AFL brain disease cases ‘tip of the iceberg’: US expert

The Age

By Greg Baum and Daniel Cherny

January 27, 2021

An American head trauma expert who helped to establish the Australian sportsbrain bank says the three cases of CTE uncovered in AFL players in the last year are enough to ring alarm bells in the sport.

Dr Chris Nowinski remembered initial scepticism in the US about the gravity of the CTE (chronic traumatic encephalopathy) when only a handful of cases hadcome to light.

"We had congressional hearings here in 2009 after 12 NFL cases," he said. "The reality is that 110 of our first 111 players had the disease. Concerning the AFL, it's important to recognise that it's a small sample, but if you look at the experience of similar sports around the world, this is just the tip of the iceberg."

Florida-based Dr Nowinski, a former pro wrestler, is co-founder and chief executive of Concussion Legacy Foundation. He is well aware of the CTE found in the brains of Polly Farmer, Danny Frawley and most recently Shane Tuck, but he did not presume to suggest explicit rule changes in the Australian code.

"There are universal changes that can be made," he said. "If we just talk about tweaking the rules at the pro level, we're not going to stop CTE. The risk accumulates over an athlete's entire career."

Dr Nowinski said it was not just about concussion. Bigger, stronger footballers, starting younger, training harder, playing more games and finishing later because of the money on offer had deepened the problem in all codes.

"I would say it's safer when it comes to concussion. We're acknowledging them and we're managing them appropriately," he said. "But we don't have any evidence to support the idea that changing how we treat concussions will significantly change CTE outcomes. We hope it's true, but there's no guarantees.

"If you have 30 per cent fewer concussions because of rule changes, but you still have as many hard blows to the head, you're not going to see a big difference.

"Tackling is dangerous. There's no safe way to do it. There are fair ways to do it, but there's no safe way to bring another man - or woman - to the ground and stop their momentum at the same time."

Dr Nowinski said there was no reason for children to play adult forms of any contact sport. "You just don't start hitting children in the head," he said. "When they're young, you don't play the adult, dangerous version of the game. What's the point? We're crazy to have children who are not getting paid and don't even understand what CTE means playing by the same rules as adults."

Melbourne AFLW champion Daisy Pearce said she was not deterred from encouraging her two-year-old twins, Roy and Sylvie, from playing when they are older.

"Footy has made me a healthier, happier person, and it's given me so much in a physical sense," she said. "My emotional wellbeing, social wellbeing, my mental health, I attribute footy to so much of that.

"I'm not in denial that I'm going to be exempt from it [CTE]. But I don't sit here worrying. It's something we have to consider. More time and more attention and more research on these things will give us more information. "But right here and now, whilst it's an unfortunate part of the game and it looks like it's going to become more prevalent as more cases come through, I think I trust that with every bit of new knowledge and research and information that does come through, the league and medical staff are taking it very seriously.

"We're in the best possible hands, and getting the best possible information. I have full faith that they're going to manage us to the best of their ability."

Adult recreational football - a staple in Australia - presented a different challenge, said Dr Nowinski. "That's educational, not ethical or about advocacy," he said. "If you're 30 years old and you feel like you need to tackle other people to getthrough the week - or are willing to be tackled - who are we to say you can't do that?"

Dr Nowinski said that as a rule, park footballers played fewer games at a lesser intensity than pros, were under less pressure to sacrifice themselves and did nothave a crowd to please.

"The audience should only matter when we're talking about professional sport," he said. "I'd say that if it's not professional, it really shouldn't be that dangerous."

For pros, the calculus is different. "I'm all for adults doing dangerous jobs if they choose, to support their families. But there's reasonable danger and there's stupid danger," he said.

This Pearce accepts. "Whilst you know you have to acknowledge that there is this risk, I'm prepared to take it on because of all the benefits that I get from playing footy as well," she said. "It's certainly made me a healthier and happier person to date, so I have to factor that into my decision to play as well."

For everyone, Dr Nowinski's remedies are in line with those of Dr Michael Buckland from the Australian sports brain bank: start them older, modify training, continue to search for ways to minimise heavy contact in games and play fewer games.

"Changes need to be made from the moment they step onto the field for the first time as a child all the way through to the end," he said. "I would say start later, hit less and we'll have fewer cases of CTE going forward."

Greg Baum



Bill for veterans' mental health care reaches $241m with 20,000 in rehab

The Age

By Caitlin Fitzsimmons

January 3, 2021

The taxpayer bill for the mental health care of former defence personnel has ballooned 35 per cent in five years, with nearly 20,000 former service members checking into rehab clinics every year.

The problem of addiction and mental illnesses among former service members is so great that some treatment providers are starting to offer veterans-only programs, including The Buttery in northern NSW kicking off a pilot study this month.

Senator Jacqui Lambie says alcohol and substance abuse issues are rife among veterans and the system is failing them at every turn.

The Australian Defence Force has more than 89,000 service members and about 6000 leave each year, often with post-traumatic stress disorder (PTSD) alongside depression and addiction. 

They are then given unlimited access to mental health care, with clinics reporting some veterans are checking into rehab repeatedly to deal with deep-rooted problems.

The Department of Veteran Affairs (DVA) spent $241 million in 2018-2019 on mental health care for 55,500 veterans, including psychiatry, psychology and treatment in hospital or rehab clinics. The total figure also includes DVA-funded mental health treatment for war widows and dependants, plus the Open Arms counselling service for current and former service members and their families. In the 2020 financial year that rose to 58,500 veterans, while Open Arms experienced a 50 per cent increase in demand between March and June because of COVID-19. A DVA spokesman said about 15 per cent of the veterans accessing mental health services were under the age of 40.

Tasmanian Senator Jacqui Lambie, who served in the army for more than 10 years in the 1990s, said the system was failing veterans at every turn, starting from the drinking culture in the armed forces and worsening in civilian life because of inadequate support.

"There's a lot of drinking once they've hit rock bottom, then they get prescribed pills for PTSD and stuff like that and they just start taking them like they're peanuts," Senator Lambie said. "They're now starting to turn to ice [crystal methamphetamine] because they're not getting the treatment."

While some clinicians say the increased demand for treatment is because of successive governments making access easier, Senator Lambie blamed the aftermath of the wars in Afghanistan and Iraq.

"All the guys who served in the Middle East are just crashing," she said.

 The Australia Defence Association, a public-interest watchdog for national security, has backed calls for a royal commission into veteran suicide and the operations of the DVA.

ADA executive director Neil James said "the problem seems to be perpetual" and could lead to a problem with recruitment as well as retention.

"The mums and dads of Australia aren't going to let their children join the Defence Force if we don't start solving some of those problems and solving them in a coherent and integrated fashion," he said.

"I don't think that's getting enough long term thought because if we don't fix it, eventually we'll have a defence capability problem because there won't be enough people wanting to join the Defence Force.”

Veterans and clinicians say the psychological problems arise from the trauma of active service, including war, peacekeeping missions and border control, but also from the gruelling training regimen, traumatic events such as accidents or physical injuries, isolation from friends and family, bullying and sexual discrimination, a stubborn culture of not showing weakness, and worries about financial security when leaving the ADF.

Melbourne Clinic medical director Richard Bonwick said he treated a lot of veterans and the main reason for an increase in demand was the improved access to services; "a good thing rather than a bad thing".

Dr Bonwick said about one in 20 civilians had a mental health condition of some kind, while up to one in five veterans with combat experience had PTSD, usually alongside substance abuse or depression. Veterans often required repeat treatment because "most of the disorders they suffer are chronic", he said.

The October federal budget provided $101.7 million over four years to further bolster mental health support for ex-service personnel, plus $23.7 million to increase transition and employment support. In October the government also established the National Commissioner for Defence and Veteran Suicide Prevention.

Meanwhile, the NSW government has provided $300,000 for The Buttery to run a pilot program to treat a small group of veterans for PTSD and substance abuse using a treatment model developed in the United States.

Chief executive Leone Crayden said veterans already accounted for at least one in seven patients in The Buttery's four-week private residential programs and it made sense to treat them together given their shared experiences and problems.

"They need something really specific to their needs," she said.

The DVA funded 18,067 patients hospitalised for mental illness in 2018-2019, up nearly 3000 from two years earlier, Australian Institute of Health and Welfare figures show. Of those, 4329 were in public hospitals and 13,828 in private hospitals.

Minister for Veterans' Affairs and Defence Personnel Darren Chester said: "The mental health of our veterans and serving members is not an issue we take lightly". He said most service members had a positive experience in the ADF and took valuable skills and experience into civilian life but vowed: "If there is a need, it will be met."

Labor has called for a royal commission into veterans' mental health and suicides, but Mr James from the ADA said it should be into the DVA itself so the issues could be considered as a whole.

RSL NSW chief executive Jon Black welcomed the government's investment and said the next steps should be to fully implement existing recommendations from previous investigations, including the Productivity Commission report on mental health, rather than setting up a new inquiry.

Soldier On ambassador Jeff Shapiro, 36, who was in the navy for 10 years and developed PTSD, depression and anxiety while working on the patrol boats in northern Australia, said mental health was an "unavoidable issue" for veterans.

"It's something that all of us, all veterans, will have some form of experience with whether it's immediate or in the future," Mr Shapiro said.

Senator Lambie employed a staff member whose main role was organising rehab for veterans, trying to keep them out of general public psychiatric hospitals because veterans with PTSD "could not cope" with erratic behaviour from ice addicts.

Senator Lambie said an increasing number were going to private rehab clinics such as Byron Private Treatment Centre at Byron Bay, but this requires individual

 



Jail for father who continued gaming after fatally injuring baby son

The Age

By Adam Cooper

December 15, 2020

A young man who fatally injured his baby son and continued playing PlayStation has been jailed for nine years.

Joseph McDonald either violently shook or caused blunt force trauma to the head of seven-week-old son Lucas on October 24 last year at their Benalla home, and over the following hours continued gaming as family members came to visit.

McDonald had a burst of anger related to his daily use of cannabis and hisaddiction to gaming, which occupied him for up to 10 hours a day, the Supreme Court heard.

Lucas appeared dazed and unsettled that night and the next day his mother, Samantha Duckmanton, took him to hospital, where he was found to be lethargic, pale and floppy. His condition worsened and he died a further four days later.

The day after the baby's death hospital staff told his family the injuries were not accidental and McDonald admitted to Ms Duckmanton he pushed too hard on Lucas' head and neck because the baby wouldn't stop crying.

But as Ms Duckmanton spoke to McDonald's father, the killer fled and spent several days on the run. He handed himself into police and was charged with murder, and eventually pleaded guilty to child homicide, an offence similar to manslaughter which relates to children aged under six.

Justice Stephen Kaye on Tuesday ordered McDonald, 23, must serve six years and eight months before he was eligible for parole.

He said Lucas was denied the right to grow into an adult and had deserved to be treated with tenderness, love and care.

"Instead, by your actions, you took his life from him and, by doing so, you have inflicted irreparable pain and grief on those who loved him and in particular on his mother and your partner, Samantha," the judge told McDonald.

"Your senseless and irresponsible act of angry violence deprived him of his most basic right, his right to life."

McDonald had long-standing anger management problems, Justice Kaye said, which were borne out of his addictions to gaming and cannabis. The former was so bad he had been diagnosed with an internet gaming disorder.

"Those two factors do not excuse or mitigate your offence at all," the judge said.

"Rather they provide an explanation for what you did. In short, your actions, which resulted in Lucas' death, occurred in a burst of anger that was inflamed by your indulgence in those two addictions."

McDonald never divulged exactly what happened while he was with Lucas and his crime was aggravated by his failure to tell Ms Duckmanton or medical staff.

While there was no evidence his evasiveness caused Lucas further harm, Justice Kaye found it "bespoke of a shameful degree of selfishness and callousness on your part.

The judge acknowledged McDonald's plea of guilty spared family members giving evidence at trial and showed some remorse.

The former timber mill worker had shown signs of depression and anxiety in prison because he was vulnerable in custody given the nature of his crime, and that the coronavirus had prevented him from receiving visits.

He has served 410 days since his arrest which will count towards his sentence.



  1. VA unlawfully turned away vulnerable veterans for decades, study says, with 400,000 more at risk
  2. Brain Injuries Are Common in Battle. The Military Has No Reliable Test for Them.
  3. Fifty US troops left with brain injuries after Iranian rocket attack
  4. This Helmet Will Save Football. Actually, Probably Not.
  5. British man found guilty of Australian Amy Parsons' murder in London
  6. My once-vibrant husband died of ALS, and my complicated grief is deep
  7. Program to Prevent Suicide by Veterans Earns Bipartisan Support
  8. Sporty teens with concussions are three times more likely to be depressed
  9. Just one season of playing football—even without a concussion—can cause brain damage
  10. Startups fighting a 'bulletproof' mentality in men's health
  11. 'His personality changed': Michael Hutchence's sister on his traumatic brain injury
  12. Toddler suffers 'catastrophic brain injury' in alleged beating
  13. Cyclist, 70, left with head and spinal injuries after being hit by car
  14. 'Choked to the point of brain damage': Ice scourge fuels domestic violence
  15. Mass Murderer Possible undiagnosed brain damage
  16. Savage attack in Melbourne's north leaves tourist with bleeding to the brain, broken jaw
  17. Link between concussion and brain damage to ensure AFL debate rages
  18. Sports commentator Billy J Smith dies after a fall
  19. Surgeon killer could be first to get10-year term under one-punch laws
  20. Liam Neeson's nephew Ronan Sexton dies, years after serious fall
  21. Toddler burnt with lighter and hit every day in lead-up to her death, court told
  22. Patron filmed unconscious, held around neck as guard evicts him from hotel
  23. FA Cup set to introduce concussion substitute trial this season
  24. Teen fighting for life after Healesville car park brawl
  25. Police discover critically injured man at Logan Village address
  26. 'Don't ask me for compassion': Angry Anderson has not forgiven his son's killer
  27. Brain Injuries Remain Undiagnosed in Thousands of Soldiers
  28. Man dies in hospital after falling to punch in Fortitude Valley
  29. Maradona to be discharged within days, says doctor
  30. Cricket bat bashing victim fights for life after Ballajura pub brawl
  31. Diego Maradona, World Cup-winning football superstar, set to undergo brain surgery
  32. 'Country footy is way behind': The missing concussion discussion in local level Aussie Rules
  33. Autistic girls going undiagnosed due to ‘camouflaging’ behaviour, study says
  34. Lisa Montgomery to be first female federal inmate executed in 67 years
  35. Man dies after being shoved to the ground in New York mask altercatio
  36. Thomas had a rare brain cancer and no good options. Then he joined a clinical trial
  37. Nearly One-Third of Covid Patients in Study Had Altered Mental State
  38. Shaun Smith supportive of daughter Amy, signed by AFLW club North Melbourne
  39. Texas residents warned of tap water tainted with brain-eating microbe
  40. 'It's been a big day for me': Smith wants change after $1.4m concussion payout
  41. Damage Assessment
  42. What are CTE and concussion and how do they affect athletes?
  43. Danny Frawley was suffering from chronic brain disease when he died
  44. Elon Musk unveils brain computer implanted in pigs
  45. Portland truck driver apparently kicked unconscious as unrest continues
  46. Treatment for aggressive brain cancer shows promise in early trial
  47. Four-year-old injured after motorbike crashes through barriers at Sydney race
  48. 'Dangerous behaviour': Horror crash in sprint to finish leaves rider fighting for life
  49. Father charged with murder over death of six-month-old baby Beau
  50. Sickening Michael Chee Kam concussion overshadows gritty Eels win
  51. We asked veterans to respond to The Post’s reporting on Clint Lorance and his platoon. Here’s what they said.
  52. Doctors find brain issues linked to Covid-19 patients – study
  53. Widow of heart surgeon killed in one-punch attack sues Melbourne hospital
  54. Crowdfunding raises £30,000 for veteran's brain tumour surgery
  55. Boy in critical condition after fall at Sydney primary school
  56. 'I began to wonder if I would be better off ending my life': The invisible war wounds
  57. VA unlawfully turned away vulnerable veterans for decades, study says, with 400,000 more at risk
  58. Brain wiring could be behind learning difficulties, say experts
  59. Concussion: there's no knockout answer
  60. CTE discovered in Polly Farmer's brain in AFL-first
  61. Six-week-old baby nearly killed in ice-fuelled attack, court told
  62. Former hard man Ron Gibbs' chilling admission as head knocks take toll
  63. An Olympic Hockey Hero, a Violent Crime and the Specter of Brain Trauma
  64. Traumatic brain injury is a signature wound of the wars in Iraq and Afghanistan. But the military still has no objective way of diagnosing it in the field.
  65. More than 100 US troops suffered traumatic brain suffered traumatic brain in Iran strike,to report
  66. Man, 28, fighting for life nearly two weeks after Southbank attack
  67. NRL pledges initial $250,000 for landmark concussion study
  68. Veterans criticize Trump's downplaying of US troops' brain injuries
  69. Trump should apologize for minimizing troops’ injuries, VFW says.
  70. Fifty US troops left with brain injuries after Iranian rocket attack
  71. Can heading a football lead to dementia? The evidence is growing
  72. Mobile phones cause tumours, Italian court rules, in defiance of evidence
  73. Scientists create decoder to turn brain activity into speech
  74. Woman reportedly wakes up from coma after 27 years
  75. Enraged Qld dad who killed toddler jailed
  76. 'We thought it would be wonderful - we didn't know what was to come'
  77. 'We thought it would be wonderful - we didn't know what was to come'
  78. Graham must wake up to dangers of concussion
  79. Footballers focus on concussion, but there are many other risk factors
  80. Ex-AFL player sues club after retiring because of concussion
  81. When will we stop butting heads over sporting concussion?
  82. Why people with brain implants are afraid of automatic doors
  83. Christchurch mosque shooting victim, 4, suffering brain damage
  84. Link between concussion and brain damage to ensure AFL debate rages

Page 4 of 32

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