The brain scans of high school football and hockey players showed subtle injury — even if they did not suffer a concussion — after taking routine hits to the head during the normal course of play, according to a University of Rochester Medical Center study.

The research, reported online in the journal Magnetic Resonance Imaging, is preliminary, involving a small sample of athletes, but nonetheless raises powerful questions about the consequences of the mildest head injury among youths with developing brains, said lead author Jeffrey Bazarian, M.D., M.P.H., associate professor of Emergency Medicine at URMC with a special interest in sports concussions.

Bazarian and colleagues used a cutting edge statistical approach to analyze before-and-after images of the players’ brains from diffusion tensor imaging (DTI). A DTI scan is similar to an MRI but it does not relay pictures, rather it captures and relays quantitative data that must be decoded and interpreted.

Collaborators and co-authors Tong Zhu, Ph.D., and Jianhui Zhong, Ph.D., uniquely applied a novel (wild bootstrap) statistical method to the DTI imaging study and detected the small but noteworthy changes in the white matter of the teenagers.

“Although this was a very small study, if con-firmed it cold have broad implications for youth sports,” Bazarian said.

“The challenge is to determine whether a critical number of head hits exist above which this type of brain injury appears, and then to get players and coaches to agree to limit play when an athlete approached that number.” Nine athletes and six

Routine Head Hits in School Sports May Cause Brain Injury

Making Headway Distributed Three Times Each Year Issue 1 Spring 2012

IN THIS ISSUE

Board of Directors…………………………Page 2

5K Run Walk & Roll Event…………...…..Page 2

Brain Injury Awareness Night…….…...….Page 3

Kids Abnormal Breathing During Sleep…Page 4

Donations & Support………………….…...Page 5

BIAU Open House …………...…….……...Page 7

Lack of Empathy Following a TBI……….Page 8

TBIs are Likely More Common..……..…..Page 9

Community Shares of Utah………………..Page 9

Competition of Brain Cells……………….Page 10

Defense & Brain Injury Center………….Page 11

Cultural Diversity in Healthcare………...Page 12

Basic Behavior Guidelines…..….……..….Page 15

Bicycle Safety……………………………...Page 16

5280 So. Commerce Drive E-190 * Murray, UT 84107 * 801-716-4993 * 800-281-8442 * www.biau.org

people in a control group from Rochester, N.Y., volunteered to take part in the research during the 2006-2007 sports season. Among the nine athletes, only one was diagnosed with a sports-related concussion that season, but six others sustained many sub-concussive blows and showed abnormalities on their post-season DTI scans that were closer to the concussed brain than to the normal brains in the control group.

The imaging changes also strongly correlated with the number of head hits (self-reported in a diary), the symptoms experienced, and independent of cognitive test results, Bazarian said.

The URMC study is unique because it was able to compare brain scans from the same player, pre-season and post-season. Most other studies compare the injured brain of one person to the normal brain of another person from a control group.

However, that becomes a problem when searching for very subtle changes, Bazarian said, because so much natural variation exists in every individual’s brain.

Indeed, among athletes there is no easy objective way to diagnose concussions. High schools, colleges, and professional programs routinely administer pre-season, computer-based cognitive tests. Yet some athletes have become adept at tricking the test, Bazarian said. They intentionally do poorly on the baseline so that a mild concussion will not show up if re-tested later. The DTI scan provides detailed information of axonal injury at the cellular level, by measuring the motion of water in the brain. Axons, which are like cables woven throughout brain tissue, swell up when injury occurs. As the swelling impacts the movement of water, scientists can measure changes in flow and volume and thus make an educated guess at the extent of axonal injury.

Measurements in the study at hand showed many changes in the brain of the player with the diagnosed concussion; however an intermediate level of changes also occurred among the players who reported anywhere from 26 to 399 total sub-concussive blows. The fewest changes occurred in the control group, as expected.

A key objective of the study was to determine if this statistical approach worked, and the preliminary results showed that white matter changes among the intermediate group were three times higher than the controls.

Continued on Page 13

Board of Directors

Executive Board

President………….Antonietta Anna Russo, Ph.D.

Past President ....Teresa Such-Neibar, D.O.

Vice Presidents ...Elizabeth Cardell, OTR/L

Edward Havas, Esq

Miette Murphy, MS, CCC,SLP

Treasurer……………Pauline Fontaine Secretary……………Tony J. Washington, BS, CWDP

Board Members

Laurence Hilton, Ph.D., CCC, SLP

Bret W. Hortin, CLU, CHFC, CASL

Cheryl Hostetter, MS, SLP

Julie McCauley, MSW

Robert B. Sykes, Esq.

Michael A. Worel

ADVISORY BOARD

Erin D. Bigler, Ph.D.

Elaine Clark, Ph.D.

Sam Goldstein, Ph.D.

Reuel McPhie, MBA, MPH, FACHCA

Elaine Pollock, B.A. John Speed, MBBS

Calendar of Events

May 19th

5K Run Walk & Roll Liberty Park

Salt Lake City

August 9th

Brain Injury Awareness Night Ogden Raptors Lindquist Field,

Ogden, Utah

October 13th

Family & Professionals Conference South Towne Expo Center

Sandy, Utah

PAGE 2 HEADWAY

PAGE 3 HEADWAY

In Recognition of Our New & Renewing Members

Doreen S. Anderson

Kathleen Blank Rebecca Clawson Lissa K. Johnson

Christian & Tiffani Martin Alice Richins

Carolyn Scheid Brooke Sessions

Kathleen Watson Maria Young

Corporate Members

Country Life Care Center Dewsnup King & Olsen

Robert DeBry & Associates Intelligis, LLC

Law Office of Brian Kelm Learning Services Corp. Phoenix Services Corp.

University of Utah Rehabilitation Center

Why Become A Member?

The Brain Injury Association of Utah’s (BIAU) primary purpose is to provide support for individuals with brain injuries and their families. The BIAU serves the community through efforts that include advocacy, educational programs and the promotion of research and training. Throughout our years of service, the BIAU has embarked on an aggressive agenda to improve the quality of life for those suffering from a brain injury, along with the needs of their families.

As a member you will receive and/or support the following:

3-issues of Brain Injury Association of Utah, Inc. newsletter

4-issues of Brain Injury Association of America newsletter The Challenge

Requested educational material

Announcements of upcoming educational conferences and/or events

Emotional support through our Helpline and/or support groups

Legislative efforts

Promotion of injury prevention

Voting privileges at BIAU annual meeting

To become a member contact us at:

801-716-4993 or 800-281-8442

or on the website: www .biau.org

PAGE 4 HEADWAY

Kids' Abnormal Breathing During Sleep Linked To Increased Risk For Behavioral Difficulties

Risk of problems later in childhood can double with snoring and apnea

A study of more than 11,000 children followed for over six years has found that young children with sleep-disordered breathing are prone to developing behavioral difficulties such as hyperactivity and aggressiveness, as well as emotional symptoms and difficulty with peer relationships, according to researchers at Albert Einstein College of Medicine of Yeshiva University. Their study, the largest and most comprehensive of its kind, published online today in the journal Pediatrics.

"This is the strongest evidence to date that snoring, mouth breathing, and apnea [abnormally long pauses in breathing during sleep] can have serious behavioral and social-emotional consequences for children," said study leader Karen Bonuck, Ph.D., professor of family and social medicine and of obstetrics & gynecology and women's health at Einstein. "Parents and pediatricians alike should be paying closer attention to sleep-disordered breathing in young children, perhaps as early as the first year of life."

Sleep-disordered breathing (SDB) is a general term for breathing difficulties that occur during sleep. Its hallmarks are snoring (which is usually accompanied by mouth breathing) and sleep apnea. SDB reportedly peaks from two to six years of age, but also occurs in younger children. About 1 in 10 children snore regularly and 2 to 4 percent have sleep apnea, according to the American Academy of Otolaryngology–Health and Neck Surgery (AAO-HNS). Common causes of SDB are enlarged tonsils or adenoids.

"Until now, we really didn't have strong evidence that SDB actually preceded problematic behavior such as hyperactivity," said Ronald D. Chervin, M.D., M.S., a co-author of the study and professor of sleep medicine and of neurology at the University of Michigan. "Previous studies suggesting a possible connection between SDB symptoms and subsequent behavioral problems weren't definitive, since they included only small numbers of patients, short follow-ups of a single SDB symptom, or limited control of variables such as low birth weight that could skew the results. But this study shows clearly that SDB symptoms do precede behavioral problems and strongly suggests that SDB symptoms are causing those problems."

The new study analyzed the combined effects of snoring, apnea and mouth-breathing patterns on the behavior of children enrolled in the Avon Longitudinal Study of Parents and Children, a project based in the United Kingdom.

Parents were asked to fill out questionnaires about their children's SDB symptoms at various intervals, from 6 to 69 months of age. (Studies of similar questionnaires have shown that parents do a good job of assessing kids' SDB: their evaluations compare well with data from carefully controlled

overnight sleep studies, Dr. Bonuck reports.). When their children were approximately four and

seven years old, parents filled out the Strengths and Difficulties Questionnaire (SDQ), which is widely used to assess behavior. The SDQ has scales for assessing a child's inattention/hyperactivity, emotional symptoms (anxiety and depression), peer problems, conduct problems (aggressiveness and rule-breaking), and prosocial behavior (sharing, helpfulness, etc.). The researchers controlled for 15 potential confounding variables, including socioeconomic status, maternal smoking during the first trimester of pregnancy, and low birthweight.

"We found that children with sleep-disordered breathing were from 40 to 100 percent more likely to develop neurobehavioral problems by age 7, compared with children without breathing problems," said Dr. Bonuck. "The biggest increase was in hyperactivity, but we saw significant increases across all five behavioral measures."

Children whose symptoms peaked early—at 6 or 18 months—were 40 percent and 50 percent more likely, respectively, to experience behavioral problems at age 7 compared with normally-breathing children. Children with the most serious behavioral problems were those with SDB symptoms that persisted throughout the evaluation period and became most severe at 30 months.

Researchers believe that SDB could cause behavior-al problems by affecting the brain in several ways: decreasing oxygen levels and increasing carbon dioxide levels in the prefrontal cortex; interrupting the restorative processes of sleep; and disrupting the balance of various cellular and chemical systems. Behavioral problems resulting from these adverse effects on the brain include impairments in executive functioning (i.e., being able to to pay attention, plan ahead, and organize), the ability to suppress behavior, and the ability to self-regulate emotion and arousal.

"Although snoring and apnea are relatively common in children, pediatricians and family physicians do not routinely check for sleep-disordered breathing," said Dr. Bonuck. "In many cases, the doctor will simply ask parents, 'How is your child sleeping?' Instead, physicians need to specifically ask parents whether their

Continued on Page 5

PAGE 5 HEADWAY

In Appreciation of Those Who Support The BIAU

January 1, 2012 — April 30, 2012

Gold Bar

$5,000 & Over

Dewsnup King & Olsen

Gold Nugget $2,500 & Over

Country Life Care Center Robert DeBry & Associates Law Office of Brian Kelm

University of Utah Rehab Center

Gold Ring $1,000 & Over

Intellegis, LLC Learning Services Corp.

Phoenix Services Corp.

Gold Chip

$500 & Over

Community Shares of Utah Yellow Cab

Gold Coin

$100 - $249 over

Elizabeth Cardell Pauline Fontaine Kathryn Ferguson Charles Gerrard Sam Goldstein Edward Havas

Cheryl Hostetter Michael Worel

Alan Mortensen Miette Murphy

Antonietta Russo

Friends of BIAU

Lisa Barnes

Sue & David Dewey Eleanor Mayhew Cindy Wilmshurst

Memoriam

Genny & Thomas Vaughn— In Memory of Brad Nicol

Volunteers

We would like to thank the many volunteers who give of their time and energy to support the mission of the BIAU. Without them this organization would not exist.

Only with your help can we continue to expand public awareness, enact legislative change, and serve the people whose lives are forever changed by the physical, cognitive, social and financial consequences of this devastating injury.

Please make your tax-deductible contribution to the

Brain Injury Association of Utah

Continued from Page 4

children are experiencing one or more of the symptoms—snoring, mouth breathing or apnea—of SDB."

"As for parents," said Dr. Bonuck, "if they suspect that their child is showing symptoms of SDB, they should ask their pediatri-cian or family physician if their child needs to be evaluated by an otolaryngologist (ear, nose and throat physician) or sleep specialist."

According to the AAO-HNS, surgery is the first-line treatment for severe pediatric SDB in cases where the tonsils and adenoids are enlarged. Another option is weight loss for overweight or obese children.

March 5, 2012

Source: Albert Einstein College of Medicine Reprinted from the Children’s Neurological Solutions

Volume 10 No. 4

________________________

Disclaimer

All information provided in official Brain Injury Association of Utah’s (BIAU) publications is provided for information purposes only and does not constitute a legal contract between the BIAU and any person or entity unless otherwise specified. BIAU does not support or endorse any resource, links or information within this publication but provides it for readers to view information that may be useful or cutting edge.

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personalized service of a local company.

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PAGE 6 HEADWAY

November 2006r of the PAGE 7 HEADWAY

The Brain Injury Association of Utah would like to thank

everyone who attended our Open House on March 15th. We would especially like to thank Mayor Snarr of Murray City for his attendance and for participating in our ribbon cutting ceremony.

We would also like to thank R. Scott Baker, President, Murray Area Chamber of Commerce, along with other members of the Chamber who were in attendance.

BIAU would also like to thank Winegars of Bountiful for their donation of the food for this event; and Skyline Floral Gardens for the table decorations. Also a big thank you to Fox News Channel 13 for covering our event and Shad from the Examiner.com.

Also like to thank our Board of Directors who were in attendance and the hard work of our Staff and volunteers who worked tirelessly to make this event a success.

Open House

PAGE 8 HEADWAY

Egocentric, self-centered, and insensitive to the needs of others: these social problems often arise in people with severe traumatic brain injury (TBI) and have been attributed in part to a loss of emotional empathy, the capacity to recognize and understand the emotions of other people. Given that traumatic brain injuries are becoming more common, and resulting empathy deficits can have negative repercussions on social functioning and quality of life, it is increasingly important to understand the processes that shape emotional empathy.

A new study has recently revealed evidence of a relationship between physiological responses to anger and a reduction of emotional empathy post-injury, as reported in a recent issue of Elsevier’s Cortex.

Researchers from the University of New South Wales, Australia, teamed up to investigate whether physiological responses to emotions correlate with emotional empathy in a group of adults with severe TBI and a group of healthy control participants. After determining the emotional empathy abilities of the participants by questionnaire, the researchers measured activation of their facial muscles and sweat glands, in response to happy and angry facial expressions, using facial electromyography (EMG) and skin conductance. They found that the control group spontaneously mimicked the emotional facial expressions they saw, and also

perspired more in response to angry faces. In contrast, those in the TBI group generally scored lower in emotional empathy and were less responsive, specifically to angry faces. Lack of emotional empathy was specifically found to be associated with reduced physiological responses to angry faces.

“The results of this study were the first to reveal that reduced emotional responsiveness observed after severe TBI is linked to changes in empathy in this population. The study also lends support to the conclusion that impaired emotional responsiveness — including facial mimicry and skin conductance — may be caused, at least in part, by dysfunction within the system responsible for emotional empathy,” explains author Arielle De Sousa. “This has important implications for understanding the impaired social functioning and poor quality of interpersonal relationships commonly seen as a consequence of TBI, and may be key to comprehending and treating empathy deficits post-injury.”

Reprinted from the Centre for Neuro Skills Inside View Issue 20.4 Fall 2011

Lack Of Empathy Following

Traumatic Brain Injury

PAGE 9 HEADWAY

MISSION

Community Shares/Utah brings hope, comfort and help to those in need. Our mission consists of human, animal, and environmental services.

We unite a remarkable and varied group of nonprofits. The-se agencies receive training, education, and financial re-sources that enable them to reach their goals and programs each year.

Community Shares/Utah recommends and encourages Utahn’s to “designate.” This is accomplished by selecting the agency and the amount of their contribution on the pledge form provided by their company. The member agency always receives the designated contribution. All money collected remains in Utah. For more information visit our website.

http://www.communitysharesutah.org

Though researchers are becoming increasingly aware of the long-term effects of head injury, few studies have looked at the prevalence of traumatic brain injury (TBI) in all age groups, including males and females, taking into account both mild and serious events. In a recent study published in Epidemiology, Mayo Clinic researchers applied a new, refined system for classifying injuries caused by force to the head and found that the incidence of traumatic brain injury is likely greater than has been estimated by the Centers for Disease Control and Prevention (CDC).

"Even mild traumatic brain injuries can affect sensory- motor functions, thinking and awareness, and communica-tion," says study author Allen Brown, M.D., director of brain rehabilitation research at Mayo Clinic. "In assessing frequency, we have likely been missing a lot of cases. This is the first population-based analysis to determine prevalence along the whole spectrum of these injuries."

Researchers used the Mayo Traumatic Brain Injury Classification System, a new brain injury method that classifies head injuries along a more comprehensive scale than ever before. The categories label patients with "definite," "probable" and "possible" TBIs, providing a way to incorporate symptoms such as a brief period of unconsciousness or even an injured patient's complaint of dizziness or nausea.

Continued on Page 14

The Brain Injury Association of Utah is a proud member of

Community Shares/Utah

Traumatic Brain Injuries Are Likely More

Common Than Previously Thought

Science Daily February 14, 2012

PAGE 10 HEADWAY

"We wanted to know how brain circuits become more efficient during the brain's development," to examine how neural activity organizes memory circuits, re-searchers used mice that had been genetically modified so that neurons of interest purposefully could be switched off.

The scientists focused on an important connection between the hippocampus, which is crucial for learning and memory, and the cerebral cortex, which is key for perception and awareness. They deactivated about 40 percent of the neurons in the connection and, over a matter of days, watched as the brain eliminated the inactive neural connections and kept only the active ones. A subsequent part of the experiment showed that if all the neurons were deactivated, their connections were not eliminated.

"This tells us that the brain has a way of telling among a group of neurons which connections are better than others," Umemori says. "The neurons are in competition with each other. So when they're all equally bad, none can be eliminated."

The researchers also looked at a part of the hippocampus called the dentate gyrus, which is only one of two areas of the brain that continues to generate new neurons throughout life. Here they found a second distinct type of competition:

Continued on Page 13

Scientists at the University of Michigan Health Sys-tem have for the first time demonstrated how memory circuits in the brain refine themselves in a living organism through two distinct types of compe-tition between cells.

Their results, published today in Neuron, mark a step forward in the search for the causes of neurolog-ical disorders associated with abnormal brain circuits, such as Alzheimer's disease, autism and schizophrenia.

"Much of our understanding of the brain's wiring has come from studying our sensory and motor systems, but far less is understood about the mecha-nisms that organize neural circuits involved in higher brain functions, like learning and memory," says senior author Hisashi Umemori, M.D., Ph.D., assistant research professor at U-M's Molecular and Behavior-al Neuroscience Institute and assistant professor of biological chemistry at the U-M Medical School.

Brain cells grow and extend along pathways to link different parts of the brain, Umemori explains. As the brain develops, these connections fine-tune themselves and become more efficient. Problems with this refinement process may be responsible for some neurological disorders.

Umemori adds. "Does the brain choose to keep good connections and get rid of bad ones and, if so, how?"

Competition Between Brain Cells Spurs Memory Circuit Development

PAGE 11

HEADWAY

or physical deficits which prevent them from accessing available systems of care. RCCs also follow service members and veterans with TBIs longitudinally to help avert poor outcomes and improve our understanding of the many factors related to outcome following TBI.

The implementation of the DVBIC Regional Care Coordination system ensures that service members and veterans with TBIs have access to appropriate medical care, support, and available resources throughout the recovery process.

The DVBIC National Office of Care Coordination is responsible for the management and growth of DVBIC’s care coordination network which serves hundreds of service members and veterans with TBIs who require any amount of support. An RCC operating from each of DVBIC’s core sites is responsible for a catchment area that may include both urban and rural populations, service members and veterans, and other diverse communities. Their goal is to facilitate access to the full scope of resources available to service members and veterans with TBI’s, and their families, in whatever area they live.

For more information on DVBIC Care Coordinators locations go to

http://www.dvbic.org/Locations.aspx

To better support service members and veterans with TBI, DVBIC created a network of Regional Care Coordinators (RCC) who are able to follow individuals within a specific region. The goal of this network is to improve service delivery by allowing professionals (nurses/social workers/counselors) specializing in TBI to guide TBI specific treatment and services.

Each DVBIC Care Coordinator is assigned to a specific geographical region of the country and tasked with monitoring service members and veterans with TBIs in that region as well as maintaining knowledge of the TBI treatment and support assets of the region (military, veteran and civilian).

Among their core responsibilities, care coordinators serve as points-of-contact to assess TBI resources in communities where individuals reside, facilitate access to those services, and ensure that individual plans of care are appropriate and therapeutic in the short-term and long-term.

DVBIC Regional Care Coordinators work to ensure optimal care and recovery for service members and veterans with TBI’s whose rehabilitation and return to community does not always follow a strict linear path, or whose injury may result in cognitive, social, behavioral

Defense and Veterans Brain Injury Center (DVBIC) National Care Coordination Network

Delivering quality healthcare to culturally diverse populations is an increasing challenge in health care. To build bridges between healthcare professionals and families from different cultures, it is important to…

Understand your values and assumptions:

Understanding your cultural heritage requires identifying your values, beliefs, and customs. Everyone has a culture, but often individuals are not aware of behaviors, habits, and customs that are culturally based. All cultures have built-in biases, but there are not right or wrong cultural beliefs.

Be aware of patients’ cultural beliefs:

Healthcare providers must know and understand culturally influenced health behaviors. Examples are cultural issues about medications, decision makers in the family, body language, diet, and herbs. By becoming aware of the patient and family’s cultural beliefs, instruction on medical care can be more effective.

Be an effective communicator:

Communication may involve interpreters and translators. Using a trained interpreter, and not a family member, is recommended. When family members are upset, it is difficult to absorb information. Using a family member to interpret increases the risk that information will not be understood correctly. Children are often the only bilingual family members present. They should never be asked to interpret issues medically complex and culturally sensitive information.

Listening is also a communication tool to provide culturally competent healthcare means to truly listen to the patient and the family to learn about the patient’s beliefs of health and illness. This cannot be stressed enough!

Culture is a complex phenomenon. It is more than race and ethnic background. Cultural diversity also includes ages, places of birth, disabilities, religious beliefs, and sexual orientation.

Culture encompasses beliefs and behaviors that are learned and shared by members of a group.

Hispanic Cultural Values:

Hispanic is a broad term that refers to groups with cultural and national identities from the Caribbean, Mexico, and Central and South America. It also includes individuals who trace their ancestry to Spain and identify themselves as Hispanic.

Primary language used is Spanish

Hispanic patients usually want extended family members present and a family member involved as an active participant in care. This reflects strong family ties.

Many Hispanics believe in self-sacrifice, giving rather than taking, and accepting fate. This reflects deep religious faith. Encourage families to accept assistance from others at home and in the hospital.

Since the present is valued over the future, Hispanic patients may be less likely to use preventive measures such as medication to prevent a condition.

Decisions about the use of medical care or preventive care or treatment are family (and many times, traditionally-based).

Asian American Cultural Values:

The term Asian American refers to people of Asian descent who are citizens or permanent residents of the United States. It encompasses at least 23 groups such as Asian Indian, Cambodian, Chinese, Filipino, Hmong, Japanese, Korean, Laotian, Thai, Vietnamese, and “other Asian” with 32 linguistic groups. These populations are highly diverse, speaking many different languages.

Unity, balance, equilibrium and harmony are concepts central to Asian health beliefs. Many Asian Americans believe that an injury disrupts their concept of balance. Their beliefs influence how they may attempt to restore this balance.

Out of respect for the medical team, the family may appear to agree with treatment plans. However, they may not follow through if it conflicts with their cultural beliefs.

Many Asian Americans consider it disrespectful to look someone directly in the eve, especially if that person is in a superior position. Many place medical professionals in this superior position.

Food is associated with spiritual values. Many do not eat certain meats.

Many Asian Americans put aside work and personal needs to care for an ill or injured relative. Encourage them to use community services. Asian American families may resist asking for or receiving services that focus on the patient’s disability until they are able to resolve feelings of shame and duty. Explain that these services can help the patient adjust and prepare for the future.

Asian American families often use Eastern and Western medicine simultaneously. Ask questions about other medicines or herbs are used at home. Some medicines and herbs interact with prescribed medicines.

Many Asia Americans have a past time orientation. They may prefer traditional approaches to healing, rather than accepting new procedures or medicines.

This information printed by permission by the TBI Project A.C.C.E.S.S. North Carolina Department of Health and Human Services, Division of Mental Health, Developmental

Disabilities and Substance Abuse Services.

PAGE 12 HEADWAY

Cultural Diversity in Healthcare

PAGE 13 HEADWAY

Continued from Page 10

newborn cells were competing with mature cells, rather competition occurring between mature cells.

When scientists blocked the dentate gyrus' ability to make new cells, the elimination stopped and the brain kept the existing cells even if they were deactivated.

"The better the brain is at eliminating bad connec-tions to keep the circuitry at its most efficient, the more efficient learning and memory will be as well," Umemori explains.

He adds, "The better we understand how these mechanisms work, the better we'll be able to understand what's happening when they aren't working."

Reprinted from the Children’s Neurological solutions Volume 9. No. 7 July 1, 2011

Continued from Page 1

Efforts to further understand the significance of study results are already underway. Bazarian and collaborators at the Rochester Center for Brain Imaging, the URMC Department of Emergency Medicine, Department of Athletics and Recreation, and the Department of Imaging Sciences, are working on an NFL-funded study of UR football players this fall. Ten players agreed to wear helmets with special sensors that objectively detect the number of head hits they sustain, the velocity and angle. Each player is also receiving a pre-season and 2 post-season DTI scans, and the data downloaded from the helmet sensors will be correlated with information from the images.

“Our studies are taking important steps toward personalized medicine for traumatic brain injury,” Bazarian said. “In the future we’d like to be able to have a baseline image of a brain and clearly know significance of changes that occur later.”

Reprinted from the Centre for Neuro Skills Inside View 21.1 Winter 2012

PAGE 14 HEADWAY

Continued from Page 9

Using the Rochester Epidemiology Project, a several decades-long compilation of medical records in Olmsted County, Minn., the team determined that TBIs occur in as many as 558 per 100,000 people, compared to the 341 per 100,000 estimated by the CDC. Researchers found that 60 percent of injuries fell outside the standard categorization used by the CDC, even though two-thirds of them were symptomatic.

Mayo researchers found the elderly and the young were found most at risk for "definite" and "possible" injury, respectively, and men were more at risk than women. The findings reinforce ongoing efforts by the CDC to create a brain injury classification that more broadly encompasses traumatic head injury.

"With more complete assessment of frequen-cy, we'll have better tools to develop preven-tion programs, optimize treatments, under-stand cost-effectiveness of care and predict outcomes for patients," says Dr. Brown.

Other study authors include Cynthia Leibson, Ph.D.; Jeanine Ransom; Nancy Diehl; Patricia Perkins; and Jay Mandrekar, Ph.D., all of Mayo Clinic, and James Malec, Ph.D., of the Rehabili-tation Hospital of Indiana.

Story Source:

The above story is reprinted from materials provided by Mayo Clinic, via Newswise.

Journal Reference:

Cynthia L. Leibson, Allen W. Brown, Jeanine E. Ransom, Nancy N. Diehl, Patricia K. Perkins, Jay Mandrekar, James F. Malec. Incidence of

Traumatic Brain Injury Across the Full Disease Spectrum. Epidemiology, 2011; 22 (6): 836 DOI: 10.1097/EDE.0b013e318231d535

Mayo Clinic (2012, February 14). Traumatic brain injuries are likely more

common than previously thought. ScienceDaily. Retrieved February 16, 2012, from http://www.sciencedaily.com­ /releases/2012/02/120214170906.htm

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment.

Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

PAGE 15

HEADWAY

Country Life Care Center Opening in the Fall of 2012

Rarely does anything of good and reliable quality just happen. Country Life Care Center represents the years of training and experience of its founders and staff. These individuals have brought together refined procedures, care planning and an environment they know, from experience, works well in the care of persons recovering from catastrophic injury or illness. Country Life Care Center is offering care services for those who have experienced catastrophic injury or illness. These individuals commonly receive care that includes ventilators, tracheosto-my, intravenous, enteral tube feeding and other forms of complex care support. Country Life will provide long to life term care programs for children, adolescents and adults. Some of the standard care programs will include ser-vices for: Traumatic Brain Injury Spinal Cord Injury

Neuro-motor Disorders Ventilator Dependency

Complex Wound Care Stroke

The facility was carefully designed to include elements that promote the comfort and service access needed by this unique program of care. Due to the age range of those we will care for, planning family involvement has been a critical factor in design. Family is a guiding influence in establishing privacy and community opportunities for gath-ering within the facility. Planning for family involvement is a very fortunate result in the development of Country Life Care. The space for in room care equipment, on unit community space, family gathering areas and outdoor access are simply designed into Country Life from the ground up.

Country Life Care Center is located at the 13747 S Redwood Road in Riverton Utah (corner of Bangerter & Red-wood). For additional information please call us at (801) 491-0682

Basic Behavior Guidelines People with brain injury often have difficulty in understanding how their behavior affects others. When this is the case, the environmental conditions surrounding people with traumatic brain injury (TBI) can have a significant impact on behavior, without the person with a brain injury fully appreciating that fact. Organize the setting and plan the approach to the per-son, to increase opportunities for successful learning and decrease behavioral problems.

Allow time for rest — people with TBI can be extremely fatigued, which can be a strong antecedent to a behavioral episode. However, do not let fatigue be used as an escape from compliance.

Keep the environment simple — people with TBI are easily over-stimulated so distractions should be kept to a minimum.

Keep instructions simple — directions should be as concrete as possible. Use non-verbal cues, such as gesturing if the person has difficulty processing audito-ry information.

Give feedback and set goals — self-monitoring skills can be diminished following brain injury, so provide frequent feedback and set goals to help the person understand how and why they are doing a task.

Be calm and redirect — remaining calm can help

reduce agitation by demonstrating control, creating a nonthreatening environment and not inadvertently reinforcing a problem behavior.

Provide choices — this can help the person feel an

element of freedom and control over his or her environ-

ment. However, use “limited” choices so there is no

opportunity to say “no” or for the person to feel over-

whelmed.

Decrease chances of failure — try to keep the success

rate above 80%. This ensures the person feels both successful and challenged.

Vary activities — alternate activities to maintain interest. Interspersing easy tasks with more difficult ones is also helpful.

Over plan — be prepared with enough activities so that you can adjust tasks to suit daily fluctuations in the person’s functioning.

Task — try dividing tasks into smaller parts, each of which can be treated as a complete task. Activities are easier to accomplish one step at a time. For support please contact the BIA in your state (go to www.biausa.org ). The process of controlling the environment is draining on family members, and getting support can be very helpful in maintaining your efforts.

Fact Brain injury is the leading cause of death in bicycle crashes; it is the leading cause of disability among those who sur-vive.

Fact Most deaths to bicyclists result from collisions with motor vehicles.

Fact A bicycle helmet protects your child’s skull, brain and face from injuries.

Fact A bicyclist who is wearing a helmet is less likely to die, be seriously injured or become disabled if hit by a car.

Fact Bicycle incidents are most likely to occur within five blocks of home.

Fact Almost half of all bicycle crashes occur in driveways and on sidewalks.

HEADWAY

Bicycling

Children are at special risk for brain injuries from falls and collisions while bicycling. Because their peripheral vision is not fully developed they do not see objects to the side as clearly as those directly ahead. Children

often misjudge the speed and distance of oncoming vehicles. They may hear sounds, but are unable to judge from where they are coming. Their undeveloped sense of danger increases their risk of injury.

Teach Your Child To

Always wear a bicycle helmet.

Bicycle only in daylight.

Follow the rules of the road: Ride on the right side of the road with

traffic

Use hand signals.

Respect traffic signals.

Stop at all intersections.

Stop and look both ways before entering a street.

Be extra careful around driveways.

Always stop, look left-right-left and listen for traffic before crossing at stop signs, stoplights and busy streets.

Check that the road is clear before turning or changing lanes.

Ride single file with at least one bicycle length between cyclists.

Use crosswalks to get across a busy street; walk, do not ride, a bike in the crosswalk.

Watch out for opening car doors and parked vehicles.