Brain and Spine Injury Law Blog

Heath Care Reform

Tim Titolo — Fri, 19 Mar 2010 09:13:11 -0800

We are down to the wire on Health Care. The Brain Injury Association of America again prompts action. I have written my representative to support the health care bill.

Brain Injury Awareness Day, 2010

Thank you to everyone that made this year’s Brain Injury Awareness Day on Capitol Hill a huge success! With record attendance at both the brain injury fair and briefing, hundreds of community members, survivors and state affiliates met with various lawmakers to advocate for increased brain injury appropriations, access to brain injury care, caregiver assistance, and other important issues. Congratulations to all for a very successful day!

Health Care Reform Update

This week, both President Obama and Speaker Pelosi lobbied to win passage of their health care reform package. However, it is still unclear whether the two have procured the 216 votes needed to win the House vote that is projected to happen this Sunday.

Now is the time for grassroots to act! I have copied below the action alert that was sent out earlier this week. If you have not yet called your representative, please do so as soon as possible!

Call Your Representative NOW – The House will Vote on Health Care Reform this Week!

The House of Representatives is set to vote on the Senate health care reform bill at the end of this week. If the measure fails, the hope of health care reform will likely vanish for this year and maybe even for years to come.

Even though the House and Senate have both passed their versions of health care reform, the only way forward for the bill is for the House to approve the Senate version.

Your voice matters now more than ever. Call TOLL FREE 1-888-876-6242, if you don’t know who your representative is, click here.

Urgent Brain Injury Health Care Reform

Tim Titolo — Wed, 17 Mar 2010 11:12:57 -0800

Brain Injury Association of America notes The House of Representatives is set to vote on the Senate health care reform bill at the end of this week.

Call Your Representative NOW – The House will Vote on Health Care Reform this Week!

Even though the House and Senate have both passed their versions of health care reform, the only way forward for the bill is for the House to approve the Senate version.

Your voice matters now more than ever. Call TOLL FREE 1-888-876-6242, if you don’t know who your representative is, click here.

Tell your representative that you are a constituent that is concerned about health care reform. Specifically, people that have sustained brain injuries need health care reform because:

Millions with health insurance are now at the mercy of insurance companies that charge premiums beyond affordability. The legislation would limit these increases.
Many with insurance find that it won't cover them when they get sick - even after they have paid premiums for years. The legislation will ban denials based on pre-existing conditions in children and adults.
Patients who reach their lifetime insurance cap after a catastrophic injury or illness will be able to continue treatment in order to regain functionality and have a better chance of returning to work or school. The bill will eliminate lifetime insurance limits.

AND...

Investing money now will save the government millions of dollars later when the private insurance companies are required to take responsibility for the premiums they collect instead of turning individuals facing catastrophic injury or illness away to rely on public plans and ultimately, the American taxpayers.

Some representatives in the House are debating on whether to vote for or against the bill. Regardless of how they voted in the past, many are still waying their options. This measure is vital to the brain injury community, and we need your help to ensure that people with brain injury gain access to the care that they need and deserve! CALL NOW!

Back, Neck and Spine Injury Diagnosis

Tim Titolo — Tue, 16 Mar 2010 12:40:27 -0800

As a back and neck injury lawyer in Las Vegas, Nevada, I encounter untreated or undiagnosed spine injury often. Even though back pain can affect people of any age, it is significantly more common among adults aged between 35 and 55 years.

Experts say that back pain is associated with the way our bones, muscles and ligaments in our backs work together.

There are several diagnostic tests to assist physicians in detecting and treating back and neck conditions.

An interesting review entitled "Physical examination for lumbar radiculopathy due to disc herniation in patients with low-back pain" (Van der Windt DAWM, et al. Cochrane Database of Systematic Reviews 2010) reveals that diagnosing back pain is not a simple matter. I read the findings.

While lower back pain ranks as a common cause of disability in the United States, determining what causes a person's back pain is often challenging. A new review on diagnosing back pain finds that no single diagnostic test is good at discriminating between patients who have a herniated disc and patients who do not.

Lawrence Kurz M.D., an orthopedic spinal surgeon at Beaumont Hospital in Royal Oak, Mich., agreed with the results of this review: No one test is specific and sensitive enough to be used as the sole guide for making an accurate diagnosis of disc herniation as the cause of sciatica.

Healthy discs are spongy cushions of cartilage that fill the spaces between vertebrae in the spine. They act as shock absorbers for the spine and allow flexibility. A herniated disc can occur when a disc incurs damage because of trauma or stress and bulges outside of its normal position to press on a nerve. This can result in pain that radiates down to the lower leg - also called sciatica.

In other conditions, including osteoporosis and similar aging disorders, bony structures could press on nerves, causing pain.

Representing injured people with back and neck pain complaints requries diverse diagnositic testing. Insurance company representative all too often point to one test to either deny or rule out a condition.

Nevada Senator Harry Reid's Family Misfortune

Tim Titolo — Mon, 15 Mar 2010 17:47:26 -0800

The Washington Post is keeping us apprised of the very serious semi-tractor trailer crash with Nevada Senator Harry Reid's wife and daughter's van this week.

Police said the Reids' van was rear-ended and crushed by a fully loaded tractor-trailer while driving in heavy Virginia traffic.

Luckily, given the severity of the impact and variables making the crash especially dangerous, the outcome appears to be positive. The tractor-trailer hit the Reids from behind pushing them into the car ahead of them and that car, inturn, into the car ahead of it. The injuries were reported as a "broken back and broken neck!"

The Senator and his family will continue to receive the hopes and prayers of my family.

What is Osteomyelitis?

Tim Titolo — Wed, 10 Mar 2010 14:54:50 -0800

Osteomyelitis means infection of the bone or bone marrow; inflammation of the bone due to infection. Osteomyelitis sometimes occurs as a complication of injury or surgery.

Merck advises Osteomyelitis occurs most commonly in young children and in older people, but all age groups are at risk. Osteomyelitis is also more likely to occur in people with serious medical conditions.

There are three types of osteomyelitis:

Acute osteomyelitis - the infection develops within two weeks of an injury, initial infection, or the start of an underlying disease.
Sub-acute osteomyelitis - the infection develops within one or two months of an injury, initial infection, or the start of an underlying disease.
Chronic osteomyelitis - the bone infection starts at least two months after an injury, initial infection, or the start of an underlying disease.

Infections can reach a bone by traveling through your bloodstream or spreading from nearby tissue. Infections can also begin in the bone itself if trauma exposes your bone to germs. Bone infections commonly affect the long bones of your body, such as your leg bones and upper arm bone, as well as your spine and pelvis.

The symptoms are pain. Doctors treat chronic osteomyelitis with surgery and antibiotics. In acute osteomyelitis in children or vertebral osteomyelitis, surgery isn't always necessary. Once considered incurable, osteomyelitis can be successfully treated today. Still, osteomyelitis is a serious condition, requiring aggressive treatment to prevent spread of your infection and to save the affected bone.

Brain Injury Association's Las Vegas Conference

Tim Titolo — Mon, 01 Mar 2010 11:52:46 -0800

Registration • Schedule• Hotel & Travel • Planning Committee • Exhibitors • Sponsors

The Brain Injury Association of America will present Brain Injury Litigation Strategies 2010 at The Signature at MGM Grand in Las Vegas on April 29-30, 2010.

Make your plans now to participate in the ONLY national legal conference that brings together plaintiff AND defense experts in brain injury litigation. Discover the winning strategies of the nation’s most experienced brain injury plaintiff’s and defense lawyers. Learn the science of brain injury from the leading medical experts.

Whether you’re a plaintiff’s or defense attorney, insurance adjuster, risk manager or in-house counsel, you’ll learn innovative strategies and techniques to effectively represent your clients…and increase your success rate. The conference features plenary sessions for all participants followed by separate breakout sessions for plaintiff’s attorneys or defense counsel and insurance professionals.

Brain Injury Association of America Home Page

Brain Injury Association of America Legislative Update

Tim Titolo — Fri, 26 Feb 2010 18:18:28 -0800

BIAA Unveils 2010 Legislative Fact Sheets

On March 3, 2010, BIAA made available its 2010 legislative fact sheets. The fact sheets outline the agenda for this year including, access to care for both civilian and military populations, TBI Act and research funding, TBI Act reauthorization, caregiver assistance, and support for the Congressional Brain Injury Task Force is now available on our home page!

Brain Injury Awareness Day 2010

Don’t forget that this year’s Brain Injury Awareness Day on Capitol Hill is set to take place on March, 17, 2010.

Below is the schedule of events for the day:

10:00 AM – 1:00 PM - Brain Injury Awareness Fair, First Floor Foyer of the Rayburn House Office Building

2:30 PM – 4:00 PM - Briefing: “From the Playground to the Pros: A Heads-Up on

Concussion”, Capitol Visitors Center – Congressional Meeting Room South

5:30 PM – 7:30 PM - Reception Celebrating Brain Injury Awareness Month, First Floor Foyer of the Rayburn House Office Building

Hope to see you there!

Health Care Reform Update

House leaders this week prepared a schedule to bring health care reform to a vote before Congress adjourns for its two-week spring recess, which begins on March 26, 2010. BIAA continues to advocate for provisions important to the brain injury community and will alert grassroots advocates if action is necessary.

BIAA Health Care Reform Update

Tim Titolo — Fri, 26 Feb 2010 16:23:38 -0800

The Brain Injury Assocation of America posted this Health Care Reform Update. Yesterday, President Obama and members of Congress and the Senate, Republican and Democrat, met to hash out a Health Care Reform Bill. American Association of Justice President, Anthony Tarricone, appeared on Anderson Cooper 360: http://www.vimeo.com/9761801

Health Care Reform Update

On February 22, 2010, in the wake of the legislative hold put on Congress after the recent Massachusetts election, the White House released an 11-page health care overhaul proposal that would extend coverage to more than 31 million people, at a 10-year cost of $950 billion. The White House says that the cost would be offset by spending reductions and tax increases, resulting in $100 billion of deficit reduction. CQ

Also this week, a bipartisan summit convened to discuss the administration’s health care plan. The White House facilitated the six-hour summit to focus on controlling costs, overhauling insurance regulations, reducing the deficit and expanding health coverage.

The group of 40 representatives and senators agreed on a new set of baseline insurance regulations but were still at odds about things like the cost of insurance premiums, patient choice issues, and deficit calculations.

BIAA is monitoring the situation closely and will continue to advocate for a health care reform plan that will provide people with brain injury access to the full continuum of care that they need and deserve.

Brain Injury Awareness Month

As most of you already know, March is brain injury awareness month! BIAA will be unveiling its 2010 legislative agenda on Tuesday, March 2, 2010. Fact sheets outlining the agenda for this year including, access to care for both civilian and military populations, TBI Act and research funding, TBI Act reauthorization, caregiver assistance, and support for the Congressional Brain Injury Task Force will be available on our website starting Tuesday!

Florida Student Suffers Brain Injury in Truck Accident

Tim Titolo — Tue, 23 Feb 2010 19:56:46 -0800

Truck driving safety is provided in the Federal Motor Carrier Safety Regulations published by the Federal Motor Carrier Safety Administration. There are specific limitations on the number of hours a driver can be on duty. Violation to these limits is unsafe and can create liability for a trucking company and its driver. Fatigued drivers make highways and roads dangerous places for all of us.

A college student in Florida alleged that the tractor-trailer driver violated federal motor carrier safety rules by failing to take the required off-duty time after working a 24-hour shift as a county firefighter. Lymon v. Bohn No. 53-2007-CA-7728 (Fla., Polk Co. Cir. Mar. 20, 2009).

Kendra Lymon, 19, was driving through an intersection on a green light when Robert Bohn, driving a tractor-trailer truck, made a left turn into the intersection even though his view was obscured by another truck in the opposite turn lane. Bohn’s tractor-trailer T-boned Lymon’s car on the driver’s side, crushing the vehicle and sending it spinning off the highway.

Her injuries included brain damage that resulted in a motor speech disorder, difficulty swallowing, mild left hemiparesis, bowel and bladder incontinence, cognitive defects, and seizures. She also sustained a fractured left scapula.

Lymon’s mother, Vanessa, on her behalf, sued Bohn and his employer, Bynum Transport, Inc. Vanessa Lymon alleged that the trucking company had provided no ongoing safety training or defensive driver program for its drivers and that it failed to enforce federal motor carrier safety rules about driving hours and rest periods.

The plaintiff alleged that Bohn began his shift without taking the mandatory 10 hours of off-duty time after working a 24-hour shift as a battalion chief for the county fire services, a violation of federal rules. Furthermore, the plaintiff claimed, he violated basic traffic safety rules by turning without waiting for a clear view.

The jury awarded the plaintiff $65 million. The defendants have appealed.

Brain Injury, Psychiatry, Faith and Religion

Tim Titolo — Tue, 23 Feb 2010 13:57:47 -0800

In a new book titled "Religion and Psychiatry: Beyond Boundaries," the author considers why and how, when and where religion (and spirituality) are at stake in the life of psychiatric patients. The interface between psychiatry and religion is explored at different levels, varying from daily clinical practice to conceptual fieldwork.

Religion is one subject that many people around the world feel extremely passionate about, either feeling strongly in their belief of a certain religion, or being against religions generally or specifically. Other people do not engage with religion at all. These choices represent a part of who we are, and as such it is essential for psychiatrists to understand and be able to relate to their patients' decisions and beliefs in this area.

Religion and Psychiatry is recommended reading for residents in psychiatry, postgraduates in theology, psychology and psychology of religion, researchers in psychiatric epidemiology and trans-cultural psychiatry, as well as professionals in theology, psychiatry and psychology of religion.

Religion (and spirituality) is very much alive and shapes the cultural values and aspirations of psychiatrist and patient alike, as does the choice of not identifying with a particular faith. Patients bring their beliefs and convictions into the doctor-patient relationship. The challenge for mental health professionals, whatever their own world view, is to develop and refine their vocabularies such that they truly understand what is communicated to them by their patients.

"The boundary between religious belief and the practice of psychiatry is becoming increasingly porous," say the editors in the Preface to Religion and Psychiatry: Beyond Boundaries. "No longer can psychiatrists in a multi-faith, multi-cultural globalized world hide behind the dismissal of religious belief as pathological, or behind a biomedical scientism, as they are more frequently confronted by distressed patients for whom religious belief may determine their choice of symptoms and their compliance with treatment."

Published on behalf of the World Psychiatric Association, Religion and Psychiatry: Beyond Boundaries, addresses the impact that religion and spirituality have on shaping cultural values, as well as the choice of not identifying with a particular faith. With this book, Peter Verhagen and colleagues provide a framework to understand the importance of these factors in mental well-being, and how to develop and refine their vocabularies to ensure they truly understand what their patients are telling them.

This is the first time that so many psychiatrists, psychologists, and theologians from all parts of the world and from so many different religious and spiritual backgrounds have worked together to produce a book addressing these important issues.

The book discusses what religious traditions can learn from each other to assist the patient, as well as the neurological basis of religious experiences. It describes training programmes that successfully incorporate aspects of religion and demonstrates how different religious and spiritual traditions can be brought together to improve psychiatric training and daily practice.

In the Foreword to Religion and Psychiatry Mario Maj, President of the World Psychiatric Association, states "The WPA welcomes this comprehensive and multifaceted volume, produced by one of its most active Scientific Sectors, hoping that the effort will continue to clarify the issue and stimulate further reflection and research."

Revising the Diagnostic and Statistical Manual

Tim Titolo — Tue, 23 Feb 2010 13:49:17 -0800

I am following the revision process of the DSM-V from my past blog posts. The New York Times published an article about the Revised Diagnostic and Statistical Manual 5th edition which is slated for publication in 2013. It has been over a decade since the manual was revised.

These are a few of the changes proposed by doctors charged with revising psychiatry’s encyclopedia of mental disorders, the guidebook that largely determines where society draws the line between normal and not normal, between eccentricity and illness, between self-indulgence and self-destruction — and, by extension, when and how patients should be treated.

Far fewer children would get a diagnosis of bipolar disorder. “Binge eating disorder” and “hypersexuality” might become part of the everyday language. (think sex rehabilitation - Tiger Woods, Charlie Sheen, David Letterman, David Duchovny) And the way many mental disorders are diagnosed and treated would be sharply revised.

For months they have been the subject of intense speculation and lobbying by advocacy groups, and some proposed changes have already been widely discussed — including folding the diagnosis of Asperger’s syndrome into a broader category, autism spectrum disorder.

But others, including a proposed alternative for bipolar disorder in many children, were recently released. Experts said the recommendations, posted online at DSM5.org for public comment, could bring rapid change in several areas.

The article states:

One significant change would be adding a childhood disorder called temper dysregulation disorder with dysphoria, a recommendation that grew out of recent findings that many wildly aggressive, irritable children who have been given a diagnosis of bipolar disorder do not have it. Temper dysregulation disorder with dysphoria is a syndrome that in recent years has been labeled childhood bipolar disorder and is actually NOT bipolar disorder. Instead, a new disorder category was created: Temper Dysregulation Disorder with Dysphoria (TDD).

Nestor Lopez-Duran PhD contributes to significant political debate in the media and the blogosphere in his blog.

The misdiagnosis led many children to be given powerful antipsychotic drugs, which have serious side effects, including metabolic changes. Antipsychotic drugs are a class of medicines used to treat psychosis and other mental and emotional conditions.

Some diagnoses of bipolar disorder have been in children as young as 2, and there have been widespread reports that doctors promoting the diagnosis received consulting and speaking fees from the makers of the drugs.

Experts gave the American Psychiatric Association, which publishes the manual, predictably mixed reviews. Some were relieved that the task force working on the manual — which includes neurologists and psychologists as well as psychiatrists — had revised the previous version rather than trying to rewrite it.

Others criticized the authors, saying many diagnoses in the manual would still lack a rigorous scientific basis.

Stanford Law School publishes an interesting blog on the DSM V.

Mild Traumatic Brain Injury-Twitter to Las Vegas

Tim Titolo — Tue, 23 Feb 2010 13:49:15 -0800

I have seen the following article on Twitter all day. I finally decided it was worth posting. This is the source of the Twitter appearing as "Mild Traumatic Brain Injury, Not So Mild After All." See Science Daily. It appears to be a hot blog topic.

Douglas Smith, MD, director of the Center for Brain Injury and Repair and professor of Neurosurgery at the University of Pennsylvania School of Medicine, will present information on the molecular mechanism at play in mild TBI (mTBI), commonly called concussions. Although mTBI affects over 1 million people each year in the United States, it is generally ignored as a major health issue. However, this 'mild' form of injury induces persisting neurological and cognitive problems in many of these patients, exacting an enormous emotional and financial toll on society.

Despite the prevalence and impact of mTBI, little is known about how mTBI affect nerve cells and connections in the brain, and therefore clinical outcomes after injury. Smith and colleagues have begun to amass data from human and animal studies on mTBI at 2-4 days after injury using advanced neuroimaging techniques. They have found distinct changes throughout the white matter in the brain. Also, protein markers of brain pathology were identified after mTBI in the blood of mTBI patients.

The team proposes a potential molecular mechanism to explain their findings. Specifically, they found that the stretching and disconnecting of nerve-cell axons after mTBI induces problems to the sodium channels found on the surface of neurons.

"This is not inconsequential," say Smith. "Indeed, the observation that brain pathology can be detected after a concussion calls for much more extensive efforts to prevent, diagnose, and treat mild traumatic brain injury."

Las Vegas Bus Company Hires Driver with Known Safety Problems

Tim Titolo — Mon, 22 Feb 2010 17:28:34 -0800

I am representing a man who was hit by a bus making a left turn in Las Vegas. The man was in the crosswalk and the driver simply did not see him. The man was hospitalized with brain injury. The Bus Company with Las Vegas offices alleged the man was walking against the pedestrian traffic signal. Somehow, the Bus Co. feels, this gave the bus driver the right to run him over. And the police officer cited the man who got hit!

The police report listed two witnesses who provided statements in Spanish. Today, I took their depositions. The witnesses were fine Mexican-American individuals, legally in this country, who told us that the bus driver was at fault and that the man had the right of way according to the traffic signal. The police never spoke to the unconscious man, and obviously did not understand or ignored the independent witnesses’ accounts. Instead police took the bus driver’s version of traffic control violation of the pedestrian had and cited the pedestrian.

This is a blatant example of how the wrong picture is frequently painted based on pre-existing prejudice. The two Mexican-American witnesses were simply discounted out of hand. The sad part was that the pedestrian had his citation dismissed partially because the cop never showed up in court, yet the stigma remains. And the bus company may have gotten away with it.

The witnesses not only stated the traffic signal allowed the man to walk into the cross walk, but that the bus was attempting, in their opinion, to flee the scene. Can you imagine: A bus company that hires drivers who would flee the scene after hitting a pedestrian and knocking him to the ground unconscious? The amazing thing is that the bus company’s own camera installed on the bus actually showed the man walk into the crosswalk; The bus make its left turn while the radio is blasting; and then the sound of “thud” when the bus hit the pedestrian.

These are situations when all the tort reform rhetoric falls short. These things really happen and consumers need protection from faceless corporations driven solely by profit and self-preservation.

Overloaded Mississippi Gravel Truck Plows Through Intersection, Catastrophically Injuring Young Motorist

Tim Titolo — Sun, 21 Feb 2010 19:34:09 -0800

A number of years ago I was involved in representing plaintiffs against Las Vegas Paving in a lawsuit alleging the truck driver's loads were routinely in excess of limits. During one such run, the trucker crashed into my client near a highschool.

Similarly, in Bryant v. APAC-Tennessee, No. CV2006-0261CD (Miss., DeSoto Co. Cir. Nov. 18, 2009) a teen and his parents sued the paving company that hired the truck’s driver, alleging the company failed to monitor his loads and supervise his conduct. The plaintiffs offered evidence that the driver had made multiple trips on the company’s behalf, each with hauls that exceeded the state’s maximum weight limit.

Ethan Bryant, 16, was driving his pickup truck on a highway. When he entered a controlled intersection on a green light, a loaded gravel truck driven by Chad McCarty struck the driver’s side of the pickup at about 50 mph.

Bryant suffered severe brain injuries, and a 16-year-old passenger in his vehicle was killed. Bryant was comatose for eight months and developed a disorder that limits oxygen to his brain. He now suffers from quadriplegia and periodic seizures and will require 24-hour care for life.

Local trucking companies all too frequently break the rules of the road. They ignore safety protocol and all too often injure users of public roads.

Factors may effect which rules must be met. For instance, Interstate Trucking, driving between states, and intrastate Trucking, driving within one state, are subject to different regualtions. Although many rules bring about some responsibility for truck companies and their drivers, it is important to know the difference. Likewise, the weight of trucks and loads may apply to different regulations and it is important to know the difference.

I have been working more closely with organizations advocating safety for public roads.

Bankrupt Las Vegas Station Casino Lawyers Up

Tim Titolo — Fri, 19 Feb 2010 09:42:32 -0800

The Las Vegas Review Journal announced Station Casino (Fertitta family business) affiliate has been sued by partner GCR Gaming (Greenspun Family business). Both families have lawyered up.

The lawsuit alleges "wrongdoing" and of flagrant and continuous breach of "contractual and fiduciary duties" in their joint-venture partnership of the Green Valley Ranch Resort.

The filing alleges Station Casinos executives breached those duties, in part, by directing high-stakes gamblers at Green Valley Ranch to other casinos that were owned solely by Station Casinos.

This comes after Station Casino's filed for bankruptcy as a partner of operations at Green Valley Ranch Resort. Whenever a bankruptcy is filed or pending, any claims by creditors, including lawsuits against the bankrupt entity or person are stayed. In other words, no lawsuits are allowed while bankruptcy is pending in most circumstances. While protecting the bankrupt corporation, this leads to denied or delayed justice for those injured by the property management's negligence.

Station's parent company filed for Chapter 11 bankruptcy protection in 2009. Chapter 11, unlike Chapter 7, is a reorganization or debt payments. Station has been attempting to provide the Bankruptcy court with a plan to repay its debts but needs cooperation from creditors.

The long and short of it is that GVR Gaming's lawsuit will require lifting the stay by the Bankruptcy Judge to proceed. A motion was filed yesterday.

My office currently has 1 lawsuit pending where Station Casino is a defendant. That matter is not subject to Station's parent company Chapter 11 bankruptcy. However, last year, before the Station Casino filed bankruptcy as to its Green Valley Ranch Resort, another matter was resolved in my office. Fortunate for my clients, they will not be denied or delayed justice because of the recent bankruptcy filing.

Ironically, President Obama is in Las Vegas today to address the public at Green Valley highschool. Worthy of note is whether Las Vegas Mayor, Oscar Goodman, will welcome President Obama in light of the President's recent comment “You don’t blow a bunch of cash in Vegas when you’re trying to save for college.” The comment also drew the ire of Democratic Senator Harry Reid. “Lay off Las Vegas,” Sen. Harry Reid said in a statement issued shortly after the remarks spread through the internet. He later went on to support President Obama.

The Study Free Will

Tim Titolo — Thu, 18 Feb 2010 19:53:03 -0800

Have religious leaders and prophets, been able to tap into something science has not? A recent grant will finance a study on the science of free will. Are we predestined to live the blueprint of life already created for each of us? Do we control our own destiny? Or is it something beyond our comprehension? Is our free will and control of destiny something foreordained toward a result that we will inevitably reach?

Since the beginning of time, philosophers, scientists and theologians have sought to find out whether human beings have free will or whether other forces are at work to control our actions, decisions and choices.

Now, Florida State University philosopher Alfred Mele has been awarded a $4.4 million grant from the John Templeton Foundation to get to the bottom of this question for the ages. Mele, the William H. and Lucyle Werkmeister Professor of Philosophy, will oversee a four-year project to improve understanding of free will in philosophy, religion and science.

The primary purpose of the project is to improve understanding of free will in three spheres: science (especially neuroscience and social psychology); philosophy; and theology. The project's website can be accessed here.

I previously posted in this blog about the new revelations of free will. In fact, in 2008, Professor John-Dylan Haynes and colleagues at the Max Planck Institute in Germany reported findings of an extraordinary experiment which seems to show that 'free will' -- the most cherished tenet of humanity, which decrees that Man has total control of his own actions -- may, in fact, be little more than an illusion.

I read the book entitled Neurophilosophy of Free Will by Henrik Walter and Cynthia Klohr. This among my many other self-study texts in theology, science and psychology posits questions including: Do we control our own future or are the choices we end up making set in place in advance?

Neuroscientists routinely investigate such classical philosophical topics as consciousness, thought, language, meaning, aesthetics, and death. According to Henrik Walter, philosophers should in turn embrace the wealth of research findings and ideas provided by neuroscience. In this book Walter applies the methodology of neurophilosophy to one of philosophy's central challenges, the notion of free will. Neurophilosophical conclusions are based on, and consistent with, scientific knowledge about the brain and its functioning.

Walter's answer to whether there is free will is, It depends. The basic questions concerning free will are (1) whether we are able to choose other than we actually do, (2) whether our choices are made intelligibly, and (3) whether we are really the originators of our choices. According to Walter, freedom of will is an illusion if we mean by it that under identical conditions we would be able to do or decide otherwise, while simultaneously acting only for reasons and being the true originators of our actions. In place of this scientifically untenable strong version of free will, Walter offers what he calls natural autonomy--self-determination unaided by supernatural powers that could exist even in an entirely determined universe. Although natural autonomy can support neither our traditional concept of guilt nor certain cherished illusions about ourselves, it does not imply the abandonment of all concepts of responsibility. For we are not mere marionettes, with no influence over our thoughts or actions.

It will be interesting to see how Dr. Mele's project adds to this conversation.

Orthopedic Treatment for Military

Tim Titolo — Wed, 17 Feb 2010 18:59:06 -0800

The American Academy of Orthopaedic Surgeons (AAOS) reports new research to benefit troops and the upcoming surge authorized by President Obama.

One of Newton's basic physical laws: For each action, there is an equal and opposite reaction. So after the surge in U.S. troops heading to Afghanistan, there will be an influx of injured veterans returning back home. But the U.S. Department of Defense has recruited its own "soldiers" in the battle against war casualties: a consortium of researchers who are improving care to wounded soldiers as well as the general public.

The fourth annual Extremity War Injuries Symposium was held in Washington, D.C., last January to bring together military and civilian orthopaedic surgeons, researchers, experts from governmental agencies, and others to discuss challenges faced by U.S. medical personnel working in Iraq and Afghanistan and to discuss ways to synergize resources and improve care for wounded warriors. A paper summarizing the findings from the symposium is published in the January 2010 issue of the Journal of the American Academy of Orthopaedic Surgeons (JAAOS).

Some of the orthopaedic researchers involved will lead a workshop about the program at the 56th annual meeting of the Orthopaedic Research Society (ORS), March 6 - 9, 2010, in New Orleans. They will also present an overview of the program during Extremity War Injuries V, a symposium that takes place Jan. 27 - 29 in Washington, D.C.

While signature war injuries include traumatic brain injury from exposure to repeat blasts, the Orthopaedic community sees its share of obvious war related injuries. The presentation of these symposiums and conferences is good thing for our veterans. It also lets us all know that there is not the same level of "discarding" our vets when they return home as was in previous wars. I suppose the best solution is to end the war and hopefully we are moving in that direction.

Continuing DSM Revisions

Tim Titolo — Tue, 16 Feb 2010 15:08:30 -0800

My ongoing investigation into the Diagnostic and Statistical Manual, anticipated 2013 release, reveals the following sources:

NPR: "Doctors use the DSM to diagnose patients, and insurance companies use it to decide on reimbursement, so it's incredibly important in the profession of psychiatry."

NPR reports on a change for children currently being diagnosed with bipolar disorder (also known as manic-depression): "The condition will be called temper dysregulation disorder, and it will be seen as a brain or biological dysfunction, but not as a necessarily lifelong condition like bipolar. ... By adding this new entry, the American Psychiatric Association is trying to use the considerable institutional power of the DSM to curb use of the pediatric bipolar label" (Spiegel, 2/10).

The Associated Press: The American Psychiatric Association "is seeking feedback via the Internet from both psychiatrists and the general public about whether the changes will be helpful before finalizing them. ... Sure to generate debate, the draft also proposes diagnosing people as being at high risk of developing some serious mental disorders -- such as dementia or schizophrenia -- based on early symptoms, even though there's no way to know who will worsen into full-blown illness" (Neergaard, 2/10).

USA Today reports on efforts to classify illness like autism as broader illnesses rather than a specific subtype: "DSM-5 proposes replacing diagnoses for autism, Asperger's, childhood disintegrative and pervasive developmental disorders with a single diagnosis, 'autism spectrum disorders,' based on deficits in social interaction and communication and the presence of repetitive behaviors and interests" (Rubin, 2/9).

To follow my other posts on proposed changes to DSM see http://brainandspine.titololawoffice.com/2010/02/articles/brain-injury-news/revising-the-diagnostic-and-statistical-manual/

http://brainandspine.titololawoffice.com/2010/02/articles/brain-injury-news/revising-the-diagnostic-and-statistical-manual/

Social Security to Add Early Onset Alzheimer's Benefit

Tim Titolo — Tue, 16 Feb 2010 14:22:40 -0800

All to often people who suffer from disease are unable to get care due to insurance company limitations and policies, lack of insurance or finances to cover expenses. Sometimes folks are left with Social Security Benefit applications for their care.

In its effort to improve and expedite the disability determination process, the Social Security Administration (SSA) has announced that it will add early-onset Alzheimer's disease to its Compassionate Allowances Initiative. The initiative identifies debilitating diseases and medical conditions that meet the SSA's disability standards for Social Security Disability Income (SSDI) or Supplemental Security Income (SSI).

Social Security is launching this expedited decision process with a total of 50 conditions. Over time, more diseases and conditions will be added. A list of the first 50 impairments -- 25 rare diseases and 25 cancers -- can be found at www.socialsecurity.gov/compassionateallowances.

This recent development will lead to increased care more quickly for those who could not otherwise afford it.

Since 2003, the Alzheimer's Association has been advocating on behalf of individuals with early-onset Alzheimer's as they navigate the Social Security disability determinations process and welcomes the SSA's decision. Until now, individuals with early-onset Alzheimer's disease have faced a myriad of challenges when applying for SSDI or SSI, including a long decision process, initial denials, and multiple appeals.

Today's decision will simplify and streamline the SSDI/SSI application process and decrease the wait time for benefits, which for some has lasted as long as three years. There are currently an estimated 5.3 million Americans with Alzheimer's disease. Although the majority of Alzheimer cases are individuals age 65 and older, a significant number of people under age 65 are also affected by this fatal disease and have few financial options other than the Social Security disability program.

This good news comes at a time when politics has brought the issue of universal health care to a stand still. It always intrigues me that certain folks think the "right" to choose a doctor, hence stumping public/social or universal health care, exists. While, at the same time, those folks shun the idea that anyone has a "right" to not be subject to Rendition based on suspicion, or the "right" of due process.

What ever your reflection on the matter, the recent Compassionate Allowances Initiative moves us in the right direction.

New Website Designed to Help with Mental Illness

Tim Titolo — Tue, 16 Feb 2010 14:09:33 -0800

I came across a new website directed at assisting with mental illness. Step Up on Second.

Step Up on Second announces the launch of its newly enhanced Web 2.0 site. Step Up on Second is a California non-profit organization providing support services for adults affected by severe and persistent mental illness, and young adults experiencing the initial symptoms of a mental illness and their families.

The interactive site provides resources for loved ones, clients, and family members in search of an organization that can provide help, hope, and a home to individuals affected by mental illness.

Step Up on Second provides help through comprehensive, integrated clinical programs for relapse prevention; hope through the embrace of community, opportunities for inclusion, advocacy, and empowerment; and permanent supportive home units for stability achieving self-determined goals.

Recently Actress Glenn Close posted on their blog.