Lakeview Blog

Dr. Michael Mozzoni Presenting on Behavioral Methods in Brain Injury Rehabilitation

Please join Lakeview at the North American Brain Injury Society’s (NABIS) Annual Conference in Miami, FL  9/11-9/15/2012 where Lakeview’s Director of Behavioral Services and Training, Dr. Michael Mozzoni, will be presenting on ‘Training Methods in Brain Injury Rehabilitation: Limbic Activation, Fluency and Discounting’.  People with Acquired Brain Injuries (ABI) often present with problems in the areas of: impulsivity, attention, memory, awareness and disinhibition. They may have difficulty learning/re-learning skills and information, which can slow progress and compromise treatment success. These deficits, in many cases, result in acquired learning disabilities.  Training methods developed in special education for persons with learning disabilities appear to be appropriate and effective for persons with ABI.  Funding pressures have dramatically decreased the time allowed for treatment, requiring therapists to use more efficient training methods. This presentation will demonstrate training methods found in the behavioral literature and effectively applied to persons with ABI. Evidence in the behavioral literature concerning methods of fluency, discounting and trial presentation will be presented with several case examples.  In addition, some original research will be presented concerning mild limbic system activation to retrain autobiographical memory. Issues of motivation, alignment of expectations and success in therapy sessions will be reviewed in relation to behavior management and skill acquisition.   For more information, please visit www.nabis.org.

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Chronic Traumatic Encephalopathy - Risk to Athletes and Veterans Post-Concussion

In 2009, Ann C. McKee, MD, Robert C. Cantu, MD, Christopher J. Nowinski, AB, E. Tessa Hedley-Whyte, MD, Brandon E. Gavett, PhD, Andrew E. Budson, MD, Veronica E. Santini, MD, Hyo-Soon Lee, MD, Caroline A. Kubilus, and Robert A. Stern, PhD, published a landmark article on Chronic Traumatic Encephalopathy (CTE) in the Journal of Neuropathology and Experimental Neurology [J Neuropathol Exp Neurol. 2009 July; 68(7): 709-735]. While 'Dementia Pugilistica' or the repeated brain trauma caused by boxing had been well established, this article raised attention to highlight other repeat concussion sports such as football. The researchers further identified and defined CTE, as a syndrome with specific pathology and symptoms. The symptoms of CTE reported include memory disturbances, behavioral and personality changes, Parkinsonism, speech and gait abnormalities and is now noted to include impulsive behavior, mood instability, increased suicide risk and eventual dementia in some instances.

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Lakeview NH Program Approved by New York State Department of Education

Lakeview New Hampshire’s Special Education School and Residential Treatment Program have been approved by New York State effective 07/-1/2012, as a school-aged, center-based, 12 month residential program for youth from New York, ages 6-21, including occupational, physical and speech-language therapies.  The program is approved to serve youth within the primary educational disability categories of Autism, Emotionally Disturbed, Intellectually Disabled, Multiple Disabilities, Orthopedic Impaired, Other Health Impaired, Learning Disabled, Traumatic Brain Injury and Visually Impaired.  With guidance from Lakeview’s Chief Operating Officer, Dr. Tina Trudel, Lakeview NH’s Executive Director, Dr. Tom Horan, oversees programs and services, with Director of Education Corinne Rocco, MEd, CAGS, Youth Director Dr. Amanda Goza, Board Certified Child Psychiatrist Dr. Kim Whitesell, School Psychologist Dr. Cathy Bergeron, and a full team of teachers, behavior analysts, neuropsychologists, counselors, case managers, recreation therapists, nurses, physicians and allied health professionals. 

Robyn R. Rushing, RRT, NRP, BBA Named Lakeview VP of Medical Operations and Development

Please join us in congratulating Lakeview’s newest Vice-President, ROBYN R. RUSHING, RRT, NRP, BBA, VP of Medical Operations and Development & Hospital Administrator.  Ms. Rushing has 20 years of hospital experience, entering the field as a licensed Respiratory Therapist. For the last few years she has been instrumental in developing Lakeview’s medical operations including home health services, ventilator programs, intermediate care unit, lab services, outpatient clinics, dialysis, bronchoscopy, endoscopy and critical care paramedic service in her role as Hospital Administrator.  Previously, Ms. Rushing served as Director of Business Development and later as Chief Executive Officer for three LTACs based in Tulsa, OK. Prior to joining Lakeview as Hospital Administrator, Ms. Rushing also served as Administrative Director for Kaiser Rehabilitation Center in Tulsa. Ms. Rushing is a Member of the American College of Healthcare Executives and a Member of the American College of Cardiovascular and Pulmonary Rehab.  She will be continuing in her role as Hospital Administrator, with Paula Ashley, RN, now serving as Associate Hospital Administrator. 

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Dr. Tina Trudel to Speak on Neurotoxin Exposure at NABIS

Neurotoxicity will be the topic of both a full-day preconference program as well as a conference session at the North American Brain Injury Society (NABIS) Annual Conference 09/12-09/15/2012 in Miami, FL.  Neurotoxic exposure, an often unrecognized cause of brain damage across the lifespan, will be addressed by leading medical, neuropsychological, life care planning and legal experts, including Lakeview President/COO and neuropsychologist, Dr. Tina Trudel.  Whether caused by exposure in utero, through childhood experience or as an adult; through low level chronic or acute episode; and environmental, residential or occupational exposure - all may result in brain damage and impairment of functioning.  This workshop on the types, assessment, treatment, rehabilitation, litigation and life care planning of neurotoxic exposure cases will be highlighted by current research and in depth case reviews. 

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Lakeview’s Jim Para-Cremer, MS, BCBA Presents at Wisconsin ABA

Jim Para-Cremer, MS, BCBA, Lakeview Administrator of Residential Programs in Wisconsin, and Daniel Parker presented a CEU course entitled ‘A Practical Approach to Positive Behavior Interventions and Support (PBIS) within Applied Settings’ at the August 13, 2012 Wisconsin statewide ABA conference.  Utilizing data and functional analysis, this workshop outlined methods that enable educators to determine the types of supports and interventions needed for students. The focus of the workshop addressed how to develop systems that assist with determining the accommodations and skills needed to promote positive adaptive and functional skills for learners.  Lakeview’s leadership team, including Jim Para-Cremer, are available to present evidence-based and best practices and approaches in the areas of education, treatment, and rehabilitation of youth and adults with neurobehavioral and developmental needs, including those with diagnoses of brain injury and autism spectrum disorders.

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Comments on the recent Bloomberg article on abuse at the FINR brain injury rehabilitation program.

 The recent Bloomberg article on abuse at the FINR brain injury rehabilitation program has spurred strong emotions and much discussion.  It is both tragic for those affected, and inexcusable to have occurred.  Lakeview hopes that the brain injury community and the general public recognize that this one example does not reflect the field of dedicated providers who respect human rights, follow rules and regulations and value the moral responsibility that is inherent in operating healthcare facilities and serving persons with BI and related conditions.  The Lakeview affiliated companies are privately owned by the very people whose bios and long term commitment to support and advocacy, are evident on this website.  This small, accountable and committed group includes our Chairman, Tony Merka, North American Brain Injury Society (NABIS) Lifetime Achievement Awardee and early supporter for the foundation of the Brain Injury Association of America (BIAA); our President, and Tony’s long term business partner Carolyn McDermott, a committed BI advocate; CEO Chris Slover, former Chairman of Brain Injury Association’s Business & Professional Council, member of the BIAA Board of Directors; and COO Dr. Tina Trudel, BIAA Founders Award Honoree (2008) for advocacy and service, as well as a board member of BIAA, NABIS and the Sarah Jane Brain Foundation, among other roles.  Lakeview programs are CARF and/or Joint Commission accredited, as we welcome external review of what we do.  We further maintain stringent corporate compliance, quality assurance and internal audit programs, including an anonymous 800 number so that any of our program participants, families, staff, funders or members of the public can directly contact our leadership with a mandatory 24 hour response time.  Lakeview always seeks to improve and lead in the field – both in our quality of care and in the respect and dignity afforded to all who receive that care. 

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Junior Seau (January 19, 1969 - May 2, 2012)

While details of the death of Junior Seau are still undetermined, his death bears a striking resemblance to other suicides and deaths from violent means that have been associated with Chronic Traumatic Encephalopathy (CTE) in professional athletes. CTE results from repetitive closed head injury wherein degeneration of brain tissue and the build-up of tau protein occur. This results in a progressive condition where dementia-like changes occur, along with mood swings, cognitive decline, memory problems and physical impairments. Previous to this self-inflicted gunshot wound, Seau had been arrested for domestic violence and had driven his car off of a cliff (reportedly due to fatigue) in 2010, potential behavioral warning signs for CTE. While not known for being concussion prone, Seau, a 12 time Pro-Bowler, amassed over 1,500 tackles in his NFL career and was an aggressive player even from his younger days in football. His brain is likely to have sustained thousands of small to large concussive forces throughout such a lengthy career.

Seau's death via a self-inflicted gunshot wound to the chest closely parallels last year's death of Dave Duerson, NFL safety, who shot himself in the chest and died. Only later was it disclosed that Duerson shot himself in the chest so that his brain could be donated for study to discern the effects of repeated concussion. Duerson's brain was studied by the Sports Legacy Institute (SLI), a Boston University based foundation started by neurologist Robert Cantu and former Harvard football player Chris Nowinski to study the long-term effects of concussions. Their examination of Duerson's brain showed he had CTE, with similar findings in the brains of 20 other dead players. Perhaps in this desparate, tragic act, Junior Seau also was sparing his brain, which had already been through so much. May the Seau family find comfort and Junior Seau rest in peace.

BIAA Business Practice College Features Lakeview Leadership

The Brain Injury Association of America's (BIAA) Business Practice College is under way this week in Las Vegas. Rehabilitation industry leaders from across the country participate in this program, which offers sessions for CEOs, COOs, Human Resources and Marketing professionals. The group's focus is to share exemplary strategies ensuring access to, and development of quality healthcare. Lakeview Vice-Presidents Sue Bartlett, LCSW, CRC and Dianne Schwarz, MEd, OT will be presenting a general session to the group on Medicaid mechanisms and trends as they relate to brain injury and rehabilitation. Sue Bartlett has over two decades of experience in BI case management, contracting and development, while Dianne Schwarz recently joined Lakeview after many years in New York state government, involved with the care of over 7,000 individuals with BI and related conditions.
The Business Practice College opens with the annual meeting of the BIAA Business and Professional Council, Chaired by Lakeview's President/COO Dr. Tina Trudel. As noted at www.biausa.org, the Council's primary goal is to increase access to care. Membership in the Council offers opportunities to stay up-to-date on health care policies, participate in coordinated legislative action, share in brain injury health outcomes and business intelligence, and communicate and network with colleagues.

Traumatic Brain Injury and 'The Vow'

The romantic drama, 'The Vow', depicting a couple dealing with the aftermath of traumatic brain injury (TBI), was released just in time for Valentine's Day box-office success. Many have asked, could something like this really happen? Yes, in fact the story is loosely based on the true story wherein Krickitt Carpenter sustained a TBI and lost memories of falling in love with her husband (Kim Carpenter). Their compelling story about TBI and the power of love can be found all over the internet. However, there are a few caveats to remember: First is that individuals with TBI typically typically have minimal retrograde amnesia (memories learned before the TBI) and far more difficulty with anterograde amnesia (memories learned after the TBI); second, most individuals injured severely enough to suffer major retrograde amnesia also have other challenges such as personality, cognitive and/or physical changes; and lastly, divorce is unfortunately common after TBI - a challenge for all of us to reach out and support those couples we encounter who are finding their way through the often difficult post-TBI journey.