Conference Promotes, Enables Medical Research

By Jeffrey Soares, USAMRMC Public Affairs

The latest advancements in healthcare for warfighters and related cutting edge research, is the focus of the 2012 Military Health System Research Symposium that opened Aug. 13 in Fort Lauderdale, Fla. The four-day symposium, sponsored by the Office of the Assistant Secretary of Defense for Health Affairs, and organized by the U.S. Army Medical Research and Materiel Command, is a joint effort supported by the U.S. Army, Navy, and Air Force, and brings together scientific leaders and researchers from throughout the world.

“This is the first time that we are combining three previously separate conferences into one joint conference by the Army, Navy, and Air Force,” Col. Dallas Hack, chair of the MHSRS said. “We now have a broader range of topics. Before it was primarily trauma care, and now it is this, plus infectious disease, operational medicine, medical simulation and training and force health protection. The interest thus far has been truly amazing.”

The vision of the MHSRS is to offer an academic-based forum in which to discuss recent accomplishments and share knowledge regarding military research and development. The annual event, which has expanded rapidly over the last decade, provides an opportunity to exchange ideas on planning and developing future studies aimed at optimizing care for members of the uniformed services in operational settings

“This year, we have over 450 presenters, including podium speakers and poster presentations,” Hack said, “and we actually had to limit the number of submissions we could accept. We have nearly 1400 people registered, and we probably will see over 1500 when all is said and done. This year’s conference is shaping up to be the biggest one yet.”

Originally established 15 years ago as Advanced Technology Applications for Combat Casualty Care, the conference has helped to unify researchers who seek ways to aid the nation’s warfighters -- both on and off of the battlefield -- before, during and after deployment. To date, the research has been successful.

For example, the general concept of the Armed Forces Institute of Regenerative Medicine grew out of conversations during the 2006 ATACCC meeting, and during the same meeting, the Army and Navy agreed to collaborate on damage control resuscitation, which has greatly speeded up research in this particular area. At the 2001 conference, a discussion between researchers from the University of Florida and Walter Reed Army Institute of Research on the concept of traumatic brain injury biomarkers led to  research collaboration on the topic. This meeting resulted in the first ever blood test for TBI to enter Phase III clinical trials. In 2008, ATACCC was the site of a joint meeting to discuss spinal cord Injury medevac litter efforts, which led to three successful studies regarding the assessment of the effects of vibration, G-force, and shock on casualties during medevac transportation.

“The only reason to have a meeting like this is to provide output -- to ensure that new things happen in the research field because of all the information shared,” Hack said. "Our focus remains the same:  to protect, sustain, and treat the warfighter with the most current technology.”

Hack added he has seen an increase in the number of non-DoD personnel attending the conference, such as those from corporations, academia, and clinics, who come to learn more about new advances in the field. Another draw is that continuing education units are offered for many in attendance as well.

“I truly believe the non-DoD personnel are coming to this meeting because they recognize that the DoD is a leader in the field of this type of research,” Hack said, “and we’ve had some major breakthroughs lately.”

Because of the increased use of improvised explosive devices during conflicts overseas, one of the topics gaining much attention is TBI, and Hack said this has become a key area of research.

“Over the course of the war, we’ve had huge progress in the area of massive trauma and massive hemorrhage, and how to treat this,” he said. “Now we’re starting to see big advances in the area of TBI, and we can look forward to seeing brain injury care translating into larger clinical trials, and into practice within the next year or two. We’re looking at the long-term, chronic effects of brain injury, which is very different than past research where we only looked at the short-term effects.”

Since the results of research aimed at the warfighter make their way into civilian medical practice, millions across the world could reap the benefits of these breakthroughs. 

And this remains the silver lining of the annual MHSRS gathering.

“What continues to amaze me,” Hack said, “is the amount of support we get for this conference. So many folks throughout the year write or phone us to say how much they look forward to this meeting, and that it is the best medical meeting of the year.”

Vaccinate to Protect Babies from Whooping Cough

By the Health.mil Staff

Pertussis, more commonly known as “whooping cough,” is on the rise in parts of the United States and proper vaccination can protect against this highly contagious bacterial infection.

The Centers for Disease Control and Prevention reports that pertussis, which causes severe coughing fits that can produce a “whooping” sound when an infected patient struggles to take a breath, has been on the rise in the United States in recent years.   The disease can be deadly to newborns and infants who are at high risk for complications, pneumonia and delays in their breathing.

Whooping cough is spread by breathing in bacteria from an infected person’s cough. Early symptoms of the disease are similar to those of a common cold but, two weeks later a persistent cough can develop along with a runny nose, fever and diarrhea. Since the symptoms are so close to those of the common cold, a doctor has to test a mucus sample to determine if it’s pertussis.

Pertussis usually affects babies and small children, who are required to receive several stages of pertussis vaccinations. Immunity can wear off over time, requiring a booster shot after the age of 18. Very few adults get that shot, however, putting them at greater risk of unknowingly passing on the infection to their children. Many times, adults will have a persistent cough that they think is a remnant of a cold or bronchitis when, in fact, it’s pertussis. Pregnant women are encouraged to get the pertussis vaccine late in the second or third trimester so they can pass on protective antibodies to their babies at birth. Teens and adults who are in frequent contact with babies are encouraged to get the vaccine, if they have not already received it, to form a virtual cocoon of immunity around the newborn.

August is immunization awareness month in the military health system.

To learn more about preventing and treating pertussis, visit the Centers for Disease Control and Prevention’s website.

Refined Screening Tools Help Detect Concussions In Theater

By the Health.mil Staff

The Military Acute Concussion Evaluation, or MACE, is the Defense Department’s standard for clinical assessment of mild traumatic brain injury (TBI) in deployed settings. MACE is the most widely-used clinical interview tool for early detection of concussions, the most common form of TBI sustained in the military. MACE was redesigned this year, along with the “Concussion Management in Deployed Settings,” another critical tool used to help first-tier health care providers improve cognitive screenings and neurological evaluations in theater.

The first two questions on the MACE ask about details of the injury event and whether there was alteration of consciousness, loss of consciousness or post-traumatic amnesia. A combination of an injury event and one of the other conditions signifies a concussion has occurred, which requires continued screening. Doctors say it’s important to have these improved tools in the deployed setting since most combat medics are not medical doctors. These first responders benefit from having a decision tree type of guidance to aid in their assessments and to get the right type of help to the wounded.

You can learn more about the MACE improvements from Dr. Donald Marion, senior clinical consultant for the Defense and Veterans Brain Injury Center (DVBIC), a Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE) center on DCoE’s blog. And, read more about TBI on health.mil.

DOD Leads Drive Toward Healthier Lifestyles

By Lisa Daniel

American Forces Press Service

WASHINGTON, July 17, 2012 – The Defense Department is taking a leading role in a governmentwide effort to stop the nation’s obesity problem,  Barbara Thompson, the director of DOD’s Office of Family Policy/Children and Youth, said.

DOD is one of 17 federal departments and agencies working together to identify opportunities for promoting healthy living as part of the White House’s National Prevention Council strategy, she explained.

“One part of that is preventing obesity,” Thompson told American Forces Press Service and The Pentagon Channel. “It has a huge impact on our quality of life, both for children and adults.”

Thompson noted a national increase in Type II diabetes and cardiovascular disease, believed caused by increased fat, salt and sugar in Americans’ diets at the same time that many children are less active than in previous generations. There was a 40 percent rise in childhood obesity between 1998 and 2008, she said.

The shift toward unhealthier foods and less exercise has developed over the past 30 years or so, and is having a huge impact on health, healthcare costs, and national security, Thompson said.  “For the first time, we’re hearing that this generation will not live longer than their parents.”

The Bipartisan Policy Center, a Washington-based think tank, issued a major report last month, “Lots to Lose,” written by two former Agriculture secretaries and two former Health and Human Services secretaries, that includes a case study of Defense Department initiatives to counteract obesity, Thompson noted.

DOD’s spending on healthcare is rising at twice the rate as the civilian sector and “unhealthy lifestyles and obesity, in particular, are significant contributors to this trend,” the report says. It has reached $50 billion annually, taking up 10 percent of the overall defense budget.

The trend is wreaking havoc on the services’ ability to recruit, creating a national security imperative, Thompson said, with only 25 percent of 17- to 24-year-olds able to meet the military’s weight standards. The majority of applicants rejected for military service today have obesity issues, she said.

In 2010, 59 percent of female recruits and 47 percent of male recruits failed the military’s entry-level fitness test, the report says.

Of those recruited, the services are seeing large increases in service members with bone fractures, thought to be the result of calcium deficiencies, and so many dental problems that 62 percent of new soldiers were not immediately deployable, the report says.

Preventing Obesity in Children

Thompson’s office instituted a “5-2-1-0” policy for the department’s schools and childcare centers, as well as civilian partners that serve National Guard and Reserve children. The numbers represent five servings of fruits and vegetables, restricting “screen time” -- TV and computers -- to two hours each day, ensuring one hour of exercise daily, and allowing no sweetened beverages.

“Policy is one of the most powerful tools we have to implement change,” Thompson said. “We’re sharing those lessons learned with civilian community.”

“The bottom line is that we have to make healthy options available and affordable. And parents need to know how important fruits and vegetables are -- and small serving sizes.”

Thompson’s tips for curbing obesity include:

--Eliminate sweetened beverages, including juices;

--Practice portion control;

--Advocate for your children;

--Ask teachers to reduce sweets in the classroom;

--Get the nutritional information for school menus and ensure that they are healthy;

--Ask grocery store managers to move sugary foods higher than eye level to young children;

--Exercise as a family;

--Cook and eat meals as a family;

--Breastfeed;

--Grow a garden, or encourage your installation to start community gardens;

--Make fruits and vegetables more appealing to children by offering a variety of color and textures; and

--Don’t stop serving a healthy food because children refuse to eat it; it can take many times of seeing it on their plate for them to adjust to the taste.

Also, Thompson said, limit electronics, not only because they make kids sedentary, but also because of the advertising. The food industry spends $10 billion annually in marketing food -- most of it high in salt or sugar -- to children, according to the “Lots to Lose” report.

As part of her “Let’s Move!” campaign to end obesity in a generation, First Lady Michelle Obama has asked food companies with advertising aimed at children to make their products healthier. Last month, Walt Disney became the first to introduce new standards for food advertising to kids. All foods marketed on Disney’s television and radio channels will be required to meet Disney’s nutrition guidelines -- which align with federal standards to promote fruit and vegetables and limit calories, sugar, sodium, and saturated fat -- by 2015, Disney officials said.

Preventing Obesity in Service Members and Families

The military is working to help service members and their families stay healthy. The Military OneSource website, www.miltaryonesource.mil, offers health coaches for adults and teens to help with weight management and to meet their overall health goals, Thompson said.

And, the first lady’s “Joining Forces” campaign recently announced that health clubs that are part of the International Health Racquet & Sportsclub Association are offering free memberships to immediate family members -- teens and older -- of deployed reservists and National Guard members. Clubs may provide additional benefits such as childcare, children’s programming, group classes, discounts for veterans, and discounts for active duty families. Participating clubs can be found at www.healthclubs.com. Also, the American Council on Exercise is offering free training and fitness instruction to family members of deployed reservists and National Guard members. Participating instructors can be found at www.acefitness.org/joiningforces.

If the governmentwide efforts and those in DOD seem like a lot just to make Americans healthier, that’s the point, Thompson said.

“We all have to be in this together,” she said. “This is going to take a national effort to change these habits that have been ingrained in us for the past 40 years.”

Big E Begins Coalition of Sailors Against Destructive Decisions Program

By Mass Communication Specialist 3rd Class Gregory White, Enterprise Carrier Strike Group Public Affairs

USS ENTERPRISE, At Sea (NNS) -- Service members aboard aircraft carrier USS Enterprise (CVN 65) formed a Coalition of Sailors Against Destructive Decisions (CSADD) committee aboard the ship July 10.

CSADD is a peer-to-peer mentoring program geared toward assisting Sailors in making positive decisions in all areas of their lives.

The program was originally created for those in ROTC, JROTC and similar programs. However, it quickly spread throughout the Navy and is now a resource for all Sailors.

Enterprise Command Master Chief Dwayne E. Huff, initiated the organization of the program aboard the carrier after attending a number of captain's masts which he felt could have been prevented if the Sailors involved were better informed before making the decisions that landed them in trouble.

"I believe that if Sailors have a program like CSADD and the mentorship that it offers, we will all benefit from it," said Huff. "I've been involved in the program at previous commands and I've seen how successful it can be when it is utilized correctly."

The purpose of the program is peer mentorship. The goals of its members are to get a group of Sailors who, through networking and discussion, can create ways to inform and inspire others to make better decisions, and to equip all hands with the tools they need to make those decisions.

"Once fully organized and established, we will meet weekly to put together ideas to help with the message we're driving to our Sailors," wrote Gunner's Mate 2nd Class Kyle T. Gregory, a member of CSADD, in an e-mail to the other members of the coalition.

The coalition has different topics they want to focus on every month in an effort to raise awareness about these issues. Topics range from addressing problems such as sexual assault to everyday issues such as car buying.

"Once or twice a month we will give training to the command via posters, skits, departmental training, etc.," wrote Gregory.

"With a program like CSADD in place Sailors have an option to ask questions and gain perspective before making decisions that could affect them in an unexpected manner," said Huff. "If we get the volunteers needed to get involved and get this program off of the ground, and if we gain interest from Sailors in utilizing the tools we offer, then the program can be a real success here."

Huff said that he believes CSADD will help Sailors make informed decisions, build trust and develop healthier relationships. It may not totally alleviate certain problems but it will definitely help.

CSADD recently held its first meeting and plan to meet at least once per month throughout the rest of deployment.

Guard and Reserve Family Fitness Program Supports Healthy Living

By the Health.mil Staff

A new program lends support to the families of deployed members of the National Guard and Reserve by helping them lead healthier, more active lifestyles.   First Lady Michelle Obama and the President’s Council on Fitness, Sports & Nutrition have announced the new fitness initiative in support of America’s National Prevention Strategy as well the First Lady’s initiatives, Let’s Move! and Joining Forces.

The program partners with trade associations representing fitness professionals and health clubs.  The associations are providing free services such as personal training, fitness instruction and free 6-month health club memberships for certain family members of deployed Reservists and National Guard members.   Clubs may also provide additional benefits such as childcare, children’s programming, group classes, discounts for veterans, and discounts for active duty families.

Service members and their families can learn more online about this effort and find participating fitness instruction. They can also find participating clubs online.

For more information about Joining Forces and how military families can lead healthier and more active lifestyles, visit the President’s Council on Fitness, Sports & Nutrition.

Face of Defense: Oregon Native Overcomes Obstacles to Serve

By Marine Corps Cpl. Walter Marino III

Marine Corps Recruit Depot San Diego

MARINE CORPS RECRUIT DEPOT SAN DIEGO, Calif., June 25, 2012 – Each recruit here probably has experienced personal hardships. For Marine Corps Pfc. Thomas S. Breiter, who recently graduated from boot camp, tough times began with his parents’ divorce when he was 8 months old.

The hardships continued in high school, he said, when he struggled for motivation to make good grades and again when his weight ballooned to 260 pounds.

But it all changed, Breiter said, when he decided to join the Marines. He knew he couldn’t join without graduating from high school and losing weight, and that motivated him to get it done.

Breiter’s love for the Marines started at an early age. His parents had been Marines, and he ended up enlisting in same military occupational specialty in which his mother served.

“Both my parents said they’d disown me if I joined any other branch,” he said with a laugh.

When Breiter acknowledged his grades needed improving, he signed himself up for six months at the Oregon National Guard Youth Challenge Program. He returned for his senior year and became active in athletics and choir. He graduated with a 3.85 grade point average.

After graduation, Breiter’s weight was the only obstacle left. He needed to slim down from 260 to 212, but ended up getting his weight down to 203 pounds by cutting out sweets and alcohol, restricting his caloric intake and eating a lot of fruit and protein.

“I wanted to start over, the 22-year-old Oregon native said. “I’ve wanted to join since I was a kid. I plan to stay in shape. I’m strong, but I could be a lot stronger. Now that I’m a Marine, I hold myself to a higher standard.”

During the initial phases of boot camp, Breiter said, he was focused solely on himself and just getting through training. But he changed his mind, he added, when he saw other recruits needed his help. By encouraging others and being vocal, Breiter became a squad leader.

Breiter’s drill instructors explained they noticed his efforts when his voice was louder than those of the other recruits.

“He showed the willingness,” said Marine Corps Staff Sgt. Johnnatan Lopez, drill instructor in Breiter’s platoon. “He stood out when he encouraged others. He was always vocal and getting people going.”

When Breiter’s rackmate Pvt. Steven J. Caasi cried after repeatedly not receiving any letters, Breiter consoled him and helped to lift his spirits.

“He was there when I was down or alone in a corner,” the 18-year-old Caasi said. “When I found out my family wasn’t coming to the graduation, he told me that I could hang out with his family. He made me feel like there was someone I could depend on. I made a really good friend in boot camp.”

Breiter said he simply took Caasi under his wing, and that Caasi now is doing much better.

“I helped him a lot during first phase,” Breiter said. “He would cry, and I could understand. A lot of times, he would want to quit, but I just helped him keep his head up, and he’s here now. He’s definitely the type of person I’m going to stay in touch with the rest of my life.”

Now that he has graduated, Breiter said, all is well.

“My parents gave me constant motivation through their letters, because I know they were thinking of me,” he said. “I definitely feel like I’ve come a long way. I’m looking forward to going to my military occupational school and continuing to grow in the Marine Corps.”