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Chris Hadfield
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How We Can Really Support Our Troops

Question: Do we\r\nunderstand soldiers’ traumas better than we used to?

\r\n\r\n

Nancy Sherman:\r\nWell we’re doing better in that we’re sending mental health clinicians \r\nout to\r\nthe field.  And at Uniform Services\r\nUniversity, which is on the campus of Bethesda Naval Hospital, I \r\nsometimes\r\nteach some of these folks who are going out to the field. \r\n So, they’re deploying with the troops\r\nand they’re going to be available, and they make themselves known in \r\nadvance,\r\nand some of them do like warrior resilience training.  I’m\r\n here, this is what a healthy soldier can expect to see,\r\nhelping commanders know that they’re there, so if some of their troops \r\nare\r\ninvolved in incidents or they lose buddies or they kill civilians, they \r\nknow\r\nwhere to go afterward and have touched base beforehand.  So,\r\n there’s much more of that.  We have more \r\nchaplains going out and\r\nbeing trained in these areas.  We\r\nalso now are using medical corpsmen to help fill these roles, so they’re\r\n not\r\njust dealing with first aid and physical wounds, but rather \r\npsychological\r\nwounds.  So, we’re doing a lot\r\nbetter.  It’s still stigmatizing to\r\ncome home and seek help and self-medication is one of the first things \r\nthat\r\nlots of folks do, sadly, which is alcohol or drugs. 

\r\n\r\n

And what we’re not doing enough of, I think, is \r\nreally\r\ngetting support to the families. \r\nThe families served too, in a way, as I said, they go to war in a\r\n sense\r\nwith their soldiers because they’re in such close communication.  They can email their war theater and\r\nhome theater are not so separated, and when they come home, they’re \r\noften\r\nlimited in resources.  How do you\r\ndeal with a soldier, male or female, who comes home and just retreats \r\ninside,\r\nor can’t begin to talk, and also unemployment rates are much higher for\r\nreturning veterans than they are for those—for civilians. 

\r\n\r\n

So, we’re getting better, but we still have this \r\nenormous\r\nyawning military/civilian divide. \r\nAnd the families in a sense are civilian families, of course, but\r\nthey’re military families because their loved ones have served and they \r\nfeel\r\nsociety often isn’t supporting them enough.

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Question: What new\r\nsolutions or interventions would you propose?

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Nancy Sherman: Certainly more money\r\n into the VA, stronger benefits, more robust\r\nprograms for seeking jobs, making sure that the military hospitals are \r\nnot\r\nthemselves shaming places.  Walter\r\nReed had a very big scandal about three years ago in mismanagement and \r\nit was a\r\nbullying place where soldiers would come home and they were still kept \r\nin\r\nholding units where they would be ready as if to deploy, but most of \r\nthem knew\r\nthey weren’t because they had such severe injuries, yet they still had \r\nto go\r\noutside for 6:30 a.m. formation, and stand in formation and whatnot.  Though many had been on very heavy\r\nmedications at night, or might not fall asleep or drift into sleep until\r\n 4:30\r\nin the morning, and if they were on leave for awhile, they didn’t get \r\nback in\r\ntime, they were really bullied. \r\nSo, making sure that our environments are healthier.  We’ve done a lot to clean those up with\r\nsomething called Warrior Transition Brigades.  Soldiers\r\n themselves helping other soldiers move through this\r\npassage. 

\r\n\r\n

But I would say, one thing we can do, and I’m \r\ninvolved in\r\nthis to some degree.  If you’re on\r\na teaching campus, talk to those veterans that have come home and try to\r\n break\r\ndown the barriers, and make them understand that they don’t have to feel\r\n it’s\r\nonly those that have been to war and come home that can really be talked\r\n to,\r\nthat we really want to understand and listen.  And\r\n similarly those that are about to go to war who are part\r\nof ROTC programs.  Make sure they\r\nare not feeling marginalized in class, or afraid to say that I’m going \r\nto be\r\nserving in a year’s time, or whatnot, and really trying on a \r\nperson-to-person\r\nbasis to break down some of the barriers in our local communities.  I think that’s really critical.  In\r\n addition to large scale policies of\r\nmore resources in the VA, having the VA talk to the military hospitals \r\nmore\r\nsmoothly.  We’re working that out\r\nright now with unified computer systems. 

\r\n\r\n

And also understanding that multiple deployments \r\nhave an\r\nattrition; a psychological attrition on the mental health of soldiers.  Resilience is sort of supposed to be,\r\nyou bounce a ball and it for a while continues to hold its bounce, but \r\nthen\r\nballs after awhile they keep bouncing and bouncing and bouncing and the \r\nbounce\r\ngets lower and lower and lower. \r\nAnd a little bit like that with troops.  You\r\n send them three and four and five times to war and their\r\nresilience just doesn’t hold up the same way as in the first round.  Stresses on families as a result, high\r\ndivorce rates.

\r\n\r\n

Question: Are some of\r\nthese stresses unavoidable in an all-volunteer army?

\r\n\r\n

Nancy Sherman: It’s\r\n an Army that wasn’t designed to fight two wars at the\r\nsame time for 10 years.  If you\r\nthink about it, I teach 18- to 22-year-olds, half of their lives have \r\nbeen exposed\r\nin a very indirect way, but nonetheless, that’s the background factor to\r\nwar.  That’s a long time, longer\r\nthan exposure during World War II.  So,\r\nyes, big debate, certainly about draft versus volunteer. \r\n I don’t think we will go back to a\r\ndraft easily.  There’s not enough\r\nsupport for that in Congress.  But\r\nwe certainly could have more service of various sorts, national service \r\nand\r\nmaking military service one of those options so that those that go into\r\nmilitary service aren't the only ones who are doing compulsory national \r\nservice.

We’re taking better psychological care of soldiers than we used to. But with deployments getting longer and longer, far more needs to be done.

Does conscious AI deserve rights?

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  • Does AI—and, more specifically, conscious AI—deserve moral rights? In this thought exploration, evolutionary biologist Richard Dawkins, ethics and tech professor Joanna Bryson, philosopher and cognitive scientist Susan Schneider, physicist Max Tegmark, philosopher Peter Singer, and bioethicist Glenn Cohen all weigh in on the question of AI rights.
  • Given the grave tragedy of slavery throughout human history, philosophers and technologists must answer this question ahead of technological development to avoid humanity creating a slave class of conscious beings.
  • One potential safeguard against that? Regulation. Once we define the context in which AI requires rights, the simplest solution may be to not build that thing.

A new hydrogel might be strong enough for knee replacements

Duke University researchers might have solved a half-century old problem.

Photo by Alexander Hassenstein/Getty Images
Technology & Innovation
  • Duke University researchers created a hydrogel that appears to be as strong and flexible as human cartilage.
  • The blend of three polymers provides enough flexibility and durability to mimic the knee.
  • The next step is to test this hydrogel in sheep; human use can take at least three years.
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Hints of the 4th dimension have been detected by physicists

What would it be like to experience the 4th dimension?

Two different experiments show hints of a 4th spatial dimension. Credit: Zilberberg Group / ETH Zürich
Technology & Innovation

Physicists have understood at least theoretically, that there may be higher dimensions, besides our normal three. The first clue came in 1905 when Einstein developed his theory of special relativity. Of course, by dimensions we’re talking about length, width, and height. Generally speaking, when we talk about a fourth dimension, it’s considered space-time. But here, physicists mean a spatial dimension beyond the normal three, not a parallel universe, as such dimensions are mistaken for in popular sci-fi shows.

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Predicting PTSD symptoms becomes possible with a new test

An algorithm may allow doctors to assess PTSD candidates for early intervention after traumatic ER visits.

Image source: camillo jimenez/Unsplash
Technology & Innovation
  • 10-15% of people visiting emergency rooms eventually develop symptoms of long-lasting PTSD.
  • Early treatment is available but there's been no way to tell who needs it.
  • Using clinical data already being collected, machine learning can identify who's at risk.

The psychological scars a traumatic experience can leave behind may have a more profound effect on a person than the original traumatic experience. Long after an acute emergency is resolved, victims of post-traumatic stress disorder (PTSD) continue to suffer its consequences.

In the U.S. some 30 million patients are annually treated in emergency departments (EDs) for a range of traumatic injuries. Add to that urgent admissions to the ED with the onset of COVID-19 symptoms. Health experts predict that some 10 percent to 15 percent of these people will develop long-lasting PTSD within a year of the initial incident. While there are interventions that can help individuals avoid PTSD, there's been no reliable way to identify those most likely to need it.

That may now have changed. A multi-disciplinary team of researchers has developed a method for predicting who is most likely to develop PTSD after a traumatic emergency-room experience. Their study is published in the journal Nature Medicine.

70 data points and machine learning

nurse wrapping patient's arm

Image source: Creators Collective/Unsplash

Study lead author Katharina Schultebraucks of Columbia University's Department Vagelos College of Physicians and Surgeons says:

"For many trauma patients, the ED visit is often their sole contact with the health care system. The time immediately after a traumatic injury is a critical window for identifying people at risk for PTSD and arranging appropriate follow-up treatment. The earlier we can treat those at risk, the better the likely outcomes."

The new PTSD test uses machine learning and 70 clinical data points plus a clinical stress-level assessment to develop a PTSD score for an individual that identifies their risk of acquiring the condition.

Among the 70 data points are stress hormone levels, inflammatory signals, high blood pressure, and an anxiety-level assessment. Says Schultebraucks, "We selected measures that are routinely collected in the ED and logged in the electronic medical record, plus answers to a few short questions about the psychological stress response. The idea was to create a tool that would be universally available and would add little burden to ED personnel."

Researchers used data from adult trauma survivors in Atlanta, Georgia (377 individuals) and New York City (221 individuals) to test their system.

Of this cohort, 90 percent of those predicted to be at high risk developed long-lasting PTSD symptoms within a year of the initial traumatic event — just 5 percent of people who never developed PTSD symptoms had been erroneously identified as being at risk.

On the other side of the coin, 29 percent of individuals were 'false negatives," tagged by the algorithm as not being at risk of PTSD, but then developing symptoms.

Going forward

person leaning their head on another's shoulder

Image source: Külli Kittus/Unsplash

Schultebraucks looks forward to more testing as the researchers continue to refine their algorithm and to instill confidence in the approach among ED clinicians: "Because previous models for predicting PTSD risk have not been validated in independent samples like our model, they haven't been adopted in clinical practice." She expects that, "Testing and validation of our model in larger samples will be necessary for the algorithm to be ready-to-use in the general population."

"Currently only 7% of level-1 trauma centers routinely screen for PTSD," notes Schultebraucks. "We hope that the algorithm will provide ED clinicians with a rapid, automatic readout that they could use for discharge planning and the prevention of PTSD." She envisions the algorithm being implemented in the future as a feature of electronic medical records.

The researchers also plan to test their algorithm at predicting PTSD in people whose traumatic experiences come in the form of health events such as heart attacks and strokes, as opposed to visits to the emergency department.

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