Aims: To determine whether double concussions can result in longer-lasting cognitive dysfunctioning than a single concussion and/or whether cognitive dysfunction is a greater risk factor for double concussions than for a single concussion.

Method: Through a national hospitalisation database, 2753 men were found who, at ages between infancy and early adulthood, had, on two separate occasions, been briefly hospitalised after a concussion. This cohort was compared with a previously obtained and comparable sample of men who had suffered a single concussion. From Draft Board records a dichotomised index was obtained indicating whether or not they had performed at or above a cut-off total score on a cognitive screening test involving four timed subtests, below cut-off being considered as dysfunctional.

Findings: For all age groups, double concussions were associated with higher rates of cognitive dysfunction than single concussions. This was especially true where the concussion(s) had occurred after cognitive testing [odds ratio = 2.53, 95% confidence interval (CI) = 1.92–3.36]. Where double concussions had occurred before cognitive testing but after age 12, cognitive dysfunction was more prevalent when the interval between concussions was less than 1 month than at longer intervals (odds ratio = 3.91, 95%CI = 1.14–13.34). It is concluded that cognitive dysfunction in young men is a risk factor for repeat concussions; at the same time cognitive dysfunction can also be a long-term consequence of two concussions occurring in close temporal proximity.

In Australia, 20% of stroke survivors are aged less than 55 years. These younger survivors value age-appropriate, identity-affirming goals, such as resuming employment. This article reports on a small qualitative research project that explored the experiences of young, higher functioning stroke survivors in re-establishing identity and returning to work. The participants understood identity as both an inner sense of self and as socially and discursively constructed. The research found that the participants actively pursued identity continuity while managing biographical disruption. Resumption of life roles and responsibilities were important for identity re-establishment, but fraught, particularly the return to work. The findings suggest that psychosocial rehabilitation could play a greater role in supporting survivors’ resumption of valued life roles, including return to work.

This study responded to a need for an updated set of film clips for the elicitation of emotion. Previous such stimuli are not only dated, but are limited in that they have been validated using participants from a narrow age range, which is problematic given conflicting reports regarding age differences in self-reported emotion elicited in a laboratory setting. The present study aimed to develop a new film stimulus set standardised on a wide age range of participants, while investigating age differences in self-reported emotion in response to film clips. An ancillary aim was to standardise film clips that were with and without dialogue. Two researchers composed a shortlist of 60 clips that were chosen to elicit six target emotions of amusement, anger, disgust, fear, happiness and sadness, as well as a neutral state. Each of the 109 participants (55 males, 54 females), aged between 18 and 88 years (M = 44.94) viewed all 60 clips. Self-reported emotional experience was measured using a computerised Visual Analogue Scale. Age differences were observed whereby participants aged 46–88 reported more intense positive and negative emotions in response to film clips than participants aged 18–45. Consistent with previous research, difficulties were found in eliciting the target emotion of anger. A success index was calculated for each film that took into consideration the mean rating on the target emotion and the degree to which the film elicited only the target emotion. We present a list of film clips recommended for future research.

Aim: To investigate the characteristics of Australian organisations providing case management to individuals who have acquired brain injury, and to determine the methods of case management service delivery including professional development and evaluation of outcomes.

Method: An anonymous 23-item web-based survey was used. Respondents were case managers who deliver services to adults and/or children with brain injuries. A snowball sampling method was used to recruit respondents from around Australia.

Findings: Fifty-one case managers completed the survey. Respondents were from a wide range of professions, the largest group being occupational therapy. The majority of respondents were based in metropolitan areas, were employed within the public health system and were based in the community. Respondents reported that the main determinant for clients receiving case management was the severity of the brain injury followed by complex family needs. Variations in practice and a lack of consistency in outcome measurement, goal setting and professional development were noted.

Discussion: This study provides an overview of characteristics of case management practices for people with acquired brain injury (ABI). Identifying roles and responsibilities of case managers is the first step to developing future research designs, which determine the effectiveness of case management.

This article reports on the design of a two-arm, randomised controlled trial of neuropsychological assessment with feedback as a direct therapeutic intervention to improve psychological wellbeing in multiple sclerosis (MS). MS patients and their caregivers are randomly allocated to one of two groups: neuropsychological assessment with feedback (the intervention), or ‘sham wait-list’ control. The trial investigates: (1) whether the intervention directly benefits patients by leading to improved knowledge of their own specific cognitive strengths and weaknesses, and improved use of adaptive psychological strategies for coping with MS; and (2) whether the intervention directly benefits caregivers by leading to improved knowledge of the patients’ specific cognitive strengths and weaknesses, and to a more positive caregiving outcome. A range of primary and secondary measures is used to evaluate these outcomes. The protocol utilises a wait-list control method which is structured to effectively blind patients and caregivers to their group allocation. Publishing the protocol prior to the results of the trial being available has a number of important methodological benefits, and informs the research community of the work that is under way to allow for collaboration and to reduce duplication of research effort. (This trial has been registered on the ANZCTR; ACTRN12612000161820.)

Severe traumatic brain injury (TBI) is the most common cause of brain injury in the Western world and leads to physical, cognitive and emotional deficits that reduce independence. Changes to psychosocial function are the most disruptive, resulting in vocational difficulties, family stress and deteriorating relationships, and are a major target for remediation. But rehabilitation is expensive and its evidence base is limited. Thus, new collaborative initiatives are needed. This article details the development of ‘Moving Ahead’, a model for a Centre of Research Excellence (CRE) for Traumatic Brain Injury Rehabilitation. This CRE offers several major innovations. First, it provides an integrated, multi-faceted approach to addressing psychosocial difficulties embracing different clinical standpoints (e.g., psychological, speech pathology, occupational therapy) and levels of investigation (e.g., basic science to community function) across the lifespan. It is based upon a close relationship with clinicians to ensure transfer of research to practice and, conversely, to ensure that research is clinically meaningful. It provides an integrated platform with which to support and train new researchers in the field via scholarships, postdoctoral fellowships, websites, meetings, mentoring and across-site training, and thus build workforce capacity for individuals with TBI and their families. It has input from the international community to contextualise research more broadly and ensure scientific rigour. Finally, it provides collaboration across sites to facilitate research and data collection.

This paper describes the added value that arises from capitalising on academic and social networks for researchers and people with acquired brain injury. First, it is proposed that brain injury researchers are connected within six degrees of separation. As a model, ‘The Oracle of Bacon’ demonstrates how any actor can be linked through his or her film roles to the actor Kevin Bacon within six steps. This concept is extrapolated to the existing networks of brain injury researchers. Capitalising on these networks can lead to potent and ground-breaking discoveries. The Clinical Centre of Research Excellence (CCRE) in Aphasia Rehabilitation provides an example of the benefits of networking and collaboration in the quest to improve the lives of people with aphasia. The CCRE uses multiple theoretical perspectives in studies evaluating the assessment and treatment of aphasia. It is utilising capacity building, knowledge translation and a community of practice to inform and expand research capacity. Networks can also be used to improve the communication of people with brain injury within their everyday environment. A recent study is described where communication partners were trained to improve the interactions of people with traumatic brain injury, which led to improvements in social networks and improved engagement in life activities. Finally, it is suggested that with the advances in e-communication, there is a great deal of scope for the use of social networking technologies in the assessment and treatment of people with acquired brain injury.