Article Date: 08 Jul 2011 - 1:00 PDT
"Creating a baseline for each youth athlete is a critical part of accurate future concussion assessment, according to researchers presenting their study at the American Orthopaedic Society for Sports Medicine's Annual Meeting in San Diego. Differences in how females and males scored on a standardized concussion assessment tool were also investigated.
"Our research analyzed whether the new Sport Concussion Assessment Tool-2 (SCAT2) has any variability in data for youth athletes and whether gender makes a difference on the scores," said presenting researcher, Anikar Chhabra, MD, MS of The Orthopaedic Clinic Association in Phoenix, AZ. "Our results showed that otherwise healthy adolescent athletes do display some variability in results so establishing each player's own baseline before the season starts and then comparing it to test results following a concussion leads to more accurate diagnosis and treatment."
Chhabra and his colleagues from A.T. Still University tested 1,134 athletes who were participating on interscholastic athletic teams at 15 different high schools in the Phoenix area, as part of a funded research project by the National Operating Committee on Standards for Athletic Equipment (NOCSAE). There were 872 males and 262 females in the study with an average age of 15. The predominant male and female sports were football and volleyball, accordingly. A brief questionnaire regarding concussion history and the SCAT2 test was given to all participants.
Females scored significantly higher on the SCAT2 total score compared to the males. Athletes with a prior history of concussion also scored significantly lower on the SCAT2.
"This data provides the first insight into how the SCAT2 scores can be used and interpreted as a sideline concussion tool and as an initial baseline analysis. With concussions accounting for approximately nine percent of all high school athletic injuries, accurately utilizing assessments like these to quickly determine an athlete's return-to-play probability is critical to long term athletic and educational performance," said Chhabra. "
American Orthopaedic Society for Sports Medicine
Article Date: 19 Aug 2011 - 1:00 PDT
"Recurring headaches are common during the year following a traumatic brain injury (TBI), regardless of the severity of the TBI, and they tend to occur more often among females and those with a pre-TBI history of headache, according to an article in Journal of Neurotrauma, a peer-reviewed journal published by Mary Ann Liebert, Inc. The article is available free online at the link below.
More than 70% of patients who had suffered a TBI reported having headaches during the first year after their injury. This finding is a result of a multi-center study described by Jeanne Hoffman, PhD, Department of Rehabilitation Medicine, University of Washington, Seattle, and a group of colleagues from University of Washington, Craig Hospital (Denver, CO), Mayo Clinic (Rochester, MN), University of Alabama at Birmingham, University of Texas Southwestern Medical School (Dallas), Virginia Commonwealth University (Richmond), and Moss Rehab (Philadelphia, PA).
Females and persons with a pre-injury history of headache were significantly more likely to report headache, but there was no statistical link between incidence of post-injury headache and the severity of the TBI."
Sources: Mary Ann Liebert, Inc., Publishers, AlphaGalileo Foundation.
Article Date: 31 Jul 2011 - 0:00 PDT
If you suffer traumatic brain injury, your risk of having a stroke within three months may increase tenfold, according to a new study reported in Stroke: Journal of the American Heart Association.
"It's reasonable to assume that cerebrovascular damage in the head caused by a traumatic brain injury can trigger either a hemorrhagic stroke [when a blood vessel bursts inside the brain] or an ischemic stroke [when an artery in the brain is blocked]," said Herng-Ching Lin, Ph.D., senior study author and professor at the School of Health Care Administration, College of Medicine, Taipei Medical University in Taiwan. "However, until now, no research had been done showing a correlation between traumatic brain injury and stroke."
It is the first study that pinpoints traumatic brain injury as a potential risk factor for subsequent stroke.
Traumatic brain injury occurs when an external force such as a bump, blow or jolt to the head disrupts the normal function of the brain. Causes include falls, vehicle accidents, and violence.
In the United States alone, approximately 1 in 53 individuals sustain a traumatic brain injury each year, according to 2004 statistics from the Centers for Disease Control and Prevention.
Worldwide, traumatic brain injuries are a major cause of physical impairment, social disruption and death.
Using records from a nationwide Taiwanese database, researchers investigated the risk of stroke in traumatic brain injury patients during a five-year period. The records included 23,199 adult traumatic brain injury patients who received ambulatory or hospital care between 2001 and 2003. The comparison group comprised 69,597 non-traumatic brain injury patients. The average age of all patients was 42 and 54 percent were male.
During the three months after injury, 2.91 percent of traumatic brain injury patients suffered a stroke compared with only 0.30 percent of those with non-traumatic brain injury - a tenfold difference.
Stroke risk in patients with traumatic brain injury decreased gradually over time, researchers said:
Stroke risk among traumatic brain injury patients with skull bone fractures was more pronounced than in traumatic brain injury patients without fractures, researchers said.
During the first three months, those with skull bone fractures were 20 times more likely to have a stroke than patients without skull bone fractures. The risk decreased over time.
Furthermore, the risk of subarachnoid hemorrhage (bleeding in the area between the brain and the thin tissues that cover the brain) and intracerebral hemorrhage (bleeding in the brain caused by the rupture of a blood vessel) increased significantly in patients with traumatic brain injury versus non-traumatic brain injury patients. . . " Read More
Many adverse events can be prevented, providing what a patient safety expert calls "humongous opportunities for improvement."
By Kevin B. O'Reilly, amednews staff. Posted April 18, 2011.
"One-third of hospital patients experience adverse events and about 7% are harmed permanently or die as a result, according to a study that detected patient safety problems at a far higher rate than other methods.
The study, in April's Health Affairs, echoes two reports issued in November 2010 that showed rates of adverse events hovering near 25% among hospitalized Medicare patients nationwide and at 10 North Carolina hospitals.
The findings draw attention to the safety troubles that have lingered in U.S. hospitals in the 12 years since the Institute of Medicine's headline-grabbing report "To Err is Human." The study cited research estimating that up to 98,000 patients die each year due to preventable medical errors.
"This is one of the best studies that now gives us a sense of how much harm is happening to patients in American hospitals," said Robert Wachter, MD, chief of the medical service at the University of California, San Francisco Medical Center, who was not involved in the research. "There is a tremendous amount of harm befalling patients who are admitted to hospitals and humongous opportunities for improvement."
To judge from a survey released March 31, patients are scared of medical mishaps. Nearly 60% of adults polled by the Consumer Reports National Research Center believe medical errors are common in hospitals, and nearly half said serious harm is common. Nearly 80% of patients said they feared contracting an infection in a hospital, 71% were worried about medication errors and 65% were scared of surgical mistakes. . . " Read More
Friday, March 25th 2011, 4:00 AM
"Gruesome photos of a battered 4-year-old girl. Autopsy reports showing she was drugged. Twine used to tie her to a bed.
Prosecutors seeking homicide convictions for the two child welfare workers assigned to protect Marchella Brett-Pierce have several pieces of dramatic evidence - but the most damning are a few bogus computer entries.
Experts say caseworker Damon Adams' alleged attempt to cover up his failure to monitor Marchella could be a silver bullet for prosecutors.
Adams, 36, is accused of never visiting Marchella's Brooklyn home despite glaring warning signs - and fudging computer records to show he checked in on her in the months before she died.
What authorities described as record tampering shows that Adams "had an understanding of the nature of his failure to act and the potential consequences for it," said Paul Gentile, a former Bronx prosecutor. "That takes the DA a significant distance to proving his case."
"The false entry indicates that he knew that he blew it," said Shapiro. "That's the key." Read More
I am opposed to violence, whether it's displayed by adults or children. I've always believed that violence is never the answer.
When raising our own family, I never, ever laid a hand on either of my kids, never cussed or screamed at them, like I've seen so many other parents do. I swore I would never do that and I kept my promise.
However, when it comes to bullies, sometimes, the only way to get through to them is for people to stand up to them and teach them a lesson or two.
Whether adult or child, bullies are cowards who pick on those they feel can't defend themselves. Did you ever see a bully go after someone he knows can defend themself? No way. They wouldn't take the chance of being humiliated in front of their peers.
I was also bullied terribly, back in seventh grade, by a tough cookie of a classmate, and her even tougher, bigger, older sister. I often thought they both could have tried out for the football team. Often the bullying occurred, in the hallway, or in class, right in front of teachers, who just stood there watching.
I tried ignoring it. I even went to the guidance counselor. That didn't help. In fact, the bullying got worse once everyone knew. Why do they think kids never tell the grown ups? Finally, when she threatened to punch me one day in class, I'd had enough. Even though my skinny knees were knocking, and I knew she could pulverize me, I stood up to her.
I stood up, raised my fists, and threatened to hit her back. Was it the right thing to do? Probaby not. We both got sent to the principal. Soon afterwards, her sister caught up with me and slammed me into a locker. Again, right in front of teachers.
But, hey, at the time, it was worth it because I'd stood up for myself for the first time in my life and it felt good. As for my classmate, she never bullied me again.
It's something I'll never forget. Constant bullying is something that stays with you forever. I think that's one reason why I later became a forensics nurse. To do whatever I could to help put a stop to such senseless violence.
Many years later, when we were a grown, I happened to run into the older sister in a store. We stood there, with our kids, and chatted for while. She looked like any other mother holding her baby on her hip. Not the pulverizer I remembered.
Surprisingly, she brought up her bullying past. And she actually apologized to me for her behavior way back then. Just goes to show people can change if they really want to.
In this video, which has gone viral across the web, one young bully, Richard Gale, after repeatedly taunting and punching Casey Heynes, a larger victim, finally got what was coming to him.
I know I'll probably get slammed on here for this. I'm sorry to have to say that but I believe it's true. Normally I would not advocate it, but sometimes, there comes a point when kids should have a right to defend themselves - within reason, of course.
In these days of kids bringing knives and guns to school, caution and cool heads are needed. It's a shame that appropriate intervention by teachers or administration didn't happen before it got to this point.
However, in this case, the victim finally stood up for himself, did what he had to do to get the bully off his back, without really hurting him, then walked away.
The victim showed enormous restraint considering the circumstances. Of course, the news media is reporting that the bully's mother is now demanding an apology from the victim who stood up to her son. Hmmm. And we wonder why her son is a bully?
Hopefully, Richard Gale has learned an important lesson which will stay with him throughout his life. And maybe, just maybe, sometime down the road, this young bully will also have the guts to apologize to his victims too.
Bob Probert knew the fierce pounding he dished out and received over 16 seasons as an NHL enforcer was taking its toll as he got older. That's why he wanted his brain to be analyzed once he died. Even though heart failure ultimately ended his life last July at age 45, Probert also was living with a damaged brain. Researchers at Boston University said Thursday that Probert had the degenerative brain disease Chronic Traumatic Encephalopathy. The disease was found through analysis of brain tissue donated by Probert.
He is the second hockey player from the program at the Center for the Study of Traumatic Encephalopathy to be diagnosed with the disease after death. Reggie Fleming, a 1960s enforcer who played before helmets became mandatory, also had CTE.
CSTE is a collaboration between Boston University Medical School and the Sports Legacy Institute that is attempting to address what it calls the "concussion crisis" in sports. The group has been at the forefront of research into head trauma in sports, and has received a $1 million gift from the NFL, which it has pushed for better treatment of concussions.
The family of former Bears safety Dave Duerson agreed to donate his brain to the study after he committed suicide last month at the age of 50.
During his years as one of the most feared players in the NHL, Probert had 3,300 penalty minutes — fifth on the league's career list. He was the toughest and most prolific fighter of his time. Probert, who struggled to overcome drinking problems during his time in the NHL, played for the Detroit Red Wings from 1985-94 and the Chicago Blackhawks from 1995-2002.
"We are only beginning to appreciate the consequences of brain trauma in sports," said Chris Nowinski, the Sports Legacy Institute's co-founder and chief executive officer. "Early evidence indicates that the historical decision not to discourage contact to the head was an enormous mistake, and we hope aggressive changes continue to be made to protect athletes, especially at the youth level." Read More
100 times normal levels of radiation reported near stricken plant. This is so tragic. I will keep them all in my thoughts and prayers: http://www.msnbc.msn.com/id/42084187/ns/world_news-asiapacific/
by Kevin Pho, MD
"Last fall, a surgeon at Johns Hopkins Hospital was shot by the distraught son of a patient for whom he was caring. The man later killed his mother, then himself. A week earlier, a patient in a Long Island, N.Y., hospital beat his nurse with a leg from a broken chair, causing serious injuries. The following month, a psychiatric technician at a Napa, Calif., state hospital was fatally attacked on the job.
This snapshot of violence against health care workers reflects a disturbing trend. According to a Bureau of Labor Statistics analysis published last year, almost 60% of assaults in the workplace occurred in a health care setting. Nearly three-quarters of these assaults were by patients or residents of a health facility."
No longer havens
"Health care settings have been traditionally thought of as “safe havens,” open to anyone as a place to be protected and cared for. This is a trend worth watching. The Joint Commission, a national accrediting agency, soberly noted last year that “health care institutions today are confronting steadily increasing rates of crime, including violent crimes such as assault, rape and homicide.”Violence is most common in psychiatric facilities and emergency departments, but can also be seen in waiting rooms, long-term care centers and critical care units."
"Nurses are the most frequent targets. According to a 2010 survey from the Emergency Nurses Association, more than half of ER nurses were victims of physical violence and verbal abuse, including being spit on, shoved, or kicked; one in four reported being assaulted more than 20 times over the past three years. The survey noted that the violence seemed to be increasing at the same time the number of alcohol-, drug- and psychiatric-related patients was rising. . . " Read More
by Eric L. Probst
""New technologies create interesting challenges to long established legal concepts." Written over fourteen years ago in a court martial decision involving the electronic transmission of pornography, United States v. Maxwell, Jr., 45 M.J. 406 (C.A.A.F. 1996), this statement has never been more relevant than it is today in the social networking era of Facebook, MySpace, Twitter, LinkedIn, and other social networking sites ("SNS"). When Congress enacted the Stored Wire and Electronics Communications Privacy Act in 1986, 18 U.S.C. §§ 2701–2711 ("SCA"), to regulate how and under what circumstances electronic information providers could produce electronic information to third parties . . . Read More
An important research study below centers on fatal cardiac injuries sustained in motor vehicle accidents. It's important to note that fractured sternum in a driver can occur even while wearing a seat belt.
March 14-16, 2011 Chicago, IL
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The bootcamp culminates in a courtroom setting during which each testifying expert presents and defends his or her own expert opinions on the witness stand.
After completing the Bootcamp, participants will be able to:
For details on program content, learning objectives, continuing education, and registration: click here
Here's another excellent post by Mr. Stratton on why people need to be cautious when posting on social media networks:
by David B. Stratton, Esq. of Jordan Coyne & Savits LLP.
February 6, 2011
"DRI's online newsletter, E-Discovery Connection, vol 5, issue 3, has a number of worthwhile articles on discovery of information on social networking sites. I like the case where a federal judge offered to do an in camera review of a party's Facebook account by "friending" the party. Think about whether you would want a federal judge reviewing all of your Facebook pages, which would include things you didn't even write."
The following cases are among those discussed in that newsletter:
EEOC v. Simply Storage Mgmt. (courtesy of Indiana Law Blog)
Posted by David B. Stratton on February 06, 2011 at 01:38 PM
From e-Discovery Connection by John D Martin: "... Federal Rule of Civil Procedure 34 (A)(1)(a) was amended in 2006 to include "electronically stored information" ("ESI") in the definition of what is subject to a request for production."
From e-Discovery Connection by John D Martin:
"... Federal Rule of Civil Procedure 34 (A)(1)(a) was amended in 2006 to include "electronically
stored information" ("ESI") in the definition of what is subject to a request for production."
committee's note (2006).
" . . Although social networking sites were in their infancy when the 2006 rules revision process began, the language of Rule 34 is broad enough to include the content onany type of internet site, as long as the content is stored. Messages, status updates, pictures, videos, contact information, and all other content posted on social networking sites fits the Rule 34 definition of "data compilations stored in any medium from which information can be obtained."
Certified Forensics Nurse Examiner and Independent Consultant