Mission Team Research Articles

Anomalous accelerations in spacecraft flybys of the Earth

The flyby anomaly is a persistent riddle in astrodynamics. Orbital analysis in several flybys of the Earth since the Galileo spacecraft flyby of the Earth in 1990 have shown that the asymptotic post-encounter velocity exhibits a difference with the initial velocity that cannot be attributed to conventional effects. To elucidate its origin, we have developed an orbital program for analyzing the trajectory of the spacecraft in the vicinity of the perigee, including both the Sun and the Moon's tidal perturbations and the geopotential zonal, tesseral and sectorial harmonics provided by the EGM96 model. The magnitude and direction of the anomalous acceleration acting upon the spacecraft can be estimated from the orbital determination program by comparing with the trajectories fitted to telemetry data as provided by the mission teams. This acceleration amounts to a fraction of a mm/s$^2$ and decays very fast with altitude. The possibility of some new physics of gravity in the altitude range for spacecraft flybys is discussed.

C&EN talks with Sherry Cady, astrobiologist

Was there life on Mars? If so, microorganisms would have left chemical signatures in martian rocks, as they have done here on Earth. Astrobiologist Sherry Cady of Pacific Northwest National Laboratory is helping Mars mission teams from the National Aeronautics & Space Administration decide where to search for fossilized evidence of life on the red planet. As a member of the SETI Institute team that is part of the NASA Astrobiology Institute, she studies Earth environments that are analogs for potential ecosystems on Mars, including hot springs, deserts, and the remains of ancient lakes. She talked with Deirdre Lockwood about how these extreme environments inform the search for life in outer space. How did you first get interested in this field? During my postdoc at NASA’s Ames Research Center, they sent me out to Yellowstone National Park in Wyoming to look at high-temperature geological formations at the hot springs. These

Implementing the National Incident Management System as a Framework for Travel Medicine in Haiti

Introduction: For the past 7 years, a nursing school has conducted biannual medical missions in a virtually inaccessible area in Haiti. Each medical mission team provides primary care, pediatric and gynecological examinations for up to 6 days in the impoverished island nation. Methods: To improve the safety of participants engaged in this humanitarian travel medicine endeavor and enhance efficiency, the United States National Incident Management System (NIMS) has been implemented as a framework. This integrated system has 5 components: (1) Preparedness, (2) Communication/Information Management, (3) Resource Management, (4) Command and Management, and (5) Ongoing Management/Maintenance. This system was originally designed for government agencies and non-governmental organizations responding to disasters and other global health emergencies. A structural plan using the framework can be implemented as an effective model for future international missions. Results: Implementation of the framework increased efficiency. While missions previously averaged approximately 100 patients daily, after incorporation of NIMS, this figure rose to 140 patients. Additionally, student feedback indicated increases in perceptions of safety and security. Conclusion: The NIMS framework applied by the Haiti medical missions team provided organizational structure and leadership for this humanitarian effort in travel medicine. Integrating NIMS into the mission has extended the outreach of global medical systems to the most rural areas of Haiti and improved care for vulnerable populations with limited access to healthcare. This framework may be used to assist other academic institutions organize safe and effective travel medicine endeavors.

Pediatric care during a short-term medical mission to a Syrian refugee camp in Northern Jordan.

Introduction:The Syrian refugee crisis, now in its 6th year, has displaced millions. Refugees depend on support from host nation governments and humanitarian organizations like the Syrian American Medical Society (SAMS). We describe the delivery of pediatric care during a SAMS short-term medical mission to a refugee camp in Northern Jordan.Methods:The medical mission team encompassed dozens of specialties. Teams visited many sites, including the Zaatari refugee camp near the Syrian border. For this study, we gathered quantitative data from one physician who provided pediatric care and anecdotes from multiple SAMS physicians who provided pediatric care in Zaatari during the same time period. The physician supplying the quantitative data recorded age, diagnoses, and prescriptions for each patient.Results:The physician saw an average of 69 patients per day. Many of these were children aged 0–4 years. At least one diagnosis was recorded for 73.9% of patients, and at least one prescription was recorded for 85.5% of patients.Discussion:Most presenting complaints involved acute infectious illnesses, but these seemed preventable and related to refugees' living situations. Mental health assessment was difficult. Referrals proved important for evaluation and management of both acute and chronic conditions. For the short term, we emphasize the importance of effective liaison with refugee camp authorities and outside health-care organizations. For the long term, we recommend increased health-care infrastructure development and more emphasis on preventative care.Conclusion:With this study, we provide new quantitative and qualitative insights into pediatric care during a short-term medical mission to a Syrian refugee camp in Northern Jordan.

The European Medical Corps: first Public Health Team mission and future perspectives.

The 2013–2016 Ebola epidemic in West Africa challenged traditional international mechanisms for public health team mobilisation to control outbreaks. Consequently, in February 2016, the European Union (EU) launched the European Medical Corps (EMC), a mechanism developed in collaboration with the World Health Organization (WHO) to rapidly deploy teams and equipment in response to public health emergencies inside and outside the EU. Public Health Teams (PHTs), a component of the EMC, consist of experts in communicable disease prevention and control from participating countries and the European Centre for Disease Prevention and Control (ECDC), to support affected countries and WHO in risk assessment and outbreak response. The European Commission’s Directorate-General European Civil Protection and Humanitarian Aid Operations and Directorate-General Health and Food Safety, and ECDC, plan and support deployments. The first EMC-PHT deployment took place in May 2016, with a team sent to Angola for a yellow fever outbreak. The aims were to evaluate transmission risks to local populations and EU citizens in Angola, the risk of regional spread and importation into the EU, and to advise Angolan and EU authorities on control measures. International actors should gain awareness of the EMC, its response capacities and the means for requesting assistance.

Book Review: Koos Stadler (Ed.), Recce: Small Team Missions behind Enemy Lines

Koos Stadler (Ed.), Recce: Small Team Missions behind Enemy Lines, Oxford and Philadelphia, Casemate Publishers, 2015, pp. 352, ₹250, ISBN 978-161200-404-4.

Philippine Academy of Rehabilitation Medicine emergency basic relief and medical aid mission project (November 2013–February 2014): the role of physiatrists in Super Typhoon Haiyan

Background: Physiatrists have provided humanitarian assistance in recent large-scale global natural disasters. Super Typhoon Haiyan, the deadliest and most costly typhoon in modern Philippine history, made landfall on 8 November 2013 resulting in significant humanitarian needs.Methods: Philippine Academy of Rehabilitation Medicine physiatrists conducted a project of 23 emergency basic relief and medical aid missions in response to Super Typhoon Haiyan from November 2013 to February 2014. The final mission was a medical aid mission to the inland rural community of Burauen, Leyte. Summary data were collected, collated, and tabulated; project and mission evaluation was performed.Results: During the humanitarian assistance project, 31,254 basic relief kits containing a variety of food and non-food items were distributed and medical services including consultation, treatment, and medicines were provided to 7255 patients. Of the 344 conditions evaluated in the medical aid mission to Burauen, Leyte 85 (59%) were physical and rehabilitation medicine conditions comprised of musculoskeletal (62 [73%]), neurological (17 [20%]), and dermatological (6 [7%]) diagnoses. Post-mission and project analysis resulted in recommendations and programmatic changes to strengthen response in future disasters. Physiatrists functioned as medical providers, mission team leaders, community advocates, and in other roles.Conclusions: This physiatrist-led humanitarian assistance project met critical basic relief and medical aid needs of persons impacted by Super Typhoon Haiyan, demonstrating significant roles performed by physiatrists in response to a large-scale natural disaster. Resulting disaster programing changes and recommendations may inform a more effective response by PARM mission teams in the Philippines as well as by other South-Eastern Asia teams comprising rehabilitation professionals to large-scale, regional natural disasters.Implications for rehabilitationLarge-scale natural disasters including tropical cyclones can have a catastrophic impact on the affected population.In response to Super Typhoon Haiyan, physiatrists representing the Philippine Academy of Rehabilitation Medicine conducted a project of 23 emergency basic relief and medical aid missions from November 2013 to February 2014.Project analysis indicates that medical mission teams responding in similar settings may expect to evaluate a significant number of physical medicine and rehabilitation conditions.Medical rehabilitation with participation by rehabilitation professionals including rehabilitation doctors is essential to the emergency medical response in large-scale natural disasters.

Manajemen Strategik dalam Peningkatan Mutu Pendidikan

This research is motivated by the phenomenon which is telling that education should be managed with the strategic management in order to be able to choose among a lot of good management to produce a most excellent management to be developed. This research was conducted in Madrasah Aliyah Negeri Kunir Wonodadi Blitar and Madrasah Aliyah Negeri (MAN) Blitar. The approach which was used in this study was a qualitative approach to the multi-site study. Data were collected through interviews, observation and documentation. The results of this study concluded that: Strategic planning at MAN Kota Blitar was conducted through activities, the formation of the formulating vision and mission team, the determination of the vision and mission, analyzes opportunities, threats, barriers, and alternative of the problem solving, Ma'had procurement, opening the enrichments class, increasing learning, and improving the quality of educators. Strategic evaluation in MAN Kunir was conducted through: official meetings, meeting with the headmaster and committees, special meeting headmaster and vice of headmaster, teacher, employees, and the headmaster meetings, and committee meetings. While in Madrasah Aliyah Negeri Blitar was conducted through: official meetings, meeting with the headmaster, and committees, special meeting headmaster vice of headmaster, teachers, employees, and the headmaster meeting, activities meeting.

Developing a team mission statement: Who are we? Where are we going? How are we going to get there?

ABSTRACTA mission statement defines a group's purpose, describes the beliefs in how a group should function, and indicates the unique values of a group. Few studies in sport have specifically investigated the influence of a mission statement, but several high-performance teams have cited mission statements as a key for improved team performance and functioning. Recently, it has become more common for consultants to provide overviews of team building interventions in sport. However, even with initial evidence that mission statements may be beneficial for team cohesion and performance, little has been written about the process of developing a mission statement in the sporting realm. Therefore, the purpose of the article is to outline the authors' experiences leading an activity to develop a season-long mission statement with a collegiate varsity gymnastics team. Additionally, an overview of how the consultants gained entry and developed trust with the coaching staff and team, as well as reflections on what went well in the process and what could be enhanced for the greatest impact are discussed.

Serving with Pharmacy Students: Reflections from a Medical Mission Team Leader and Preceptor.

The medical mission field is an innovative setting for training and evaluating health care professional students. The motivating factor of serving indigent populations as a means of a humanitarian, or oftentimes a spiritual act, makes medical missions an attractive option for student participation. At the Gregory School of Pharmacy, medical mission teams are an integral part of the pharmacy program, including the opportunity for students to earn elective credit during their fourth year. This commentary provides five key elements to consider when serving with, training and evaluating pharmacy students from the perspective of a team leader and preceptor.

Creating a sustainable mission

Background: Medical missions have become a part of the Global Health Programs at many academic institutions. Commonly these programs involve annual trips to locations in the United States and around the world. The University of Toledo Medical Center (UTMC) sought to develop a sustainable mission that has educational and clinical value to both the local community and academic institution. Methods: The Department of Emergency Medicine at UTMC has worked with Salud Total, a small health clinic in La Ceiba, Honduras. Salud Total is staffed by a general practitioner, nurse and ancillary staff. During a mission the clinical volume increases over 100 patients a day. UTMC staff and senior ED residents see general medical complaints and perform small surgical procedures. Specialists, such as cardiologists and obstetricians see those needing specialty care. Education is provided in the form of bedside clinical teaching and materials distributed to staff and patients. Results: This mission has provided clinical services to an underserved population, providing specialty medical care that otherwise was unavailable to these patients. Returning every 3 to 4 months allows the mission team to follow-up on treatment or procedures initiated on prior visits and provides the opportunity to advance clinical care through ongoing teaching and education. Conclusions: Through our approach, we have enhanced clinical capabilities, increased the knowledge and skill set of the local practitioner as well as provided education to the patient and local community. Future expansion involves incorporation of telemedicine to provide real-time support for this clinic population and medical staff.

선교사역의 극대화를 위한 전략적 방안으로의 ‘팀 선교’

20세기 말에 들어서며 한국교회는 선교의 부흥기를 맞게 된다. 이 기간 한국교단과 교회 및 선교단체들은 효과적이며 성공적인 선교를 위한 상호연합과 협력의 필요성에 따라 1990년 ‘한국세계선교협의회’를 태동시켰다. 이후, 지난 25년간 ‘한국세계선교협의회’는 ‘한국선교정책’(5自정책, NCOWE정책, CAS정책)과 한국선교 ‘5차 5개년 개발 계획’(Target2030)을 수립하고 그에 관련한 구체적인 선교전략들을 개발해오며 한국선교의 방향과 전략선교의 모델을 제시해 왔다. 이런 정책들과 전략들은 한국의 선교본부행정을 체계화하고 발전시키는데 크게 기여했다. 반면에 선교의 제일 자원이며 가장 중요한 요소인 선교사의 중도탈락을 미연에 방지하고, 나아가 선교사역의 효과를 극대화시킬 수 있는 근본적인 전략을 제시하는 데는 미흡했다. 따라서 본 연구는 이 미흡한 점을 보완하고 선교사역의 극대화를 이룰 전략적 방안으로서 ‘팀 선교’를 제시하는 것을 목적으로 했다. 본 연구의 들어가는 말에서는 연구의 목적, 주제, 연구 배경을 서술했다. 본론 부분에서는 첫째로 ‘팀 선교의 정의와 기원’이 삼위일체 하나님과 가정에 있음과 둘째로 ‘‘오이케이오스’(οίκειος) 정신’, ‘동역자 의식’, ‘은사에 따른 사역’이 선교사의 정체성을 바로 세우며 견고한 동역선교를 가능하게 하는 ‘팀 선교’의 기본원리가 되는 근거를 제시했다. 셋째로 선교현장에서 ‘팀 선교’의 전형이 되게 하는 실행 가능한 시스템으로의 3가지 핵심요건인 ‘확고한 정체성을 위한 명확한 규정과 지침 수립’, ‘언어와 문화 습득을 위한 구속력 있는 제도적 환경구축’, ‘사역의 극대화를 위한 조직적인 네트워크 시스템 구축’을 제시했다. 마지막으로 나가는 말에서는 ‘선교사역의 극대화를 위한 전략적 방안으로서의 팀 선교’의 타당성을 기업경영의 혁신의 중심에 있는 ‘팀 시스템’의 원리와 유익의 비교를 통해 결론지었다.

Juno set to explore Jupiter

“Juno, welcome to Jupiter.” With those words from Jennifer Delavan at the Jet Propulsion Laboratory’s mission control on July 4, Juno mission team members burst into cheers. The National Aeronautics & Space Administration’s probe had just successfully performed one of the riskiest maneuvers ever undertaken by a spacecraft, braking at a high speed to settle into orbit around our solar system’s giant gas planet, while taking care to avoid Jupiter’s intense radiation. “To accomplish a mission of this complexity is just truly amazing,” says Geoffrey L. Yoder, acting associate administrator for NASA’s Science Mission Directorate, at a press conference after the event. The Juno mission’s goal is to help answer many questions that still remain about Jupiter’s origin. Scientists expect a trove of data about the composition of Jupiter’s atmosphere, the nature of its core and its auroras, and the characteristics of its magnetic field. This new information should allow

Project Bibliographies: Tracking the Expansion of Knowledge Using JPL Project Publications.

The Jet Propulsion Laboratory (JPL) Library defines a project bibliography as a bibliography of publicly available publications relating to a specific JPL instrument or mission. These bibliographies may be used to share information between distant project team members, as part of the required Education and Public Outreach effort, or as part of required reports to management or sponsors. While some bibliographies may be done by the mission's team members, the JPL Library staff has been involved in a number of project bibliographies over the years. The JPL Library currently has 10 ongoing project bibliographies. Basic requirements and search terms are developed by discussions with the project representative. For most of our project bibliographies this means looking for the project/mission name in the title, abstract, or keyword fields in commercial databases. We provide regular updates to the project. Metrics compiled from the comprehensive bibliographies have been particularly useful to projects. Both metrics and the publication lists support the contribution by JPL missions to scientific knowledge. [ABSTRACT FROM AUTHOR]

Scheduling Ocean Color Observations for a GEO-Stationary Satellite

The GEO-Stationary Coastal and Air Pollution Events (GEO-CAPE) mission plans to put a visible spectrum imaging instrument on a satellite in geo-stationary orbit to perform ocean color remote sensing. Two different instrument designs, Filter Radiometer (FR) and COastal Ecosystems Dynamic Imager (COEDI), with different shape for the imaged area and image acquisition time, are being evaluated. Scheduling observations for either instrument requires optimizing science objectives in the presence of predicted cloud cover and available daylight. We model this scheduling problem as both Mixed Integer Linear Program (MILP) and Constraint Programming (CP) problems, and compare these two formulations for FR and COEDI using real cloudiness data collected at different times throughout the year. Our results show that MILP is the more suitable technique, and the schedule quality metric shows FR is the preferred design. We have reported our results to the GEO-CAPE mission team to assist them making an informed decision for the next step in formulating this mission.

Rosetta mission operations for landing

The International Rosetta Mission of the European Space Agency (ESA) was launched on 2nd March 2004 on its 10 year journey to comet Churyumov-Gerasimenko and has reached it early August 2014. The main mission objectives were to perform close observations of the comet nucleus throughout its orbit around the Sun and deliver the lander Philae to its surface. This paper describers the activities at mission operations level that allowed the landing of Philae.The landing preparation phase was mainly characterised by the definition of the landing selection process, to which several parties contributed, and by the definition of the strategy for comet characterisation, the orbital strategy for lander delivery, and the definition and validation of the operations timeline.The definition of the landing site selection process involved almost all components of the mission team; Rosetta has been the first, and so far only mission, that could not rely on data collected by previous missions for the landing site selection. This forced the teams to include an intensive observation campaign as a mandatory part of the process; several science teams actively contributed to this campaign thus making results from science observations part of the mandatory operational products. The time allocated to the comet characterisation phase was in the order of a few weeks and all the processes, tools, and interfaces required an extensive planning an validation. Being the descent of Philae purely ballistic, the main driver for the orbital strategy was the capability to accurately control the position and velocity of Rosetta at Philae’s separation. The resulting operations timeline had to merge this need of frequent orbit determination and control with the complexity of the ground segment and the inherent risk of problems when doing critical activities in short times.This paper describes the contribution of the Mission Control Centre (MOC) at the European Space Operations Centre (ESOC) to this mission phase and the lessons learned that can be derived from this experience.

Http://www.omicsgroup.org/journals/can-skintoskin-holding-in-the-nicu-support-lactation-2167-1168-1000360.php?aid=78129

Objective: Humanitarian medical and/or surgical missions have become common over the past 50 years. Little is known, however, about the quality of these missions, especially when a patient becomes unstable and requires resuscitation. We would like to present the “mock code” Operation Smile uses to ensure the best quality of care should a medical or surgical emergency arise during a mission. Operation Smile, a worldwide children’s medical charity, provides surgery for children with correctable facial deformities in 51 countries. The mock code was initially implemented as an educational tool to enhance skills and team dynamics. It has become a useful practice for preparing a team of medical professionals to respond to an unexpected medical or surgical emergency. A mock code is performed at each mission prior to the start of the surgical week. The mission team consists of 35-60 members, including medical professionals from many different countries and diverse backgrounds. Team members have varying levels of expertise, and thus a mock code is vital to give good resuscitative care. The volume of cases, the variety of professional backgrounds, the unfamiliar equipment and protocols, the language and cultural barriers, and the fact that these individuals have not previously worked together makes it essential to develop an emergency-preparedness plan. Emergencies involving pediatric patients generate a great deal of anxiety for the child, for the parents, and for the medical and nursing staff involved. Running an emergency code is always a challenge, especially when the patient is a child. Conclusion: The use of this tool allows us to build a special alliance between medical and nursing staff prior to an emergency. The mock code empowers nurses and doctors to feel more prepared to respond to pediatric emergencies and improve the quality of resuscitative care, should the need arise.

Probable Buruli Ulcer Disease in Honduras.

Buruli ulcer disease, caused by infection with Mycobacterium ulcerans, is prevalent in central and western Sub-Saharan Africa and in southeastern Australia, and it occurs sporadically in other tropical and subtropical locales [1–3]. This report addresses a case of possible Buruli ulcer disease in an adolescent girl in Honduras. The subject was a 16-year-old female living in a rural coastal village in Honduras (near La Ceiba). She developed 2 ulcerative lesions on her leg that grew from small pinpoint lesions, to abscesses, to large undermined ulcers over a period of several weeks (see Figure ​Figure1).1). The lesions were painless. Local topical remedies were ineffective. She had no systemic symptoms, and she did not develop other lesions. There was no history of trauma. Insect and mosquito bites are a part of everyday life in her village, and she had not traveled elsewhere. There were no contacts with similar lesions. She was discovered during a medical mission trip to Honduras. Scrapings and small biopsies were performed and transported in sealed, insulated sterile tubes (with a minuscule amount of sterile saline) for processing in the United States. Treatment with topical antifungals and oral itraconazole was of no benefit. She was later treated with oral rifampin and clarithromycin [4, 5]. When other members of the mission team returned to the area several months later, the young woman could not be found. After return to the United States, the scrapings and biopsies were processed in the clinical microbiology laboratory of Parkland Health and Hospital System in Dallas, Texas. They were cultured in the MGIT (Becton-Dickenson) system as well as on Lowenstein-Jensen medium. Both scrapings and tissue biopsies were stained with acid-fast stains. The stains revealed clumps of acid-fast bacilli, both intra- and extracellular in location. Cultures performed at 30°C, and held for 8 weeks, grew scantily and were presumptively identified as M ulcerans by phenotypic methods. There was growth at 30°C, but not at higher temperatures, nor at 25°C. Small colonies showed rough morphology on Lowenstein-Jensen medium, they were nonpigmented, and niacin and nitrate reduction tests were negative [6]. AccuProbes for Mycobacterium tuberculosis, Mycobacterium avium, Mycobacterium gordonae, and Mycobacterium kansasii complexes were negative. Funding limitations precluded molecular characterization. We believe that this represents a case of Buruli ulcer disease acquired in coastal Honduras. No reports of this condition in Honduras were found in the PubMed, MeSH, or Cochrane Reviews databases [7, 8]. Thus, this is the first known report of Buruli ulcer disease acquired in Honduras. Figure 1.

Using the Oldest Military Force for the Newest National Defense

The National Guard is establishing Cyber Mission Teams (CMT) that will fulfill a federal role to backfill active duty defending Department of Defense networks, but are also exploring how they could effectively fulfill state missions. The President, Council of Governors, and USCYBERCOM Commander have expressed concerns about U.S. critical infrastructure cyber network vulnerabilities and the increasing magnitude of threat our adversaries pose to those networks’ security. This article explores using this emerging National Guard capability in a state role for protection of critical infrastructure cyber networks. Most of the critical infrastructure is privately owned. Although current executive orders and policy mandate government sharing of This article is available in Journal of Strategic Security: http://scholarcommons.usf.edu/jss/vol8/iss4/1 cyber threat information, private providers’ reciprocation of sharing their vulnerabilities is voluntary. This article contends that effective cyber defense requires strong private-public partnerships. We developed a critical infrastructure cyber defense model based upon key characteristics from the literature on private-public partnerships and performed a case study of current cyber defense partnerships to validate the model. Our research shows this model to be a useful guide for emerging National Guard Cyber Mission Forces to consider when establishing partnerships for effective critical infrastructure cyber defense. This article is available in Journal of Strategic Security: http://scholarcommons.usf.edu/jss/vol8/iss4/1

Inclusion of physical therapy services on a short term mobile medical mission team to Nicaragua: a qualitative description study of team members’ observations and recommendations for improvement

Context: Access to physical therapy (PT) services is sorely limited in many developing countries due to the constraints of poverty and regional insufficiency in the number of PT providers. Opportunities exist for physical therapists to participate in short term mobile medical mission (STMMM) efforts to provide PT services in many of those regions. However, there is a relative dearth of research regarding the utility of including PT services in STMMM endeavors. Objective: The aim of this study was to ascertain the impressions and recommendations of medical mission team members regarding the inclusion of PT services during a STMMM trip to underserved areas of Nicaragua. Methods:This was a qualitative description study conducted in 2014. Data were derived from interviews with STMMM participants and analyzed using conventional content analysis as described by Hsieh and Shannon. Results: Emergent themes included evidence of: (1) patient need for and benefit from PT services; (2) team member need for physical therapy services for trip related disorders; and (3) a high prevalence of patient orthopedic disorders related to strenuous activities of daily living. There were also a number of reported limitations in the delivery of PT services including: (1) language barriers; (2) lack of medical provider familiarity with PT capability; and (3) limited means of providing follow-up care. Respondent recommendations included: (1) addition of more translators; (2) inclusion of additional treatment modalities; (3) utilization of Nicaraguan therapists or health care workers to facilitate patient follow-up; and (4) the provision of a comprehensive screening program to improve identification of patients in need of PT services. Conclusion:This study contributes to the understanding of corollaries associated with the addition of PT services to a STMMM and provides recommendations to improve PT services in that context. Additional research is needed to evaluate the soundness of participant responses and whether this information is transferable to STMMM efforts in other communities. Further research is also needed to establish best PT practices in the STMMM context.