Dear colleague and ABI stakeholder,

ONF is pleased to release the results of the Systems Analysis of Health and Community Services for Acquired Brain Injury in Ontario. Some of you took part in surveys and interviews, and this is greatly appreciated.

The Systems Analysis was initiated to describe the scope and nature of health and community services, the linkages that exist at the various points of the continuum, as well as linkages across transitions from children to adult services. The project examined services within and across LHINs and at a provincial level.

Attached for your interest is the ABI Systems Analysis – Executive Summary

We have also prepared Synopses on some specific aspects of the report, where findings, recommendations and implications are included.
– ABI Systems Analysis – Synopsis-Children and Youth Services
– ABI Systems Analysis – Synopsis-Mental Health Services
– ABI Systems Analysis – Synopsis-ALC and Wait Lists
– ABI Systems Analysis – Synopsis-Program Exclusion Criteria

I hope that you find this information interesting and helpful to you, your networks and your organization,
Kind regards,

Corinne Kagan
Senior Program Director, ABI
Ontario Neurotrauma Foundation
90 Eglinton Avenue East – Suite 601
Toronto, ON M4P 2Y3
Tel: (416) 422-2228, extension 204
Email: corinne@onf.org

Released: 6/11/2010 5:25 PM EDT Source: Johns Hopkins Medicine

Newswise — Experts from Johns Hopkins Medicine hosted a press conference following a continuing medical education program on the epidemiology of head injury in professional football. The program was an evidence-based review of traumatic brain injury in the sport.

The objectives of the conference on Traumatic Brain Injury in Professional Football: An Evidence-Base Perspective was to assess the current scientific knowledge on this subject and to make recommendations for the future research needed to answer the remaining questions regarding the diagnosis and treatment of traumatic brain injury (TBI).

Among the major recommendations for the future mild traumatic brain injury (MTBI) biomarkers research agenda were:
• Conduct prospective longitudinal studies evaluating the value of clinical tests, serum biomarkers, imaging, and electrophysiological tests in a.) differentiating players with and without traumatic brain damage, b.) detecting the effect of preventive/therapeutic interventions, and c.) predicting long-term cognitive and behavioral outcomes.
• The need for MRI and PET studies to determine in vivo morphological and functional correlates of physical impacts, concussions and long-term post-TBI cognitive decline.
• The need to implement MRI and electrophysiology studies to identify mechanisms of neural plasticity following MTBI.
For the area of long-term neuropsychiatric outcomes after TBI, the following research agenda was recommended:
• A study of former players, with state-of-the-art measures, to determine:
- Rates of neuropsychiatric disorders by age
- The relationship between neuropsychiatric disorders and cumulative exposure to sub-concussive or concussive impacts sustained across the player’s career.
• Design and start a cohort study of retiring players for the same purpose.
Research recommendations for chronic traumatic encephalopathy (CTE) include:
• Additional study of CTE pathology and neurobiology.
• Development of biomarkers to detect CTE in vivo among former players and other athletes.
• Development of animal models to test the hypothesis that repeat injury leads to degenerative tauopathy and to identify mechanisms that can be targets for intervention.
Recommendations for mitigating the consequences of TBI in football include:
• Development of a longitudinal concussion and “hits” database to capture prior and present episodes, quantify symptoms, document evaluations for return to play and document rehabilitation strategies.

Full story, video and podcasts: http://www.hopkinsmedicine.org/mediaII/TBI.html

Acquired brain injury (ABI) is defined as damage to the brain, which occurs at least seven days after birth and is not related to congenital disorder. The damage may be caused by traumatic injury to the brain or a non-traumatic cause, such as stroke, tumour, aneurysm, anoxia or an infection.

Childhood ABI is one of the leading causes of death and long-term disability. After an ABI, children and youth and their families may experience changes in many areas of their lives. These may include physical and mental health, ways of thinking, behaviour, social and family life, self-concept, and economic circumstances. Recovery from ABI varies a great deal among children and youth. Our understanding of the recovery process among young people suggests that it is complicated because this recovery is happening at the same time as changes that occur naturally as part of typical development. Even for those with mild ABI, in spite of apparently complete recovery in the weeks immediately following ABI, it is possible that some of these children and their families will have difficulties in the future.

Investigators at CanChild have studied transitions to home, school and community, and the trajectories and consequences of childhood ABI.

Please visit: http://canchild.icreate3.esolutionsgroup.ca/en/childrenfamilies/braininjury.asp

We are a research group based at the University of Birmingham in the U.K. We are interested in how family members cope when a relative has had a brain injury, such as a head injury or a stroke. One of our interests relates to the expectations family members have for the recovery of their relative.

To look at this issue properly, we need to develop a questionnaire that assesses the expectations of the family member. We have developed a first version on the basis of a previous study we did about expectations; direct consultation with some family carers; and an existing questionnaire. We now need to evaluate this version of the questionnaire by getting a large number of family members to fill it in.

We would be very grateful if you could take some time to complete the questionnaire. The questionnaire is quite long, but your answers will help us to improve the questionnaire by, for example, reducing its length.

The questionnaire is meant for people who have (or expect to have in the future) a significant caring role for a family member who has had a brain injury within the last 12 months. If you do not fall into this category, thank you for your time but please do not submit your answers to us.

Please be assured that your confidentiality is guaranteed. We will not ask you to give your name or any other details that might make it easy to identify you. No one but ourselves will see the individual answers that you give. Because we won’t ask for your name, we will be unable to identify the person who has given these answers.

If you do not feel happy about answering the questions, please do not continue with the survey.

If the questionnaire raises concerns for you, you may contact your local Headway, Stroke Association or other similar organization, who should be able to address these concerns. You may also contact us, Andrew Brennan and Gerry Riley, Clinical Psychologists, via email at Andrew.Brennan@sbpct.nhs.uk or G.A.Riley@bham.ac.uk. We would also welcome your views if you have any general observations about the questionnaire.

If you would like a summary of the final research report, please send us an e-mail to request this.

Survey Link:
https://www.surveymonkey.com/s.aspx?sm=BAkQOkS8ILAgJBrWBfT_2few_3d_3d

Dr. Andrew Brennan, Clinical Psychologist
Tel 0121 442 3448/3303

The effect of traumatic brain injury on the health of homeless people

Brain injury in a forensic psychiatry population

Snowboarder versus Tree – Significant Abdominal and Head Trauma, please see pages 18-20 From the Official Journal of the National Emergency Nurses Affiliation Inc. Fall 2008

Understanding the Repercussions of Cognitive Impairment on Daily Life which effect ABI-TBI Survivors (pdf-581kb)
by Carolina Bottari, PhD, McGill University