Helping VA rehabilitate those with multiple wounds of war

Micaela Cornis-Pop oversees more than 110 rehabilitation facilities around the country, helping the Department of Veterans Affairs (VA) stay at the forefront of developments in treating traumatic brain injury and other medical injuries and issues facing injured veterans and military service members.

With the increase in battlefield survival rates of military personnel serving in Iraq and Afghanistan, service members live with more complex casualties, which led the VA to coin the word “polytrauma” to describe multiple injuries to one person, the most prevalent of which is traumatic brain injury, but also can include post-traumatic stress disorder, multiple amputations, burns, auditory and visual impairments and mental health issues.

In 2005, Cornis-Pop helped conceive, develop and implement the VA’s Polytrauma System of Care, an integrated network of facilities that provide specialized programs to help wounded men and women recover, and move from acute care to outpatient rehabilitation and reintegration into the community. She now leads and manages the system, developing policies and procedures and monitoring their implementation.

“We have a direct impact on how health care is delivered and is impacting veterans and service members, and that is tremendously gratifying,” said Cornis-Pop, national program manager of the Polytrauma System of Care at the Veterans Health Administration, Rehabilitation and Prosthetic Services, at the VA.

She also is responsible for providing education opportunities for VA health care providers who treat traumatic brain injuries. And the system works with another 39 VA locations that provide some, but not all elements of comprehensive polytrauma rehabilitation care, to define the care those facilities can provide and help make the decision when to refer patients to another level of care.

In addition, Cornis-Pop was the lead author and editor of a “massive project” to publish a 166-page book that came out in April 2010, which serves as an accredited independent study course on traumatic brain injury for members of VA health care teams around the country, said Joel Scholten, director of Special Projects at the Physical Medicine and Rehabilitation Program Office (PM&R), which manages the Polytrauma System of Care. Nearly 12,000 clinicians have completed the course between April 2010 and July 2012, using either the book or a Web version of it.

Cornis-Pop “has the innate ability to pull people together and get focused on a task and think creatively, and, most amazingly, develop an end product that is useful and veteran-centric,” Scholten said. “She develops programs and projects that have been sustained because they are clinically relevant. It’s not just policy that is developed and sits there.”

Dr. David Cifu, national director of the PM&R office, not only relies on Cornis-Pop to coordinate the care programs around the country but also to respond to outside requests for information, including from Congress. “She’s the person who makes it all happen,” he said. “She doesn’t care about getting credit. She just gets things done. That’s gold.”

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BCA to source for workers from Sri Lanka, Philippines

SINGAPORE: Sri Lanka and the Philippines have been identified as new source countries for construction workers.

The Building and Construction Authority (BCA) told MediaCorp that two test centres will be set up in Sri Lanka.

Approval is also being sought from the Philippine authorities to establish test centres there.

The BCA hopes to bring in skilled construction workers from Sri Lanka and Philippines to boost supply and diversify the source for foreign labour.

Demand for foreign construction workers is expected to remain strong in the years ahead.

The government is ramping up infrastructure development such as expanding the rail network and building more flats and health-care facilities.

In a recent report, the National Population and Talent Division expects the demand for foreign construction workers on low-skilled work permit holders to increase from some 250,000 in 2011 to about 280,000 in the next two to three years.

The main sources of foreign construction workers in Singapore are from China, India and Bangladesh.

The authorities want to be less reliant on these countries and have identified Sri Lanka and the Philippines as viable options.

Mr Neo Choon Keong, who is the Group Director of Manpower and Strategies Policy at the Building and Construction Authority, said: "What we are seeing now is that the major sources like China, India, because of the fast development the number of workers is actually coming down over time, because there are plenty of jobs there.

"So for resilience perspective, we are working with the industry to open up new sources to locate skilled workers. Notwithstanding our efforts to reduce the numbers of foreign workers overall through the adoption of technology as well as better building designs."

The BCA said most workers in Sri Lanka and Philippines speak English and this will help improve communication on the construction site.

Construction workers who want to work in Singapore have to go through a rigorous training regime in their country.

They have to stay in the training centre and undergo a full-time programme lasting between three and six months.

Only seven out of 10 of these workers would eventually pass the test.

After the training, potential workers have to go through a five hour practical test on essential craft skills as well as a one hour theory test on trade knowledge.

Currently, there are 26 overseas testing centres in China, India, Bangladesh, Thailand and Myanmar.

Potential workers can choose to be tested in 29 construction skills.

Construction company Progressive Builders will be operating one of the two new test centres in Sri Lanka.

Its managing director Ng Yek Meng said for a start, workers will be tested in 12 construction skills such as steel reinforcement work, tiling and plastering.

He said these tests are to ensure workers coming to Singapore are of a certain standard and quality, and could in turn help raise productivity.

Mr Ng said: "Some of the workers, especially if they come from agriculture, don't even know how to operate certain equipment. The test is quite stringent not only in Sri Lanka but for all source countries. Whoever can pass the test, I think they are of a certain quality. So this is how we can sieve the good ones and the bad ones."

The test centres in Sri Lanka are expected to be operational in six months' time.

Besides bringing in better quality construction foreign workers, the BCA also has a comprehensive training framework to continuously upgrade them.

Some 12,000 foreign construction foreign workers have upgraded their skills through these various programmes.

- CNA/fa

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Sushilkumar Shinde asks parties to give views on reviewing rape laws

NEW DELHI: The government has asked political parties to give their views on reviewing rape laws to Justice J S Verma Committee, set up to suggest amendments in the statute to provide speedier justice and enhanced punishment in cases of aggravated sexual assault against women.

In letters to leaders of all national and state political parties, home minister Sushilkumar Shinde said in the light of gang rape of a 23-year-old girl in Delhi, the government has given its anxious consideration to the need for reviewing the present laws relating to sexual assault of extreme nature against women.

The government had on December 23 constituted the Committee under the chairmanship of Justice (retd) Verma, former Chief Justice of India, to look into the possible amendments of the criminal law so as to provide for quicker trial and enhanced punishment to criminals in such cases.

"I shall be grateful if you could forward your views on the issue to the committee so that the committee can consider them while making their recommendations. I would urge you to communicate your views as early as possible as the committee has been asked to finalize its recommendations early," he said in the letter, a copy of which was made available today.

The three-member committee has been asked to submit its report to the government in 30 days. The other members of the committee are Justice (retd) Leila Seth, former Chief Justice of Himachal Pradesh high court, and former solicitor general Gopal Subramaniam.

Justice Verma committee has become fully operational and in located in Vigyan Bhavan Annexe in New Delhi and can be contacted at telephone no.- 011-23022031 and through email :- justice.verma@nic.in with suggestions and views.

Under the existing law, the maximum punishment for rape is life term but the nationwide outrage over the December 16 gang rape of the physiotherapy student in a moving bus here has sparked a demand for death penalty to rapists. The girl breathed her last on Saturday in a Singapore hospital.

Congress president Sonia Gandhi has stepped in to make some key suggestions to the government for stricter laws on sex crimes against women and enhanced punishment to the perpetrators.

BJP has favoured death for perpetrators of such heinous crimes and demanded a special session of Parliament for amending the laws.

The government has, however, brushed aside the opposition demand for an immediate special session, saying a decision on the issue could be taken only after the Justice Verma committee gives its report.

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Space Pictures This Week: Ice “Broccoli,” Solar Storm

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  Happy Trails

  Photograph by Alex Cherney, TWAN

  Amateur astronomer Alex Cherney captured these star trails as they blazed above Lake Tyrrell, a salt lake in Victoria, Australia in October 2011 and posted to The World At Night website December 25, 2012.

  (See pictures of another Australian salt lake, Lake Eyre.)

  Published December 31, 2012

  
  











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  Tokyo From Space

  
  Image courtesy DLR

  The sprawling Japanese capital Tokyo looks like a funky computer chip in this image taken by Germany's Earth-observing satellite TerraSAR-X and released December 20.

  Launched in 2007, the satellite's radar sensors map Earth from 319 miles (514 kilometers) up in a near-polar orbit.

  Published December 31, 2012

  
  











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  Extreme View

  
  Image courtesy SDO/NASA

  NASA's Solar Dynamics Observatory snapped this extreme ultraviolet view of an active region on the sun as it rotated into view from December 16 to December 18. Ultraviolet light makes it easier to trace the whorls and loops created by superheated gas, or plasma, and the sun's magnetic field lines.

  Active solar regions such as this create space weather that, when aimed at Earth, can disrupt satellite communications and electronics. (See more pictures of solar activity and space weather.)

  Published December 31, 2012

  
  











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  Saturn’s Dark Side

  
  Image courtesy SSI/Caltech/NASA

  This image of the unlit side of Saturn's S rings, released December 24, was taken with visible light by NASA's Cassini spacecraft.

  The shadow of Saturn's innermost major moon, Mimas, is visible as a black oval south of the rings' shadow. For those with completely dust-free computer monitors, Janus, another Saturnian moon, is visible as a tiny white speck above the planet's north pole. (Learn about Saturn's major moons.)

  Published December 31, 2012

  
  











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  A River Runs Through It

  
  Image courtesy ESA/JAXA

  The European Space Agency released this picture—taken by Japan's satellite ALOS—of Italy's longest river on December 14.

  The Po river and its surrounding fields divide Italy into its northern and southern regions. The Japanese used ALOS, which they lost contact with in late April 2011, to generate precise land maps, monitor disasters, and conduct resource surveys. (Read an excerpt from National Geographic magazine about the Po river.)

  Published December 31, 2012

  
  











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  Glacial "Broccoli"

  
  Image from DigitalGlobe/Getty Images

  The Moshniy glacier, located on the Russian archipelago Novaya Zemlya in the Arctic Ocean, calves chunks of ice and debris into a pattern reminiscent of broccoli in an image released December 20.

  Novaya Zemlya was a sensitive military area during the Cold War, and was also the site of the most powerful nuclear device ever detonated. The energy released by the 50-megaton "Tsar" bomb was ten times that of all the explosions set off during World War II.

  Published December 31, 2012

  
  











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  Image courtesy Caltech/SSI/NASA

  Published December 31, 2012

  
  

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Senate Approves 'Fiscal Cliff' Deal, Sends to House

Two hours after a midnight deadline for action, the Senate passed legislation early New Year's Day to avert the so-called "fiscal cliff" with an overwhelming vote of 89-8.

Senate passage set the stage for a final showdown in the House, where a vote could come as early as today.

"While neither Democrats nor Republicans got everything they wanted, this agreement is the right thing to do for our country and the House should pass it without delay," President Obama said in a statement shortly after the vote.

"There's more work to do to reduce our deficits, and I'm willing to do it. But tonight's agreement ensures that, going forward, we will continue to reduce the deficit through a combination of new spending cuts and new revenues from the wealthiest Americans," he added.

The bill extends Bush-era tax cuts permanently for people making less than $400,000 per year and households making less than $450,000.

The steep "sequester" budget cuts scheduled to go into effect with the New Year would be postponed for two months.

The deal also would affect taxes on investment income and estates, and extend unemployment benefits for a year.
Officials also decided at the last minute to use the measure to prevent a $900 pay raise for lawmakers due to take effect this spring.

'Fiscal Cliff': Lawmakers Scramble for Last-Minute Deal Watch Video

The failure of a deal to pass Congress by Jan. 1 technically triggers an income tax hike on all Americans and automatic spending cuts, though lawmakers could still prevent a tax hike by making retroactive any legislation that passes in the weeks ahead, experts said.

The deal at hand will not entirely solve the problem of the "fiscal cliff," however. In fact, it could set up a new showdown over the same spending cuts in just two months that would be amplified by a brewing fight over how to raise the debt ceiling beyond $16.4 trillion. That new fiscal battle has the potential to eclipse the "fiscal cliff" in short order.

In addition to extending current tax rates for households making $450,000 or less, the latest plan would raise the estate tax from 35 to 40 percent for estates larger than $5 million; and prevent the alternative minimum tax from hammering millions of middle-class workers.

Capital gains taxes would rise to 20 percent from 15 percent.

The deal would also extend for one year unemployment insurance benefits set to expire today for two million people, and avert a steep cut to Medicare payments for doctors.

"Working though the night and throughout the day we've reached an agreement with Sen. McConnell," Senate Majority Leader Harry Reid, D-Nev., said early Tuesday morning prior to the vote.

"I've said all along our most important priority is protecting middle class Americans, this legislation does that," Reid added.

He said he is "disappointed" they were not able to make the grand bargain and that more work needs to be done in the future.

"But we tried, if we did nothing the threat of a recession is very real," Reid concluded.

Speaking after Reid, Senate Minority Leader Mitch McConnell, R-KY., called the deal an "imperfect solution" and noted this should not be the model on how things get done in the Senate.

McConnell also thanked Vice President Joe Biden, who visited Capitol Hill late Monday night and brokered the deal with McConnell.

The House Democratic leader Nancy Pelosi issued a statement saying that when legislation clears the Senate, "I will present it to the House Democratic caucus."

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Senate negotiators yet to reach ‘fiscal cliff’ deal as clock winds down

Vice President Joseph Biden and Sen. Mitch McConnell were locked in urgent talks late Sunday over the “fiscal cliff” after Democrats offered several significant concessions on taxes, including a proposal to raise rates only on earnings over $450,000 a year.

With a New Year’s Eve deadline hours away, Democrats abandoned their earlier demand to raise tax rates on household income over $250,000 a year, as President Obama vowed during the recent presidential campaign.

They also relented on the politically sensitive issue of the estate tax, according to a detailed account of the Democratic offer obtained by The Post, promising to stage a vote in the Senate that would guarantee that taxes on inherited estates remain at their current low levels, a key GOP demand.

Still, McConnell (R-Ky.) was holding out to set the income threshold for tax increases even higher, at $550,000, according to people close to the talks in both parties. And he was protesting a Democratic proposal to raise taxes on investment profits for households with income above $250,000.

The two sides were also sharply at odds over automatic spending cuts set to decimate budgets at the Pentagon and other federal agencies next month. Democrats were seeking to delay the cuts, known as the “sequester,” until 2015, without identifying other savings to compensate. They were also pressing to extend unemployment benefits, farm subsidies and Medicare payments to doctors, again without offsetting cuts as Republicans demand.

Unless the two sides can reach agreement, historic tax hikes are set to hit virtually every American on Jan. 1, potentially driving the nation back into recession. An impasse would also throw the coming tax filing season into chaos, as nearly 30 million unsuspecting taxpayers would be required to pay the costly alternative minimum tax for the first time.

As Biden and McConnell traded phone calls deep into the night, lawmakers waited anxiously for news. Though members of both parties received lengthy briefings from their respective leaders about the status of the talks, senators were just as likely to predict that the nation was on the verge of a self-inflicted economic crisis as they were to predict that salvation was at hand.

“I think we’re going over the cliff,” Sen. Lindsey O. Graham (R-S.C.) wrote on Twitter in the middle of the day.

“The two parties are so close that they can’t afford to walk away,” Sen. Mike Johanns (R-Neb.) countered hours later. “I continue to be optimistic.”

Biden, a veteran dealmaker who served in the Senate for 36 years, entered the talks Sunday at McConnell’s request after the Republican leader said he had grown “frustrated” by the pace of negotiations with Senate Majority Leader Harry M. Reid (D-Nev.).

Personal relations between the two Senate leaders have deteriorated after two years of draining battles over the budget. On Sunday, their antagonism produced a confusing day when talks seemed to be collapsing even as the two sides were moving closer to agreement on several fundamental issues.

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Singapore rigbuilders set for strong 2013: analysts

SINGAPORE : Singapore rigbuilders Keppel Offshore & Marine (O&M) and Sembcorp Marine have secured a slew of contracts this year.

Analysts have said the two companies could see another strong set of orders in 2013, driven by robust demand for ultra-deepwater rigs.

Keppel O&M booked about US$8 billion worth of contracts this year - its second highest on record.

This follows a record S$10 billion worth of contracts which Keppel O&M secured in 2011.

Keppel O&M said over 65 per cent (US$5.36 billion) of the orders in 2012 came from Brazil.

Looking ahead, Keppel said it is developing a new product that will enable drilling in deeper and harsher environments.

Tong Chong Heong, chief executive officer of Keppel Offshore & Marine, said: "There are also new frontiers, new areas where more rigs are required, and with the emergence of areas such as the Caspian, Black Sea, Mexico and many parts of Southeast Asia, demand for rigs has gone up."

Keppel O&M along with Sembcorp Marine are big players in the offshore rig building industry, accounting for some 70 per cent of the global market share for jack-up rigs.

Analysts said the growing demand for ultra-deepwater drilling vessels and equipment will continue to support business growth.

Low Pei Han, investment analyst at OCBC Investment Research, said: "O&M companies have seen very good order books, Keppel and Sembcorp Marine each secured about 10 billion dollars worth of orders this year.

"About 50 per cent of each came from Sete Brasil and Petrobras, which is what the market had more or less anticipated. Going into 2013, we expect Sete Brasil and Petrobras orders to remain about the same level as this year, which will be about S$4 billion to S$5 billion."

But the Singapore rigbuilders are likely to face stiffer competition from Korean and Chinese companies.

Analysts said some Chinese shipbuilders are offering similar products at a 20 per cent discount.

For example, earlier this month, Yangzijiang secured a US$170 million order for a jack-up rig, while a similar contract at Keppel O&M cost US$205 million.

According to the China Association of the National Shipbuilding Industry, China hopes to capture 20 per cent of the global market for rigs, production facilities and offshore products by 2015.

But some analysts said Singapore rig builders are not likely to lose their competitive edge anytime soon.

Janice Chua, head of equity research (Singapore) at DBS Vickers, said: "It is a tall order for the Chinese yards to try and get the global market share for rigs.

"In order for the Chinese yards to have a bigger market share globally, what is more important is the soft skills of project management, engineering, design expertise, as well as ensuring that they can deliver the projects on time and according to the clients specification. That will take at least three years to build for any of these offshore structures."

Increasing shale gas production in the US could also present a new competitive landscape for rigbuilders.

Jason Waldie, associate director at Douglas Westwood, said: "The wild card here is whether the US is going to export, or how much the US is going to export. Certainly I know the US government is planning to export a very good share of its gas to the market. Now what impact does that have for the yards?"

Analysts expect the demand for rigs to come under some pressure should the US decide to export a substantial amount of shale gas.

- CNA/ms

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AIADMK to go it alone in LS polls: Jayalalithaa

CHENNAI: Slamming the Congress and BJP in Karnataka for being "determined" in denying Cauvery water to Tamil Nadu, AIADMK chief Jayalalithaa on Monday said her party would go it alone in the next Lok Sabha polls and secure all 40 seats in order to assert its rights in Delhi.

Both parties were "united" and "determined" not to give Tamil Nadu its due share of water from Cauvery river, a combative Jayalalithaa said in her address to partymen at the AIADMK general council near here.

"To ensure Tamil Nadu's rights and prevent (Cauvery) delta regions from turning into a desert, we have to independently fight the coming Lok Sabha polls and win all 40 seats" (39 in Tamil Nadu and one in Puducherry), the Tamil Nadu Chief Minister said, virtually sounding the election bugle.

"We have to work out our path. We can't be dependent on anyone as such a situation has been created. Some parties may have to depend on national parties like BJP or Congress which lead respective coalitions, but that depends on their situation," she said in an apparent reference to her main rival, the DMK.

But her party was in a situation where it cannot depend on anyone. "We have to decide our future, chalk out our path. We cannot depend on BJP or Congress," she said in an impassioned appeal, observing she had all along in her life taken decisions for herself and not depended on others.

She neither had a family to fall back on and this was not out of choice but it was her "fate," she said.

Hitting out at the Congress and BJP, she recalled that Congress leaders SM Krishna and M Veerappa Moily had accompanied the Karnataka BJP chief minister Jagadish Shettar to impress upon the Prime Minister on Karnataka's reluctance to release water.

Taking a dig at the DMK on the issue, Jayalalithaa said "it is learnt that DMK MPs had during their meeting with the Prime Minister sought not to notify the final award of the Cauvery tribunal," reiterating her earlier similar remarks made in this matter.

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How to Banish That New Year's Eve Hangover

For those of us who enjoy the occasional cocktail, the holiday season would be incomplete without certain treats of the liquid variety. Some look forward to the creamy charms of rum-laced eggnog; others anticipate cupfuls of high-octane punch or mugs of warm, spiced wine.

No matter what's in your glass, raising one as the year winds down is tradition. What could be more festive? The problem is, one drink leads to two, then the party gets going and a third is generously poured. Soon, the music fades and the morning arrives—and with it, the dreaded hangover. (Explore a human-body interactive.)

Whether it's a pounding headache, a queasy stomach, sweating, or just general misery, the damage has been done. So now it's time to remedy the situation. What's the quickest way to banish the pain? It depends who you ask.

Doctors typically recommend water for hydration and ibuprofen to reduce inflammation. Taking B vitamins is also good, according to anesthesiologist Jason Burke, because they help the body metabolize alcohol and produce energy.

Burke should know a thing or two about veisalgia, the medical term for hangover. At his Las Vegas clinic Hangover Heaven, Burke treats thousands of people suffering from the effects of drinking to excess with hydrating fluids and medications approved by the U.S. Food and Drug Administration.

"No two hangovers are the same," he said, adding that the unfavorable condition costs society billions of dollars-mostly from lost productivity and people taking sick days from work.

Hot Peppers for Hangovers?

So what's the advice from the nonmedical community? Suggestions range from greasy breakfasts to vanilla milkshakes to spending time in a steamy sauna. A friend insists hot peppers are the only way to combat a hangover's wrath. Another swears by the palliative effects of a bloody mary. In fact, many people just have another drink, following the old "hair of the dog that bit you" strategy.

Whether such "cures" actually get rid of a hangover is debatable, but one thing's for sure: the sorry state is universal. The only people immune to hangovers are the ones who avoid alcohol altogether.

So for those who do indulge, even if it's just once in awhile, see our interactive featuring cures from around the world (also above). As New Year's Eve looms with its attendant excuse to imbibe, perhaps it would be wise to stock your refrigerator with one of these antidotes. Pickled herring, anyone?

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Hillary Clinton Hospitalized With Blood Clot

(MICHAL CIZEK/AFP/Getty Images)

By DANA HUGHES and DEAN SCHABNER

Secretary Hillary Clinton was hospitalized today after a doctors doing a follow-up exam discovered a blood clot had formed, stemming from the concussion she sustained several weeks ago.

She is being treated with anti-coagulants and is at NewYork-Presbyterian Hospital so that they can monitor the medication over the next 48 hours, Deputy Assistant Secretary Philippe Reines said.

Her doctors will continue to assess her condition, including other issues associated with her concussion. They will determine if any further action is required, Reines said.

Clinton, 65, originally fell ill from a stomach virus following a whirlwind trip to Europe at the beginning of the month, which caused such severe dehydration that she fainted and fell at home, suffering a concussion. No ambulance was called and she was not hospitalized, according to a state department official.

The stomach virus had caused Clinton to cancel a planned trip to North Africa and the United Arab Emirates, and also her scheduled testimony before Congress at hearings on the attack on the U.S. consulate in Benghazi, Libya.

According to a U.S. official, the secretary had two teams of doctors, including specialists, examine her after the fall.  They also ran tests to rule out more serious ailments beyond the virus and the concussion. During the course of the week after her concussion, Clinton was on an IV drip and being monitored by a nurse, while also recovering from the pain caused by the fall.

Medical experts consulted by ABC News said that it was impossible to know for sure the true nature or severity of Clinton’s condition, given the sparse information provided by the State Department. However, most noted that the information available could indicate that Clinton had a deep venous thrombosis,which is a clot in the large veins in the legs.

“A concussion (traumatic brain injury) in itself increases risk of this clot. Likely the concussion has increased her bed rest,” said Dr. Brian D. Greenwald, Medical Director JFK Jonson Rehabilitation Center for Head Injuries. “Immobility is also a risk for DVT. Long flights are also a risk factor for DVT but the recent concussion is the most likely cause.

“Anticoagulants are the treatment,” he said. “If DVT goes untreated it can lead to pulmonary embolism (PE). PE is a clot traveling from veins in legs to lungs which is life threatening. Many people die each year from this.

“Now that she is being treated with blood thinners her risks of PE are decreased,” he said. “Blood thinners carry risk of bleeding but are common and can be safely used.”

Dr. Allen Sills, associate professor of Neurological Surgery at Vanderbilt University Medical Center, said it was most likely that the clot was not located in Clinton’s brain, since she is being treated with anticoagulants.

“This is certainly not a common occurrence after a concussion, and is most likely related to either inactivity or some other injury suffered in the fall,” he said.

Dr. Neil Martin, the head of Neurovascular Surgery at the University of California, Los Angeles, Medical Center, said blood thinners are often given for blood clots in the legs, and it is “very unusual” for anticoagulants to be given for blood clots in the head.

But he cautioned about speculating too much about Clinton’s condition before more information is available.

“If we don’t know where it is, there is the possibility of several different indications,” he said. “I don’t know if there is any connection between what she’s got now and the concussion. All I can tell you is, at this point, it’s almost impossible to speculate unless we know what’s going on there.”

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