Recognizing and managing concussion in school sport.

Every country around the world enjoys some sort of sport. The Olympics sees countries from all over the globe participate in elite sport, in both winter and summer competitions. Australia is widely known for cricket and rugby; America is known for baseball and gridiron football (among others). These sports are played at an elite level as well as beginners from early ages as young as 4 years in the backyard. Yet, it is also these sports that can deliver a ball at the speed of 100 km/h (football), 105 km/h (baseball), 112 km/h (rugby), 150 km/h (cricket), and 211 km/h (soccer). This is the same force that a car collision can produce. That force eventually finds a target, and in some cases, unfortunately, it is a head. Damage to the brain is not only from the impact of the ball hitting its target but rather also the shearing forces of acceleration-deceleration injury that can cause extensive injuries. There has been much discussion of late regarding concussion in sport and the accumulative effects of head blows resulting in varying degrees of memory loss and dementia later in life. The media have been saturated with heightened awareness of chronic traumatic encephalopathy. This, however, is still being researched. It is true that each concussion compounds the one before, but rather than focus on the injury, managers/coaches and sporting codes should be focusing on the identification and proper management of a suspected concussion and the return-to-play protocols. This is especially important in our schools where growing brains need nurturing. Neuroscience nurses are at the forefront of educating school children, teachers, and coaches through partnering with local schools. This article will focus on concussion recognition and management in school sport.

[Work after brain damage: unpredictability of outcomes]. / Le travail après une lésion cérébrale, l'imprévisibilité des trajectoires.

The Unit for Evaluation, Re-Education and Socio-Professional Orientation (UEROS) is a bridge between the hospital environment and professional life. It assists brain-damaged patients with their social and professional reintegration while taking into account their specific needs.

How do you know when your patient is "waking up": coma recovery assessment in a complex continuing care setting.

Coma, vegetative state (VS) and minimally conscious state (MCS) are disastrous outcomes following severe traumatic brain injury. Due to the extent of the resultant neurological deficits including hemisphere damage, loss of cellular integrity, altered and abnormal movements such as flexor and extensor patterns, and alterations in cranial nerve function, it can become difficult for the interprofessional team to identify when a patient is emerging from their coma. The Glasgow Coma Scale (GCS), commonly used to assess patients with traumatic brain injury (TBI) is not comprehensive or sensitive enough to provide concrete evidence that a patient is emerging from VS to an MCS. The purpose of this paper is to present a case study of a patient who has emerged from a persistent VS to promote a deeper understanding of what is involved when working with this clientele. Challenges in assessment of cognitive functioning, the development of successful communication through the use of technology and the goals of therapy amongst the various health team members will be provided. Collaborative support with the family will also be discussed. Members of the interprofessional team explored the literature to determine coma recovery assessment tools and best evidence guidelines to direct their interventions with this patient.

[Burden of primary caregivers of young patients with brain damage].

OBJECTIVES: The objective of this study was to shed light on (1) the extent to which primary caregivers of patients with brain damage feel nursing-care burden, and (2) the relationship between such burden and other attributes in a cross-sectional manner. METHODS: We conducted an anonymous questionnaire survey of primary caregivers of young patients with brain damage. The survey was conducted between November 2008 and March 2009. The number of valid responses was 53 (response rate 56%). To assess burden of caregivers, we used the Short Version of the Japanese Version of the Zarit Caregiver Burden Interview (J-ZBI_8). RESULTS: With regard to burden felt by primary caregivers "concerns about excretion" and "problematic behavior" were stressed. Individuals who were less than 50 in age most strongly felt burden. Moreover, burden was greater for spouses than for guardians. CONCLUSION: In order to reduce the burden of caregivers in case of primary caregivers, rehabilitation concerning young patients with brain damage and efforts to enhance their capabilities are important. In addition, it is also necessary to provide social resources so that primary caregivers can rely on other persons without worry.