Smart Phones, Service Members & PTSD Treatments

The computer age has dramatically impacted the practice of medicine.  No matter what specialty of health care you look to, technology has enabled new tools to support the work of providers and facilitate the healing of patients.

Behavioral health is no exception.

Mobile computing platforms, such as smart phones and tablet computers, provide capabilities that can provide constant, hip pocket access to a range of potentially helpful tools.

The Department of Defense (DoD)National Center for Telehealth and Technology (T2), the Center for Deployment Psychology (CDP), and the Department of Veterans Affairs (VA) National Center for PTSD collaborated to develop the PE Coach smartphone app.  This new smartphone  application, or app,  was recently released to support the face-to-face psychotherapy of service members or veterans engaged in treatment for posttraumatic stress disorder (PTSD).

When a patient is diagnosed with PTSD, behavioral health providers have several effective treatments from which to choose.  One of those treatments, prolonged exposure (PE), asks patients to revisit the memory of the traumatic event in their imagination.

These sessions are audio recorded and the patient listens to the recording each day.  Between PE treatment sessions, patients also confront safe but distressing situations, places, and circumstances that either remind them of the trauma or feel unsafe.

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Sizing Up Today’s Soldier

Dr. Claire Gordon and her team spent 18 months collecting the measurements of nearly 12,000 soldiers as part of their anthropometric study at Natick Soldier Research, Development and Engineering Center. (By David Kamm, NSRDEC Photographer)

What is the true measure of today’s soldier?

If the question were philosophical, the answer could stir some debate. From a physical standpoint, however, Dr. Claire Gordon and Cynthia Blackwell will soon provide as accurate an answer as you’re likely to find anywhere.

Gordon, Blackwell and others at the Natick Soldier Research, Development and Engineering Center have been working since October 2010 on ANSUR II, an anthropometric survey of 11,961 soldiers – including active duty, aviators, Army Reservists and National Guardsmen – over 18 months that is expected to improve the design and fit of clothing and individual equipment.

The data will also help shape future combat vehicles, aircraft and weapon systems.

When they finished collecting data in April, the NSRDEC researchers had 94 body measurements and three-dimensional surface scans for males and females gathered from numerous units across the country at 13 measuring locations.

“Literally, the Army’s been doing anthropometry since the Civil War,” said Gordon, senior research scientist in biological anthropology at NSRDEC. “Everything a soldier wears, carries, flies, drives, rides in, work in and sleeps in depends on anthropometry.”

“The Army is the most diverse user group of any kind in the world, because we’re a melting pot as a country. So we have more variability in body size and shape than anybody in the world.”

The Army hadn’t conducted a comprehensive survey of body dimensions since 1988, however, and soldiers have evolved a great deal since then.

“All of the military are heavier, without being taller, than they were 20 years ago,” Gordon said. “That extra body fat changes the meaning of a lot of our dimensions. It’s the kind of thing you can’t forecast.”
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Targeting Illness Faster, Safer, And More Effectively

In addition to keeping the warfighter safe while deployed in theater, there is a clear need to maintain warfighter health throughout their military service. For example, the Military Infectious Disease Research Program reports that more warfighters are hospitalized each year for infectious diseases than are wounded in combat.

The negative effects of warfighter illness and downtime multiply when extended across the military: numerous medicines must be transported to military treatment facilities around the world, soldiers must be trained to fill new roles, and in some cases operational plans must be modified or even postponed.

A rapid and adaptable platform to treat military-relevant disease may reduce this logistical burden and increase operational readiness. In Vivo Nanoplatforms for Therapeutics (IVN:Tx) seeks revolutionary treatment methods to get sick warfighters back on their feet, fast.

This solicitation calls for development of nanoplatforms that treat a variety of diseases. Such nanoparticle therapeutic platforms could be rapidly modified to treat a broad range of diseases, but more importantly will be based on safe and effective technologies.

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Time For An HIV Vaccine

Deployed U.S. forces have historically been exposed to diseases that are not prevalent in the U.S. such as malaria, leishmaniasis and dengue.

To combat these disease threats, the U.S. military has excelled at infectious disease research and spurred some of medicine’s greatest advances in disease prevention, diagnostics, and treatment.

When the HIV epidemic first emerged in the 1980s, the U.S. government immediately recognized the threat the disease could pose to service members.

In response, Congress established the U.S. Military HIV Research Program (MHRP) at the Walter Reed Army Institute of Research. In this age of global deployments, HIV not only continues to pose a threat to service members, but it can also compromise the stability of a nation where the disease is prevalent and endanger worldwide security.

Early in the epidemic, the U.S. military emerged as a leader when MHRP developed the first HIV disease staging system, which was adopted by the Army in 1986.

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Inspiring Future Leaders STEMS From Innovative Thinking

Ms. Mariam Cocker, from Eleanor Roosvelt High School in Maryland, takes the controls of an F-35 Simulator, instructed by Lockheed Martin Fighter Demonstration Center.

The 317th Recruiting Squadron, based at Joint Base Andrews, Maryland, recently started a program to inspire innovation and creativity in Science, Technology, Engineering and Math (STEM) programs.  They challenged students in Washington D.C., Virginia and Maryland schools with a simple question: Why are STEM careers important to our Nation?

The squadron received an overwhelming response.  Recruiters reached out with the Air Force STEM 2020 Challenge contest to hundreds of schools in the region.  Upon learning of the program, counselors and teachers in Middle Schools and High Schools responded by posted the contest on their social media sites and web pages.

It went viral from there.

The 317 RCS received submissions from schools all over the DC, Virginia and Maryland area.  Eventually, 20 outstanding essay writers were selected in April, and given “golden e-vites” to spend the day learning about innovation in the Department of Defense.  They were each allowed to bring a parent with them.  “This is the Willy Wonka” of STEM programs,” stated MSgt Buffy Brown, Air Force STEM 2020 coordinator.

Essay contest winners were invited to Washington D.C. for a day of innovation and exploration.  They received insider tours of the Pentagon from senior strategy members assigned to the Joint Staff and Air Staff.

I believe we refer to this as the VIP tour.

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Better Than GPS – Going Where No Electronic Map Has Gone Before

Keep right at the fork.  Take the first exit at the roundabout.  Recalculating.  Destination on the left.

Ultimate cosmic directional power, yet the parking garage sends you into retreat. Sigh. (Artist Interpretation of GPS satellite; image courtesy of NASA)

Admit it, you read those words in the voice of your handy GPS.  Mine’s named Stella.  She enjoys making abrupt decisions with wild abandon and no regard for my personal safety.  Yet I totally rely on her, so I allow her to treat me this way.  That’s a sign of the times.  We’ve abandoned maps in lieu of little devices that give us step-by-step instructions, leading us to our destination.

Even if that means you end up taking knee-jerk driving commands that make you look like you’re operating a car full of bees.

Still, as cruel as Stella is to me, I still rely on her for many things, so when she decides to give me the cold shoulder – for example, we go through a tunnel and she loses direction –  it sends me spiraling into a directionless panic.

So, since knowing where you are going is sort of an important thing for service members, what are the troops down range doing when they go through a tunnel?

When the maps aren’t enough and the GPS is recalculating, who you gonna call?  The Defense Advanced Research Projects Agency!

There’s a theme song in there, I just know it.

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Stopping Cancer Before It Starts

Honduran Dr. Jose Mejia, left, and Col. George Peoples, Mobile Surgical Team, work together to perform surgery on a Honduran boy at Santa Teresa Hospital in Comayagua, Honduras. (By Air Force Staff Sgt. Bryan Franks)

An Army doctor has helped develop a vaccine that he believes will prevent cancer, or at least its recurrence.

The drug NeuVax began phase III clinical trials Jan. 20, which Col. George Peoples said could lead to its Food and Drug Administration, or FDA, approval. Peoples is chief of surgical oncology at the San Antonio Military Medical Center when he’s not traveling the world to provide surgical expertise or working to try and find a cure for cancer.

He is currently deployed to Honduras.

The phase III clinical trial for NeuVax will involve at least 700 breast cancer patients at 100 sites in the United States and abroad. The trial is titled PRESENT, Prevention of Recurrence in Early-Stage, Node-Positive Breast Cancer with Low to Intermediate HER2 Expression with NeuVax Treatment.

Participants will receive one intradermal injection every month for six months, followed by a booster inoculation every six months thereafter. The primary endpoint is disease-free survival at three years.
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Looking for Uranium In All The Wrong Places

Dr. Jose Centeno, director of the Joint Pathology Center’s Biophysical Toxicology and Depleted Uranium/Embedded Metal Fragment Laboratories, demonstrates the variety of shrapnel pieces removed from service members and veterans. (DOD photo by Terri Moon Cronk)

Military doctors here are examining shrapnel taken from service members and veterans, looking for depleted uranium and other metals.

The Joint Pathology Center’s Biophysical Toxicology and Depleted Uranium/Embedded Metal Fragment Laboratories branch is analyzing the embedded fragments and providing second opinions at military and Veterans Affairs medical centers to treat those who had retained shrapnel.

“Our goal is to improve the care of wounded warriors,” said Army Col. (Dr.) Thomas Baker, interim director of the Joint Pathology Center, the umbrella organization for the lab.

“We advise [doctors] how to follow up and what treatment is needed” to mitigate the potential effects of uranium and other metals, he said.

The lab analyzes all combat-associated metal fragments taken from DOD personnel that might pose a long-term health risk, such as depleted uranium, which can contribute to kidney damage over time, Baker explained.

The lab also develops laboratory capabilities in metal toxicology to support the Defense Department, The Pathology Center and VA and Army programs that require exposure assessment to depleted uranium, embedded fragment analysis and analysis of certain metal alloys, officials said.

The only one of its kind in the United States, Baker said, the lab keeps a registry of the fragments for future re-evaluation. The register now includes 600 specimens.

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