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

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500

1000

1500

2000

2500

3000

3500

4000

Suspected(n=30,983)

Confirmed(n=4,275)

Week of illness onset

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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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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