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Dr Josh Faulkner “This was 100 times faster than the biggest international trials that tested cooling in stroke patients previously.” In whatWill describes as “a brilliant result”, 39 of the 40 participants tolerated the cooling cap throughout their clot retrieval procedure, and no serious side effects were identified. The impact extends beyond the study itself. Patients and families embraced the chance to contribute to a project that could improve outcomes for future stroke patients. One participant who made a full recovery later wrote to thank the team for their work. Building on these encouraging findings, Will and colleagues have secured further Foundation funding to launch a randomised controlled trial that will showwhether head cooling can actually reduce the size of strokes and slow brain injury. Results from that trial should be through in the next three years. “We hope it shows that head cooling reduces the size of strokes. If so, then we would embark on a definitive large international clinical trial to prove that head cooling reduces disability in people with stroke,” saysWill. “Ten years from now, cooling caps could be found in most emergency departments and ambulances around the world, helping thousands of people every day.” The potential impact is especially significant for New Zealanders living in rural and remote communities. “This is exactly the problemwe are trying to address,” saysWill. “If head-cooling can slow down the brain damage that occurs because of delays, this will help a lot of people.” “The process of recruiting patients in a study like this is challenging, because there is a very narrow window when head-cooling can be started. Fortunately, we had a very dedicated team of research nurses who were available to come in at any hour to do this.” DrWill Diprose Becoming unstuck: Helping people move forward after concussion Most people expect to recover from concussion quickly: take it easy for a few days, then gradually return to normal life. But for many New Zealanders, the journey is far more complicated. Clinical psychologist/neuropsychologist and researcher Dr Josh Faulkner has spent years working with people whose symptoms continue long after a mild traumatic brain injury (commonly called concussion). The injury itself may have been an everyday accident: a fall, a knock to the head, a slip on the stairs. Yet the effects can reach into every part of someone’s life, affecting work, sleep, relationships, confidence and mood. “What fascinated me was this idea of ‘stuckness'," Josh says. “People were often very stuck in their injury.” Symptoms such as headaches, fatigue and difficulty concentrating are real and distressing, but they can also be intensified by stress, poor sleep and fear. For some people, this creates a draining cycle: they monitor every symptom, worry that something is wrong, become more anxious, and feel even less able to recover. Josh’s research aims to help break that cycle. With support from the Neurological Foundation, Josh and a large New Zealand team are testing Action mTBI, a five-session psychological therapy programme delivered by trained psychologists through existing concussion services. The programme is based on Acceptance and Commitment Therapy, or ACT, a well- established approach that helps people make room for difficult thoughts and feelings while reconnecting with what matters most to them. Rather than asking people to push symptoms away, ACT helps them live alongside difficult experiences without letting them take over. For someone whose concussion has begun to dominate daily life, that shift can be powerful. It can help them rebuild confidence, return to valued activities and see themselves as more than their injury, says Josh. continued next page   continued from previous page Will with his wife, Amy, and daughter Lily. 18 19