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Full text of "DTIC AD1038354: Diabetes in Combat: Effect of Military Deployment on Diabetes Mellitus in Air Force Personnel"

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DEPARTMENT OF THE AIR FORCE 
59TH MEDICAL WING (AETC) 

JOINT BASE SAN ANTONIO - LACKLAND TEXAS 



14 July 2017 


MEMORANDUM FOR SGOM5E 

ATTN: LT COL IRENE FOLARON 

FROM: 59 MDW/SGVU 

SUBJECT: Professional Presentation Approval 

1. Your paper, entitled Diabetes in Combat: Effect of Military Deployment on Diabetes 
Mellitus in Air Force Personnel p resented at/published to Military Health System 
Research Symposium. Kissimmee. FL 27-30 Aug 2017 in accordance with MDW1 41- 
108, has been approved and assigned local file # 17277. 

2. Pertinent biographic information (name of author(s) title, etc.) has been entered into our 
computer file. Please advise us (by phone or mail) that your presentation was given. At 
that time, we will need the date (month, day and year) along with the location of your 
presentation, it is important to update this information so that we can provide quality 
support for you, your department, and the Medical Center commander. This information 
is used to document the scholarly activities of our professional staff and students, which is 
an essential component of Wilford Hall Ambulatory Surgical Center (WHASC) internship 
and residency programs. 

3. Please know that if you are a Graduate Health Sciences Education student and your 
department has told you they cannot fund your publication, the 59th Clinical Research 
Division may pay for your basic journal publishing charges (to include costs for tables 
and black and white photos). We cannot pay for reprints. If you are a 59 MDW staff 
member, we can forward your request for funds to the designated Wing POC at the Chief 
Scientist’s Office, Ms. Alice Houy, office phone: 210-292-8029; email address: 
alice.houy.civ@mail.mil. 

4. Congratulations, and thank you for your efforts and time. Your contributions are vital to 
the medical mission. We look forward to assisting you in your future 
publication/presentation efforts. 



LINDA STEEL-GOODWIN, Col, USAF, BSC 
Director, Clinical Investigations & Research Support 


Warrior Medics - Mission Ready - Patient Focused 









PROCESSING OF PROFESSIONAL MEDICAL RESEARCH/TECHNICAL PUBLICATIONS/PRESENTATIONS- 

INSTR UCTIONS 

USE ONLY THE MOST CURRENT 59 MDW FORM 3039 LOCATED ON AF E-PUBLISHING 

1, The author must complete page two of this form: 

a. In Section 2, add the funding source for your study [ e g., 59 MDW CRD Graduate Health Sciences Education (GHSE) (SG5 O&M), SG5 R&D, 

Tri-Service Nursing Research Program (TSNRP): Defense Medical Research & Development Program (DMRDP): NIH; Congressional^ Directed 
Medical Research Program (CDMRP); Grants; etc.J 

b In Section 2. there may be funding available for journal costs, if your department is not paying for figures, tables or photographs for your publication 
Please state "YES' or "NO" in Section 2 of the form, if you need publication funding support 

2 Print your name, rank/grade, sign and date the form in the author's signature block or use an electronic signature. 

3. Attach a copy of ihe 59 MDW IRB or IACUC approval letter for the research related study If this is a technical publication/presentation, state the type 
(e g case report. QA/QI study, program evaluation study, informational report/briefing, etc,) in the "Protocol Title" box 

4 Attach a copy of your abstract, paper, poster and other supporting documentation. 

5 s a ve and forward, via email, the processing form and alt supporting documentation to your unit commander, program director or immediate supervisor for 
review/approval. 

6. On page 2, have either your unit commander, program director or immediate supervisor: 

a. Print their name, rank/grade, title; sign and date the form in the approving authority's signature block or use an electronic signature 

7 Submit your completed form and all supporting documentation to the CRD for processing (59crdpubspres@us.af.mil). This should be accomplished no 
later than 30 days before final clearance is required to publish/present your materials. If you have any questions or concerns, please contact the 59 
CRD/Publications and Presentations Section at 292-7141 for assistance. 

8. The 59 GRD/Publications and Presentations Section will route the request form to clinical investigations, 502 ISG/JAC (Ethics Review} and Public Affairs 
(59 MDW/PA) for review and then forward you a final letter of approval or disapproval. 

9. Once your manuscript, poster or presentation has been approved for a one-time public release, you may proceed with your publication or presentation 
submission activities, as stated on this form. Note: For each new release of medical research or technical Information as a publication/presentation, a new 
59 MDW Form 3039 must be submitted for review and approvaL 


10 If your manuscript is accepted for scientific publication, please contact the 59 CRD/Publications and Presentations Section at 292-7141 This information 
is reported to the 59 MDW/CC All medical research or technical information publications/presentations must be reported to the Defense Technical 
information Center (DITC). See 59 MOWI 41-108, Presentation and Publication of Medical and Technical Papers r for additional information 

11 The Joint Ethics Regulation (JER) DoD 5500.07-R, Standards of Conduct , provides standards of ethical conduct for all DoD personnel and their interactions 
with other non-DoD entities, organizations, societies, conferences, etc. Part of the Form 3039 review and approval process includes a legal 

ethics review to address any potential conflicts related to DoD personnel participating in non-DoD sponsored conferences, professional meetings, 
publication/presentation disclosures to domestic and foreign audiences, DoD personnel accepting non-DoD contributions, awards, honoraria, gifts, etc The 
specific circumstances for your presentation will determine whether a legal review is necessary. If you (as the author) or your supervisor check “NO” in 
block 17 of the Form 3039* your research or technical documents will not be forwarded to the 502 ISG/JAC legal office for an ethics review. To 
assist you in making this decision about whether to request a legal review, the following examples are provided as a guideline: 

For presentations before professional societies and like organizations, the 59 MDW Public Affairs Office (PAG) will provide the needed review to 
ensure proper disclaimers are included and the subject matter of the presentation does not create any cause for DoD concern. 

If Ihe sponsor of a conference or meeting is a DoD entity, an ethics review of your presentation is not required, since the DoD entity is responsible to 
obtain all approvals for the event 

If the sponsor of a conference or meeting is a non-DoD commercial entity or an entity seeking to do business with the government, then your presentation 
should have an ethics review. 

If your travel is being paid for (in whole or in part) by a non-Federa! entity (someone other than the government), a legal ethics review is needed These 
requests for legal review should come through the 59 MDW Gifts and Grants Office to 502 iSG/JAC. 


If you are receiving an honorarium or payment for speaking, a legal ethics review is required. 

If you (as the author) or your supervisor check "YES" in block 17 of the Form 3039. your research or technical documents will be forwarded simultaneously 
to the 502 ISG/JAC legal office and PAG for review to help reduce turn-around time. If you have any questions regarding legal reviews, please contact the 
legal office at (210) 671-5795/3365, DSN 473. 


NOTE: 


NOTE: 


All abstracts papers, posters, etc., should contain the following disclaimer statement: ^ , , n . 

-The views expressed are those of the (author(s)J f presenter(s)J and do not reflect the official views or policy of the Department of Defense 

or its Components'* 

All abstracts, papers, posters, etc . should contain the following disclaimer statement for research involving humans: 

"The voluntary, fully informed consent of the subjects used in this research was obtained as required by 32 CFR 219 and DODI3216.02 _AFI 


NOTE: All abstracts, papers, posters, etc., should contain the following disclaimer statement for research involving animals, as required by AFMAN 

■•The experiments reported herein were conducted according to the principles set forth in the National Institute of Health Publication No. 
80-23, Guide for (he Care and Use of Laboratory Animals and the Animal Welfare Act of 1966, as amended. 

PREVIOUS EDITIONS ARE OBSOLETE Page 1 of 3 Pages 


59 MDW FORM 3039, 20160628 

Prescribed by 59 MDW! 41-108 






PROCESSING OF PROFESSIONAL MEDICAL RESEARCH/TECHNICAL PUBLICATIONS/PRESENTATIONS 


1. TO: CLINICAL RESEARCH 

2. FROM: (Authors Name, Rank, Grade. Office Symbol) 

Folaron, Irene, Lt Col, 0-5, SGOM5E 

3. GME/GHSE STUDENT: 
□ YES g] NO 

4. PROTOCOL NUMBER: 

FWH20160079H 

5 . PROTOCOL TITLE: (NOTE: For each new release of medical research or technical information as a publication/presentation, a i 

new 59 MDW Form 3039 


must be submitted for review and approval) 


Effect of Military Deployment on Diabetes Mellitus in Active Duty Air Force Personnel 

6. TITLE OF MATERIAL TO BE PUBLISHED OR PRESENTED: 


Diabetes in Combat: Effect of Military Deployment on Diabetes Mellitus in Air Force Personnel 

7. FUNDING RECEIVED FOR THIS STUDY? Q] YES ^ NO FUNDING SOURCE: 

8 DO YOU NEED FUNDING SUPPORT FOR PUBLICATION PURPOSES: YES □ NO 

9. IS THIS MATERIAL CLASSIFIED? □ YES [g] NO _____ 

10. IS THIS MATERIAL SUBJECT TO ANY LEGAL RESTRICTIONS FOR PUBLICATION OR PRESENTATION THROUGH A COLLABORATIVE RESEARCH 

AND DEVELOPMENT AGREEMENT (CRADA), MATERIAL TRANSFER AGREEMENT (MTA), INTELLECTUAL PROPERTY RIGHTS AGREEMENT ETC,? 
YES ^ NO NOTE: If the answer is YES then attach a copy of the Agreement to the Publications/Presentalions Request Form. 

11. MATERIAL IS FOR: |g| DOMESTIC RELEASE □ FOREIGN RELEASE 

CHECK APPROPRIATE BOX OR BOXES FOR APPROVAL WITH THIS REQUEST ATTACH COPY OF MATERIAL TO BE PUBLtSHED/PRESENTEP 
Q 11a. PUBLICATION/JOURNAL (List intended pub! ication/jo urn a I.) 


□ 11b PUBLISHED ABSTRACT (List intended journal) 


[g] 11c, POSTER {To be demonstrated at meeting: name of meeting, city, state, and date of meeting.) 
Military Health System Research Symposium, Kissimmee, FL, 27-30 Aug 2017 

| | nd PLATFORM PRESENTATION (At civilian institutions: name of meeting, state, and date of meting.) 


| | lie. OTHER (Describe: name of meeting, city, state, and date of meeting) 


12. HAVE YOUR ATTACHED RESEARCH/TECHNICAL MATERIALS BEEN PREVIOUSLY APPROVED TO BE PUBLISHED/PRESENTED? 
[gl YES □ NO ASSIGNED FILE# 17149 __ DATE 16 Mar 2017 __ 

13 EXPECTED DATE WHEN YOU WILL NEED THE CRD TO SUBMIT YOUR CLEARED P R E S ENT AT! G N /P U B LI CAT IO N TO DTIC 

NOTE: All publications/presentations are requi red to be placed in the Defense Technical Information Center (DTIC) __ 

DATE 


August OK 2017 

14. 59 MDW PRIMARY POINT OF CONTACT (Last Name. First Name. M L. email) 


15. DUTY PHONE/PAGER NUMBER 


Folaron, Irene; irene. folaron,mil@mail.mil 


916-2672 


16. AUTHORSHIP AND CO-AUTHGR(S) List in the order they will appear In the manuscript. 


LAST NAME, FIRST NAME AND M.l. 


a. Primary/Corresponding Author 

Folaron, Irene 


b Wardian, Jana L 


c. True, Mark W 


d Saucrwein, Tom J 


GRADE/RANK 


0-5, Lt Col 


CTR 


0-6, Col 


GS-15 


SQUADRQN/GRQUP/OFF1CE SYMBOL 


959th M DOS/959th MDG 


959th MDS P/95 9th M DOG 


959th MDOS/959th MDG 


959th MDS P/95 9th M DOG 


INSTITUTION (If not 59 MDW) 


e 


17. IS A 502 ISG/JAC ETHICS REVIEW REQUIRED (JER DOD 5500,07-R)? Q YES 


NO 


I CERTIFY ANY HUMAN OR ANIMAL RESEARCH RELATED STUDIES WERE APPROVED AND PERFORMED IN STRICT ACCORDANCE WITH 32 CFfT 
219, AFMAN 40-401JP, AND 59 MDW! 41-108. I HAVE READ THE FINAL VERSION OF THE ATTACHED MATERIAL AND CERTIFY THAT IT IS AN 
ACCURATE MANUSCRIPT FOR PUBLICATION AND/OR PRESENTATION 
18. AUTHOR'S PRINTED NAME. RANK, GRADE 


Irene, Folaron, Lt Col, 0-5 


21, APPROVING AUTHORITY'S PRINTED NAME, RANK, TITLE 

Mark W. T rue, Col, 0-6, Director of Medical Education, 59 MDW 


19 AUTHOR’S SIGNATURE 

FOLARON.IRENE ! 145914724 - 


22. APPROVING AUTHORITY'S SIGNATURE 

TRUE MARK W 1119949757 'TPTT— -.- 


20. DATE 
1 June 2017 


23. DATE 

1 June 2017 


59 MDW FORM 3039, 20160628 

Prescribed by 59 MDWI 41-108 


PREVIOUS EDITIONS ARE OBSOLETE 


Page 2 of 3 Pages 









































































PROCESSING OF PROFESSIONAL MEDICAL RESEARCH/TECHNICAL PUBLICATIONS/PRESENTATIONS 


1st ENDORSEMENT (59 MDW/SGVU Use Only) 


TO: Clinical Research Division 
59 MDW/CRD 

Contact 292-7141 for email instructions. 


24, DATE RECEIVED 
July 11, 2017 


26 DATE REVIEWED 

13 Jul 2017 


25. ASSIGNED PROCESSING REQUEST FILE NUMBER 
17277 


27 DATE FORWARDED TO 502 ISG/JAC 


28 AUTHOR CONTACTED FOR RECOMMENDED OR NECESSARY CHANGES: □ NO gj YES If yes, give date 13 Jul 2017 


□ N/A 


29. COMMENTS □ APPROVED □ DISAPPROVED 

The poster presentation is approved. The author provided the IRB approval letter For her research effort. 


30. PRINTED NAME. RANK/GRADE. TITLE OF REVIEWER 

Rocky Cal cote, PhD, Clinical Research Administrator 

31. REVIEWER SIGNATURE 

CALOTTE ROCKY D 1170245944 

32 DATE 

2nd ENDORSEMENT (502 ISG/JAC Use Only} 

33 DATE RECEIVED 

34. DATE FORWARDED TO 59 MDW/PA 


35. COMMENTS □APPROVED (In compliance with security and policy review directives) □DISAPPROVED 


36. PRINTED NAME, RANK/GRADE, TITLE OF REVIEWER 

37. REVIEWER SIGNATURE 

38. DATE 

3rd ENDORSEMENT (59 MDW/PA Use Only) 

39 DATE RECEIVED 


40 DATE FORWARDED TO 59 MDW/SGVU 


July 13,2017 


July 13, 2017 


41 COMMENTS ^ APPROVED (In compliance with security and policy review directives.) Qj DISAPPROVED 


42. PRINTED NAME, RANK/GRADE. TITLE OF REVIEWER 

Kevin linutna, SSgt/E-5, 59 MDW Public Affairs 

43. REVIEWER SIGNATURE 

1 IN UMA KE VIN. M IT S UGU. 1296227 

6i3 srMrJUtsii. 11 

44. DATE 

July 13, 2017 

4th ENDORSEMENT (59 MDW/SGVU Use Only} _____________ 

45 DATE RECEIVED 

46 SENIOR AUTHOR NOTIFIED BY PHONE OF APPROVAL OR DISAPPROVAL 
□ YES □ NO □ COULD NOT BE REACHED □ LEFT MESSAGE 

47 COMMENTS □ APPROVED □ DISAPPROVED 


48. PRINTED NAME. RANK/GRADE, TITLE OF REVIEWER 

49. REVIEWER SIGNATURE 

50. DATE 


Page 3 of 3 Pages 


59 MDW FORM 3039. 20160628 

Prescribed by 59 MDWI 41-108 


PREVIOUS EDITIONS ARE OBSOLETE 






















































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