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| A blog dedicated to providing information, news and legal updates for individuals and families who have suffered a traumatic brain injury. Updated regularly and maintained by Bruce Stern of Stark & Stark. |
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Violence and Traumatic Brain Injury
I was pleased to receive this month’s issue of the Brain Injury Professional, The Official Publication of the North America Brain Injury Society. This issue focuses on the important subject of violence and traumatic brain injury.
The guest editor this month is Gene Langlois, ScD, MPH, from the Centers for Disease Control and Prevention (CDC).
As stated by Dr. Ron Savage, Executive Vice President, “Our current data are frightening. Estimates range from 960,000 incidents of violence against a current or former spouse, boyfriend or girlfriend per year (US Dept. of Justice), to 3,000,000 women who are physically abused by their husbands or boyfriends per year. According to Dr. Langlois, 11% of TBI deaths, hospitalizations and emergency room visits are related to physical violence.
This is a very important issue and I invite all of my readers to obtain a copy and to join NABIS.
Brain Injury Basics for Families: Fall 2008 Schedule
The Brain Injury Association of New Jersey has announced the Fall 2008 Brain Injury Basics for Families schedule.
These educational seminars will:
- Provide an overview of brain injury, including definitions and the rate of incidence
- Provide information on the effects of brain injury on families, including the stages of grief family members experience
- Provide information about the common consequences of brain injury: cognitive, physical, and emotional
- Provide information about strategies families can utilize and tips for caregivers
- Provide information on resources available through the Brain Injury Association of New Jersey and agencies throughout the state
You can access the brochures, list of seminar dates, and registration information here.
Improvements to Medical Care for Veterans
Last Thursday, the Department of Veterans Affairs Inspector General released a report calling for the need to improve the medical care provided to veterans who sustained traumatic brain injury.
According to the report, Inspector General’s office studied the cases of 52 Iraqi and Afghan war veterans to determine whether or not the care they had received had improved since the Inspector General’s report of two years ago in July 2006. Although the report indicated that overall care had improved, nevertheless there were still patients and families who had not received the appropriate medical treatment and follow-up.
This report followed a study released last month by the Rand Corporation, a nonprofit research group. What was most interesting in that report was that Rand Corp. found that patients with mild traumatic brain injury required $27,260 to $32,760 a year to treat a patient with a mild traumatic brain injury. Severe traumatic brain injury cases required an annual cost of $268,900 to $408,250 per year.
Clearly, the Rand study documents that there is certainly nothing ‘mild’ about mild traumatic brain injury. 
Brain Injury Awareness For Older Americans
In recognition of Older Americans Month, the Brain Injury Association of New Jersey will be having two Brain Injury Awareness events at the State House in Trenton. Details are as follows:
From 9:00 – 2:00 on Thursday, May 8th in Committee Room 14
From 9:00 – 2:00 on Tuesday, May 13th in Committee Room 3
For additional information, please visit the Brain Injury Association of New Jersey's website here.
President Bush Passes Traumatic Brain Injury Act of 2008
On Monday, April 28, 2008, President Bush signed into law S. 793, the "Traumatic Brain Injury Act of 2008," which authorizes appropriations and will make changes to the Department of Health and Human Services programs. These programs provide grants for State programs for increased support for tracking and reporting of brain injuries and resources for brain injury rehabilitation.
This law is a long time coming and is a huge step for the prevention and care of those suffering from a traumatic brain injury.
Report on Brain Injuries in Troops from RAND Corporation
A new study released by the RAND Corporation reported that 19% of our American troops serving in Afghanistan and Iraq said that they may have experienced a traumatic brain injury yet a majority of these have never been evaluated or treated.
This study further evidences the need for better evaluation and treatment for our troops. From a neurolaw standpoint, this study should be very helpful in deflecting defense attacks against our clients with traumatic brain injury who leave the scene of an accident without receiving any medical attention or, who are seen in the emergency room yet don’t complain about any of the effects of a brain injury or concussion.
For those interested in following up on this story, I direct you to the New York Times story that appeared in the April 18, 2008 issue. 
7th World Congress on Brain Injury
I have just returned from attending the 7th World Congress on Brain Injury which was held in conjunction with the National Congress of the Portugese Society of PMR Lisbon, Portugal. This World Congress was sponsored and held under the auspices of the International Brain Injury Association.
The Congress brought experts from around the world to discuss advanced techniques in the treatment and care of patients with traumatic brain injury. Over the next few weeks, I will provide summaries of some of the presentations and posters which were most applicable to the field of brain injury litigation.
From an organizational standpoint, readers of my blog are well aware that I presently serve as treasurer of the International Brain Injury Association. While in Lisbon, I attended numerous organizational meetings to advance the causes of this outstanding organization.
On Thursday, I attended the Board of Directors meeting at which time the Board of Directors of IBIA adopted the new by-laws which I had drafted at the request of the IBIA chair, Nathan Zasler, M.D.
On Friday, the entire Board of Governors met at which time, Dr. Jose Leon-Carrion was elected to fill the newly-created position of vice chair. Dr. Leon-Carrion is a physiatrist who practices in Seville, Spain. Dr. Claudio Perino, a physician from Turin, Italy was elected to replace Dr. Leon-Carrion as the new secretary. Finally, Jennie Ponfords, Ph.D., a neuropsychologist practicing in Melbourne, Australia was elected to serve on the executive board. Dr. Nathan Zasler, a physiatrist from Richmond, Virginia will continue as chairman of IBIA and I will continue to serve as treasurer.
The Board also selected eight new board members with diverse practices and from diverse parts of the world.
At the Board meeting, it was the consensus of the Board of Governors that the 8th World Congress on Brain Injury should be held in the United States. The Board is still considering various proposals with regard to site selection.
Congratulations go out to Dr. Zasler as well as Margaret Roberts and Chas Haynes of MCC Association Management who did an outstanding job in coordinating and running this outstanding Congress. 
House expands aid for brain injuries
The House of Representatives voted last Tuesday on a bill to expand research and surveillance of traumatic brain injuries. The new legislation will also help to ensure that all newborns get adequate screening for genetic or metabolic diseases. The brain trauma bill, passed 392-1 by the House, which has already been approved by the Senate, and the Senate is expected to act soon to send it to President Bush for his signature.
The legislation authorizes National Institutes of Health programs through fiscal year 2011 and directs the Centers for Disease Control and Prevention to conduct a study into national traumatic brain injury trends and identify treatments. It also supports Health Resources Service Administration grants to fund state projects to improve access to rehabilitation.
Representative Bill Pascrell, D-N.J., was a chief sponsor of the bill, and said that up to two-thirds of those wounded in Iraq have injuries affecting the brain, and many, especially those from the National Guard and the Reserves, have to turn to civilian care because their injuries are initially misdiagnosed or go undiagnosed.
This is a huge step in the care and resources that will be available to those suffering from traumatic brain injuries. You can read more on the bill and the positive effects it will have for those in need here.
2008 Annual Seminar: Reconnecting Mind and Body
The Brain Injury Association of New Jersey will hold the 26th Annual Seminar: Reconnecting Mind and Body. The seminar will be held May 14-15, 2008 at the Sheraton Eatontown Hotel and Conference Center.
The seminar will cover topics such as, New Frontiers in Wellness Practices, Cutting Edge Research, Navigating the Legal Landscape, and Caregiving, among many others. The Brain Injury Association of New Jersey is an approved provider for AACBIS and the NJ Department of Education Continuing Education Credits. Continuing Education Credits are pending for NJ, NY, Social Work, CRCC, CCMC, CDMS, APA, PT and ASAH.
You can access the seminar brochure, seminar outline and registration information here.
Changes In Behavior and Personality After Brain Injury
The Brian Injury Association of New Jersey is scheduled to hold two upcoming seminars on the behavioral changes people face after suffering a traumatic brain injury. The seminars will provide an overview of brain injuries including common symptoms and the prevalence of TBIs in New Jersey.
The seminar will also discuss how to identify the common behavioral changes that can occur after a brain injury has occurred, and some of the common causes of these behavioral changes. The seminar will also discuss the psychosocial issues faced by individuals with brain injuries, and how these issues can change with age.
The seminars will be held:
April 10, 2008
9:15 AM - 3:30 PM
Kessler Institute for Rehabilitation
West Orange, NJ
April 16,2008
9:15 AM - 3:30 PM
PSE&G Conference Center
Edison, NJ
You can find more information on these seminars, and how to register here. 
Presentation on Mild and Acquired Traumatic Brain Injury
Yesterday morning I attended a fascinating presentation by Anne Forrest, Ph.D. which was sponsored by ReMed in West Conshohocken, PA. Dr. Forrest received her Bachelor of Arts from Yale University and her Ph.D. in Economics from Duke University. In June 1997, she was involved in a minor rear-end collision in which she nevertheless sustained a “mild” traumatic brain injury.
In her presentation, Dr. Forrest discussed the difficulties she had with the medical community , legal system and insurance industry, which unfortunately is a story told too often by survivors of traumatic brain injury. Because she did not lose consciousness, many of the doctors failed to recognize the seriousness of her injuries, some of them even implying that it was psychological or even worse malingering. She unfortunately went from doctor to doctor, professional to professional until finally her injury was properly diagnosed.
From the legal standpoint, the person who struck her had very little insurance and she asserted an under insured motorist claim which she ultimately lost when defendants’ IME doctors, who labeled her a malingerer, ultimately prevailed. Yet, eleven years later, with the litigation long since done, Dr. Forrest still has not recovered, and is still hopeful, possibly next week, that she will be able to get her driver’s license back.
Today, Dr. Forrest has become one of the nation’s leading patient advocates for survivors with acquired traumatic brain injury. I certainly applaud her hard work not only in her rehabilitation but in her new professional endeavors. 
NABIS Holds 6th Annual Conference on Brain Injury
The North American Brain Injury Society will hold it's 6th Annual Conference on Brain Injury October 2-4, 2008 in New Orleans, Louisiana. The conference is the largest annual gathering of North American professionals working in the field of brain injury. Attendees are comprised of basic scientists, rehabilitation physicians, psychiatrists, psychologists, neuropsychologists, speech pathologists, occupational therapists, physical therapists, social workers, nurses, case managers, legal professionals, advocates and all others working in the field of brain injury.
The 2008 conference will focus on four concurrent education tracks covering the following topic areas: - Medical-Clinical Best Practices
- Research/Science
- Life Long Living & Working
- Legal Issues in Brain Injury
In all, over 60 of the leading experts from North America will present the latest advances in the science, rehabilitation and treatment of traumatic brain injury. You can access additional information on the conference at the NABIS website here.
New Life Expectancy Tables
For many people with acquired traumatic brain injury, an adequate life care plan is essential. In personal injury cases, where the value of a life care plan is part of the damages, an essential ingredient is the life expectancy of the individual. In New Jersey and many other states, the Courts utilize a gender, race and ethnic neutral life expectancy, utilizing one life expectancy table regardless of gender or race.
Most recently “New government researches found large and growing disparities in life expectancy for richer and poorer Americans, paralleling the growth of income inequality in the last two decades.”
As reported in Sunday’s New York Times, researchers from the Department of Health and Human Services looked at life expectancy, among many other factors, using census data on education, income, poverty and housing to name but a few of the factors looked at.
This finding was similar to a study conducted by Ellen R. Meara, a health economist at Harvard Medical School who reported that in the 1980s and 1990s “virtually all gains in life expectancy occurred among highly-educated groups.” This was also similar to a Center for Disease Control and Prevention report in February documenting those with higher levels of education and income were much more likely to receive cardiac rehabilitation care than those with lower education and less income.
Since life expectancy represents only the average (50th percentile) life expectancy of Americans, half the population will live longer than the average life expectancy tables. This will have a profound effect in cases where attorneys representing those with acquired traumatic brain injury fail to adequately alert a jury of this potential result.
The International Rehabilitation Conference
On Wednesday, March 12, 2008 I had the pleasure of presenting a seminar at the International Rehabilitation Conference (NeuroHabana 2008) in Havana, Cuba.
My presentation was on the topic of “Third Party Observers During Neuropsychological Testing”. Professionals in the Traumatic Brain Injury field from the United States, Cuba, Serbia, Israel and several South American countries were in attendance.
This was a great event and I was proud to have been able to participate with so many other professionals in the TBI field and on such an important topic.
New Website for Teens
The Brain Injury Association of New Jersey is pleased to announce its new resource website targeting teenagers in order to develop feedback from teens, addressing traffic safety and brain injury prevention. The website is a new way to reach teens, who currently are at highest risk for suffering from a brain injury.
The site provides information and educational resources in hopes of preventing teen brain injuries before they start. The site also shows teens the real life consequences of their risky behavior.
The material is presented in a manner which appeals to this age group because it was developed with their input and reviews. There are some graphic videos, pictures, true stories and a comment page where people can post their questions and thoughts.
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Doing it head-on
When you promote, you want to get results. That is the purpose of promotions anyway. Most of the time though, they do not work the way you want it to. Why do this happen?
Maybe your promotions are not sending your readers the right message.
Even if they are highly targeted but are not really giving out the correct message, do not expect any good results to come your way.
The kind of business that you have should be the primary focus of what your promotion is all about. Have you ever seen those advertising that says something but actually means another? They are rampant everywhere.
Do not expect your customers to be good at figuring out what you are saying by saying them in idiomatic ways. Reality is that not many people have the time to try and figure out what is the real meaning is behind your promotion. Get it to them straight on.
If you want to be noticed, do not always attempt to differ your promotion. Some of the can work but most do not. What if yours fall into the “do not”?
Blogger Business Cards
Using index cards for business card is not anymore new. I have read an article about how it can be used for this purpose. The article was tackling about styles and techniques on how to go about using creativity in these cards.
Blogher Business Cards tackled some new ideas I have not read on the article I mentioned above. But it has the same concept; index cards as business cards.
Why not? If you think about the expenses that you will incur on the paper stock that you need to use, I am sure you will really like this other possibility. With every ounce of creativity that you have in you, you can turn these simple cards into a business card that not everyone sees everyday. A unique one for that matter.
It will not surprise me if you find some printing companies like Full Color Printing Company catering to this kind of things. Try it out and see for yourself. What have you got to lose, anyway? On the other hand, maybe you will be surprised to find that you can actually gain more out of something so simple.
Planning a blue tooth installation
Installations for BlueTooth may not be as demanding as IrDA installations, which require direct line-of-sight.
Because BlueTooth is a radio-frequency-based communication, it can penetrate walls and objects to a certain extent. It also has a somewhat larger range, so you can create a larger print zone.
A larger print zone is a benefit, but it also creates some issues about where the devices need to be placed in relation to the printer. Obviously the users' desks or work center locations must to be within the range of the BlueTooth-enabled printer.
With a 30-foot radius, quite a few desks can be placed within range, but remember that the farther out you go, the weaker the signal strength. The upshot is that the practical limitation is more like 15 feet instead of 30. This is still reasonable, but with most printers installed against the wall (where the outlets typically are), you're really giving yourself a 15-foot radius out from the wall.
The 15-foot radius also needs to incorporate any walkways or open space in which users move around, which means it's possible that you could get five to twelve people at desks or tables within that radius. This would adequately serve the needs for most consulting or special events where printing is needed.
How do you choose the right digital camera in time for the holidays?
Most photographers swear by one brand over the other. If you are already particularly loyal to just one brand, then you can shun the others and bask in just one aisle. But if you are a little bit more open-minded, then you’ve got a bigger playground to frolic in.
You will need to see what kind of memory card the camera needs, and what kind of batteries fuel it. Most digital cameras use AA batteries, so investing in a bunch of rechargeable ones is fine.
Try it out. Most people make the mistake of reading the box, swiping their credit card, and coming home to find out that they’re not comfortable with their latest purchase.
While still in the store, try taking a bunch of photos. Make sure it fits well in your hand, and is easy to use. The most user-friendly cameras out there are Canon, Casio, and Kodak but you might want to try out others. Take your time in familiarizing yourself with the possible units you’ll be taking pictures with.
Snapshot Image Cleaning
Snapshot is a valuable technique to save our precious time when working with images in Photoshop – be it an original copy image, something from a digital camera or from a scanned slide or negative. This is usually used to clean up images such as images for publication use.
The technique is so easy, it only involves a four-step method and is easy to recall. You can make use of this in many situations like adjusting levels, color, saturation, sharpness and other corrections without wasting time with layer masks, lasso tools, layers, rubber stamping or magic wand. To ensure that your eyes are fixed to your subject, you can use this method.
Soft-eyes are scanning problems inherent of the natural film curvature while scanning. To avoid soft-eyes problems, use snapshots technique which allows fixation in few seconds. To do this, first open your file. Then go to filter > sharpen > unsharp mask. After that, a dialog box will appear with unsharp mask defaults. Set the default amount to 75 percent, radius to 1 pixel and threshold levels to zero or one. Finally, click OK. You may notice that the entire image has the unsharp mask applied to it beforehand. As a result, it sharpens the overall image.
The texture is no longer as soft as it first appeared. This is the time when the snapshots will save your artwork.
To correct the flaws, you must go to the history palette. If it you did not find it in your desktop, you can find it normally on the right in Photoshop by default. Go to window > Show history. Once you have located your history palette, select the bold arrow-button on its right side. Click and hold it until a menu appears then go to New Snapshot. When you release your mouse, another dialog box will appear. You must enter in it the name “unsharp eyes”, then click OK.
If you have more than one snapshot in a working file, do not forget to label your snapshots to be able to have a better workflow management when it comes to organization of your images. It is nice to do it that way for easy and fast selection and for an efficient scheme.
Proper Scanning Resolution
One thing to master about scanning is the proper scanning resolution. The proper resolution to scan depends on how you intended it to be used.
Before scanning it is important to know these five vital information: size of the original image, size of the printed image, LPI at which your image will be printed, resolution multiplier and the process of editing the scanned image. The hint is - the higher the resolution, the larger the file size.
To calculate the final image resolution, these are the solutions:
1. If the size of the image is absolute, multiply LPI by your resolution multiplier. Ex. LPI x 2 for brochures.
2. if the size of the image is not absolute, multiply LPI by your resolution multiplier and then the size of the final image as a percentage to the original. Ex. LPI x 2 x %.
In cases of commercial printing, ask your print shop if you do not know the required LPI as well as other specifications.
Scanning at a slightly higher resolution is most of the time advantageous. By that, it is easier to dump unneeded resolution after scanning. Moreover, reduce your image to the final resolution before placing it in your document for printing.
In most of the print works, 300 dpi is the standard print resolution. The standard resolution for web is 72 dpi. This works best in computer screens. If you you're scanning in an image and only going to use it for web you could maintain it at 72 dpi. Film print’s standard resolution on the other hand is 720 dpi. That way you can make enlargements. The general rule with resolution is that never go up but you can always go down. If you have a 720 dpi image, you can at any rate bring it down to 300 dpi and still look sound.
If you are using photographs for your web, scan them at 72 or 100 dpi.72 dpi is screen resolution and the preferred format for saving the image is jpeg though you can also use .psd. Remember that when you Save As, you are creating a copy of your current document and you are decreasing its file size. You can also save your file within Photoshop. This will allow you to preview your work to adjust the quality of the same. If the image is really huge, simply go to Image > Image Size and bring down the resolution to 300 for print or 72 for web or change the image dimensions if it is indispensable.
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