physician category day highlights a brief review by capt dana thomas category day co-chair
TRANSCRIPT
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Physician Category Day Highlights
A Brief Review by CAPT Dana Thomas
Category Day Co-Chair
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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
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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
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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
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Monrovia Under SiegeAugust 2014
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Overcrowded ETUsAugust 2014
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Rioting in MonroviaAugust 2014
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Community DeathsAugust 2014
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Demand Exceeds SupplyAugust 2014
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Frieden Visits LiberiaAugust 2014
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Obama Meets with CDCSeptember 2014
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Pledge of Military SupportSeptember 2014
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Training for HCWsOctober 2014
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Treatment for HCWsNovember 2014
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Emergency Operations CenterEbola Response
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Thomas H. Bornemann, Ed.D., DirectorMental Health Program
The Carter Center
The Liberia Mental Health Program
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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
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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
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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
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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
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MONROVIA
Distribution of Credentialed 144 Mental Health Clinicians after 7 cohorts (August 2014)
41 Mental Health Clinicians in
Montserrado, where ~40% of population
resides
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Anti-Stigma Activities
Stigma Reduction
Family Psychoeducation
Advocacy Consumers & Caregivers
Training: Journalists Pharmacists Law enforcement Religious leaders
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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.
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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
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Vector borne and Zoonotic Diseases:One Health Perspective
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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
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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)
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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
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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
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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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3131
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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3232
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
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Unaccompanied Children Mission
Office of Refugee Relocation – CDR Curi KimCenters for Disease Control – LCDR Jevon McFaddenCustoms and Border Protection – LCDR Nisha Money
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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
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CAPT Paul Jung, USPHSAssociate Director
Office of Health Services
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Peace Corps Health Services
• Screening Applicants• In-Country Medical Services• Post-Service Medical Coverage• Quality Improvement• Epidemiology & Surveillance• Mental Health Counseling
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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
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“Top 10” Health Conditions 2013
Gastro
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al c
onditions
Infe
ctio
us der
mat
itis
Denta
l pro
blem
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Men
tal h
ealth
conce
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Uninte
ntional
inju
ries
Gynec
ologic
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fect
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Febril
e ill
nesse
s
Mal
aria
Enviro
nmen
tal h
ealth
conce
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Sexual
ly tr
ansm
itted
infe
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ns0.0
50.0
55.4
23.619.0 18.4
13.8 12.0 10.0
2.9 2.5 2.3
Ra
te p
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10
0 V
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rs
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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