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APPENDIX E
Workshop Agendas
WORKSHOP I APRIL 16, 1998
Mirage Room I, Holiday Inn Georgetown
AGENDA
8:15
Introduction of the Study and the Purpose of the Workshop
Philip Russell, MD. Samuel Gaze, MD.
Johns Hopkins School of Public Washington University
Health
8:30 Force Medical Protection
LTC Tom Clines, USA
Medical Readiness Division
The Joint Stay J-4
8:45 Health Enrollment Assessment Review (HEAR)
Maj Vincent Fonseca, USAF, MC
Office for Prevention and Health Service Assessment
9:05 Pre- and Postdeployment Questionnaires
Maj Sheila Kin ty, USAF, BSC
Director, Deployment Surveillance Team
9:20 Proposed Recruit Assessment Program
CAPT Craig Hyams, MC, USN Frances Murphy, ~D., ~P.H.
Naval Medical Research Institute Department of Veterans Affairs
9:40
Break
9:50 Global Epidemiologic Tracking System
Maj Kevin Hall, USAF, MC
Office of the Command Surgeon, Langley AFB
222
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APPENDIX E
223
10:05 Current Deployment Surveillance Practices in Bosnia and SW Asia
LTC(P) Robert F. DeFraites, MC, USA
Office of the Army Surgeon General
10:35 DMSS/DMED and Progress Toward Integrated Medical
Surveillance
John F. Brundage, ~D., ~P.H., (COL, Ret. J
Henry ~ Jackson Foundation
1 1:00 Break
1 1:10 Panel Discussion on Medical Surveillance Issues
LTC Catherine Bonnefil, AN, Capt Samuel Hall, USAF, BSC
USA
USA CHPPM
John F. Brundage, MD.,
MP.H., (COL, Ret)
Henry Jackson Foundation
LTC Tom Clines, USA
J-4, Medical Readiness Division
LTC(P) Robert F. DeFraites,
MC, USA
Office of the Army Surgeon
General
Maj Vincent Fonseca, USAF, MC
Ofc. for Prevention and Health
Svc. Assessment
Maj Kevin Hall, USAF, MC
Ofc. of the Command Surgeon,
Langley AFB
Ofc. for Prevention and Health
Svc. Assessment
CDR Kevin R. Hanson, MC, USN
USUHS-PMB
CAPT Craig Hyams, MC, USN
NMR7
COL Bruce H. Jones, MC, USA
USA CHPPM
LTC(P) Patrick W. Kelley, MC,
USA
WRAIR
Maj Sheila Kin ty, USAF, BSC
Clinical Business Area/CHCSII
Frances Murphy, ~D., ~P.H.
Department of Veterans Affairs
12:30 Working Lunch continuing discussion
1:20
Medical Recordkeeping-CHCS and CHCSII
Col Lynn Ray, USAF, BSC
C7-7(~.S 77 Program Manager
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224 STRATEGIESTOPROTECTTHEHEALTHOFDEPLOYED U.S. FORCES
Medical Recordkeeping CPR and GCPR
Col Lynn Ray, USAF, BSC Robert Kolodner, ~D.
CHCS II Program Manager Department of Veterans Affairs
Force Health Protection and the Portable Information Carrier
Col Lynn Ray, USAF, BSC
CHCS II Program Manager
LTC Mark Lyford, USA
Theater Information Management
Program
2:20 Panel Discussion on Medical Recordkeeping Issues
MAJ Catherine Beck, MS, USA Robert Kolodner, ~D.
TATRC Department of Veterans Affairs
Maj Kevin Hall, USAF, MC
Ofc. of the Command Surgeon,
Langley AFB
Col Lynn Ray, USAF, BSC
CHCS II Program Manager
3:15 Open Portion of Meeting Adjourned
LTC Mark Lyford, USA
Theatre Information Management
Program
WORKSHOP II JULY 14-15, 1998
Mirage Room I, Holiday Inn Georgetown
AGENDA
8:15
Introduction of the Study and the Purpose of the Workshop
Samuel Gaze, MD.
Washington University
Philip Russell, MD.
Johns Hopkins School of Public
Health
I. What do we know about unexplained physical symptoms and how they
might be prevented?
Unexplained Physical Symptoms in Primary Care and the
Community: What Might We Learn for Prevention in the
Military?
(presented July 15 for schedule conflict reasons)
8:30 Medically Unexplained Symptoms in Survivors of Community
Disasters
Carol North, ~D.
Washington University
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APPENDIX E
8:55
9:20
10:10 Break
Somatic and Psychosomatic Consequences of Technological
Disasters
Evelyn Bromet Ph.D.
SUNY Stony Brook
War Syndromes and Their Evaluation
CAPT Craig Hyams, MC, USN
Naval Medical Research Institute
War Syndromes Since 1900: An Ongoing Study
Dr. Edgar Jones
University of London
Relationship of Psychological Symptoms and Self-Reported
Exposure to Gulf War Health Problems: Preliminary Findings
Jessica Wolfe, Ph.D.
VA Medical Center, Boston
10:45 The Prewar Health Care Seeking Patterns of Soldiers Who
Develop Unexplained Illnesses
Dick Miller, MD.
Medical Follow-up Agency
11:00 Current Early Testing Practices in the Military
LTC Margot Krauss, MC, USA
Walter Reed Army Institute of Research
Dr. Imelda Idar
Office of Naval Training
CDR Glenna Tinney
Navy Bureau of Medicine and Surgery
225
12:00 Stressful Events and Factors That Modify or Amplify Their Impact
Bruce Dohrenwend Ph.D.
New York State Psychiatric Institute and Columbia University
Working Lunch provided
1:15 Can We Predict the Development of Medically Unexplained
Illnesses? Psychological, Medical, and Public Policy Challenges
Terry Keane, Ph.D.
VA Medical Center, Boston
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226 STRATEGIES TO PROTECT THE HEALTH OF DEPLOYED U.S. FORCES
1:40 Summary from USUHS conference, "Pathways, Dynamics, arid
Relationships Involved ire the Somatic Cor~sequer~ces arid Symptomatic
Responses to Stress The Directions of Future Research. "
Ann Norwood, ~D.
Uniformed Services University of the Health Sciences
II. Examining Opportunities for Prevention/Intervention in the Military
Setting
A. Induction/Start of Basic Training
Panel Discussion
What appears to be the epidemiology of unexplained symptoms?
. To what extent is it possible to identify people at high risk of
developing unexplained illnesses?
. What screening tests might be appropriate for the military?
. How many people might be identified as at higher risk?
. What prevention efforts might be directed at those at higher risk?
. What additional data are needed?
3:00 Break
E. Tertiary Prevention-What is known about treatment?
3:15 Multidisciplinary Treatment of Persistent Symptoms After Gulf
War Service
Charles Engel, Jr., ~D., OPT.
Walter Reed Army Medical Center
Uniformed Services University of the Health Sciences
Treating Medically Unexplained Symptoms: The Real and
Potential Contributions of Cognitive-Behavioral Therapy
Arthur New, Ph.D.
Allegheny University of the Health Sciences
Treating Medically Unexplained Symptoms: Linking Physiologic
Mechanisms to More Effective Treatments
Daniel Claw, ~D.
Georgetown University Medical Center
4:15 Panel Discussion
What has been learned about tertiary prevention of unexplained
symptoms?
. What additional research is needed?
Are any additional methods of treatment being explored?
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APPENDIX E
5:15 Adjourn
AGENDA CONTINUED
July 15, 1998
8:10 Reintroduction to the Workshop, quick recap of July 14
Dr. Samuel Gaze
8:20 Unexplained Physical Symptoms in Primary Care and the
Community: What Might We Learn for Prevention in the
Military?
Wayne Katon, MD.
University of Washington
Host Neuroendocrine Factors in Susceptibility and Resistance to
Inflammatory and Infectious Diseases: Implications for
Unexplained Symptoms
Esther Sternberg, ~D.
National Institute of Mental Health
9:10 Neuroendocrinology of Stress and Related Pathophysiology
George Chrousos, MD.
National Institute of Child Health and Human Development
9:35 Panel Discussion-Physiologic Measures
. What implications do these presentations on the physiologic factors
and unexplained illnesses provide for prevention in the military
setting?
. What additional data are needed?
10:30 Break
II. Examining Opportunities for Prevention/Intervention in the Military
Setting (continued)
B. Predeployment (Routinely or Immediate-Predeployment)
10:40 Risk Communication
227
What Are Current Risk Communication Practices in the Military,
and What Is Known of Their Efficacy?
Kevin Delaney
U.S. Army Center for Health Promotion and Preventive Medicine
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228 STRATEGIES TO PROTECT THE HEALTH OF DEPLOYED U.S. FORCES
11:05 What Does the Research on Informational Interventions to Reduce
the Stress of Medical Procedures Tell Us About Communicating to
Troops the Risks of Deployment?
Jean Johnson Ph.D., R.N., F.A.A.N.
University of Rochester
11:30 Communicating with Veterans Exposed to Depleted Uranium
Kathleen McPhaul, ~P.H., R.N.
University of Maryland
11:55 Panel Discussion-Risk Communication
. What type and how much information would be helpful in
communicating to troops the risks of deployment?
. What changes in risk communication methods are feasible within the
deployment setting?
. What are current risk communication training procedures for
commanders?
. What changes in communications Dom leaders are envisaged after
hazardous exposures in future deployments?
. What additional data are needed?
12:40 Working Lunch continued discussion
C. During Deployment
What Are Current Military Practices to Measure or Counteract Stress
During Deployment?
1:15 Combat Stress Teams
COL James Stokes
Army Medical Department Center and School
1:40 Measuring Operational Physical Signs of Stress
MAJSpencer Campbell
WRAIR
D. Redeployment (Return to U.S.)
How Does the Military Currently Prepare Troops for
Reintegration/Reunion ?
Army Practices
LTC James Jackson
Army Community Service
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APPENDIX E
3:20
Navy Practices
CDR Glenna Tinney
Navy Bureau of Medicine and Surgery
Panel Discussion-Prevention during and after deployment
. Are current measures taken to prevent acute casualties also
preventive for unexplained physical outcomes? Do any data exist to
address this topic?
What types of data are needed to better understand any relationship
between stress during deployment and unexplained illnesses?
What types of data are needed to better understand any relationship
between reintegration difficulties and unexplained illnesses?
. What additional preventive measures might be explored?
Break
3:30 Concluding Discussions-What Additional Issues Should Be
Considered for Action or Research for Preventing Unexplained
Symptoms in Deployed Populations?
4:00 Public Portion of Meeting Adjourned
Start of closed meeting
Adjourn
WORKSHOP III OCTOBER 1-2, 1998
Workshop on Medical Protection from Chemical and Biological
Warfare Agents
and
Follow-Up Workshop on Medical Surveillance
Green Building, Washington, D.C.
AGENDA
8:00 Introduction of the Study and the Purpose of the Workshop
Philip Russell, MD. Samuel Gaze, MD.
Johns Hopkins School of Public Washington University
Health
8:15
229
Medical Doctrine for NBC Threats
Mr. Roy Flowers
Technical Publications Writer
AMEDD Center and School
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230 STRATEGIESTOPROTECTTHEHEALTHOFDEPLOYED U.S. FORCES
8:45 Medical Protection from Chemical Warfare Agents
COL James Little
Commander, U.S. Army Medical Research Institute of Chemical Defense
9:15 Discussion of Medical Doctrine and Protection from CW
1 0:00 Break
Medical Protection from Biological Warfare Agents
10:15 Threat, Training, and Treatment
COL Gerald Parker
Commander, U.S. Army Medical Research Institute of Infectious
Disease
Medical Product Development
LTC Robert Borowski
Deputy Program Manager for Medical Systems
Joint Program Office for Biological Defense
1 1:15 Policy Development for Vaccine Use
Major General John Parker
Commander, U.S. Army Medical Research and Materiel Command
Discussion of Medical Doctrine and Protection from BW
12:30 Working Lunch-continuing discussion
After Lunch-Medical Surveillance Portion of Agenda
1:30 Presentation of Paper on Medical Surveillance in the Military
(follow-up to IOM Workshop held April 16, 1998)
Lee H. Harrison, ~D. Robert Pinner, ~D.
University of Pittsburgh Centers for Disease Control and
Prevention
Panel Discussion of Medical Surveillance Issues
3:00 Break
3:15 Continued Discussion of Medical Surveillance Issues
Surveillance Systems and Illness Registries After Future Deployments
5:00 Adjourn
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APPENDIX E
AGENDA CONTINUED
Friday, October 2
8:30 Improving the Denominators for Medical Surveillance
Norma St. Claire
Director, Joint Requirements and Integration
Office of the Secretary of Defense for Personnel and Readiness
Questions and Discussion
231
9:30 How Well Is Surveillance and Record Keeping Taking Place with
the Administration of the Anthrax Vaccine?
LTC Randy Randolph
DOD Anthrax Program
Office of the Army Surgeon General
Questions and Discussion
Open Meeting Adjourned
WORKSHOP IV JANUARY 13-14, 1999
The Cecil and Ida Green Building, Washington, D.C.
AGENDA
8:00 Introduction of the Study and the Purpose of the Workshop
Samuel Gaze, MD. Philip Russell, MD.
Washington University Johns Hopkins School of Public
Health
8:05 Medical Record Keeping Update on Progress
GCPR
Robert Kolodner, ~D.
Department of Veterans Affairs
CHCSII and PIC
Col Deborah Page
Director, Force Health Protection
CHCS II Program Office
9:00 Paper Presentation:
Clement McDonald, MD.
Regenstrief Institute for Health
Care
Maureen Coyle
Department of Veterans Affairs
Edward Hammond, Ph.D.
Duke University Medical Center
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232 STRATEGIES TO PROTECT THE HEALTH OF DEPLOYED U.S. FORCES
9:45 Discussion
11:15 Break
11:30 Medical Recordkeeping as Described in, "A National Obligation:
Planning for Health Preparedness for and Readjustment of the
Military, Veterans, and Their Families After Future Deployments"
LTC Mary Ann Morreale
Military Health System Technology Interagency Sharing
Office of the Assistant Secretary of Defense for Health Affairs
12: 15 Lunch
1:00 Reserve Issues
Background, Medical Surveillance, and Health Care
Mr. Dan Kohner
CAPT Sheila Brackett
Col Kathleen Woody
Office of the Assistant Secretary of Defense for Reserve Affairs
Reintegration of Reserve Component Members into the Home
Environment upon Redeployment
LTC Jane Meyer
Office of the Assistant Secretary of Defense for Reserve Affairs
Discussion
3:00 Break
3:15 Preventing Medically Unexplained Physical Symptoms
Paper Presentation: Unexplained Physical Symptoms in Primary Care
and the Community: What Might We Learn for Prevention in the
Military?
LTC Charles C. Engel, Jr., ~D., ~P.H.
Walter Reed Army Medical Center
Uniformed Services University
Paper Presentation: Can We Predict the Development of Medically
Unexplained Illnesses? Psychological, Medical, and Public Policy
Challenges
Terry Keane, Ph.D.
VA Medical Center, Boston
Discussion of Possibilities for Prevention
5:30 Adjourn for the day
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APPENDIX E
233
AGENDA CONTINUED
Thursday, January 14, 1999
8:30 Discussion of "A National Obligation: Planning for Health
Preparedness for and Readjustment of the Military, Veterans, and
Their Families After Future Deployments"
Research
Dr. Tim Gerrity
Special Assistant to Chief Research and Development Officer
Department of Veterans Affairs
Discussion
9:00
Deployment Health
CAPTDavid Trump
Program Director, Preventive Medicine and Surveillance
Office of the Assistant Secretary of Defense for Health Affairs
Discussion
9:30 Risk Communication
Dr. Max Lum
Director, Office of Health Communications
National Institute of Occupational Safety and Health
Implementation of Risk Communication Changes Within
the Military
Input from: Kevin Delaney
Risk Communication Team
Center for Health Promotion and Preventive Medicine
(unable to attend due to inclement weather)
Lt Col Steve Williams
Office of the Special Assistant for Gulf War mnesses
Discussion
10:45 Break
11:00 Accession Standards
Col Michael Ostroski
Directorate for Accession Policy
Retention Standards
Ms. Tin a Wortzel
Office of the Army Surgeon General
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234 STRATEGIES TO PROTECT THE HEALTH OF DEPLOYED U.S. FORCES
Lunch
12:45 Role of Laboratories in Military Public Health Surveillance
COL Patrick Kelley
Walter Reed Army Institute of Research
COL James Bolton
U.S. Army Medical Command
End of open portion of meeting
"REALITY CHECK" MEETING MARCH 23-24, 1999
The Cecil and Ida Green Building, Washington, D.C.
AGENDA
8:00 Introduction of the Study and the Purpose of the Meeting
Philip Russell, MD. Samuel Gaze, MD.
Johns Hopkins School of Public Washington University
Health
Introductions of Meeting Participants
8:30 Brief Review of Bosnia and SWA Morbidity Data
COL Jose Sanchez-Bosnia
Lt Col Don Thompson-SWA
9:15 CENTCOM Perspective on Deployment Surveillance
Col Bruce Green, CENTCOM/SG
9:30 Discussion of Pre-Deployment Preventive Medicine and Protective
Measures
What has been the experience in Bosnia, SW Asia, or other recent
deployments for:
pre-deployment questionnaires
. risk communication issues
. degree ofautomation
. psychological factors
10:30 Break
Preventive Medicine and Protective Measures During Deployment
. medical surveillance through weekly DNBI and other means
. medical record keeping degree of automation and other issues
risk communication
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APPENDIX E
psychological factors
. vaccination/prophylactic drugs
Working Lunch Continued Discussion
1:00 Preventive Medicine and Protective Measures Following Return
from Deployment
. post-deployment questionnaires and follow-up
. post-deployment serum draws
. health surveillance following deployment
risk communication
. reintegration issues
2:30 Break
General Issues in Preventive Medicine and Risk Reduction for
Deployed Forces
buy-in of line commanders
. medical record keeping logistics of data collection
. medically unexplained physical symptoms
interaction of PM and mental health docs/caregivers
. risk communication
4:15 Summary Comments and Suggestions from Military Participants
Adjourn
AGENDA CONTINUED
March 24, 1999
At Skyline Buildings ir' North err' Virginia
8:00 Demonstration of Public Health Care Application (PHCA)
9:30 Briefing by Office of Information Management for the Military
Health System
Mr. James Reardon
Director, Information Management, Technology, and Reengineering
Adjourn Open Session
235
Representative terms from entire chapter:
medical surveillance
