The Army's new paradigm for tackling traumatic brain injuries - We Are The Mighty
MIGHTY TRENDING

The Army’s new paradigm for tackling traumatic brain injuries

Frontline medics and providers delved into the military’s latest paradigm shift of traumatic brain injury assessment and treatment March 7, 2019, at the Warfighter Brain Health Training Symposium at Madigan Army Medical Center.

“The need for training this year is greater than most years because just about every standard system that we use in our assessment and management of TBI are being overhauled based on the latest state of the science,” said Maj. (Dr.) Joseph Kamerath, the director of the TBI and Intrepid Spirit Center at Madigan.


A warfighter brain health memo issued last fall by Patrick Shanahan, acting Secretary of Defense, when he was serving as the Deputy Secretary of Defense established a commitment to understanding, preventing, diagnosing, and treating TBI in all of its forms, and the 2018 Defense Authorization Act also called for expanding blast research.

“We’re in an environment where we understand that the effects on readiness are greater than we ever thought, the numbers of service members sustaining TBI continue to be high despite the decreased operative tempo, and that we need to put a bigger emphasis on preventing TBI, and when people do have a TBI, mitigating the effects to maximize not only their wellness but our military readiness,” Kamerath said.

The Army’s new paradigm for tackling traumatic brain injuries

Director of the TBI and Intrepid Spirit Center at Madigan Maj. (Dr.) Joseph Kamerath.

He spoke to an audience of primarily frontline providers such as primary care managers and medics, who he called “the backbone of far-forward military health care.”

Researchers presenting at the symposium emphasized the key role of medics in early detection and treatment of TBIs as being influential in the long-term health of service members.

Although years past the height of the wars in Iraq and Afghanistan, TBIs are still a substantial issue affecting readiness, with nearly 18,000 new TBI diagnoses in the Department of Defense in 2017.

Current research is developing evidence that the long-term symptoms of mild TBIs, or concussions, may be more prevalent than previously thought.

“We used to say 85 percent are going to be fine; 85 percent of mild TBIs are (going to be) 100 percent better,” said Kamerath.

However, he said researchers are now finding that a certain percent of that 85 percent are experiencing more subtle symptoms, such as changes in vision, headaches, sleep, and concentration.

“One of the really unique things that’s been recognized is that in the coming several months after sustaining a mild traumatic brain injury, a soldier or a college athlete is twice as likely as their peer to sustain a lower extremity musculoskeletal injury be that hip, knee or ankle,” he said.

A potential reason could be that the subtle balance deficits caused by a TBI may make people more likely to sustain an injury.

From there, the math to TBIs affecting readiness is simple. Twice the rate of musculoskeletal injuries, which are one of the greatest health concerns which affect warfighter readiness, means that even the subtle mid- and long-term effects of TBIs could have real mission impacts. In other words, if readiness matters and TBIs affect readiness, then understanding the best way to assess, treat and mitigate the risks of TBIs also matter, Kamerath said.

“We are working to develop the best ways to make sure that they get back in the fight without sustaining injuries and maximize the readiness of our force,” he said.

One of the ways to better treat TBIs is to get patients to specialists faster. Historically, TBI specialty clinics cared for patients living with the chronic effects of TBI, who may have been referred after months of related symptoms. Now, the standard is that if a patient experiences an uncomplicated TBI yet is not improving seven days later to refer them to TBI specialists, who in turn are committed to seeing patients within seven days of the referral.

The Army’s new paradigm for tackling traumatic brain injuries

U.S. Army Pfc. Shawn Williams of the 1st Stryker Brigade Combat Team, 25th Infantry Division based in Fort Wainwright, Alaska, gives the thumbs-up to members of his unit as he is evacuated after being injured by a roadside bomb.

(Photo by U.S. Navy Lt. j.g. Haraz N. Ghanbari)

“With more and more evidence suggesting that early rehab can be helpful to mitigate long-term effects, the push now is to change our model,” said Kamerath. “This is really the right way forward to get people in early, getting them into see the appropriate specialist early, so that they can get the care that’s needed.”

Other speakers addressed the long-term effects of TBIs, including the increased levels of disabilities experienced by blast concussion patients compared to those with non-blast TBIs one year after their initial injuries.

Dr. Christine MacDonald, an associate professor of neurological surgery at the University of Washington, explained that her longitudinal study found that 74 percent of concussive blast patients still experienced health reductions five years after their injuries. The best early predictors of these long-term reductions include being at an older age at the time of injury, having a TBI diagnosis, experiencing greater depression symptoms, exhibiting a slower reaction time, and demonstrating less word generation (aka verbal fluency).

Another study presented by Dr. Jesse Fann, a professor of psychiatry and behavior sciences and adjunct professor of rehabilitation medicine and epidemiology at the University of Washington, found a long-term increased risk of dementia for people with TBIs.

“The impact of a TBI is higher when you have a TBI earlier in life,” said Fann.

He shared that more severe TBIs also increase the risk of later developing dementia. While only 0.4 percent of the people studied had dementia due to TBI, that statistic is still significant given the large number of people who eventually do suffer from dementia, he said.

While the symposium included long-term potential effects of TBIs, it also offered medical providers tools that they can use now to better assess TBIs with the hope that better detection leads to better treatment.

While the Military Acute Concussion Evaluation is the standard for TBI screenings, the older algorithms are being replaced by the Concussion Management Tool, according to Kamerath. It is also incorporating the Vestibular/Ocular Motor Screening. Other new tools include the BrainScope One Device.

“When we get patients with TBI, our biggest concern is if it’s life-threatening now,” said Maj. Nicholas Koreerat, a clinical specialist in orthopedic physical therapy.

He briefed on the BrainScope One Device, which detects if bleeding occurs in the brain after a traumatic brain injury. Before the military began using it, the options to treat suspected brain bleeds downrange where to either “wait and see” or medevac the patient for a CT scan. However, if service members are medevaced unnecessarily, operational effectiveness decreases as aircraft are diverted for unneeded medevacs. Due to its high rate of sensitivity, the BrainScope increases the effectiveness and accuracy of determining treatment for patients who may experience brain bleeds, Koreerat said.

The Army’s new paradigm for tackling traumatic brain injuries

(US Army photo)

Another frontline screening tool now available is the Vestibular/Ocular Motor Screening, presented by Maj. Katrina Monti, the senior physician assistant for the 1st Special Forces Group (Airborne). The six-minute screening tool assesses headache, dizziness, nausea, and fogginess following specific maneuvers used to cluster TBI-associated symptoms. Monti explained that 60 percent of concussions result in these vestibular symptoms, and that patients tend to have poorer outcomes and longer recovery times with these symptoms as well.

“The big takeaway for me from that presentation was just how easy it is to implement some of the new tools that are coming out from the research that we’re seeing in the field, in deployment or other real-life settings, not just in clinics and hospitals,” said Kasey Zink with the Geneva Foundation, which funds research like the VOMS tool.

Others learned that just because TBI assessment tools may be easy to use, other factors may serve as barriers to screening.

In fact, underreporting mild TBIs occurs in the field because of lack of awareness — service members may not know which symptoms are related to concussions — and because they sometimes don’t want to be taken off their teams, even temporarily, for medical observation or treatment, said Monti. The key, she said, was in part greater education of the troops on mTBIs, to include awareness that earlier reporting can lead to faster improvement of symptoms and earlier return to duty.

This article originally appeared on United States Army. Follow @USArmy on Twitter.

MIGHTY SURVIVAL

Hospitals desperate: If you can sew, we need you!

With the influx of COVID-19 patients, hospitals across the country are critically short of personal protective equipment. Doctors have equated the dire situation to being at war with no ammo; walking into rooms knowing their skillsets are necessary and yet completely vulnerable.

A nurse who asked not to be named shared the horror story of wearing the same disposable mask all day, soaked with condensation from her own breath, knowing that it very well was likely rendered useless after only a short time on her overnight shift. “It’s borderline criminal,” she said. “We are being asked to walk into the fire without basic PPE. You see full hazmat suits on the news overseas, and we can’t even get the basics. This is the United States of America and our supply rooms look like that of a third world country.”

Now, they’re begging for your help.



In World War II, citizens were asked to pitch in for the war effort. Women became Rosies, children collected scrap metal and held tin drives, families grew Victory Gardens.

Our current war on COVID-19 is certainly different. The enemy wears no uniform, takes no sides and is invisible to the eye. But the collective efforts needed from our country to step up remains the same. First, stay home. We’ve heard it over and over again but the importance of physical and social distancing in order to flatten the curve will protect these medical workers and facilities from being overwhelmed with patients at the same time.

Second, hospitals are asking that if you can sew, to make masks. While homemade masks are nowhere near the standards and protections offered by medical grade masks, something is certainly better than nothing. This document put together by UC Berkeley School of Public Health lists hospitals that are currently accepting masks, standards that they’re using and how to drop off. This list is ever-growing, but not exhaustive. If you don’t see your local hospital on the list, reach out to them via social media or call them to see if they’re accepting masks.

How to Sew a Surgical Face Mask for Hospitals

www.youtube.com

Don’t have fabric? JOANN fabrics launched a program last week that provides free fabric, elastic and other essential materials so that customers can make masks at home to donate.

This is our time to come together as a nation, pitch in where we can and help our soldiers on the front lines: our medical community.

The Army’s new paradigm for tackling traumatic brain injuries


MIGHTY TRENDING

‘America’s Tall Ship’ makes first visit to Norway since 1963

It’s not necessarily the ship that comes to mind when you think about America flexing its muscles abroad to project seapower and dominance.

But when the U.S. Coast Guard’s Barque Eagle, known as “America’s Tall Ship,” came into port here [Oslo, Norway] May 5, 2019, for the first time since 1963, the locals were eager to see it. More than 1,300 people visited the ship May 5, 2019; the vessel sees 90,000 tourists each year, officials said.

The ship trains hundreds of cadets each summer on the basics of navigation and seamanship — something the service believes can still make a tough and ready Coastie despite the emergence of a near-peer power competition.


It’s not always about learning on the newest technology. The Coast Guard thinks some things are just meant to be done old school.

The Army’s new paradigm for tackling traumatic brain injuries

As the sun sets, a crew member acts as lookout aboard Barque Eagle in the North Atlantic, April 2, 2014.

(U.S. Coast Guard photo by Petty Officer 2nd Class LaNola Stone)

“They don’t come here to learn how to sail, although that is a bonus,” said Chief Petty Officer Kevin Johnson, the training cutter’s command chief, master-at-arms and food service officer for the last three years.

“We’re teaching you how to work as a team,” he said during an hour-long tour of the ship. “And it’s tradition.”

Two groups of 150 cadets each will soon embark on the service’s 12-week summer program. The first group is comprised of third-class cadets, the second of first-class cadets.

The cutter will likely hit its max capacity of 234 crew with each group; 50 enlisted and eight officers man the ship year round. Roughly 40 percent of the trainees are women, Johnson said.

The ship, which has only basic radars for navigation, will also host a number of international cadets during the training program. Members “from as far as Micronesia” have come to learn team building and leadership on the Eagle, designated WIX-327, he said.

The Army’s new paradigm for tackling traumatic brain injuries

Coast Guard Academy cadets learn how to furl sail on the Eagle‘s bowsprit under the tutelage of a petty officer while sailing among the British Virgin Islands in 2013.

(U.S. Coast Guard photo)

Life onboard the ship is meant to give cadets the “life as an enlisted person” experience, demanding strength and discipline, he said. They’ll climb to the top of the mainmast, which towers above the deck at 147 feet. Most cadets know that “someone still has to put the flag up” and furl the sail by hand.

“They still climb the rigging,” Johnson said, adding that the small boats need to be lowered by hand.

He said two cadets have gone overboard during his tenure: one while touching up the hull en route to Ireland and another who lost balance on the rigging and fell into the water.

“They’re both OK,” said Johnson, a 19-year veteran of the service.

The Army’s new paradigm for tackling traumatic brain injuries

Helm station on the U.S. Coast Guard’s Barque Eagle.

The cadets will take their meals in five shifts, retire to the berthing quarters to sleep, and leave the ship to explore cities when “there isn’t work that needs to be done,” he said.

The 295-foot vessel is rooted in training. Built in 1936, it was formerly known as the Horst Wessel and operated by Germany for its cadet training program during World War II before it was captured by the British in 1945. It was then traded to the U.S. a year later.

During a four-year service life extension program, completed last year, more than 1,500 square feet of original German hull plate was removed and replaced, Johnson said. The ship was home-ported in Baltimore, Maryland, while the upgrades were being finished.

The Eagle requires “constant maintenance,” and the cadets and crew know it, he said. During its 19-day trip across the Atlantic en route to Portsmouth in the United Kingdom last week, two sails split during bad weather. One split more than once.

The Army’s new paradigm for tackling traumatic brain injuries

The New York Fire Department vessel, Firefighter, honors the Coast Guard Cutter Eagle as it rests anchored at the Statue of Liberty, Friday, Aug. 5, 2011.

“I think they even got the sewing machines out” to fix them, Johnson said. There are layers of baggywrinkle — old, fringe-like rope — meant to protect the sails from chafing.

The ship has been largely Atlantic-based, sailing to the Caribbean and various European locations. The Eagle has visited Australia, but otherwise hasn’t made its way to other parts of the Pacific Rim. “Not yet, anyway,” Johnson said.

The Eagle, which can hit 17 knots max speed under sail, heads next to Kiel, Germany, to pick up the first summer class of cadets. It will then sail to Copenhagen, Denmark; Antwerp, Belgium; the Netherlands; the Azores; and finally back to the Coast Guard Academy in New London, Connecticut, which will be its homeport after this summer.

The German-turned-American trainer will also participate in events marking the 75th anniversary of the D-Day landings and the Battle of Normandy on June 6, 2019

This article originally appeared on Military.com. Follow @militarydotcom on Twitter..

MIGHTY CULTURE

Why Day of the Deployed should be a federal holiday

In the United States, we enjoy a good amount of federal holidays, during which many employers give their employees a paid day off. During these breaks, which sometimes result in a three- or four-day weekend, everyone can take some time to relax with friends and family — maybe even enjoy a barbecue.

Everyone, that is, except the troops deployed to combat zones. On these days, troops will (sometimes) get a slightly nicer meal served by their chain of command before they return to the grind.

To celebrate the troops that are in harm’s way and the sacrifices their families make, we have today, October 26th, the oft-forgotten Day of the Deployed. Despite the fact that it’s officially recognized by all 50 states as of 2012, you’ll likely see far more people posting things to their social media account about National Breadstick Day, which, this year, happens to share the date.

While the holiday doesn’t necessarily call for huge, elaborate celebration, officially recognizing it as a federal holiday during times of ongoing conflicts would go a long way. Hear us out.


The Army’s new paradigm for tackling traumatic brain injuries

Lt. Col. Honsa’s cousin worked to give him a nationally recognized holiday while he was deployed… The rest of our families need to step up their care package game…

(U.S. Army)

Of the ten holidays observed by the federal government, two of them directly honor the military: Memorial Day, for fallen troops, and Veterans Day, for the living. There’s also Armed Forces Day, which honors the current, active duty military, but that holiday is rarely recognized outside of the military community.

The Day of the Deployed is similar to Armed Forces Day, but it specifically honors the troops who are currently deployed. The holiday first began in 2006 when Shelle Michaels Aberle approached North Dakota Governor John Hoeven to officially proclaim a day to specifically honor the troops out there fightin’ the good fight. The date October 26th was selected in honor of Aberle’s cousin, Lt. Col. David Hosna — the birthday of a soldier who, at the time, was deployed.

When Hoeven became a senator, he sponsored S.Res.295 on October 18th, 2011, to designate October 26th as the “Day of the Deployed.” It was approved unanimously and without any amendments. Since then, all 50 states have officially observed the holiday.

Six years later and the holiday is nothing more than a footnote at the bottom of calendars, found by those looking for wacky holidays — and that’s a shame. A day to commemorate the heroic acts of the troops fighting on the front lines does not deserve to be on the same level as Talk-Like-A-Pirate Day.

Federal recognition of the day would put it in league with the holidays that people get an extended weekend to celebrate — you know, the ones people take seriously. For this to make most sense, we’d need to make a couple of changes:

First, it should become a floating holiday — this year, it falls on the last Friday of October. In our opinion, that’s the perfect place for it. Not only would that mean a three-day weekend, it also means it could incorporate Remember Everyone Deployed Fridays in an official capacity, which gives people a way to celebrate.

The Army’s new paradigm for tackling traumatic brain injuries

And with the way that the postal system works for outlaying combat outposts, the care packages would arrive just before Christmas!

(U.S. Navy photo by Lt. j.g. Matthew Stroup)

On this newly upgraded National Day of the Deployed, everyone would wear red as a symbol and, as an action, they’d send care packages out to those on the front line. Hell, even if only a tiny fraction of the American population actually sends care packages, that’d be a huge windfall for the troops.

The Army’s new paradigm for tackling traumatic brain injuries

A day to remember the troops deployed overseas is an objectively better reason for a four day weekend.

(U.S. Army photo by CPT Jarrod Morris, TAAC-E Public Affairs)

Now, let’s take a look at the competitors. There are already three holidays that fall around(ish) the last Friday of October: Halloween, Columbus Day, and Veterans Day.

On Halloween, children enjoy a day of free candy and dressing like princesses and superheroes while adults awkwardly party while disguised as various pop-culture references. An extended weekend around that time would be very welcomed by the public — it wouldn’t hurt to give people a day off and let them know they have the troops to thank for it.

Earlier in the month, there’s Columbus Day, a federal holiday that’s becoming less relevant and more contentious by the year. As time goes on, evidence surfaces that suggests that Columbus, as an explorer, never stepped foot on American soil. He wasn’t the first person — or even the first European — to get here, and whether we should celebrate beginning of harsh times for American Indians is hotly debated. A 2014 report from Rasmussen showed that only eight percent of the U.S. population even believes that the day is even important. Honestly, we can’t see there being much push-back if we nixed Columbus Day in favor of Day of the Deployed.

The Army’s new paradigm for tackling traumatic brain injuries

It’d also never leave the American public’s mind that our troops are still not home to enjoy the little things — like paid time off.

(U.S. Navy photo by Lt. j.g. Lauren M. Gaidry)

Finally, on the other side of October, we’ve got Veterans Day. If Day of the Deployed were to become a floating holiday, it’d fall somewhere between eleven and eighteen days before Veterans Day.

If the final Friday of October happened to be the 31st, that means the country would enjoy back-to-back three-day weekends. If it fell on the 25th — the longest possible gap — that’d mean people could enjoy a total of eight days off and ten days of work between two holidays honoring the troops and what they’ve given this great nation of ours.

Give people that kind of time off and the freedom to enjoy themselves a bit, and you’ll truly drive home the point that brave men and women are out there sacrificing so that we can enjoy the liberties we do.

Articles

Admiral’s drunken, naked antics cost him his job

A top logistics officer was removed from his post after a night of drinking ended with him wandering a Florida hotel naked, the Navy announced Dec. 7.


The Army’s new paradigm for tackling traumatic brain injuries
Photo: US Navy

Rear Adm. David Baucom was the director of Strategy, Policy, Capabilities, and Logistics at the U.S. Transportation Command, a joint-service post that oversees logistics in all military branches. He was attending a conference in Ponte Vedra Beach, Florida in April when his drinking got away from him.

Navy investigators who looked into the event tallied up at least eight drinks for the admiral for the night of Apr. 7. Security cameras filmed Baucom stumbling around the hotel and hitting his head on a barstool during the night. He also wet his pants at one point, according to the Stars and Stripes.

Eventually, a hotel employee collected Baucom and took him to his room, said the Washington Times. But Baucom awoke and reemerged naked from the room hours later and his room door locked behind him.

Baucom later told a colleague he hadn’t packed pajamas because his suitcase was full and he didn’t want to pay a baggage fee for another bag, the Washington Post reported.

Two women staying at the hotel saw the admiral walking around the hotel and searching for a towel. They reported it to hotel employees and Baucom was led back to his room.

The Army’s new paradigm for tackling traumatic brain injuries
Rear. Adm. David Baucom, seen here wearing clothes, tours a uniform issue facility that is full of clothes. Photo: US Navy Mass Communications Specialist 1st Class Andre N. McIntyre

The admiral checked himself into a drug and alcohol program when he got back to his base, the Navy Times reported. He also has a medical condition that contributed to the incident.

Still, the Navy knows a drunken sailor when they see one and determined that his actions had more to do with his intoxication than his medication. The 34-year veteran was removed from his post and reprimanded for his behavior.

MIGHTY TRENDING

This is how John Kelly shut down speculation on President Trump’s gold star family call

Florida Congresswoman Rep. Frederica Wilson claimed she was with the wife of a fallen Special Forces soldier when the woman received a phone call from President Donald Trump. Wilson claims the president had some insensitive words for the grieving young woman.


“He said to the wife, ‘Well, I guess he knew what he was getting into,’ ” said Wilson. “How insensitive can you be?”

The call was to Sgt. La David Johnson’s widow Myeshia after her husband was killed in an ambush in Niger with three other soldiers on Oct. 4. The couple had two children and were expecting a third.

The Army’s new paradigm for tackling traumatic brain injuries
Sergeant La David Johnson and three other soldiers were killed in action in Niger on Oct. 4, 2017.

President Trump denied the accusation via Twitter, while the White House Press Secretary, Sarah Huckabee Sanders described the call as “respectful” and “sympathetic” but asserted that no recordings of the calls exist.

Johnson’s mother, who was also listening to the call, then stepped into the media spotlight by affirming Wilson’s story.

The White House has since criticized the Florida Congresswoman for politicizing the practice of calling Gold Star Families on the event that their loved one was killed in action. But President Trump opened himself to criticism on this issue as well, by falsely claiming that his predecessors never did anything like it

Enter former Marine Gen. John Kelly, now the White House Chief of Staff.

Read: Everybody should read General John Kelly’s speech about two Marines in the path of a truck bomb

President Trump told reporters President Obama  never called then-Gen. Kelly when the General’s son was killed in Afghanistan in 2010. The White House claims Kelly was on hand for Trump’s call to Johnson and saw the conversation as “respectful” and appropriate.”

On Oct. 19, Kelly himself took the podium during the White House Press Briefing to explain to reporters what happens when American troop are killed in action, how the remains are transported, how the family is notified, and who sends their condolences.

The Army’s new paradigm for tackling traumatic brain injuries

Kelly set the record straight with how Presidents send their condolences and how it should be done. He confirmed that President Obama did not call his family – not as a criticism, just a fact. And Kelly advised Trump against calling too.

“I recommended that he not do it,” Kelly said. “It is just not the phone call they’re looking forward to. … It’s not a negative thing.”

When Trump decided to call he asked Kelly how to make the call and what to say. He told the president there’s no way he would ever understand how to make that call.

“If you’re not in the family, if you’ve never worn the uniform, if you’ve never been in combat, you can’t even imagine how to make that call,” Kelly said.

As he continued, Kelly emotionally recalled what Gen. Joseph Dunford, the casualty officer assigned to the Kelly family, told him when Kelly’s son was killed in action.

“He [Kelly’s son] knew what he was getting into… he knew what the possibilities were, because we’re at war,” Kelly recalled. “When he died, he was surrounded by the best men on this earth, his friends. That’s what the president tried to say to four families the other day.”

The Army’s new paradigm for tackling traumatic brain injuries
U.S. Marine Gen. John F. Kelly, left, and Marine Corps Gen. Joseph F. Dunford, chairman of the Joint Chiefs of Staff, stand at attention. (U.S. Marine Corps photo)

Related: This is why John Kelly could comfort families of fallen troops

Kelly then lashed out at Rep. Wilson for tarnishing what he believed was one more formerly sacred institution in America. He said he had to go walk among “the finest men and women on this earth. … You can always find them because they’re in Arlington National Cemetery.”

Watch the full press briefing below:

https://www.youtube.com/watch?v=Ps5ttDzWBaY
MIGHTY CULTURE

The 13 funniest military memes for the week of October 26th

Oh boy, picking just one military news story and riffing on it is going to be hard this week.

Let’s see… The Coasties beat the Marines in a sniper competition. The Marines drew another skydick over Miramar. Civilians learned that the Air Force has enough money to waste hundreds of thousands on easily broken coffee mugs. A soldier got arrested in South Korea for kicking a policeman in the nads. And the Commander-in-Chief said he’d, “send in the military — not the guard — but the military,” effectively discrediting the efforts of over half a million guardsmen.

Because I can’t come up with anything funnier than reality has been this week for the military, I’ll just remind you that your Cyber Security cert is almost expired. You should probably get on that.


The Army’s new paradigm for tackling traumatic brain injuries

(Meme via Decelerate Your Life)

The Army’s new paradigm for tackling traumatic brain injuries

(Meme via Air Force Nation Humor)

The Army’s new paradigm for tackling traumatic brain injuries

(Meme via The Salty Soldier)

The Army’s new paradigm for tackling traumatic brain injuries

(Meme via Hooah My Ass Off)

The Army’s new paradigm for tackling traumatic brain injuries

(Meme via Smokepit Fairytales)

The Army’s new paradigm for tackling traumatic brain injuries

(Meme via Battle Bars)

The Army’s new paradigm for tackling traumatic brain injuries

(Meme via Pop Smoke)

The Army’s new paradigm for tackling traumatic brain injuries

(Meme via Private News Network)

The Army’s new paradigm for tackling traumatic brain injuries

(Meme via Ranger Up)

The Army’s new paradigm for tackling traumatic brain injuries

(Meme via Valhalla Wear)

The Army’s new paradigm for tackling traumatic brain injuries

(Meme via Untied Status Marin Crops)

The Army’s new paradigm for tackling traumatic brain injuries

(Meme via Army as F*ck)

The Army’s new paradigm for tackling traumatic brain injuries

(Meme via US Army WTF Moments)

13. The perfect Halloween costume doesn’t exi-

No, seriously. You should probably get your Cyber Security training done.

MIGHTY TRENDING

Team Rubicon’s co-founder receives the Pat Tillman Award for Service

Jake Wood has seen and done a lot in his life, so you know when he calls receiving the Pat Tillman Award for Service “humbling,” it’s a meaningful statement. The co-founder and CEO of Team Rubicon was a United States Marine and scout sniper in Iraq and Afghanistan. He’s testified in Congress on veterans’ mental health and briefed the last three Presidents of the United States about the issues returning veterans face.

Now, he’s been recognized by the ESPY awards, the annual presentation from ESPN and ABC honoring athletes for their performance in sports and sports-related activities. While deploying American military veterans to help disaster areas other rescue organizations won’t touch isn’t necessarily a sport, one can argue it’s definitely athletic.

But you don’t have to argue for Jake Wood.


The Army’s new paradigm for tackling traumatic brain injuries

Tillman as a Ranger and as a Cardinal.

The Pat Tillman Award for Service is presented at the ESPYs to honor an individual with a strong connection to sports who has served others in a way that echoes the Tillman legacy. Previous honorees include 2016’s Sgt. Elizabeth Marks, who overcame hip injuries sustained in Iraq but still became the world’s number one paraswimmer. In 2015, it was awarded to Danielle Green, who joined the military after playing basketball at Notre Dame and lost her arm in Iraq. Green returned to help other veterans struggling to adjust to life after the military.

For Jake Wood, this award hits close to home. Wood was playing on the offensive line at the University of Wisconsin when Pat Tillman was killed in action in Afghanistan in 2004. It was after Tillman died that Wood told his coach he was off to join the Marine Corps, where he spent four years.

He was out for just three months before he saw the devastation in Haiti. It was in Port-Au-Prince that a handful of volunteers formed the first heartbeat of what would be come Team Rubicon. Now, the organization is 80,000 members strong.

The Army’s new paradigm for tackling traumatic brain injuries

Wood in Haiti on Team Rubicon’s first mission.

And Jake Wood, the former o-lineman for the Badgers, is being recognized for forming a group that helps those most in need while giving struggling military veterans a new mission in life.

Pat Tillman would be proud.

MIGHTY TRENDING

Iran is hit with droughts, riots, and now power shortages

The Iranian capital was hit by power outages amid protests in Tehran over worsening economic conditions in the country.

The semiofficial Fars news agency reported that Tehran was hit by a blackout for several hours on June 27, 2018, due to the “overheating” of the nation’s power grid.

The Iran Power Network Management Company, a power supplier, said consumption reached a peak at 4 p.m. local time on June 26, 2018, prompting the blackouts.


The Energy Ministry has said electricity consumption has increased by some 28 percent compared to 2017.

Energy Minister Reza Ardakanian said in April 2018 that electricity output from hydropower plants would decrease because Iran was experiencing its worst drought in the past 50 years.

The Army’s new paradigm for tackling traumatic brain injuries

Ardakanian said power outages were inevitable and urged consumers to use less electricity.

The power shortages in Tehran coincided with demonstrations in the capital and other cities over the falling value of the national currency, the rial.

The value of the rial has plummeted by nearly a half in the last six months, helping feed a spiral of rising prices for everyday goods.

The currency’s fall accelerated after U.S. President Donald Trump announced in May 2018 that he was pulling the United States out of Iran’s nuclear deal with world powers and reinstating U.S. sanctions against Tehran.

Protesters on the streets and in Tehran’s Grand Bazaar staged demonstrations for three consecutive days starting from June 24, 2018.

There were no reports of fresh protests on June 28, 2018, a day after a heavy police presence on Tehran’s streets and at the Grand Bazaar.

Articles

US-backed forces were supposed to assault ISIS capital two weeks ago

The start date of the offensive to oust Islamic State fighters from the city of Raqqa and end the terror group’s state-building project has been announced several times in the past few months, often with great fanfare by commanders in the Kurdish-led Syrian Democratic Forces, the United States’ ground ally in northern Syria.


The last announcement came in March when Kurdish commanders said an assault on the city would begin April 1.

Two weeks later that start date, like many others, has come and gone, prompting the months-long question: when will the U.S.-backed SDF offensive shift gears from isolating Raqqa, which is hemmed in on three sides now, to mounting an assault to retake the capital of the jihadists’ self-styled caliphate?

The Army’s new paradigm for tackling traumatic brain injuries
A Marine directs an F/A-18D Hornet returning to an undisclosed location in support of Operation Inherent Resolve, the operation to eliminate the ISIL terrorist group and the threat they pose to Iraq, Syria, and the wider international community, June 9, 2016. (U.S. Marine Corps photo by Sgt. Donald Holbert)

Over the weekend, Syrian President Bashar al-Assad told the French news agency AFP he would support whomever wants to oust Islamic State militants from Raqqa, but mocked the delay in an assault on the city, which U.S. officials believe is being defended by around 4,000 IS fighters.

“What we hear is only allegations about liberating Raqqa. We’ve been hearing that for nearly a year now, or less than a year, but nothing happened on the ground,” he said. “It’s not clear who is going to liberate Raqqa…It’s not clear yet.”

No firm answer about a new start date was forthcoming on April 15 from U.S. Secretary of Defense Jim Mattis when he met in Washington with his Turkish counterpart, Fikri Isik.

The Turkish defense minister again complicated the U.S. effort to choreograph an agreement among multiple local and international players about a Raqqa offensive by pressing Ankara’s long-standing demand for the U.S. to end its alliance with the Kurdish People’s Protection Units, or YPG, whose fighters dominate the ranks of the SDF.

There were no signs that the Turkish request made persistently by Ankara in recent months, and relayed by President Recep Tayyip Erdogan during a February phone call with U.S. President Donald Trump, will be heeded.

U.S. officials say they envisage the Raqqa battle will resemble the fight in neighboring Iraq, where local indigenous forces have been waging the struggle to retake the northern city of Mosul, the last IS major urban stronghold in that country.

Also read: Defeating ISIS is hard; preventing ISIS 3.0 could be harder

Some 500 U.S. special forces soldiers deployed in northern Syria are helping to train and advise SDF units.

Mattis later said at a press conference the U.S. remains in solidarity with Ankara when it comes to fighting Islamic State militants and Turkey’s outlawed Kurdistan Workers’ Party, or PKK, but he made no mention of discontinuing the alliance with the YPG, the armed wing of Syria’s Democratic Union Party, or PYD.

The Turks, who fear the emergence of a Kurdish state in north Syria, maintain there’s no real distinction between the PYD and the PKK, which has been waging an insurgency in Turkey for more than three decades.

The Army’s new paradigm for tackling traumatic brain injuries
A U.S. Army M109A6 Paladin deployed in support of Combined Joint Task Force – Operation Inherent Resolve. (Photo: U.S. Army Spc. Christopher Brecht)

Mattis cited the long security relationship between the U.S. and Turkey, dating back to 1952 when Turkey joined NATO; but, in the wake of the April 16 constitutional referendum that greatly enhances the Turkish president’s powers, analysts say it is unclear how much Erdogan values his country’s alliance with the West, and whether his slim victory will embolden him to disrupt a Raqqa assault by the SDF.

Earlier in April, Erdogan ramped up the pressure on Washington, saying his government is planning new offensives in northern Syria this spring against groups deemed terrorist organizations by Ankara, including IS and the PYD’s militia.

In March, Turkish forces escalated attacks on the YPG in northern Syria, forcing the U.S. to deploy a small number of forces in and around the town of Manbij to the northwest of Raqqa to “deter” Turkish-SDF clashes and ensure the focus remains on Islamic State.

Meanwhile, Raqqa is being pummeled by airstrikes mounted by U.S.-led coalition forces and Syrian warplanes.

Local anti-IS activists say the air raids fail to distinguish between military and non-military targets; however, with IS fighters seeded throughout the city and surrounding villages, being able to draw a distinction is become increasingly challenging, say U.S. officials.

The Army’s new paradigm for tackling traumatic brain injuries
U.S. Airmen load pallets of nonlethal aid for the Syrian Opposition Coalition onto a C-17 Globemaster III aircraft at an undisclosed base May 9, 2013. U.S. forces provided humanitarian aid to refugees of the Syrian civil war. (Dept. of Defense photo by Staff Sgt. Nicole Manzanares, U.S. Air Force)

“Civilians are now [caught] between the criminal terrorists on one side and the international coalition’s indiscriminate bombing on the other side,” said Hamoud Almousa, a founding member of the activist network Raqqa is Being Slaughtered Silently, which is opposed to an assault on the city being led by the YPG.

“Liberating [Raqqa] does not come by burning it and destroying it over its people who have suffered a lot from the terrorist group’s violations,” he added.

The Syrian Observatory for Human Rights, a London-based monitoring group that relies on a network of activists for its information, said that four civilians — two women and two children — were killed April 17 in an airstrike believed to have been carried out by coalition warplanes on the Teshreen Farmarea north of Raqqa.

The Observatory says between March 1 and April 10, airstrikes killed 224 civilians. They included 38 children under the age of 18, and 37 women.

Another mainly Arab anti-IS activist network, Eye on the Homeland, complains at the lack of international condemnation about the civilian casualties from the airstrikes, arguing civilians caught in the conflict are being treated inhumanely.

“We assert that the liberation of civilians from all forms of terrorism requires that military forces acting in the area avoid civilian killing, displacement, and the destruction of their properties whenever possible,” the network said recently on its website.

It warned the deaths will “be used to by terrorist organizations in their propaganda to convince civilians that these military forces do not have their interests at heart” and will “only further fuel radicalization.”

MIGHTY CULTURE

Yabba Dabba Doo: Did you know the Army owned dinosaurs?

It turns out a massive flood control project is an excellent way to unearth dinosaurs. At least, that’s what happened back in 1993 in Coralville, Iowa.

In 1993, Coralville, Iowa, experienced 28 days of rain. More than 17,000 cubic feet of water flowed over a spillway, wiping out the state’s yearly crop of soybeans and corn. Roads were obliterated, people’s lives were in jeopardy, and the city was literally drowning.


The Coralville Dam was built in the 1950s by the US Army Corps of Engineers to help provide flood protection for the Iowa River Valley to the south. It was named after the city, which had weirdly received its name from the ancient fossilized reefs that stud the river’s limestone.

Once the rains stopped and the citizens of the city could step outside without being swept away, the Corps returned to the site to assess the damage and explore the choices for reconstructing the dam. What they discovered shocked everyone.

The Corps discovered that the floods eroded five feet of limestone from the edge of the spillway. This created a gorge and unearthed several fossil beds, most of which were about 375 million years old. The fossils were mainly marine creatures that had once lived in the sea that used to cover Iowa. Because the Corps discovered them, all the sea creatures immediately became the property of the US Army.

That’s not to say that the Army will be opening a theme park filled with these fossils any time soon, but it’s pretty exciting to think that the Army has done its part to help advance the field of paleontology.

The survey archaeologist for the Corps, Nancy Brighton, said that the collection spans the entire paleontological record. So anything relating to animals and the natural world that existed before humans are included in that.

Because the Corps of Engineers manages more than 8 million acres of land across the United States, finds like the one in Iowa aren’t super uncommon. In fact, the Corps asl owns one of the most intact T. rex skeletons ever found. More on that later.

All thanks in part to the Flood Control Act, signed by Franklin D. Roosevelt in 1936 that decreed the need for dams, levees, and dikes all across the country. But before construction could begin on those early-iteration dams, the Corps had to complete a thorough survey. Those surveys almost always exposed ancient fossil beds.

In fact, it’s assumed that most of what American archeologists have discovered are thanks in part to the efforts of the Corps. All of the hydropower and flood control projects that started back in the 1950s certainly paved the way for new discoveries.

The greatest of all of these discoveries didn’t happen way back, though. It was just a few decades ago, in 1988, on Labor Day. That morning, Kathy Wankel, a hiker, and amateur fossil collector, was trekking through Montana’s Fort Peck Reservoir when something caught her eye.

At first, she thought it was a shoulder blade pushing up through the rocky soil. The lighting was perfect, according to Wankel, which allowed her to see the webby pattern of bone marrow, and that’s when she knew she’d discovered something big.

And by big, of course, we mean enormous. Wankel and her husband had stumbled on the remains of a T. rex thought to have roamed the Montana area some 66 million years ago. The discovery that Wankel and her husband made was one of just eight at the time. Since then, about 50 other skeletons have been discovered.

It took nearly a year to figure out who owned the land where the skeleton was found. At long last, the Corps began to dig. It took several years and a large team to unearth the 38-foot skeleton weighing in at nearly six tons. The most astonishing part? It was almost one hundred percent complete, making it the first specimen to be discovered with small lower arm bones fully intact.

Since 2017, the T. rex has called the Smithsonian National Museum of Natural History home. The Corps of Engineers has agreed to a 50-year loan to ensure that all Americans have a chance to see it – when the world’s not locked down with COVID, at least.

MIGHTY TRENDING

Russia releases details of upcoming war games

On Sept. 7, 2018, two US F-22 Raptor fighter jets intercepted two Russian nuclear-capable Tu-95MC strategic bombers flying over the Arctic Ocean, escorting them for part of their journey over the waters of the Arctic and the Bering and Okhotsk seas.

The US planes tracked the Russian bombers until they left the area, flying west over the Aleutian Islands.

A defense official told The Washington Free Beacon that the bombers may have been practicing for a cruise-missile strike on US missile-defense sites and radars in Alaska — which may be a feature of the Russia’s upcoming massive Vostok-18 exercise that Russian officials have said will be the largest such drill since the Cold War.


Russian troops have already undergone “snap inspections” in preparation for the exercise, the active portion of which will take place between Sept. 11 to Sept. 17, 2018, Russian Defense Minister Sergei Shoigu said, according to Russian state-media outlet Tass.

Exercises will take place at five ground testing areas and four aerial testing areas over the Sea of Japan and the Bering and Okhotsk seas.

“Aircraft have been flying maximum range sorties with refueling in flight and practicing landings at tactical airfields. Naval ships have been performing combat maneuvering and firing practices,” Shoigu said, according to Tass.

The Army’s new paradigm for tackling traumatic brain injuries

Russian armored vehicles participating in Zapad-2017 exercises.

(Russian Ministry of Defense)

Shoigu said in late August 2018 that about 300,000 Russian personnel and 1,000 aircraft, including drones, would take part, adding that “up to 80 combat and logistics ships and up to 36,000 tanks, armored personnel carriers and other vehicles” will be involved.

Valery Gerasimov, the head of Russia’s general staff, said Sept. 6, 2018, that 21 formations had been mobilized in 10 regions for the exercise, the main purpose of which, he said, “is to check the level of training that can be assessed only in an exercise of proper scale.”

“This exercise, to be held on the bilateral basis, will be the strictest test of combat skills and the military districts’ readiness for ground, air and naval operations,” he added.

“Involved in the exercise will be forces from the Eastern and Central federal districts, the Northern Fleet, and Airborne Forces, as well as long-range, military transport and tactical aircraft of Russia’s Aerospace Force,” Gerasimov said, according to Tass.

Gerasimov also said that Chinese and Mongolian personnel will take part “side by side” with Russian forces.

Shoigu said in September 2018 that up to 3,500 Chinese army personnel would be involved “in the main scenario at the Tsugol proving ground” in Russia’s Eastern Military District.

China’s involvement has elicited surprise, given that Vostok, or East, has long been seen as Moscow’s preparation for a potential conflict with Beijing. China and Russia have done joint drills before, but this appears to be the first time Beijing has taken part in the Vostok exercise.

The Army’s new paradigm for tackling traumatic brain injuries

Chinese President Xi Jinping and Russian President Vladimir Putin.

China “is now being invited to join as a friend and even a quasi-ally,” Alexander Gabuev, a China expert at the Carnegie Moscow Center, told The New York Times in August 2018.

The exercise is also expected to include simulated nuclear-weapons attacks, US officials told The Free Beacon. A Pentagon official said the US would watch the war games closely, calling them “strategic messaging” by both China and Russia.

Mongolia is also participating for the first time, and contingents from there and China are “completing coordination and adjustment at the Tsugol proving ground,” Gerasimov said, referring to an area near the eastern intersection of the three countries’ borders — where Gabuev suggested they might be restricted so Russian troops elsewhere could train for a potential clash with China.

NATO has also criticized the exercise, with a spokesman for the alliance saying it “fits into a pattern we have seen over some time: a more assertive Russia, significantly increasing its defense budget and its military presence.”

Russia’s deputy defense minister, Col-Gen. Alexander Fomin said in September 2018 that the upcoming drills “lacked the slightest traces” of “anti-NATO bias or aggressiveness.”

Fomin also said Russian military personnel had been briefed on security and safety measures in accordance with Moscow’s agreements with neighboring countries, including the US.

This article originally appeared on Business Insider. Follow @BusinessInsider on Twitter.

MIGHTY TRENDING

A former SecDef dispels myths about the Tet Offensive

Around midnight on Jan. 30, 1968, Vietcong and North Vietnamese Army troops began a massive surprise attack on U.S., South Vietnamese, and allied forces across South Vietnam.


The Tet Offensive, as it came to be known, was actually a three-phase campaign, lasting from Jan. 30 – March 28, May 5 – June 15, and Aug. 17 – Sept. 23.

“The event really defined the course of the rest of the [Vietnam] war and how it ended, which was a pretty inglorious ending,” said former Secretary of Defense Chuck Hagel.

Hagel, who was with the 47th Infantry Regiment in Vietnam during Tet, spoke at the “Vietnam: The Tet Offensive” panel discussion, Jan. 25, at the National Archives.

Then a 21-year-old private first class, Hagel, just two months in country, said his mechanized infantry unit sustained heavy casualties in the vicinity of Long Binh.

The attack was a complete surprise, he said. What happened in Long Binh was typical of what was happening across the country.

The U.S. had completely underestimated the strength of the North Vietnamese Army and Vietcong guerrilla forces from South Vietnam, he said. It came as a shock to the American public and turned public opinion against the war.

The Army’s new paradigm for tackling traumatic brain injuries

One of the myths of Tet, he said, is that it was a big enemy military victory, he added. It wasn’t. “Our military actually did very well considering.”

Erik B. Villard, a historian with the U.S. Army Center of Military History, said there were other myths about Tet, some of which he wrote about in his Center for Military History book, “Combat Operations: Staying the Course, October 1967 to September 1968.”

One myth, he said, was that the North Vietnamese orchestrated a number of major battles prior to Tet in the autumn of 1967 to draw U.S. forces away from the cities so they would be in a better position to succeed in capturing the urban areas.

The real story is more interesting, he said. The 1967 battles were local and regional campaigns, planned over the spring and summer of that year.

The idea for the Tet Offensive did not even occur to the enemy at the time, as their strategic planning process tended to be short-term and, at times, very chaotic, he said.

Also, why would they want to launch a major battle in November 1967, just months before Tet when full strength would be needed? There wouldn’t be adequate recovery time, he said, noting that the National Archives provided some key documents he used in his research.

Also Read: 17 wild facts about the Vietnam War

A second myth, Villard said, was that Gen. William Westmoreland, the commander of American forces in Vietnam, “was wedded to this notion of victory through attrition; that the way to succeed was to kill enough of the enemy that you crossed this imaginary threshold and you could just kind of grind your way toward success.

“Westmoreland deserves far more credit than he’s gotten in my view,” he added.

He was a shrewd person who understood the value of pacification and cutting enemy supply lines, as he was doing in secret operations to cut the Ho Chi Minh Trail, Villard noted.

A third myth, he said, is that U.S. military policy changed when Westmoreland was replaced by Gen. Creighton Williams Abrams Jr. in June 1968, in the middle of the Tet Offensive.

Abrams and Westmoreland saw mostly eye-to-eye on strategy, he said. The mission continued to be defending bases and lines of communication, as well as air interdiction operations and supporting pacification.

Pacification was a term used at the time to denote counterinsurgency operations, which included advise and assist missions and winning over the loyalty of the local population.

The Army’s new paradigm for tackling traumatic brain injuries
Group of Soldiers from ARVN with SFC Norman A. Doney, 5th S.F. Group Abn., 1st S.F., Vietnam, Sept. 1968.

Policy didn’t actually change until after mid-1969 when Vietnamization took hold, he said. Vietnamization consisted of drawing down U.S. forces and transferring responsibility to the South Vietnamese forces.

The buildup of forces into 1968 and the draw down a year later had already been planned on Westmoreland’s watch, he said.

Merle L. Pribbenow II, an author specializing in the Vietnam War, with five years of service in Vietnam during the war as a CIA operative, said that a widespread myth was that the Tet Offensive was a well planned and executed enemy attack.

That’s completely false, he said, referencing documents and interviews of NVA and VC commanders after the war.

Many of those generals became bitter with the way they and their units were treated by their own military and political leaders and the high numbers of casualties that resulted, he said.

“We focus on how we felt Army commanders screwed up and were unprepared. [The North Vietnamese] were saying the exact same things again and again,” he said.

After the war, the Vietnamese did tactical reviews and battle studies, just as the U.S. Army did, to learn lessons and assess strengths and weaknesses, he noted.

The takeaway from that assessment, he said, was that the communists acknowledged that a lot of the poor decision-making during Tet resulted from underestimating U.S. military response, as well as the loyalty of the South Vietnamese people.

Like the Americans, the communists also inflated their own body counts, minimized their failures, and exaggerated their accomplishments, he said.

The Army’s new paradigm for tackling traumatic brain injuries
The 47th Infantry Regiment takes the offensive May 1968 in South Saigon. Former Secretary of Defense Chuck Hagel was with the 47th Infantry in Vietnam during the Tet Offensive and he spoke about it at the National Archives Jan. 25, 2018. (Photo from Kenneth Pollard)

The biggest problem, he added, was that shortcomings were not reported up the chain of command and authorities refused to listen to subordinates.

As a result of the assessment, he said the military leadership of Vietnam decided on a new approach. From then on, leaders were instructed to encourage subordinates to tell the truth, even if it wasn’t something they wanted to hear or went against their own thinking.

Gregory Daddis, an associate professor of history and director of Chapman University’s Master of Arts program in War and Society, said another myth was that the U.S. media was to blame for the lack of political will after the Tet Offensive.

There’s a tendency, he said, to find someone to blame when a bad outcome occurs.

Looking back 50 years ago to the Tet Offensive gives everyone an opportunity to gain a better perspective on everything that took place, he said.

An important takeaway from Tet, he said, is that sometimes military action might not be the best tool in all situations to achieve the desired political effect.

Hagel added that “in the end, war is determined not by military might but by the support of the people. We found ourselves on the wrong side of that.”

He concluded: “The sacrifices made by over 56,000 Americans who lost their lives and hundreds of thousands of individuals who were wounded, and all who served, were never really given much recognition for an assignment they didn’t choose. But they served and they served honorably, and did what their country asked them to do. And I think that’s a part of this story that needs to be told more often.”