Brain Injury Association of America Testimony to House Subcommittee on Labor Health and Human Services

Here is the testimony submitted by the Brain Injury Association of America (BIAA)  to the Senate Appropriations Subcommittee on Labor Health and Human Services and Related Agencies concerning proposed funding increases for TBI Act programs and the TBI Model Systems of Care Program.

Testimony of the Brain Injury Association of America on CDC, HRSA – Department of Health and Human Services, NIDRR – Department of Education:

Prepared for the Subcommittee on Labor, Health and Human Services,

Education and Related Agencies

May 6, 2013

Chairman Harkin and ranking member Moran, thank you for the opportunity to submit this written testimony with regard to the FY 2014 Labor-HHS-Education appropriations bill. This testimony is on behalf of the Brain Injury Association of America (BIAA), our national network of state affiliates, and hundreds of local chapters and support groups from across the country.

In the civilian population alone every year, more than 1.7 million people sustain brain injuries from falls, car crashes, assaults and contact sports. Males are more likely than females to sustain brain injuries. Children, teens and seniors are at greatest risk.

Recently, we are seeing an increasing number of service members returning from the conflicts in Iraq and Afghanistan with TBI, which has been termed one of the signature injuries of the War. Many of these returning service members are undiagnosed or misdiagnosed and subsequently they and their families will look to community and local resources for information to better understand TBI and to obtain vital support services to facilitate successful reintegration into the community.

For the past 14 years Congress has provided minimal funding through the HRSA Federal TBI Program to assist States in developing services and systems to help individuals with a range of service and family support needs following their loved one’s brain injury. Similarly, the grants to state Protection and Advocacy Systems to assist individuals with traumatic brain injuries in accessing services through education, legal and advocacy remedies are woefully underfunded. Rehabilitation, community support and long-term care systems are still developing in many States, while stretched to capacity in others. Additional numbers of individuals with TBI as the result of war-related injuries only adds more stress to these inadequately funded systems.

BIAA respectfully urges you to provide States with the resources they need to address both the civilian and military populations who look to them for much needed support in order to live and work in their communities.

With broader regard to all of the programs authorized through the TBI Act, BIAA specifically requests:

$10 million (+ $4 million) for the Centers for Disease Control and Prevention TBI Registries and Surveillance, Brain Injury Acute Care Guidelines, Prevention and National Public Education/Awareness

 $8 million (+ $1 million) for the Health Resources and Services Administration (HRSA) Federal TBI State Grant Program

$4 million (+ $1 million) for the HRSA Federal TBI Protection & Advocacy (P&A) Systems Grant Program

CDC – National Injury Center - The Centers for Disease Control and Prevention’s National Injury Center is responsible for assessing the incidence and prevalence of TBI in the United States. The CDC estimates that 1.7 million TBIs occur each year and 3.4 million Americans live with a life-long disability as a result of TBI. In addition, the TBI Act as amended in 2008 requires the CDC to coordinate with the Departments of Defense and Veterans Affairs to include the number of TBIs occurring in the military. This coordination will likely increase CDC’s estimate of the number of Americans sustaining TBI and living with the consequences.

CDC also funds states for TBI registries, creates and disseminates public and professional educational materials, for families, caregivers and medical personnel, and has recently collaborated with the National Football League and National Hockey League to improve awareness of the incidence of concussion in sports. CDC plays a leading role in helping standardize evidence based guidelines for the management of TBI and $1 million of this request would go to fund CDC’s work in this area.

HRSA TBI State Grant Program - The TBI Act authorizes the HHS, Health Resources and Service Administration (HRSA) to award grants to (1) states, American Indian Consortia and territories to improve access to service delivery and to (2) state Protection and Advocacy (P&A) Systems to expand advocacy services to include individuals with traumatic brain injury. For the past thirteen years the HRSA Federal TBI State Grant Program has supported state efforts to address the needs of persons with brain injury and their families and to expand and improve services to underserved and unserved populations including children and youth; veterans and returning troops; and individuals with co-occurring conditions

In FY 2009, HRSA reduced the number of state grant awards to 15, in order to increase each monetary award from $118,000 to $250,000. This means that many states that had participated in the program in past years have now been forced to close down their operations, leaving many unable to access brain injury care.

Increasing the program to $8 million will provide funding necessary to sustain the grants for the 21 states currently receiving funding along with the three additional states added this year and to ensure funding for four additional states. Steady increases over five years for this program will provide for each state including the District of Columbia and the American Indian Consortium and territories to sustain and expand state service delivery; and to expand the use of the grant funds to pay for such services as Information & Referral (I&R), systems coordination and other necessary services and supports identified by the state.

HRSA TBI P&A Program - Similarly, the HRSA TBI P&A Program currently provides funding to all state P&A systems for purposes of protecting the legal and human rights of individuals with TBI. State P&As provide a wide range of activities including training in self-advocacy, outreach, information & referral and legal assistance to people residing in nursing homes, to returning military seeking veterans benefits, and students who need educational services.

Effective Protection and Advocacy services for people with traumatic brain injury is needed to help reduce government expenditures and increase productivity, independence and community integration. However, advocates must possess specialized skills, and their work is often time-intensive. A $4 million appropriation would ensure that each P&A can move towards providing a significant PATBI program with appropriate staff time and expertise.

NIDRR TBI Model Systems of Care - Funding for the TBI Model Systems in the Department of Education is urgently needed to ensure that the nation’s valuable TBI research capacity is not diminished, and to maintain and build upon the 16 TBI Model Systems research centers around the country.

The TBI Model Systems of Care program represents an already existing vital national network of expertise and research in the field of TBI, and weakening this program would have resounding effects on both military and civilian populations. The TBI Model Systems are the only source of non-proprietary longitudinal data on what happens to people with brain injury. They are a key source of evidence-based medicine, and serve as a “proving ground” for future researchers.

In order to make this program more comprehensive, Congress should provide $11 million (+ $1.5 million) in FY 2014 for NIDRR’s TBI Model Systems of Care program, in order to add one new Collaborative Research Project. In addition, given the national importance of this research program, the TBI Model Systems of Care should receive “line-item” status within the broader NIDRR budget.

We ask that you consider favorably these requests for the CDC, the HRSA Federal TBI Program, and the NIDRR TBI Model Systems Program to further data collection, increase public awareness, improve medical care, assist states in coordinating services, protect the rights of persons with TBI, and bolster vital research.

May 14, 2013 | Permalink | Comments (0) | TrackBack (0)

Brain Injury Association of America webinars

The Brain Injury Association of America has announced the following webinars:

 

April 23, 2013, 3 p.m. ET, David Strauss Memorial Lecture: Four Ways of Being in the World of Brain Injury 

 

Sheldon Herring, PhD, will present on the different roles and dynamics involved in brain injury. 

Registration ends April 19, 2013 at 5 p.m. ET.

May 8, 2013, 3 p.m. ET, Caregiver Education Series: Using Computers to Assist in Cognitive Rehabilitation

Dr. Gerald Voelbel will present an overview of the best practices in cognitive rehabilitation and how computer based training programs can help cognitive recovery after brain injury.

Registration ends May 6, 2013, at 5 p.m. ET.

May 30, 2013, 3 p.m. ET, David Strauss Memorial Lecture: Neurotechnology

Randolph Nudo, PhD, will discuss neurotechology research that holds promise for people with brain injury.

Registration ends May 28, 2013, at 5 p.m. ET.

June 13, 2013, 3 p.m. ET, David Strauss Memorial Lecture: The Rehabilitation Continuum

Nicole Grandjean, PhD, will guide the audience through every stage of treatment in brain injury rehabilitation, with particular emphasis on the post-acute setting.

Registration ends June 11, 2013, at 5 p.m. ET.

June 26, 2013, 3 p.m. ET, Business of Brain Injury Webinar: Using the Baldrige Leadership Award Criteria at Special Tree

Lynn Slevin will describe how Special Tree has incorporated principles of the Baldrige evaluation criteria in its systems for employees and clients.

Registration ends June 24, 2013, at 5 p.m. ET.

July 18, 2013, 3 p.m. ET, Mitch Rosenthal Memorial Webinar: Sexual Functioning after TBI

Angelle Sander, PhD, will discuss current research on sexuality following TBI.

Registration ends July 16, 2013, at 5 p.m. ET. 

Click here for further information on these web broadcasts,

July 31, 2013, 3 p.m. ET, Caregiver Education Series: Getting Things Done with Smart Apps

Michelle Ranae Wild will explore a number of productivity apps available to help after brain injury.

Registration ends July 29, 2013, at 5 p.m. ET. 

April 19, 2013 | Permalink | Comments (0) | TrackBack (0)

New York State Brain Injury Association Annual Conference

The 31st annual conference of the Brain Injury Association of New York State (BIANYS) will be held on Thursday and Friday, June 6 & 7, 2013 at the Marriott Hotel on Wolf Road in Albany. The conference is entitled, “Uniting as the Voice of Brain Injury”

The first day of the conference features fifteen workshops and presentations from introductory workshops to in-depth discussions on specific topics. On Friday, there will be an "Advocacy Discussion," a highly interactive and educational advocacy exchange.

Highlights of the program include:

A two-workshop session on research trends presented by two of the leading specialists in the field, Dr. Steven Flanagan, MD and Dr. Mary Hibbard, PhD, ABPP(RP) of Rusk Institute of Rehabilitation Medicine. The
seminar focuses on the latest research in brain injury diagnosis and treatment.

A session on understanding and maximizing DOH/OPWDD initiatives that will provide great information for TBI providers.

Workshops on visual processing issues, returning to work after TBI, and art therapy as a rehabilitative tool.

Click here for further conference information

April 18, 2013 | Permalink | Comments (0) | TrackBack (0)

Brain Injury Association of America: Legislative News

Here is the latest legislative news report from the Brain Injury Association of America (BIAA):

Traumatic Brain Injury (TBI) Act Reauthorization 2013

On Wednesday, March 13, 2013, the TBI Act, H.R. 1098, was introduced by Reps. Pascrell and Rooney, co-chairs of the Congressional Brain Injury Task Force. This bill will reauthorize the current programs relating to TBI and also will move the state grant and protection and advocacy grant programs from the Maternal and Child Health Bureau to another agency with the U.S. Department of Health and Human Services. The move acknowledges the impact of TBI across the age span, including older adults and returning service members/veterans. The Congressional Brain Injury Task Force recommends relocating the program to better coordinate with federal agencies regarding long-term services and supports available to individuals with other disabilities, particularly the long-term services and supports provision of the Affordable Care Act. BIAA thanks Reps. Pascrell and Rooney for introducing this important legislation. Please call your Member of Congress and ask them to co-sponsor H.R. 1098 today!

President's Budget FY 2014

This week, President Obama released his proposed fiscal year (FY) 2014 budget. In the budget, the President proposed to cancel sequestration and replace it with an additional $1.8 trillion in deficit reduction through new revenue, $400 billion in health savings, Social Security changes, and $200 billion in discretionary cuts split evenly between defense and nondefense programs. It is unlikely Congress will pass the president's budget.

Also in the President's proposed FY2014 budget, BIAA is pleased to report that programs authorized by the TBI Act, including the HRSA Federal TBI Program and the CDC's important TBI work have both been recommended to receive at least the same funding found in FY12 final and FY13 CR appropriations bills, $10 million for HRSA and just under $7 million for CDC.

The CDC collects data, links both military and civilian populations with TBI services, increases public awareness, and conducts public health research. The HRSA Federal TBI Program funds 21 states to improve systems coordination access to care for people with brain injury.

The budget recommends $110 million in funds for the National Institute on Disability and Rehabilitation Research (NIDRR) of the U.S. Department of Education. NIDRR administers grants to the TBI Model Systems which is a collection of research centers located across the United States that conduct disability and rehabilitation research. The TBI Model Systems are the only source of non-proprietary longitudinal data on what happens to people with brain injury. The TBI Model Systems are a key source of evidence-based medicine, and serve as a "proving ground" for future researchers.

 

BIAA will continue to work to ensure that legislators understand the importance of these programs and how they affect the 3.5 million people across the United States with brain injury. 

April 14, 2013 | Permalink | Comments (0) | TrackBack (0)

Why the Court must not dismiss the lawsuit by players against the NFL

I am honored that my thoughts on the current players lawsuit against the NFL, "NFL Lawsuit Sheds lIght on Concussion Risks"  was published this evening on the Huffington Post, blog:

 

http://www.huffingtonpost.com/michael-v-kaplen/post_4612_b_3039472.html

 

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.

April 8, 2013 | Permalink | Comments (0) | TrackBack (0)

Traumatic brain injury legal seminar

I am honored to be speaking on May 3rd on cross examination techniques in the trial of a traumatic brain injury case at the American Association for Justice (AAJ) Seminar, Litigating Traumatic Brain Injury Cases to be held in New Orleans.

The program addresses the rapidly evolving changes in traumatic brain injury diagnosis, rehabilitation, and treatment, dedicated to arming attorneys with the tools and insights to effectively represent their clients with brain damage.

The faculty of experienced trial lawyers and doctors will cover important topics in traumatic brain injury cases and provide winning litigation strategies. Personal injury attorneys can learn about new developments in neuroimaging, how to work with brain injured clients, telling the TBI victim’s story, using educational specialists at trial in pediatric traumatic brain injury cases, cross-examination of the defendant’s experts, and more.

Program registrants are invited to spend the weekend and enjoy the New Orleans Jazz & Heritage Festival.

View the agenda, faculty, and register  by clicking here. For questions, you can AAJ Education at 202-965-3500, ext. 8612.

April 7, 2013 | Permalink | Comments (0) | TrackBack (0)

Brain Injury and Concussion Awareness Day at Citi Field

Save the date. 

Brain Injury/Concussion Awareness Day. 

The Brain Injury Associaiton of New York State has announced that the third annual Brain Injury and Concussion Awareness Day will be held at Citi Field, home of the New York Mets on July 21, 2013.

Join BIANYS in raising awareness while the Mets play the Phillies - get there early to receive a Dwight Gooden bobblehead!

April 6, 2013 | Permalink | Comments (0) | TrackBack (0)

Brain Injury Conferences scheduled for April and May 2013

Here is a list of upcoming brain injury conferences in May and June:

Brain Injury Association of Minnesota Annual Conference
4/11/2013 - 4/12/2013
Brooklyn Center, MN
800-669-6442

Brain Injury Association of Maryland Annual Conference
4/18/2013 - 4/19/2013
Baltimore, MD
410-448-2924

Brain Injury Association of Texas Annual Conference
4/25/2013 - 4/26/2013
Round Rock, TX
800-392-0040

Brain Injury Association of Wisconsin Annual Conference
4/29/2013 - 4/30/2013
Wisconsin Dells, WI
262-790-9660

Rehabilitation of the Adult and Child with Traumatic Brain Injury
5/2/2013 - 5/3/2013
Williamsburg, VA
703-451-8881 ext. 224

Brain Injury: Diagnosis and Treatment
5/10/2013 - 5/11/2013
Missoula, MT
406-329-5733

Brain Injury Association of New Hampshire Annual Conference
5/15/2013
Concord, NH
800-444-6443

Brain Injury Alliance of New Jersey Annual Conference
5/16/2013 - 5/17/2013
New Jersey
732-745-0200


Neuro-Visual Processing Therapy
5/17/2013 - 5/18/2013
San Antonio, TX
800-591-1160

April 4, 2013 | Permalink | Comments (0) | TrackBack (0)

Upcoming brain injury conferences April and May 2013

Here is a list of upcoming brain injury conferences in May and June: Brain Injury Association of Minnesota Annual Conference 4/11/2013 - 4/12/2013 Brooklyn Center, MN 800-669-6442 Brain Injury Association of Maryland Annual Conference 4/18/2013 - 4/19/2013 Baltimore, MD 410-448-2924 Brain Injury Association of Texas Annual Conference 4/25/2013 - 4/26/2013 Round Rock, TX 800-392-0040 Brain Injury Association of Wisconsin Annual Conference 4/29/2013 - 4/30/2013 Wisconsin Dells, WI 262-790-9660 Rehabilitation of the Adult and Child with Traumatic Brain Injury 5/2/2013 - 5/3/2013 Williamsburg, VA 703-451-8881 ext. 224 Brain Injury: Diagnosis and Treatment 5/10/2013 - 5/11/2013 Missoula, MT 406-329-5733 Brain Injury Association of New Hampshire Annual Conference 5/15/2013 Concord, NH 800-444-6443 Brain Injury Alliance of New Jersey Annual Conference 5/16/2013 - 5/17/2013 New Jersey732-745-0200 Neuro-Visual Processing Therapy 5/17/2013 - 5/18/2013 San Antonio, TX 800-591-1160 Washington State Traumatic Brain Injury Conference 5/23/2013 - 5/24/2013 Seattle, WA 877-TBI-1766 Brain Injury Association of Pennsylvania Annual Conference 5/24/2013 - 5/25/2013 Lancaster, PA 866-635-7097

April 4, 2013 | Permalink | Comments (0) | TrackBack (0)

Mapping the Human Brain

The New York Times reports this morning that the Obama admiration will announce a plan latter today for the investment of $100 million starting in 2014 focused on research to understand how the human brain functions. “Obama to Unveil Initiative to Map the Human Brain”

The plan is to develop new technology that will enable scientists to map and understand the complex circuits that comprise the human brain.  According to the Times story, “The effort will require the development of new tools not yet available to neuroscientists and, eventually, perhaps lead to progress in treating diseases
like Alzheimer’s and epilepsy and traumatic brain injury. It will involve both government agencies and private institutions”.

The plan has been named the Brain Research Through Advancing Innovative Neurotechnologies, or Brain for short. Government agencies to be involved in the project are: the National Institutes of Health, the Defense Advanced
Research Projects Agency and the National Science Foundation.

April 2, 2013 | Permalink | Comments (0) | TrackBack (0)

North American Brain Injury Society call for abstracts

The North American Brain Injury Society's, 11th Annual Conference on Brain Injury is scheduled to be held at the InterContinental Hotel, New Orleans, Louisiana from September 18-21, 2013.

The brain injury society has issued a call for abstracts for presentation at the annual meeting.

Accepted abstracts will be published in the Journal of Head Trauma Rehabilitation.

The abstract submission deadline: May 22, 2013.

Awards will be given to the top abstracts in each of the following categories:

Basic research, animal
Basic research, human
Case report
Clinical research, acute and sub-acute rehabilitation 
Clinical research, acute care 
Clinical research, post-acute care
Descriptive model  Prevention 
Translational science

To submit your abstract, click here

 

 

March 24, 2013 | Permalink | Comments (0) | TrackBack (0)

Webinar: Supporting Students Returning to the Classroom Post-Concussion

The Brain Injury Association of New York State is offering a free webinar: Return to Learn: Supporting Students Returning to the Classroom Post-Concussion.

Time and date: Wednesday, March 27, 2013, 1:00 pm - 2:15 pm (EST)

Overview: This webinar covers the "return-to-learn" process after concussion. Dr. Brian Rieger will discuss the challenges faced by students returning to the classroom after mild traumatic brain injury, especially in cases of complicated or prolonged recovery. He will also review the various academic accommodations that can be implemented to assist these students.

Dr. Rieger is Chief Rehabilitation Psychologist and director of the Upstate Concussion Center at SUNY Upstate Medical University in Syracuse, New York. He is a member of the New York State Public High School Athletic Association (NYPHSAA) Concussion Management Team and is the Psychology Liaison to the NYSPHSAA Safety Committee. For more information, please click here

March 23, 2013 | Permalink | Comments (0) | TrackBack (0)

American Academy of Neurology issues important updated sports concussion management guidelines

The American Academy of Neurology has issued important revisions to its guidelines for sports concussions in the Journal Neurology.

 

The academy has attempted to answer the following questions:

 

1. For athletes, what factors increase or decrease concussion risk?

2a. For athletes suspected of having sustained concussion, what diagnostic tools are useful in identifying those with concussion?

2b. For athletes suspected of having sustained concussion, what diagnostic tools are useful in identifying those at increased risk for severe or prolonged early impairments, neurologic catastrophe, or chronic neurobehavioral
impairment?

3. For athletes with concussion, what clinical factors are useful in identifying those at increased risk for severe or prolonged early post- concussion impairments, neurologic catastrophe, recurrent concussions, or
chronic neurobehavioral impairment?

4. For athletes with concussion, what interventions enhance recovery, reduce the risk of recurrent concussion, or diminish long-term sequelae?

Here is the summary of their results:

“Specific risk factors can increase or decrease concussion risk. Diagnostic tools to help identify individuals with concussion include graded symptom checklists, the Standardized Assessment of Concussion, neuropsychological assessments, and the Balance Error Scoring System. Ongoing clinical symptoms, concussion history, and younger age identify those at risk for post-concussion impairments.  Risk factors for recurrent concussion include history of multiple concussions, particularly within 10 days after initial concussion. Risk factors for chronic neurobehavioral impairment include concussion exposure and APOE e4 genotype. Data are insufficient to show that any intervention enhances recovery or diminishes long-term  sequelae post-concussion.”

 The bottom line?  All concussions are different and each player suspected of having a concussion needs to be
individually evaluated with a combination of resources including neuropsychological assessment and medical evaluation.  Concussions are serious injuries and when in doubt, keep them out!

March 19, 2013 | Permalink | Comments (0) | TrackBack (0)

Important updates from the Brain Injury Associaton of America

Here is the latest legislative update from the Brain Injury Associaton of America:

TBI Act Reauthorization 2013

 

On Wednesday, March 13, 2013, the TBI Act, H.R. 1098, was introduced by Reps. Pascrell and Rooney, co-chairs of the Congressional Brain Injury Task Force.


This bill will reauthorize the current programs relating to TBI and also will move the state grant and protection and advocacy grant programs from the Maternal and Child Health Bureau to another agency with the U.S. Department of Health and Human Services. The move acknowledges the impact of TBI across the age span, including older adults and returning service members/veterans. The Congressional Brain Injury Task Force recommends relocating the program to better coordinate with federal agencies regarding long-term services and
supports available to individuals with other disabilities, particularly the long-term services and supports provision of the Affordable Care Act. BIAA thanks Reps. Pascrell and Rooney for introducing this important legislation.
Please call your Member of Congress and ask them to co-sponsor H.R. 1098 today!

 

Brain Injury Awareness Day 2013

 

A big thank you to everyone who participated in brain injury awareness day on Capitol Hill!!! BIAA appreciates all the advocates who traveled to Washington on March 13 to educate Congress on the resources needed for individuals with brain injury and their families. BIAA would like to thank the Congressional Brain Injury Task Force, especially Reps. Pascrell and Rooney, for planning a successful event. Also, BIAA thanks all of the advocates who contacted their congressional representatives to inform them March 13 was Brain Injury
Awareness Day on Capitol Hill and encouraged them to attend the day's events.

 

The exhibit fair and briefing were both very well-attended, with standing room only. During the afternoon reception, Rep. Pascrell touched all of our hearts when he presented the Purple Heart medal to a solider that sustained TBI's in Iraq and Afghanistan. The solider had given Rep. Pascrell his medal for all the work the Congressman has done on behalf of individuals who have sustained a traumatic brain injury.

 

Brain Injury Policy Meeting

 

On Thursday, March 14, 2013, the Brain Injury Association of America hosted a policy strategy meeting to discuss where the brain injury community can speak with one voice. Participants at the meeting included American Congress of Rehabilitation Medicine, National Association of State Head Injury Administrators, North American Brain Injury Society, Sarah Jane Brain Foundation, TBI Model Systems Project Directors and the United States Brain Injury Alliance. BIAA thanks the organizations for attending and looks forward to future collaborations.

March 16, 2013 | Permalink | Comments (0) | TrackBack (0)

Brain Injury in the Community

The sixth annual Brain Injury in the Community program sponsored by the Brain Injury Association of New York State features a presentation by Susan H. Connors, President/CEO of the Brain Injury Association of America.

Ms. Connors and other speakers including experts in brain injury rehabilitation will showcase the issues that confront individuals with brain injury and their families across the lifespan.

The program is designed to provide vital information and share concrete strategies for families and professionals supporting individuals with brain injury.

Brain Injury in the Community is a great educational opportunity for individuals with brain injury, family members, community members, discharge planners, nurses, allied health care professionals, social workers and families.

The program in New York City is scheduled for Thursday, April 18 from 8:30am - 1:00pm at OPWDD First Floor Auditorium, 75 Morton Street, New York, NY

For further information, click here.

March 15, 2013 | Permalink | Comments (0) | TrackBack (0)

New research to develop novel traumatic brain injury imaging technology

Traumatic brain injury research received an important boost this week as a result of a $60 million joint initiative between the National Football League (NFL) and General Electric (GE) whose aim is to develop novel imaging technology and other tech-based approaches to aid in the prevention, detection and management of traumatic brain injury (TBI) and concussions.

The theme of a video shown at a joint news conference was “the better we understand the brain, the better we can protect it”.

Hopefully the research that is developed will enable scientists to better understand the effects of trauma on the brain and brain functioning.

According to NFL Commissioner, Goodell, the primary aim of the initiative is “better diagnosis, treatment and prevention of brain injury”. He admitted that “there is a lot more to do” and that any way to “speed up” the process to “develop new technology to better protect the brain” would be in the best interests of all players– but also younger players in high school, college and those much younger”.

The project will proceed in two parts. The first part will involve a $40 million research project led by GE to better diagnose mild traumatic brain injury (TBI), and to predict the outcomes over time. The second phase will focus on materials and structural design of equipment (helmets) to protect the brain from impacts.

March 14, 2013 | Permalink | Comments (0) | TrackBack (0)

Brain injury in the military

The latest version of BrainLine Military News, March 2013 is now available to view on line.  Brainline Military is a service of BrainLine  BrainLine Military is a service of WETA, the flagship public television and radio station in the nation's capital.

Here are some highlights from the March issue:

What Saved Former Marine Matt Brown from Suicide?

Former Marine Matt Brown, who has combat-related TBI and PTSD, was dangerously suicidal and he would never "sugarcoat" that fact. It was finding his voice to help others that saved him. It was also his wonderfully wicked sense of humor. Watch BrainLine’s video, “What Saved Former Marine Matt Brown from Suicide?” and hear Matt describe how his life has changed for the better.

Watch "What Saved Former Marine Matt Brown from Suicide?"

Watch "Matt Brown: Becoming a New Person After TBI and PTSD"

Watch "Matt Brown: Strategies, Patterns, and Routine Are Key"  

Who Are the Faces of TBI Research?

As a researcher and clinician, Geoffrey Ling, PhD, MD, Col. (Ret.) knows that research for traumatic brain injury needs to be fast and efficient because patients are waiting now! Program manager at the Defense Advanced Research Projects Agency (DARPA), Dr. Ling says, “Seeing patients … working with them daily is very grounding. It reminds me who needs this care …” Hear more, watch BrainLine’s interview with Dr. Ling, “The ‘Faces’ of TBI.”

Broken Brains

Because of a devastating helicopter crash, Special Forces medic Karl Holt’s war in Afghanistan had ended. But a new battle had just begun. It was one that would rage long after his ruptures, fractures, broken bones, and dislocations had healed. Holt lost consciousness on the helicopter, the result of a traumatic brain injury that went untreated for nearly two years. It transformed Holt from a soldier who kicked in doors in Afghanistan to a man who had to put sticky notes on the door of his North Carolina home reminding him to lock it before leaving. Read WORLD magazine’s article, “Broken Brains,” to learn how Holt is rebuilding his life.

For more information about TBI and the military visit  BrainLineMilitary

March 13, 2013 | Permalink | Comments (0) | TrackBack (0)

Brain Injury Association of New York State, 20th annual art exhibiton-call for artists

Be a part of the 20th Annual Art Exhibit sponsored by the Brain Injury Association of New York State (BIANYS)

BIANYS has issued a call for New York State artists for the 20th Annual BIANYS Art Exhibit.

This year, the show will take place in Albany from April 8-12, 2013. The exhibit consists of artwork in many different mediums from artists in New York State who have sustained a brain injury.

Interested artists are encouraged to submit their work. If you have any questions about the Exhibit, you can contact Vicki Clingan at (518) 459-7911.

March 12, 2013 | Permalink | Comments (0) | TrackBack (0)

Seeking Comments on the Pediatric Mild TBI Guideline Protocol

Between March 7 and April 7, the Pediatric Mild Traumatic Brain Injury (TBI) Guideline Workgroup is seeking public comment on a guideline protocol on diagnosing and treating pediatric mild TBI (among patients age 18 and under).

Comprised of leading experts in the field of TBI, CDC Injury Center’s Board of Scientific Counselors established the Pediatric Mild TBI Guideline Workgroup to create a clinical guideline for health care professionals working in the acute care and primary care setting.

The Workgroup is using the American Academy of Neurology’s (AAN) guideline development process to develop a multidisciplinary, evidence-based guideline. You can access the guideline protocol for review and comment   by clicking here 

Public comment on the guideline protocol is one of the first steps in the evidence-based clinical guideline development process. To learn more about the Pediatric Mild TBI Guideline Workgroup and next steps for the project, click here 

March 12, 2013 | Permalink | Comments (0) | TrackBack (0)

National Brain Injury Survey from Sarah Jane Brain Foundation

The Sarah Jane Brain Foundation (SJBF) and CE Outcomes have announced a national survey to identify gaps in services and research dealing with brain injury.

This is a joint effort during Brain Injury Awareness Month to understand the current state of brain injury across the country and across two different clinical populations (youth/developing brain and adult/developed brain).

The survey will investigate the differences in services between “Mild” TBI/concussions and moderate to severe brain injury. In addition, the assessment will analyze across the continuum of care from prevention to acute care/rehabilitation services to reintegration/long-term care. The online survey is being hosted by CE Outcomes and can be accessed by clicking here.

“This survey will include physicians, psychologists, educators, allied health professionals, and most importantly families and brain injury survivors across this country,” said Dr. Ron Savage, President of SJBF and author of the survey. “We will have data from thousands of voices to better understand the gaps in services that impact the lives of millions of people. Those voices will be heard.”

March 12, 2013 | Permalink | Comments (0) | TrackBack (0)

New York Brain Injury Attorney, Shana De Caro named to judicial screening committee

Congratulations to my partner, New York Personal Injury Attorney, Shana De Caro for her appointment to the newly formed Judicial Screening Committee of the New York State Academy of Trial Attorneys.

Shana will be one of 15 statewide representatives to the committee. The committee will vet the candidates selected to fill a vacancy in the New York Court of Appeals, New York State’s highest court because of a vacancy created by the death of Judge Jones. In the future, this committee will screen and interview other Court of Appeals candidates and candidates for the Appellate Divisions in New York State.

Shana De Caro also serves as elected secretary of the Civil Justice Foundation, a national group of trial attorneys that makes grants to nonprofit organizations with innovative programs designed to preserve and protect the civil justice system. With her expertise and experience in traumatic brain injury litigation, she serves as the elected secretary of the executive committee of the American Association of Justice, Traumatic Brain Injury Litigation Group.

New York Brain Injury Atorney, Shana De Caro has been named one of the top one hundred trial lawyers in New York State by the American Trial Lawyers Association. She also serves on the board of advisors of the American Association of Justice Interstate Bus Accident Litigation Group and is a member of the association’s Nursing Home Litigation Group and Truck Accident Litigation Group.

March 11, 2013 | Permalink | Comments (0) | TrackBack (0)

More proof that “mild” traumatic brain injury is anything but mild

Scientific evidence is being to accumulate to establish the permanent consequences of mild traumatic brain damage, long referred to as the “invisible injury”.

In research sponsored by the National Institutes of Health at the Human Brain Lab located at the Medical College of Gerogia, scientists have been able to capture in real time, the damage to brain cells that takes place following a concussion. 

The research, published in the journal Brain reports proof of the swelling of blood vessels resulting in reduced flow of blood and resulting nourishment to nerve cells following mild brain trauma.  The secondary damage to the nerve cell takes place in the hours following initial injury.

The neuroscientists say they watched as the astrocytes, the small cells that supply neurons with nutrients and help maintain normal electrical activity and blood flow, swell and smoother the neurons.  Sergei Kirov, lab director is quoted as saying, “we saw every branch, every small wire and how it gets cut. We saw how it destroys networks.  It really goes downhill. It’s the first time we know of that someone has watched this type of minor injury play out over the course of 24 hours.”   

Hopefully this work will lead to better treatment in the immediate hours following the initial brain trauma and ways to protect nerve cells and brain function.

March 10, 2013 | Permalink | Comments (0) | TrackBack (0)

Simple blood test may detect brain damage in athletes even from subconcussive blows to the head

New research from The Cleveland Clinic and the University of Rochester suggests that even sub concussive blows to the brain may cause long term brain injury and can be detected by a simple blood test.

The researchers found that cumulative trauma to the head cause a brain protein to leak into the blood stream following a head injury.  The study conducted among college found that even though none of the players suffered a concussion during the season, four of them showed signs of an autoimmune response that has been associated with brain disorders.

The study was published March 6, 2013, in the online journal PLOS ONE and was sponsored by the National Institute of Neurological Disorders and Stroke (NINDS). 

The protein, known as S100B is found only in the brain; finding S100B in the blood indicates damage to the blood-brain barrier and is widely used as a marker of traumatic brain damage when other typical signs or symptoms are absent. The researchers studying the release of this protein found that once in the bloodstream, S100B is seen by the immune system as a foreign invader, triggering an autoimmune response that releases auto-antibodies against S100B. Those antibodies then seep back into the brain through the damaged blood-brain barrier, attacking brain tissue and leading to long-term brain damage.

It has been suggested that utilizing this blood test may prove to be an effective, quick and cost effective means of detecting traumatic brain injury in athletes.A blood test will be much less expensive (about $40) and could be performed anywhere, such as locker rooms or doctors' offices. More importantly, though, the blood test could offer a yes-or-no determination of whether an athlete requires medical intervention as a result of in-game collisions.

 

March 9, 2013 | Permalink | Comments (1) | TrackBack (0)

Please attend Brain Injury Awareness Day on Capital Hill

Just a reminder that March 13, 2013 is Brain Injury Awareness Day on Capitol Hill.

The Brain Injury Association of America is working with the Congressional Brain Injury Task Force to plan an important day to provide needed information to members of Congress and their staff on the far reaching and multi-faceted issues facing persons with brain injury and their families. 

Here is the Schedule of Events:

10:00 AM - 2:00 PM
Brain Injury Awareness Fair
Rayburn House Office Building, First Floor Foyer

2:30 PM - 4:00 PM
Briefing: "Promoting Brain Injury Awareness through Public/Private Partnerships"
Rayburn House Office Building, the Gold Room 2168

Panelists:

COL. Jamie B. Grimes, MD, MC, USA, National Director, Defense and Veterans Brain Injury Center
Sara Patterson, Associate Director for Policy, Centers for Disease Control
Katie Clarke Adamson, Director of Health Partnerships and Policy,YMCA of the USA
Roland Gerritsen van der Hoop, MD, PhD, Chief Medical Officer, BHR Pharma
Ralph Ibson, National Policy Director, Wounded Warrior Project

5:30 PM - 7:30 PM
Reception Celebrating Brain Injury Awareness Month
Rayburn House Office Building, B-354

The Brain Injury Association of America (BIAA) encourages advocates to make appoints to visit with congressional representatives during Awareness Day. BIAA's 2013 legislative issue briefs are available at the Advocacy and Government Affairs section of their website. 

March 8, 2013 | Permalink | Comments (0) | TrackBack (0)

Living with brain injury-New Program Sponsored by the Brain Injury Association of New York State

The Brain Injury Association of New York State and Transitions of Long Island are sponsoring a program “Living with Acquired Brain Injury-Factors Linked to Successful Recoveries” on Sunday, March 10 from 9am - 3pm to be held at North Shore University Hospital, Rust Auditorium, 300 Community Drive, Manhasset, NY

The keynote address is scheduled to be delivered by Lee Woodruff, co-author of In An Instant, the story of her family's journey to recovery following the TBI her husband sustained in Iraq. She is also a freelance writer, contributing editor to CBS This Morning, and member of the Board of Trustees for the Bob Woodruff Foundation.

Also on the schedule is a panel discussion from alumni of the Transitions program, as well as sessions on technology, robotics, communication, and vision deficits after brain injury.

The program will provide insight and information on brain injury and recovery and is a great opportunity for survivors, family members, community members, doctors, paraprofessionals, rehabilitation counselors, and
other health care professionals.

Continuing education credits for physical therapists and occupational therapists are available, as are certificates of attendance.

Registration details are available by clicking here .

March 5, 2013 | Permalink | Comments (0) | TrackBack (0)

Distinguishing Traumatic Brain Injury from Post Traumatic Stress Disorder

Attempts are being made at the New York University School of Medicine to distinguish Traumatic Brain Injury and Post Traumatic Stress Disorder.

Frequently there is overlap between the symptoms caused by both of these conditions and clinicians often must rely on self-reports from patients.

The New York Times reports that one of the largest studies of its kind is being undertaken by a team of researchers based out of New York University’s medical school have begun a five-year study to find biological signals, known as biomarkers, that could provide reliable, objective evidence of those so-called invisible injuries of war.

The NYU project is significant both because of its size — researchers hope to recruit 1,500 subjects and because much of its financing is already guaranteed through a $17 million grant from the Steven A. and Alexandra M. Cohen Foundation, founded by the billionaire hedge-fund manager.

The Times reports that biomarkers are physiological road signs that can tell doctors whether a person has a disease or injury, or is likely to contract a particular ailment. Tissue damaged by a heart attack releases chemicals into the blood that can be detected. Abnormal levels of the proteins amyloid and tau, as well as shrinkage of certain areas of the brain, are considered markers of Alzheimer’s disease.

The lack of reliable markers for PTSD and mild T.B.I. has had significant consequences, experts say. Without clear-cut tests to spot them early, the disorders can go undetected until symptoms become disabling. Misdiagnoses readily occur, leading to ineffective or even damaging treatments. Beyond confirming or debunking diagnoses, dependable biomarkers could also be used to determine whether treatments for PTSD or T.B.I. are effective.

The subjects will undergo a diverse battery of tests to analyze hormone levels, blood chemistry, genetic makeup, brain structure and even voices. One team will use magnetic resonance imaging to compare the brain structures of healthy people with those of people with PTSD. Another team will use brain imaging to test a theory that abnormalities in the thalamus, a part of the central brain that acts as a switchboard for nerve signals, are an indication of head trauma. Other researchers will look for biomarkers in genes, blood and hormones. One group will even analyze audio recordings of speech to see whether evidence of PTSD can be found in the pitch, timber and tone of voices.

You can read the full New York Times article by clicking here.

February 26, 2013 | Permalink | Comments (0) | TrackBack (0)

Educating Schools & Students on Brain Injury and Concussion

The George Washington University School of Higher Education is sponsoring a three credit course this summer  from July 15–19, 2013 focusing on educational issues and pediatric traumatic brain injuries.

This five-day, multi-disciplinary institute is open to graduate-level students in the fields of education, counseling, psychology, social work, medicine, nursing, law, and related therapies. Brain Injury professionals and parents of children with brain injuries are encouraged to attend. Undergraduates are welcome to enroll with advisor recommendation. The course will focus on family systems theory and the many systems involved in pediatric brain injury and concussion recovery. Presentations and panel discussions will sort through topics which define recovery trajectories, expectation of school outcomes after concussion, and how all parties can work cohesively towards successfully returning students to the school setting.

On Wednesday, July 17th, I am honored to participate in a special symposium whichc will be held as part of the course.  This brain injury symposium is intended to provide brain injury education to the professional community of education professionals, therapists, and parents of children with traumatic brain injuries. The symposium will address the potential for life-long deficits in learning and attention after a mild traumatic brain injury. Those not seeking credit (such as students, professionals in the field of brain injury, teachers, administrators, and families) are invited to register for the one-day symposium.

 For more information click here or call 202-994-6360 for more information.

February 25, 2013 | Permalink | Comments (0) | TrackBack (0)

Brain Injury Association of America-Legislative Update

Here is the latest legislative update from the Brain Injury Association of America (BIAA):

Last week, BIAA met with key federal agencies, congressional offices and related organizations to advocate for legislative and regulatory initiatives that would improve access to care for individuals with brain injury, including: • Patient-Centered Outcomes Research Institute (PCORI) • National Institute on Disability and Rehabilitation Research (NIDRR) • Senator Tim Johnson (D-SD) • Senator Mark Kirk (R-IL) • American Academy of Physical Medicine and Rehabilitation • American Medical Rehabilitation Providers Association

This week, BIAA submitted comments to the Agency for Healthcare Research and Quality (AHRQ) regarding future research needs of multidisciplinary rehabilitation of adults with moderate to severe TBI.

We also submitted comments to Centers on Medicare and Medicaid on the proposed regulations for the Patient Protection and Affordable Care Act's Essential Health Benefits in Alternative Benefit Plans and collaborated with the Consortium of Citizens with Disabilities in filing comments relative to other aspects of Medicaid expansion under the Affordable Care Act. Click here to read the comments.

February 24, 2013 | Permalink | Comments (0) | TrackBack (0)

New technology to decrease seizures

Can cooling the brain limit the severity of seizures?

A new study reported in the Annals of Neurology: Mild passive focal cooling prevents epileptic seizures after head injury in rats suggests that cooling the brain can limit the severity of seizures.

Traumatic brain injury is a leading cause of traumatic epilepsy and seizure disorder.  The study suggests that chronic seizures which are often resistant to medication can be effectively treated by cooling of the brain.  The authors even believe that this therapy may prevent further seizures from taking place.

While cooling the human brain is not easy to accomplish, success has been reported with even a two degree Celsius drop in temperature. The physician researchers at Washington University in St. Louis have begun developing technology to cool the brain circuits in humans. 

February 23, 2013 | Permalink | Comments (0) | TrackBack (0)

NASCAR may require baseline neuropsychological testing for its drivers

Baseline concussion testing may become mandatory for all NASCAR race drivers as early as 2014 according to news reports.

 Reportedly, NASCAR spokesman Kerry Tharp said that NASCAR has been providing information during competitors' annual preseason physicals about the imPACT test, which measures several neurocognitive functions including memory, reaction time, attention span and other cognitive abilities.

Baseline testing is performed at the beginning of each season to determine an athlete’s cognitive abilities before a concussion takes place. The athlete is then retested after a concussion or head injury and the results are compared to the earlier test. This provides medical professionals with important information on how the brain is healing and whether a player has fully recovered from the concussion. While the test cannot provide all of the answers, it is part of the arsenal of information that allows for an intelligent decision on when an athlete can return to play.

February 20, 2013 | Permalink | Comments (0) | TrackBack (0)