ACPM 2012

I spent Tuesday through Sunday in Orlando for the 2012 conference of the American College of Preventive Medicine, which has been a combination of a lot of fun and a lot of work (well, as much work as sitting in rooms in a conference center is).

The conference started on Wednesday (Tuesday was just a travel day) with a session on health economics and cost-effective analyses (yes, it was as exciting as it sounds). Thursday was a very long day, with a run in the morning before breakfast (a little more than 4 miles through Downtown Disney and surrounding areas), followed by sessions all day, poster presentation in the evening, and one more session that ended at 9:30. Long day. Here's a (not great) picture of my poster:

Friday was a slightly shorter day, mostly because I didn't see anything interesting to go to for one of the sessions and I decided to take a nap instead. The day also ended earlier, with the last session ending at 4:30 and my fellow residents and I deciding to go out to Universal City Walk for dinner afterwards. There were some big-name restaurants there, but it being a Friday night, the wait at some was rather ridiculous. We tried to go to Emeril's, but when they told us it was a 2-2.5 hour wait, we decided to hit Hard Rock Cafe instead. And because it was Hard Rock, we went to the store, where Derek decided to model the merchandise:

Saturday morning started with a long run, again through Downtown Disney and around the golf course. I actually got lost around the golf course, which made for a nice run, and amazingly enough, I made it back to the hotel with almost exactly the right mileage for the run (six miles). Here was my course:

Most of the sessions on Saturday (at least, most I attended) were part of the Uniformed Service Academy of Preventive Medicine offerings, which included a business meeting (terribly exciting), followed by a session on measuring behavioral health in the Army, then a session on vaccine surveillance in the military. In the evening was the awards banquet, which was a dress-up event. Derek and Raul only kinda understand the concept of dressing up:

Derek ended up getting an award for his oral presentation on degenerative disc disease, so we're very proud of him.

In all, it was a good conference, and I hope that next year I'm not too busy with work to go again.

82nd Civil Affairs Battalion, Ft. Stewart, GA

Again, I'm a bit behind on posting big news. Last Wednesday (as in, a week and a half ago), I received word that I will be becoming the preventive medicine officer for the 82nd Civil Affairs Battalion of the 85th Civil Affairs Brigade. For those of you confused about what the difference between a battalion and brigade is, here's a chart for you:

The 85th Civil Affairs Brigade is brand-new (activated 16 SEP 2011), which means my battalion (based in Ft. Stewart, GA) is brand new--as in, the stand-up date is SEP 2012. So I'll be coming into a brand-new position, which is kinda cool and really scary. Cool because I get to drive what my position is, scary because I have to drive what my position is. The whole, "Am I really smart/talented enough for this?" question that will, I hope, be answered soon (and answered to the positive).

Little bit of background as to the brigade and battalion. The 85th CA Brigade was stood up because the Army realized it needed more civil affairs assets, and decided to put that in the active component, instead of the reserves, where most of the other CA assets are (nine reserve CA brigades and one active duty to support special operations existed previously). There are 5 battalions in the new brigade: the 81st is at Ft. Hood (activated in 2011); 82nd at Ft. Stewart, one (forget the number) at Ft. Bragg, to be activated in September; and one at Ft. Lewis and one at Ft. Bliss to come in 2013. Each of the battalions takes a different part of the globe, with the 82nd taking Africa. The only other part of the world I think would be more interesting to go (in terms of health needs and diseases) would be the Pacific, and that's going to belong to Ft. Lewis, once that battalion exists. I've started convincing my friend Raul, who will be graduating next year, that that's the job he wants.

As far as what I'll be doing, here's the official guidance in the field manual for Preventive Medicine Services (Field Manual 4-02.17, in case you were wondering):

3-14. Civil Affairs Units
In CA units, assigned PVNTMED personnel assess the public health capabilities of a country or area, but
are not responsible for directly providing PVNTMED services to them. As such, PVNTMED personnel
are assigned to CA companies, detachments, brigades, and commands. The type and number of PVNTMED
personnel assigned is dependent upon the unit. Since the staff's role is advisory, it has no organic
equipment and must coordinate for support from PVNTMED detachments and the AO supporting medical
laboratory. If available, CA units are also supported by PVNTMED detachments.

That's what I'll be doing when I'm in the field, but in the meantime, I'm still waiting for my official orders to appear and trying to figure out what training I need to do before September, but I am excited about it. 

Executive Summary and Information Paper

It's been a week since the end of my POPM, so I've been a bit of a slacker about writing about the end of it. Sorry. Overall, it was a really good rotation and taught me a lot about the necessary steps in making policy (it's not a short nor simple process).

Most of my work during the rotation involved reading memos and proposed regulations and comparing them to current regulations to see how they fit (and that was an oversimplification of the whole thing). I also researched current issues that were coming in to POPM (things that people from outside the Office of the Surgeon General thought needed attention) and tried to make a decision about how important it would be. One of those issues was a report of twelve cases of swine flu (a different swine flu, not H1N1) in five states. After doing research, which mostly consisted of reading what the CDC has to say about it, I wrote an executive summary and information paper. Also easier said than done.

An executive summary is a short and concise summary of an issue, and there are very specific formatting rules for it, from the font and size to the fact that it has to be fewer than fifteen lines of information. Here's my EXSUM (we like acronyms):

(U) 12 HUMAN CASES OF INFLUENZA A(H3N2)v IN THE US.  (U) (DASG-PPM-NC)  Since August 2011, the Centers for Disease Control and Prevention (CDC) reported 12 human cases in five states of swine-origin influenza A (H3N2)v.  No cases have been reported among DoD beneficiaries.  Severity of illness is similar to seasonal influenza with three hospitalizations and no deaths.  The majority of cases occurred in children who have had contact with swine, with evidence of limited human-to-human transmission.  CDC provides interim guidance to clinical and laboratory personnel for surveillance and testing.  MEDCOM provided guidance to Army medical treatment facility laboratories on 13 Jan 2012 regarding typing and subtyping of specimens. Preventive medicine personnel will report all confirmed, probable, or suspected influenza A(H3N2)v cases in Disease Reporting System Internet and to local public health authorities.  Healthcare personnel should encourage beneficiaries to be immunized against seasonal influenza, as this may confer partial protection against influenza A(H3N2)v virus.     

If, after reading an EXSUM, someone wants more information, they request it and are provided an information paper, which, as it sounds, contains more information. It's supposed to be less than one page (again, very specific formatting rules), but can be longer. Mine was about a paragraph onto the second page, and I won't subject you to that.

So now that I'm done with POPM, I'm spending a little bit of time hanging out at WRAIR on what we refer to as "research downtime". Unfortunately, my research project happens to be at that exact place where there is nothing I can do to accelerate it, which makes my research downtime more of just, well, downtime. It's given me the opportunity to work out during the lunch hour, which is quite enjoyable, and get my poster ready to present at the ACPM conference in a couple of weeks. And get caught up on sleep, which after the commute I had to go down to Falls Church, was a bit lacking.