physician category day highlights a brief review by capt dana thomas category day co-chair
TRANSCRIPT
Physician Category Day Highlights
A Brief Review by CAPT Dana Thomas
Category Day Co-Chair
Purpose of Category Day
• Facilitate a deeper understanding of PHS Medical Officers’ work across the agencies
• Inspire cohesion among PHS Medical Officers
• Earn CME on topics of interest and importance to PHS Medical Officers
Overview
• 13 educational sessions with 20 speakers
• 2 panels (Ebola and Unaccompanied Minors)
• Keynote speaker: Atlantan entrepreneur’s perspective on creating a public health career of your dreams
• Advice from the CPO and DSG
Ebola Epidemic - Beating the Odds
• LCDRs Fran Abanyie and Rachel Idowu moderated a panel of speakers representing every facet of response – CAPT Jordan Tappero– CDR John Beltrami– LCDR Jevon McFadden– LCDR Satish Pillai– LCDR Erik Reeves
• Each shared their strategic, logistic, operational and tactical experiences
• Combined, this approach took us from flailing to winning the fight against Ebola
Monrovia Under SiegeAugust 2014
Overcrowded ETUsAugust 2014
Rioting in MonroviaAugust 2014
Community DeathsAugust 2014
Demand Exceeds SupplyAugust 2014
Frieden Visits LiberiaAugust 2014
Obama Meets with CDCSeptember 2014
Pledge of Military SupportSeptember 2014
Training for HCWsOctober 2014
Treatment for HCWsNovember 2014
Emergency Operations CenterEbola Response
Thomas H. Bornemann, Ed.D., DirectorMental Health Program
The Carter Center
The Liberia Mental Health Program
Liberia - Mental Health Care Need
MH disorders prevalent throughout the population after 13-years of civil war
Significant prevalence among ex-combatants
Access 1 psychiatrist 36 in-patient mental health beds 41% have access to health services
Barriers Funding Cultural Resources
Johnson et al, JAMA, 2008Population and Housing Census, LISGIS 2008
The Lancet Series on Global Mental Health
No Health Without Mental Health9
Contributions of mental disorders to disability and mortality
Reproductive and sexual health Maternal and child health Injuries Implications for policy and practice
About 14% of the global burden of disease has been attributed to neuropsychiatric disorders, mostly due to depression and other common mental disorders, alcohol-use and substance-use disorders, and psychoses
2007 & 2011
To work with the Liberian governmentin implementing 3 key components of its Strategic Plan:
1) Training a sustainable mental health workforce
2) Implementing the national mental health policy and plan
3) Reducing stigma and empowering Liberians with mental illness and family caregivers
The Carter Center Mental Health Liberia Program Objectives
Partner with Nursing Schools to establish new cadre of health worker Nurses and Physicians Assistants who become Mental Health Clinicians
return to their primary care settings with new credential and new skills
Training a Sustainable Mental Health Workforce
MONROVIA
Distribution of Credentialed 144 Mental Health Clinicians after 7 cohorts (August 2014)
41 Mental Health Clinicians in
Montserrado, where ~40% of population
resides
Anti-Stigma Activities
Stigma Reduction
Family Psychoeducation
Advocacy Consumers & Caregivers
Training: Journalists Pharmacists Law enforcement Religious leaders
What Does it Take to be Psychologically Resilient?
• CDR Meena Vythilingam discussed a host of factors that promote psychological resilience– Non-modifiable factors: Neurobiological factors
including serotonergic and adrenergic c systems especially ones involving the dopamine and cortisol.
– Modifiable factors: Positive emotions and optimism, humor, cognitive flexibility, cognitive explanatory style and reappraisal, acceptance, religion/spirituality, altruism, social support, having role models, and exercise.
Women and Infants in Times of Disaster
• CAPT Barfield described unique risks for women and children during disaster
• Introduced the Reproductive Health Assessment and Disaster Toolkit
Vector borne and Zoonotic Diseases:One Health Perspective
First Report of Rocky Mountain Spotted Fever (RMSF) in Eastern Arizona with
Novel Vector
2003: child death on reservation in eastern Arizona
15 additional RMSF cases identified during 2003–2004
Reported Chikungunya in Puerto Rico, 2014
0
500
1000
1500
2000
2500
3000
3500
4000
Suspected(n=30,983)
Confirmed(n=4,275)
Week of illness onset
Nu
mb
er
of
rep
ort
ed
cases
Total tested (n=6,107)
Largest Lymphocytic Choriomeningitis Virus (LCMV) outbreak associated with
mice
Wild mice likely source of infection
Feeder-mice had a wide and complex distribution chain exposing thousands of people
Not regulated by Food and Drug Administration or the USDA Animal and Plant Health Inspection Services
Safety regulation lies with States
Integrative Medicine
• CAPT George Ceremuga explained the origin and purpose of Reiki, a Japanese practice that uses light hand placements to promote balance, stress relief, and self-healing.
• He led a practice session which simply required hand placements over the vital organs and some major endocrine glands to create a relaxing and balancing effect on our whole system
Integrative Medicine
• CDR Sarah Arnold explained the origins and purpose of Battlefield Accupuncture (BFA)
• Followed by live demonstration– Auricular technique– Semi-permanent gold needles– 5 points in specific order– Easy- fast – effective – safe
• Scientific benefits of plant based diet were described
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Scientific PublishingCAPT Christine Casey, MMWR editor
Begin with end in mind (at study inception)
What do you want to accomplish?
Who do you need to reach?
So what, now what?
Who should make a difference, and how?
Write abstract and construct table shells first
Ask for non-expert review and interview for understanding
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Pearls
Good work can be “rejected” for lots of reasons
Hitting the target is the prime goal Niche is important Don’t waste time
Communicate (co-authors, journal)
Think (early) about longevity, launch, ancillary materials and secondary audiences/dissemination
Unaccompanied Children Mission
Office of Refugee Relocation – CDR Curi KimCenters for Disease Control – LCDR Jevon McFaddenCustoms and Border Protection – LCDR Nisha Money
UC Program Responsibilities
Care and custody of UC (provide shelter, food, clothing, and services)
Make and implement placement and transfer decisions
Reunify UC with qualified sponsors
Oversee a network of ORR-funded care provider facilities
Monitor care providers and ensure compliance with national care standards
CAPT Paul Jung, USPHSAssociate Director
Office of Health Services
Peace Corps Health Services
• Screening Applicants• In-Country Medical Services• Post-Service Medical Coverage• Quality Improvement• Epidemiology & Surveillance• Mental Health Counseling
In-Country Medical Services
• Peace Corps Medical Officers in-country(122 total, about 1 per 56 Volunteers)
• Clinical Consultations with HQ staff• Regional Medical Officers• Specialists In-Country and in Washington• In-Country Hospitalizations• Regional and U.S. Medical Evacuations
“Top 10” Health Conditions 2013
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Febril
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50.0
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23.619.0 18.4
13.8 12.0 10.0
2.9 2.5 2.3
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Invitation
• Interested in attending USPHS Conference next May in Oklahoma City?
• Interested in presenting your experience or do you know someone who would be an excellent addition to our line up?
– If yes, contact Dana Thomas or Kim Roman!– Call for abstracts in October 2015