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Much of the data gathered by Dr. Schmid comes from reports occuring in the aftermath of Fukushima. Additionally, Dr. Schmid appears to use multiple reviews of past nuclear emergencies and protocols. She uses these articles, international statements, policies, and current treaties to build her argument.

At this time, the group does not appear to have drawn any significant research nor produced any. I would be intrigued to see if medical personnel (such as emergency medicine residents doing their research fellowships) would have any interest in the group, their call volume, and patient outcomes.

"Third, we have seen that structural interventions can have an enormous impact on outcomes, even in the face of cost­effectiveness analyses and the flawed policies of international bodies"

"These are not the tasks for which clinicians were trained, but they are central to the struggle to reduce premature suffering and death. The importance of structural interventions for the future of health care means that practitioners of medicine and public health must make common cause with others who are trained to intervene more proximally."

"Pioneers of modern public health during the nineteenth century, such as Rudolph Virchow, understood that epidemic disease and dismal life expectancies were tightly linked to social conditions"

1) "Approaches based on preparedness may not be guided by rigorous cost-benefit analysis. Rather, they are aimed at developing the capability to respond to various types of potentially catastrophic biological events"

2) "This analytical approach, when turned to the field of biosecurity, makes neither broad prescriptions for the improvement of health and security, nor blanket denunciations of new biosecurity interventions. Rather, it examines how policymakers, scientists, and security planners have constituted potential future events as biosecurity threats, and have responded by criticizing, redeploying, or reworking existing apparatuses"

3) "But increased attention and funding to health preparedness by no means implies consensus around a single approach. The existing institutions of public health are not easily reconciled with the new demands and norms of health preparedness and there is considerable disagreement about the appropriate way to achieve preparedness."

1) "The most bizarre, and perhaps most telling, moment in the hearing occurred when Rep Anthony D. Weiner of New York, addressing the panel of experts, asked for the person in charge of the investigation to raise his hand. When three hands went up..."

2) "Clashes over authority among powerful institutions both public and private, competition among rival experts for influence, inquiry into a disaster elevated to the status of a memorial for the dead: these are the base elements of the World Trade Center investigation. And yet, even a brief historical review shows us that these elements are not unique."

3) "They were not reassuring, or especially enlightening answers. Some things were already known."

1) "In this new state of social world, the body of the immigrant has become illegitimate as labor force, since it is always suspected of deleteriously affecting the job market, but the body of the foreigner has found a new source of legitimacy through illness, which, under certain conditions of seriousness and impossibility of receiving treatment in the country of origin, makes it possible to obtain a residence permit on "humanitarian grounds."

2) "Yet the variation in medical opinions observed was due less to the form of the procedure than to the use the medical officer made of it."

3) "Evaluation of this criterion, however, was not the outcome of a unilateral decision by the examining doctor or the social worker. Foreigners and their families might also develop tactics once they knew how the system worked."

The overarching goal of the report appears to be an overarching analysis of the current systems in place to address and research mental health outcomes in disaster events. The article firstly presents comorbidities known to predispose individuals to development of mental illness.This would be in the hands of the response team to recognize that a certain population may be more predisposed to developing PTSD from the event-- such as children or females, who have shown increased levels of PTSD and MDD. Recognizing that students from an all-girl's K-12 School who have just come from, say, a forest fire will be more likely to develop mental health complications after the disaster than a population of older, male welders will help streamline appropriate responses.

Secondly, by exploring and recognizing these factors (pre, peri, post), emergency responses can help prepare and minimize mental health effects. For example, by implementing PFA in all government agencies, this help mitigate the traumatic effects of experiencing a disaster; PFA includes three distinct goals in treating these patients, including limiting stress reactions and regaining feelings of control. 

Thirdly, while studying mental health in the wake of disasters is crucial to ensuring successful and adequate interventions, there are four major challenges, all discussed in the report (defining target population, obtaining representative sample, implementing an appropriate study design, and measuring key constructs). The authors contend that for future research, several key changes can be made to benefit overall research outcomes. These include widening the scope of psycho-pathological inquiry from to include other disorders such as GAD and panic disorder, the time ranges studied (with higher emphasis on pre/peri factors to help tailor interventions), other factors that create predisposition, and further intervention implementation.

The major stakeholders are those exposed to the contaminated water (and subsequently suffer from cancer and other major illnesses) and the Marine Corps. Unfortunately, the Marine Corps and other government agencies show fairly limited attempts to aid those fighting for information about Camp Lejeune. Moreover, several meetings within Washington DC reveal the nature of policy making; how special interest groups often overshadow the common welfare of the public. Jerry Ensingmer and his counterparts often deal with the harsh realities of fighting giants with slingshots, and often have to choose between family and trying to help those also effected by the contaminated water. There are many questions raised about how much governing bodies actually care about soldiers, and how deep the "semper fi" motto actually goes. 

Byron Good, Ph.D., is a professor of Medical Anthropology at Harvard Medical School. His primary area of research is mental illness and how social perceptions evolves around these issues, in terms of both treatment and social acceptance. Dr. Good has several works on these issues, including several that explore the perspective of bio-medicine in non-western medical knowledge, the cultural meaning of mental illness, and patient narrative during illness. His publications including several papers, books, and edited volumes; he is regarded as a major contributor to the field of psychological anthropology.