that the second impact syndrome and permanent brain damage as a result of multiple concussions is not a risk to professional football players; and their dangerous statement that "many NFL players can be safely allowed to return to play on the day of the injury after sustaining a mild TBI." These deceits imperiled professional football players and innocent children, who model themselves after their football idols, with the permanent cognitive, behavioral, social and emotional consequences of brain trauma. Their coaches all look to the NFL for guidance in protecting their players.
The Committee formed in 1994 was a charade. The group's leader, a rheumatologist, was unqualified to render any opinion about brain injury, possessed no formal training or certification in neurology, and misrepresented his credentials on his CV and during Congressional testimony. The committee reports were deliberately designed to mislead the players and the public. Twenty-five years later, when Congress held hearings on the important issue of concussion and player safety, committee and league representatives denied the connection between football and brain trauma.
The NFL mild traumatic brain injury committee's co-chair, Ira Casson, in a written statement to Congress stated: "My position is that there is not enough valid, reliable or objective scientific evidence at present to determine whether or not repeat head impacts in professional football result in long-term brain damage,"
Representative Linda T. Sánchez, Democrat of California, skeptically responded to similar assertions by NFL Commissioner Roger Goodell by stating; "And it sort of reminds me of the tobacco companies pre-'90s when they kept saying, 'Oh, there's no link between smoking and damage to your health.'" The league and its physicians prior to, during and after this hearing, have conspired together in what amounts to a pattern of civil racketeering, to deprive injured players of their right to disability benefits, medical care and rehabilitation treatment coverage.
A searchlight must be directed at the morally reprehensible long-term conduct of the NFL in failing to be truthful and protect the lives and health of players. The players and their attorneys must be given the opportunity to conduct discovery and expose the game of Russian roulette that the league has played with dire consequences to players. The questions, "What did they know?" and "When did they know it?" must be answered under penalties of perjury.
There has never been any serious question that football is a concussion delivery system. But despite this knowledge, over the years, players have been encouraged to "shake it off." They have been rewarded for big hits and for violently sacking a quarterback. They have been told there is no evidence linking concussions to long-term brain trauma. The conduct of the NFL is duplicitous and must be scrutinized under a bright and honest light to reveal the truth.
Michael V. Kaplen, Esq., a senior partner in the New York law firm, De Caro & Kaplen, LLP is an attorney who concentrates his legal practice on representing victims of brain trauma. He is the current chair of the New York State Traumatic Brain Injury Services Coordinating Council.
Monday, April 08, 2013
The Alzheimer's Caregiver Recommends Animal Therapy for Alzheimer's Patients
From Broadway World:
Over the years, countless health organizations have used pet therapy for patients suffering from various mental diseases. But Tom Elin, CEO of The Alzheimer's Caregiver, says this kind of therapy is especially beneficial to Alzheimer's patients suffering from dementia.
In animal-assisted therapy, often called pet therapy, specially-trained dogs and other animals are used to interact with people in need of stimulation and socialization.
Elin says Alzheimer's patients who have dementia benefit from the presence of therapy animals in eldercare settings. He says a major advantage is reducing agitation, which is common among dementia patients.
According to the Alzheimer's Caregiver, many of the benefits are also physical. Elin says patients who receive pet visitations increase their physical activity through playing, grooming, and walking the animals. He says some dementia patients eat more following a dog's visit.
In addition, Elin says animal therapy can help Alzheimer's patients deal with their feelings of loneliness and isolation, as well as relieve depression and disorientation. He believes that interacting with pets provides an opportunity for positive nonverbal communication.
Memory impaired patients may withdraw from people, but find animal interaction easier, less painful and non-threatening. Other patients simply enjoy the presence of the dog and find pet interaction to be soothing. They benefit from the physical contact provided by contact with a pet.
Find more information about caring for people with Alzheimer's disease at www.thealzheimerscaregiver.com.
About The Alzheimer's Caregiver.com:
The Alzheimer's Caregiver translates academic, scientific, and clinical research about Alzheimer's disease for professional and at-home caregivers. It offers education, training and materials which often allow users to keep patients at home longer than would be possible otherwise. To find out what The Alzheimer's Caregiver can do for you or a loved one, visit www.TheAlzheimersCaregiver.com.
Sunday, April 07, 2013
Florida State University Center for Brain Repair Researches in Several Areas
Jack is very pleased that Florida State University, right here in Tallahassee, now has a Center for Brain Repair. The Center's mission is:
research, discovery, education and community outreach in the areas of prevention, amelioration, treatment, and repair of injuries or damage to the brain and spinal cord resulting from trauma, genetic and degenerative diseases, cardiovascular anomalies including stroke, drug abuse, environmental toxins, and other causes.
Right now, they seem to be focusing on four major areas of research:
Dystonia and other movement disorders
Dystonia and other movement disorders are major targets of our clinical and basic science research program. Our goal is to develop novel methods of diagnosis and treatment of these disorders.
As a group, the major neurodegenerative diseases, i.e., Alzheimer’s Disease, Parkinson’s Disease and Huntington’s Disease, significantly affect the quality of life. The goal of our research programs is to develop treatments that ameliorate the adverse effects of these diseases and improve the patients’ quality of life. The clinical research program utilizes our access to Parkinson’s Disease patients and focuses not only on Parkinson’s Disease per se but also on balance disorders.
Other research programs examine the role of melatonin in sleep disorders and its relationship to cognitive decline in neurodegenerative diseases such as Alzheimer’s Disease. In addition, our basic science research program includes a focus on temporal lobe epilepsy. Thus our strengths in basic science research encompass a wide range – from circadian rhythms to ion channels and from animal models to human subjects.
Children’s Health Network
Our ongoing research programs in pediatric neuroscience are focused on basic research on ADHD and the impact of maternal nicotine and cocaine abuse during pregnancy on children’s cognitive development. Our plans for the near future include expanding the basic research program to include genetic and proteomic analysis of biological specimens from children suffering from ADHD, depression, bipolar disease and autism.
Traumatic brain injury
Traumatic brain injury from falls, automobile accidents, sport injuries and military combat affects hundreds of thousands of Americans every year. Our research programs on the effects of trauma to the brain and spinal cord examine the structure and function of neural circuits and cognitive performance following traumatic injury. The goal is identification of genetic, biochemical and structural biomarkers and development of novel methods of diagnosis and treatment.
A major focus of our traumatic brain injury program is the development of stem cell-based therapies to aid recovery from brain trauma. Our programs will integrate clinical research using patients as well as bench research on the cellular and molecular mechanisms of brain repair. Our plans for the future include using structural and functional magnetic imaging technology to supplement and expand our clinical and basic research programs.
Link to Florida State University College of Medicine.
Heart Risks May Also Point to Dementia Risk
From Web MD:
Study looked at factors like blood pressure and cholesterol levels
Assessing a person's future risk of heart disease and stroke may be a better predictor of mental decline than a dementia risk test, new research suggests.
The study included about 7,800 men and women with an average age of 55. Each participant's risk of heart disease, stroke and dementia was calculated at the start of the study.
The heart disease assessment included the risk factors of age, blood pressure, high blood pressure treatment, smoking, diabetes and levels of total cholesterol and "good" HDL cholesterol.
The stroke assessment included similar risk factors plus history of heart disease and irregular heart beat.
The dementia risk score included age, education, blood pressure, body-mass index (a measure of body fat based on height and weight), total cholesterol, exercise levels and whether a person had a specific type of the gene associated with dementia.
Ten years after having these risk assessments, the participants underwent tests of their thinking and memory (cognitive) abilities. All three risk tests were able to predict cognitive decline over 10 years, but heart disease risk scores had a stronger link with cognitive decline than dementia risk scores.
Both heart and stroke risk were associated with decline in all cognitive tests except memory. Dementia risk was not linked with declines in memory or verbal abilities, according to the study, which was published in the April 2 issue of the journal Neurology.
"Although the dementia and cardiovascular risk scores all predict cognitive decline starting in late middle age, cardiovascular risk scores may have an advantage over the dementia risk score for use in prevention and for targeting changeable risk factors since they are already used by many physicians," Sara Kaffashian, of the French National Institute of Health and Medical Research, said in a journal news release.
"The findings also emphasize the importance of risk factors for cardiovascular disease such as high cholesterol and high blood pressure in not only increasing risk of heart disease and stroke but also having a negative impact on cognitive abilities," Kaffashian said
Link to Web MD.
Saturday, April 06, 2013
President Obama Pitches Brain Mapping Project, But Are We Late To The Table?
President Obama has proposed $100 million in federal funding to seed an exhaustive brain mapping initiative similar to the Human Genome Project that mapped all human DNA, officially called Brain Research through Advancing Innovative Neurotechnologies (BRAIN).
“Imagine if we could reverse traumatic brain injury and PTSD for our wounded veterans coming home,” Obama said at an event unveiling the initiative at the White House. He also pointed to the initiative as a major step toward finding cures for diseases such as Alzheimer’s and autism.
Aside from these health benefits, Obama said the project will eventually create jobs and drive economic growth. He cited the Human Genome Project, completed in 2003, as proof, claiming it had paid $141 for every dollar invested.
“As humans we can identify galaxies light-years away, study particles smaller than an atom but we still haven’t unlocked the mystery of the three pounds of matter than sits between our ears,” Obama said.
The President’s proposal will be sent to Congress next week as part of his overall budget request. Early on, the initiative seems to have bipartisan support.
“Mapping the human brain is exactly the type of research we should be funding, by reprioritizing the $250 million we currently spend on political and social science research into expanded medical research, including the expedited mapping of the human brain. It’s great science,” said House Majority Leader Eric Cantor in a public statement.
This response sounds promising (few want to be on the wrong side of brain research), but one might ask why it has taken the U.S. so long to arrive at a table populated with global superpowers?
The European Union, for example, already has a similar initiative up and running called The Human Brain Project, funded with one billion euros (one euro equals roughly $1.28). It’s only a few months old, but arrived to the table significantly earlier than BRAIN.
China may be farther along than Europe or the U.S., with older initiatives such as Brainnetome, and long-standing ties to the U.S.-based Organization for Human Brain Mapping, which held its 2012 Annual Meeting in Beijing.
And a number of private companies around the world have already started brain mapping projects, although its unlikely any have the breadth and depth of the initiative President Obama has announced.
No doubt, a down economy and increasingly stringent budget constraints have stalled the White House’s momentum, and in this case the saying “better late than never” certainly applies.
As outlined by the White House, BRAIN will be a broad-based public-private partnership involving top researchers from government agencies and privately funded organizations, including: the National Institutes ofHealth (NIH), the Defense Advanced Research Projects Agency (DARPA), the National Science Foundation (NSF), The Allen Institute for Brain Science, The Howard Hughes Medical Institute, and the Salk Institute for Biological Studies.
That’s a lot of fire power, and if organized successfully the results could be astonishing.
Link to Forbes.
Friday, April 05, 2013
Canada: Hockey brain injury rate high
Nearly half of all traumatic brain injuries among Canadian youths who required a trip to a hospital emergency room were from ice hockey, researchers say.
Dr. Michael Cusimano of St. Michael's Hospital in Toronto looked at causes of sports-related brain injuries suffered by Canadian youth.
"Unless we understand how children are getting hurt in sport, we can't develop ways to prevent these serious injuries from happening," Cusimano, a neurosurgeon who led the study, said in a statement. "One would think that we know the reasons why kids are having brain injuries in sports, but until now, it was based mainly on anecdotes."
The study used data from The Canadian Hospitals Injury Reporting and Prevention Program to look at the almost 13,000 children and youth ages 5-19 who had a sports-related brain injury from 1990-2009.
The researchers categorized injuries by players' ages, what sport they occurred in and what mechanisms had caused them such as "struck by player," "struck by object," struck by sport implement," such as ball or stick, "struck by playing surface" and "other."
Hockey accounted for 44.3 percent of all injuries and almost 70 percent of them occurred in children age 10 and older as a result of player-to-player contact or being hit into the boards.
"This shows that body contact is still an area where we need to make major inroads to preventing brain injuries," Cusimano said. "For example, enforcing existing rules and making more effective incentives and disincentives about checking from behind could make huge improvements."
Link to UPI.com
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