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The Little Lab That Could
Released: 12/1/2017

Story Courtesy of Future Forces Magazine

 Photo Courtesy of Naval Health Research Center Public Affairs

 By. Capt Marshall Monteville, Commanding Officer, NHRC 

W
ith an initial budget of $30,000 from the Navy’s Bureau of Medicine and Surgery, furniture and office equipment supplied from a nearby Navy confinement facility, and a mission “to conduct research in neuropsychiatry as it applies to naval service,” the Naval Health Research Center (NHRC) was commissioned on 1 June 1959.
Originally named the Navy Medical Neuropsychiatric Research Unit (NMNPRU), one of the command’s first assignments was to conduct research in support of screening scientists and support personnel for Operation Deep Freeze, a joint scientific research effort in the Antarctic, supported by the Navy and directed by the National Science Foundation. Dr. Eric Gunderson, who would eventually become one of NHRC’s scientific directors, conducted a series of psychological studies on Deep Freeze personnel, enabling him to successfully develop predictors for prospective candidates who would adjust well to Antarctica’s challenging environment.
Another major focus of NHRC’s early research was the study of the psychological aspects of sleep and its impact on performance. These studies were led by Dr. Laverne Johnson, who also would go on to become scientific director at NHRC and a noted sleep research pioneer.
Evolution and Expansion
Over the next decade and a half, NHRC’s mission evolved and expanded. By 1974, NMNPRU had been renamed the Naval Health Research Center in recognition of the broader scope of its research programs. The command’s new mission was “to conduct research and development on the medical and psychological aspects of health and performance of naval service personnel.”
The year 1974 also saw the launch of the Center for Prisoner of War Studies at NHRC, now located in Pensacola, Florida. The center was established to examine the health and psychosocial effects of captivity and being subjected to severely inhumane conditions, including torture, among returning Vietnam service members.
Today, NHRC is housed in 24 historic military barracks that have been renovated into state-of-the-art laboratories and research facilities aboard Naval Base Point Loma, overlooking San Diego Bay. The lab’s core research areas are operational readiness and health, operational infectious diseases, and military population health, all focusing on the total health and readiness of warfighters and their families.

NHRC has a long and illustrious history of conducting research that innovates and flexes to meet the needs of our operational forces. Our scientists align our research with fleet and force requirements as we look ahead and anticipate the challenges our Navy and Marine Corps team will face in future battlespaces.
NHRC’s core competencies today include physical health and wellness; psychological and behavioral health; injury, injury prevention, and rehabilitation; physical and cognitive performance; medical modeling and decision support; and infectious diseases surveillance and research.
Operationally Ready
Readiness is why we exist. Every research project is geared to improve warfighter performance or find solutions to health-related problems that impede readiness. Whether we’re investigating methods for improving survivability and optimizing human performance or improving our data science capabilities to support medical and logistical decision-making, readiness is what we do.
Within NHRC’s operational readiness and health division, scientists in the warfighter performance department conduct studies designed to keep service members in top physical and fighting shape by investigating innovative methods to maximize performance, boost resilience, and prevent injuries to keep warfighters healthy and medically ready.
But injuries do happen and operational tempos ramp up, which is why our researchers also study topics that include methods for improving rehabilitation therapies for wounded warriors and reducing the negative effects of fatigue and limited sleep. Research projects that address warfighter performance include identification of objective neuromarkers of performance through electroencephalogram (EEG) measurement; characterization of physiological and physical changes in special operators while training and operating underwater; modification of Navy shipboard physiological heat exposure limits; and evaluation of targeted, novel vestibular rehabilitation programs for traumatic brain injuries.

To support this research, NHRC is home to the Warfighter Performance Laboratory, a 6,000-square foot human performance laboratory with capabilities that include: the Computer Assisted Rehabilitation Environment, an immersive virtual reality system with visual, auditory, vestibular, and tactile sensory inputs; a two-bedroom sleep and fatigue laboratory; and an environmental chamber with a temperature range of -23 to 130 degrees Fahrenheit.
The lab allows scientists to conduct a range of studies, all under one roof, to address the challenges faced by modern warfighters, including fatigue, heat stress, musculoskeletal injury, and diminished cognitive performance. Being collocated enables NHRC’s multidisciplinary scientists—physiologists, biomedical engineers, and neuroscientists—to collaborate. The research possibilities are only limited by their imagination.
Operationally relevant medical research at NHRC is about more than just muscle and bones—it’s also about bytes and bits. For more than 35 years, NHRC has been refining its expertise in managing “big data.”
The medical modeling, simulation, and mission support team analyzes large volumes of data and develops medical planning, logistics, and decision support tools.
Data analysts who focus on expeditionary medical research collect and scrub data from numerous medical, operational, and tactical datasets and integrate it into the Expeditionary Medical Encounter Database (EMED), a comprehensive repository created by NHRC scientists. Current research projects include investigation of extremity trauma to maximize health and quality of life outcomes, and the study of blast-related outcomes in the auditory system to mitigate injury and improve outcomes
NHRC’s data scientists also have developed software tools to support operational readiness by providing military line and medical leaders with validated, science-based methods for making informed decisions that improve survivability and long-term health outcomes for injured and ill service members. These tools, which have been validated and accredited by the Department of Defense and use EMED as a foundation, include the Joint Medical Planning Tool and the Medical Planners Toolkit.
No matter where the mission takes our military, the tools developed by NHRC researchers provide accurate and reliable information to decision-makers, ensuring our warfighters receive the right care and treatment at the right time and in the right place.
Healthy Military Populations
Beyond the battlefield, understanding the health effects, physical as well as psychological, of military service in the near and long term is an important component of maintaining readiness. NHRC researchers do this by investigating risk and resilience factors that impact the health and wellness of service members and their families.
Our military population health research is key to improving the overall health of our warfighters and military families. NHRC partners with other military services, the Department of Veterans Affairs, industry leaders, and academia to conduct long-term health studies, develop appropriate health surveillance strategies, and create and evaluate health and wellness programs and products. Being proactive by using research to understand the factors that impact health, allows us to improve overall readiness by targeting those factors that promote physical and mental resilience and mitigating the ones that pose health risks.
Since 1999, NHRC has been designated the Department of Defense’s deployment health research center. Researchers on the deployment health team conduct many leading epidemiological and behavioral health studies and they are responsible for several longitudinal studies, including:
The Millennium Cohort Program: This is the largest prospective health study in Defense Department history and investigates how military occupational exposures, including those encountered during deployments, affect the long-term health of service members.
Millennium Cohort Family Program: The first longitudinal study to follow a population-based cohort of military spouses and assess the long-term effects of military service and deployment on family health.
The Recruit Assessment Program: This program collects baseline health data and preservice exposures from Marine recruits to understand how military service affects health outcomes. Data collected is being used to inform early intervention and prevention programs to protect health and readiness.
Reproductive Health Research: These studies, which include the birth and infant health registry, evaluate reproductive health outcomes in relation to specific military exposures such as vaccines and those related to deployment, occupation, or geographic location.

The long-term health of warfighters is important, but NHRC’s health and behavioral sciences team also is working to address some of the more immediate challenges our warfighters face. Researchers are studying clinical treatments that address the unique needs of military members, health promotion interventions to improve health and resilience, and risk factors for psychological and behavioral health problems. Current research projects include the development and evaluation of a novel treatment for service members with comorbid post-traumatic stress disorder and major depressive disorder, development of self-guided workbooks to help service members reduce stress, development of a mobile app to reduce prescription drug misuse, and the creation and validation of improved suicide screening tools for healthcare providers.
One of the best things about being a Navy researcher is knowing the work we are doing is having a direct and positive impact on our warfighters. Our work isn’t theoretical, it’s practical. The work we do in the lab is translated into practical tools and interventions and put to work to improve warfighter health.
Fighting Infectious Diseases
Often, the biggest threats to the health and readiness of the US military aren’t bullets or roadside bombs—they’re microscopic organisms that can spread from person to person like wildfire.
These tiny pathogens— viruses and bacteria—cause illness and death without discrimination, decimating the readiness of individuals and entire units. Before World War II, more warfighters were lost to disease than combat. But science has turned the tide in this battle and NHRC scientists are on the front lines of this fight.
The basic and applied biomedical research we’re conducting is critical to force health protection and mission readiness. Our military operates globally, serving in areas of the world where they may be exposed to endemic infectious diseases. Many of our Sailors and Marines also live in close quarters—in barracks and shipboard berthing spaces—making them vulnerable to contagious illnesses, like influenza and norovirus. Disease outbreaks, especially in an operational environment, can compromise the mission. Our job is to see that it doesn’t.
NHRC’s biosurveillance team’s research serves as an early-warning system for dangerous pathogens and potential pandemics. Scientists at NHRC continually monitor for the presence of infectious diseases in military populations. When researchers find a potential disease threat, they alert leaders within the military and civilian medical communities so they can take action to prevent or contain disease outbreaks.
The team has a proven track record of doing just that. In 2009, scientists at NHRC conducting routine respiratory surveillance on samples collected from clinics in Southern California identified two influenza A cases that were different. They didn’t sub-type as either of the seasonal strains in circulation at the time. Researchers had identified the first cases of the H1N1 pandemic. Early identification allowed public health authorities to respond to the outbreak quickly.
The team’s current research includes ongoing respiratory and acute gastroenteritis surveillance, enteric bacterial antimicrobial resistance, evaluation of diagnostics for clinical and field use to rapidly detect illness, and improved treatments for endemic and pandemic influenza.
Researchers within NHRC’s clinical studies department support the health and readiness of the Navy and Marine Corps by conducting clinical trials that target diseases that affect warfighters, including adenovirus, norovirus, and shingles. Through clinical studies and ongoing research, scientists further understanding of these diseases to advance diagnostic capabilities and disease prevention measures such as new and improved vaccines and treatments.
One success story involved the vaccine for adenovirus. After the vaccine was discontinued in the mid-1990s at recruit training commands throughout the Defense Department, research done by NHRC helped get the vaccine reinstated in 2011, dramatically reducing rates of adenovirus among recruits—cases went from 250 each week to two. This work has positively affected recruit training by reducing the number of training days missed because of illness.
Currently, NHRC’s clinical studies team also is evaluating the effectiveness of the first norovirus vaccine in reducing outbreaks of acute gastroenteritis; a novel test (dried blood spot matrix) for assessing immunogenicity of a variety of vaccines; meningococcal carriage studies to understand why military recruits have higher risk for meningococcal disease; and an analysis of the incidence of varicella (chickenpox) and shingles in military populations to inform vaccination schedules and potential modification to reduce rates of shingles. 
 
The Future
From its humble beginnings, the scientific studies conducted by NHRC researchers have contributed to improved health and readiness not just for Sailors and Marines, but also for the rest of the Defense Department and even the civilian community.
In charting a course for the future, NHRC will continue to lean forward, maintain an agile mindset, and align research activities with the needs of warfighters in the fleet and on the field to enhance their health and readiness, increase their survivability, boost their resilience and recovery, and help them operate at the pinnacle of human performance.
Naval Medical Research and Development