Helen learned Friday her daughter Katie, who currently has an acquired brain injury, was one of 280 patients whose medical records have been inappropriately viewed by PRHC staff since Jan. 1. Katie’s records were also inappropriately viewed by an employee last year. “My biggest concern is what did you do with the information? Why did you want it? And who the hell are you to look at my daughter’s private, very personal stuff?” Helen said.

The hospital has fired seven employees since the start of the year for accessing patient records when they were not entitled to view those records, hospital officials have said. Another two PRHC employees lost their jobs in October for privacy breaches.

Katie was 26 years old when she went into a diabetic coma in February. While Katie was fighting for her life in the intensive care unit, a dietary technician named Dana Gildon-Cormier viewed her files six to seven times within the period of a month, Helen said. PRHC staff notified Helen about the breach in the fall and informed her that Gildon-Cormier had been fired, Helen said. Helen has never met Gildon-Cormier and she said the woman had no cause to view Katie’s medical records. “Why did somebody putting meals together get access to my daughter’s medical records? What right did she have to even look at it? At the time, Katie was on tube feeding. She didn’t need any dietary foods,” Helen said.

A PRHC spokesperson could not be reached for comment last night and Gildon Cormier could not be reached for comment. Compounding the issue, Helen said the hospital told her Friday that PRHC nurse Mandy Edgerton-Reid also viewed Katie’s records without cause this year. In the past week, multiple PRHC patients have told The Examiner their files were also accessed by Gildon-Cormier or Edgerton-Reid. Neither woman returned The Examiner’s calls Friday afternoon.

Helen said she doesn’t understand why a nurse who has never treated her daughter would want to view Katie’s medical records. Those electronic records would have included the results of medical tests, physician referrals and doctor reports, Helen said. “This bothers me especially that a nurse did this,” Helen said. “When they become nurses, it’s a part of their training to be private, to be confidential.”

PRHC said it has recently stepped up its education campaign by giving presentations to staff, putting up posters about the rules and sharing screen-savers that remind staff a breach could ruin their career. Meanwhile, some patients who were victims of privacy breaches are preparing to take legal action against the PRHC. Helen and her family are concentrating on Katie’s rehabilitation. Katie has had to re-learn how to walk, talk and perform basic functions but she has recovered beyond doctor’s expectations and continues to improve. “Katie has gone through enough. The last thing we want to worry about is someone trying to steal her information,” Helen said.

Source: The Peterborough Examiner Staff Writer 05.12.12

May 11, 2012 - Girls take longer to recover from sports-related concussions than boys do, according to new research.

High school athletes, both boys and girls, also have longer recovery times than do college athletes, says researcher Tracey Covassin, PhD, associate professor of kinesiology and a certified athletic trainer at Michigan State University.”We have known that high school kids will take longer,” Covassin tells WebMD. “We are starting to show there are differences between female and male athletes.”

Covassin’s study evaluated 222 high school and college athletes who had sustained a concussion.

After a concussion, females also did worse than males on visual memory tests. They had more symptoms, Covassin found.

The study is published in The American Journal of Sports Medicine.

Concussion: The Problem

A concussion, a type of traumatic brain injury, results from an impact to the head. Those affected can have headaches, concentration problems, memory and balance problems, blurry vision, and nausea. A concussion changes the way your brain functions, according to the CDC. It can occur even with a helmet on. Most do not involve loss of consciousness.

The injuries can lead to memory and communication problems, depression, and early dementia, the CDC says. From 2001 through 2005, more than 150,000 sports-related concussions occurred in young people 14 to 19, Covassin says. However, the actual number is probably much higher, she says. The statistics only reflect concussions treated at an emergency department. Awareness of the problem has grown in the wake of hundreds of lawsuits from former National Football League players. They are suing the NFL for what they claim are concussion-related dementia and other brain problems.

Concussion, Gender, and Age: Study Details

After the concussions, Covassin gave standard tests to measure thinking skills such as verbal and visual memory. She evaluated symptoms. She repeated the tests two, seven, and 14 days later. She also tested the athletes’ balance at one, two, and three days after the concussion. The athletes played football, soccer, volleyball, basketball, wrestling, ice hockey, softball, rugby, crew, baseball, cheerleading, and lacrosse.

Among the findings:

- High school athletes did worse than college athletes on tests of verbal and visual memory (such as recalling a group of words just read).

- Girls and young women did worse than boys and young men on visual memory.

- Girls and young women had more symptoms than boys and young men.

“Our high school athletes took longer to recover than college athletes,” Covassin says. “The college athletes had recovered by seven days. All [high school and college athletes] went back to normal within 14 days.” She cannot pinpoint exactly when the high school athletes recovered.

Exactly why girls have more symptoms is not certain, Covassin says. Some researchers suggest that a woman’s greater rate of blood flow in the brain compared to men’s may somehow make the symptoms worse and last longer. Based on her new findings, teachers and coaches may need to make some accommodations for the athletes whose symptoms are worse and recovery slower, Covassin says. Some athletes may need to be excused from classes for a few days after concussion, she says. The study was funded by the National Operating Committee on Standards for Athletic Equipment.

Concussions in High School, College Athletes: Perspective

The new research confirms earlier findings and adds to growing research about gender differences, says Gillian Hotz, PhD, director of the concussion program and professor of neurological surgery at the University of Miami Miller School of Medicine. She reviewed the findings for WebMD.

Educating parents, coaches, and youth is key, she says. A crucial message? “If you get a headache [after a hit], pull yourself out,” she tells young athletes. Too often, she says, kids, encouraged by parents and coaches, will play through the pain. “I get parents in my clinic who say, ‘They have to play, they have to play,’ and they are still recovering from a concussion,” Hotz says.

Concussion Education

Parents can be on the lookout for symptoms in their young athletes, Covassin says. Symptoms may come on later, not right after the hit, she says. As for young athletes, “they need to understand that they need to tell someone [about the hit].” Boys are more likely to play through than are girls, she says. About 35 states, the District of Columbia, and the city of Chicago have passed youth concussion laws, according to a tally by the National Football League, which supports the effort.

The laws require: Young athletes, parents, and guardians to sign an information form about concussions.

Removal of young athletes from play or practice if a concussion is suspected.

Clearance from a health care professional trained in concussions before an athlete can resume play or practice.

Source: WebMD 05.11.12

Scientists at the Virginia Commonwealth University School of Medicine say this may explain the neurological symptoms experienced by those who have experienced a head injury associated with sports, accidents or combat.

Previous research has shown that even a mild case of traumatic brain injury (TBI) can result in long-lasting neurological issues, such as slowing of cognitive processes, confusion, chronic headaches, post-traumatic stress disorder, and depression.

Led by Kimberle M. Jacobs, Ph.D., associate professor in the Department of Anatomy and Neurobiology, the research team said they used sophisticated bioimaging and electrophysiological approaches to demonstrate that mild injury can cause structural disruption of axons in the brain while also changing the way the neurons fire in areas where they have not been structurally altered.

Axons are nerve fibers in the brain responsible for conducting electrical impulses. The researchers used models of mild traumatic brain injury and followed neurons in live cortical slices.

“These findings should help move the field forward by providing a unique bioimaging and electrophysiological approach to assess the evolving changes evoked by mild TBI and their potential therapeutic modulation,” said co-investigator John T. Povlishock, Ph.D., professor and chair of the VCU School of Medicine’s Department of Anatomy and Neurobiology.

The study was published in the May issue of the Journal of Neuroscience.

Source: PsychCentral 05.12.12

I took a soccer ball to the face in February. After the initial dizziness and the warm roar behind my forehead came a wave of bottomless sadness unlike anything I’d ever felt before. As my teammates kept playing, I sat groggily on the bench and decided that the manner in which I’d been hurt, arriving late to a defensive play in my team’s own end, perfectly embodied all the failings of my adult life: I had no discipline, no foresight; my life goals were all pipe dreams that laziness had let slip away; I couldn’t ever truly love the people around me. I mentioned a bit of this to the ER docs that night, and they said yes, that’s one of the symptoms, it’ll pass.

But I hadn’t thrown up, my pupils were normal, and the dizziness was already settling, so they diagnosed me with a mild concussion and told me it would all clear up in “7 to 10 days.” That was early February. The waves of gloom lasted almost through the end of the semester, and the headaches still hang at a background level. Along the way there was a bit of the cognitive stuff — fumbling for words, drawing a blank on a classmate’s name, throwing the crosswords down when they started spinning. But these felt blessedly tangible (Look, Ma! I’ve got a concussion!) alongside the creepy emotional fallout.

I was exhausted and unable to write. I drove to school because walking made my head feel funny, and because solo walks could suddenly bloom into spells of breathless doubt. I apologized to my very patient girlfriend so often that it became weirdly rote: ‘Yes, I still have a headache.’ And one spring night, my head thumping, I sat on the couch at a party among friends and told myself that I wanted to die.

We all have our lost moments, and I’ve skirmished with your standard neurotic-writer depression over the years. I have, in long-gone dark days, had a version of that couch conversation before. But the concussion was new and terrifying on two fronts:

1) the basic symptoms alone were, for me at least, a perfect physical manifestation of the cloudiness and doom depression already traffics in, and

2) a concussion makes you doubt, in a very visceral way, your ability to govern your own head. Your thinker is broken. Am I really depressed, or do I just have an endless headache? What’s the difference anymore? Or, like a movie plot, has the bump on the head revealed a purer, darker, lonelier self, the person I always feared I was?

All this from one errant soccer ball in a game of clumsy, enthusiastic amateurs. The doctors now tell me it could be months before I’m totally clear. Junior Seau’s supposed to have had multiple unreported concussions during his two-decade career. Suicide’s an icky thing to talk about, or to justify in any way, and it’s just a fan’s romanticism to assume that anyone who played with Seau’s ferocity already had his own peaks and valleys to cross. But my god, if I was living with some giant, 1,526-career-tackles version of this desperate fog in my head, I’m not sure all the love of San Diego could keep the demons at bay.

Source: TheAtlantic  05.07.2012

But during a recent trip to San Diego to speak at a neurology conference hosted by Scripps Health, Parker said he has not seen his research, widely covered in the scientific press, catch fire among the drug companies that could use it to create a new kind of battlefield first aid for the brain.

“No one was interested in taking it, nobody,” Parker said.

A professor at the Harvard School of Engineering and Applied Sciences, Parker knows a thing or two about what soldiers encounter on the battlefield. As a major in the Army National Guard, Parker did two tours of duty in Afghanistan.

The U.S. Department of Defense estimates that more than 220,000 American soldiers have sustained traumatic brain injuries since the country went to war in 2001. Brain injuries can come from a hard blow to the head, or from the blast wave that radiates outward from an explosion. Many American veterans have come home with detectable brain injuries, even though their bodies are otherwise intact. Traumatic brain injury symptoms range from headache and confusion to mood changes and lack of concentration.

Parker is not a neuroscientist. His doctorate, earned at Vanderbilt University, is in applied physics.

In the lab, his team built a simulator that can deliver a precise amount of force to batches of rat nerve cells under microscope surveillance. Using this technique, Parker has been able to observe the shock wave traveling inside the nerve cells, causing them to jiggle like Jell-O in a dish, causing swelling and damage to the cells’ fragile dendrites and axons. Nerve cells use these slight structures to communicate among themselves.

Parker explained to the Scripps audience that the shock seems to travel along a neuron’sintegrins, long protein strings that serve both as signaling pathways and also as a kind of scaffolding that anchors cells to other cells.

Parker’s study found that the administration of a drug called Rho-kinase immediately after the simulated blast reduced the amount of injury that a neuron’s axons sustained.

This is where Parker starts to dream about what could be. His mind travels back to Afghanistan, to the combat zone, to those times when it was necessary to pull injured soldiers, their ears ringing, from hulking, twisted military vehicles after the detonation of a roadside bomb.

“When I open up that MRAP door and pull that blown-up kid out of there, the chemical cascades that might eventually lead to Alzheimer’s are already starting, and right now I’ve got no first aid to prevent that. The whole idea that if I could give some kid an inhaler or a nasal spray where I could deliver a therapeutic (drug) within minutes of him having been blasted, that would be the dream,” Parker said.

At this moment, the scientist-soldier’s dream is just that. He noted that it is a long way from a lab table experiment using rat cells to a drug that works in humans.

To close the distance, he said, he will need to pass the torch to biotechnology companies whose specialty is creating new drugs. He said more must be known about traumatic brain injury in order to get such companies interested.

He said he believes the government should first embark on a massive study of all brain-injured veterans similar to the way the famous Framingham Heart Study once studied 5,209 men and women in the town of Framingham, Mass. That study, which started in 1948, taught scientists much about the risk factors of heart disease.

At the moment, Parker said, America has a huge population of similar-age citizens —- veterans —- already diagnosed with traumatic brain injuries. He said he believes now is the time for the government to strike, to do something big like President Richard Nixon’s declaration of war on cancer in 1971.

“We’ve learned more about the brain and neurological disorders in the last three years than we’ve probably learned in the last 50 years. Now’s the time to capitalize on that,” Parker said. “Fund that and bring as many people together on it as possible. In the military, we mass our troops at the decisive point. Now’s the decisive point in TBI.”

Dr. Donald G. Stein, a professor of emergency medicine at Emory University in Atlanta, is no stranger to the long and difficult process of turning a lab observation into a treatment. Years ago, the doctor noticed a difference in how female and male rats fared after brain injury. His research showed that rats with higher levels of the chemical progesterone seemed to recover more thoroughly from injury.

Today he is in state three clinical trials using progesterone to treat brain injury patients. He said moving forward on promising research is always difficult when government support is needed.

“With the current stalemate in Congress, it’s very hard for people to work together, even if it is in the national interest,” Stein said.

The doctor said he agrees with Parker that a greater effort is needed to develop traumatic brain injury treatments. But he noted that a greater effort always entails hard choices.

“Should you take money away from heart disease, cancer, birth defect research … I would never make that claim, no,” Stein said.

Source: North County Times 05.02.2012

The Department of National Defence is cutting the jobs of medical professionals involved in suicide prevention and monitoring post-traumatic stress disorders — despite claims by DND and the Canadian Forces that dealing with such health issues is a priority.

The move comes on the heels of a new report indicating that suicides have increased in the Canadian Forces. At the same time, the issue of suicide and post-traumatic stress disorder (PTSD) in the military is also under scrutiny at a military police complaints hearing in Ottawa. That hearing is examining how the Canadian Forces dealt with the case of Cpl. Stuart Langridge, an Afghanistan veteran who killed himself.

The unions representing the health workers have been notified that 15 of the 25 jobs in that area will be cut. The workers perform key roles, union officials say.

They have been told that the DND’s Deployment Health Section is being shut down, cutting four jobs, including those of suicide prevention specialists. The employees also monitor PTSD rates and traumatic brain injury.

Eight of the 18 jobs in DND’s epidemiology section also will be cut. Those include epidemiologists and researchers who analyze mental health issues such as depression, PTSD, and suicide.

The unions say a trial program on injury prevention at Canadian Forces Base Valcartier also will be closed because of the budget cuts. They note that the injury rate among Canadian Forces members is twice that of the general Canadian population.

The Professional Institute of the Public Service of Canada and the Canadian Association of Professional Employees, the unions representing the workers, are calling on the Conservative government to reverse the cuts.

“At a time when there is increasing awareness of mental health problems among our veterans returning from conflict and concerns that PTSD, depression and suicide are serious issues for the Canadian Forces, the government’s decision to withdraw from this area of work is quite simply irresponsible,” said PIPSC president Gary Corbett.

The unions say that one of the team members in the deployment health section to be shut down is also the co-chair of the Canadian Forces Expert Panel on Suicide Prevention.

The unions also warn that eliminating the jobs of epidemiologists and researchers will cripple DND’s capability to monitor the health of military personnel.

Claude Poirier, president of the Canadian Association of Professional Employees, pointed out that monitoring the health of Canadian Forces members “is not merely optional” for DND. “Because Canadian Forces members are generally excluded from health surveys conducted by Statistics Canada, DND studies are essential to identify health issues affecting military personnel, and to target areas for intervention,” he noted in a statement.

DND did not comment on the job cuts.

Statistics released Monday by DND show that the number of suicides among Canadian Forces personnel increased last year. Twenty soldiers died of suicide in 2011 — 19 men and one woman, the department reported. Just 12 soldiers took their lives in 2010, all of them male.

In response to those statistics, Lt.-Col. Rakesh Jetly, a psychiatrist and senior mental-health adviser at the Defence Department, told Postmedia News, “We’re taking it very seriously.”

Jetly said dealing with the hidden mental wounds of the battlefield is one of the department’s top priorities. The department is doing everything it can to prevent suicide and to provide mental-health services to returning soldiers, he added.

But union members say the move to eliminate such key health jobs undercuts claims by the Conservative government that only “back-office operations” not affecting front-line services would be hit by the budget cuts. Overall, DND will see the jobs of between 900 to 1,000 civilian employees eliminated.

Other front-line service jobs are also being eliminated. Documents leaked to the Ottawa Citizen show that Defence Research and Development Canada (DRDC) is taking a significant share of the government’s cuts at DND; its budget has been slashed by 13 per cent and its workforce will be reduced by 15 per cent, or 242 full-time jobs.

The defence researchers and scientists are credited with saving soldiers’ lives in Afghanistan by coming up with innovative technology and protective systems.

As a result of the layoffs, the defence science organization is stopping work on a bomb detection project at its Suffield, Alta., site. The Counter Terrorism Technology Centre at Suffield, which conducts research into chemical, biological, radiological, nuclear and explosive incidents, also will be scaled back. Some robotics work will be cut and commitments to research for public security programs will be reviewed.

Scientists at DRDC Ottawa will reduce their efforts in computer network security and support for radar system design work, according to the documents. Basic research into naval radar will be stopped.

Military officers privately worry the cuts could put troops at risk in the future since science and research provides an edge to soldiers on the front lines.

Other jobs being eliminated at DND range from clerks and secretaries to food services and kitchen staff. In addition, the positions of radiation safety personnel, weapons technicians, ammunition technicians, English-language teachers, heavy truck mechanics, laboratory assistants, drivers and dental hygienists will be eliminated.

Source: Ottawa Citizen 05.03.2012

The federal government is investing up to $100 million in brain research.

Federal health minister Leona Aglukkaq announced in Toronto Thursday plans to create the Canadian Brain Research Fund. It will support neuroscience research looking into commonalities of a wide range of disorders, including depression, Alzheimer’s disease, multiple sclerosis, autism, brain tumours, traumatic brain injury, chronic pain, schizophrenia, addictions, post-traumatic stress, Parkinson and epilepsy.

“One in three Canadians will face a neurological disorder, injury, or psychiatric disease, at some point in their lives,” Aglukkaq said in a statement. “This investment will strengthen Canada’s position as a world leader in research in the identification and treatment of brain disorders.”

The new fund will provide up to $100 million to the Brain Canada Foundation, which will then work to find donors and partners to match this amount, effectively doubling the investment. The foundation plans to look for financial support from private donations and charitable contributions.

“The Canada Brain Research Fund will raise awareness and understanding of the brain and brain disease, and increase support for Canada’s excellent and innovative brain research,” said Inez Jabalpurwala, president and CEO of Brain Canada. “Every Canadian will benefit from the Government of Canada’s leadership and vision in this important area.”

Brain Canada plans to create three types of grants to encourage collaboration and accelerate the pace of discovery. Specifically the grants will support:

• Teams of scientists that have the best proposals for producing rapid progress in understanding and treating brain diseases;

• Investments in technologies that will allow the sharing of research knowledge and innovative ideas, and encourage collaboration between disciplines;

• Trainees for a period of two to three years to support a new generation of neuroscientists

Source: TheStar 05.03.2012

From NPR News, this is ALL THINGS CONSIDERED. I’m Robert Siegel.

AUDIE CORNISH, HOST:

And I’m Audie Cornish. The premature death of an athlete is always shocking, but these days, pointed questions abound whenever a former NFL player dies. The suicide this week of Junior Seau, age 43, once again raised concerns about head injuries in football. He had played 20 seasons in the NFL, only leaving the field two years ago. Sportswriter Stefan Fatsis joins us now, as he does most Fridays. Hi there, Stefan.

STEFAN FATSIS, BYLINE: Hey, Audie.

CORNISH: So to start, for those of us who, you know, don’t know the full story of this player, tell us about him. I mean, I’m reading that he’s being called one of the greatest all-around linebackers maybe ever. I mean, what was he like on the field?

FATSIS: Well, he played the bulk of his career for the San Diego Chargers. They drafted him fifth overall in 1990 out of Southern California, also played for the Miami Dolphins, the New England Patriots, a 12-time All Pro. He was ferocious on the field. He coupled that with a lot of dancing and fist-pumping theatrics. And he stayed in the NFL a long, long time. Twenty years is a remarkably long career.

CORNISH: Stefan, we should say that Junior Seau’s death has been ruled a suicide, but that he did not leave any sort of note that we’re aware of. At the same time, I have yet to see a sportswriter talk about this without mentioning the ongoing discussion in NFL about traumatic brain injury.

FATSIS: The reason for that is the way Seau killed himself: he shot himself in the chest. And two other retired NFL players killed themselves exactly in this manner, specifically so that their brains could be studied after their deaths for the existence of chronic traumatic encephalopathy, CTE, which is this degenerative disease of the brain that can be caused by repeated head trauma, as you get in football, and has been linked to depression, dementia, other behavioral problems.

And that’s relevant in Seau’s case because of those 20 years that he played in the NFL, which means he played football for about 30 years. That’s 30 years of jolts to the brain, and that’s going to come up in any death of an NFL player prematurely.

CORNISH: Now, we’re learning this week also that his family may allow his brain to be studied, and we don’t know if this was Seau’s intent to have his brain studied. I mean, what’s going to happen here?

FATSIS: Well, it appears that, yeah, Seau’s family has given permission for a forensic analysis of his brain. There are two groups that have been doing this on dead athletes, not just football players. The pathologist who first identified physical evidence of CTE in the brains of dead football players - Bennet Omalu - he participated in Seau’s autopsy in San Diego. There’s another group at Boston University that’s also asked to analyze Seau’s brain. That will take weeks. Longer term, every brain that’s studied for evidence of this sort of disease is critical to get a deeper scientific understanding of the damage caused by football and other contact sports.

CORNISH: At this point, what does it say that any occurrence like this, this kind of death, brings to the forefront this discussion about the NFL and football in general?

FATSIS: Oh, I think it’s important for the NFL because it does threaten its hegemony as America’s most popular sport. Those metrics aren’t going to change overnight. But there is this reasonable threat that people are going to start thinking about the NFL differently. You had this week the former NFL MVP quarterback Kurt Warner said he prefer it if his sons didn’t play football. And just today, The New York Times has a profile of the widow of Ray Easterling who played nine years in the NFL, and is one of those players who shot himself in the chest two weeks ago at age 62. Easterling’s widow describes her husband’s 20-year medical decline in that New York Times story. She says she’s going to continue a legal fight on behalf of Easterling against the NFL.

CORNISH: And that’s not the only lawsuit going on, right, Stefan?

FATSIS: No. Easterling was the lead plaintiff in the first lawsuit filed by ex-players. Those lawsuits are claiming that the league failed to inform them of the dangers of concussions, the risks of traumatic brain disease. There are now 68 cases, about 1,800 former NFL players as plaintiffs. The number just grows every week. Another one was just filed yesterday in Atlanta. The league’s position is that it never attempted to mislead players. The lawsuits are barred under collective bargaining. It’s going to take years, obviously, to litigate this stuff. But again, it’s this drip, drip, drip that is changing how we think about football.

CORNISH: Stefan, thank you so much for talking to us.

FATSIS: Thanks, Audie.

CORNISH: Stefan Fatsis is the author of “A Few Seconds of Panic: A Sportswriter Plays in the NFL.” He joins us most Fridays to talk about sports and the business of sports.

Source: NPR 05.04.2012

The caregiver logs into the CUE YOU website to schedule as many as 64 messages to be delivered to the client’s iPhone. These reminders or messages of love and support - including text, videos, audio files, photographs - even a ‘Joke of the Day’ from our collection - are sent to the recipient’s iPhone as a ‘package’, which means that they will be delivered to the recipient without interruption, even if there is a power outage or lost internet connection.

Mastering CUE YOU is very easy for the message recipient. When each message is scheduled for delivery, it previews automatically on the iPhone, accompanied by a chirp, or a vibration. To receive the entire message the recipient simply swipes the face of the device. When finished, a simple tap of the ‘I’ve Done It!’ button triggers a ‘Thank You!’ message but - more importantly - it also triggers CUE YOU to send acknowledgement to the caregiver that the message has been received. It is actually easier to use than a television remote control.

CUE YOU was designed to take advantage of the special features built into the iPhone, making it accessible for those with visual or hearing impairment, or for those who cannot read.

For more information on please visit our website at http://www.cueyoultd.com
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THURSDAY, AUGUST 30, 2012 COPPER CREEK GOLF CLUB

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