Nmcp Request for Publication / Presentation Approval (Rppa)

NMCP REQUEST FOR PUBLICATION / PRESENTATION APPROVAL (RPPA)

I. READ THESE GENERAL INSTRUCTIONS BEFORE COMPLETING THE FORM:

 All types of authored works must be reviewed by your department head, director, OPSEC officer, Public Affairs Officer, the NMCP command publication officer, and if applicable, the attending veterinarian.  Do not route the forms yourself, CID will do that for you.  All forms are on the CID SharePoint page and may be accessed at: https://nmcp.med.navy.mil/CID/SitePages/Publication%20Approval.aspx  Complete the author section of the form (see pages 3-4 below) and e-mail it along with your authored document to Ms. Suzanne Workman at: [email protected]  If the topic is research related attach your most recent IRB/IACUC approval letter or continuing review  For assistance with large files contact Ms. Suzanne Workman  Allow 2 weeks for NMCP approval. Your (author) deadline should be earlier than the conference or journal deadline to allow time to make changes requested by reviewer(s).  NME review (use the BUMED PAO Request Form) is required for materials that concern: Overseas contingency operations (OCO); PTSD; TBI; mental health issues; suicide; domestic violence; sexual assault, substance abuse; amputations; HIV; women’s issues; animal research, or other controversial topics or issues of media interest; and those that contradict or affect the plans, policies, programs, or operations of the DoD or the U.S. Government, or national security.  Allow 5 weeks for NME and BUMED approval. NME and BUMED will not make exceptions.  All authors must complete research integrity training. Use this link to access training and instructions: https://nmcp.med.navy.mil/CID/SitePages/Training.aspx  Abstract approval does not constitute approval of the full paper or presentation based on the abstract. Approval must be requested every time your material is published or presented.  Approval is NOT required for presentations before an all DoD affiliated audience (military members, federal employees, or contractors). If there is a remote possibility that members of the media or the public will be in attendance then publication approval is required.  If journal costs are associated with this publication, contact Ms. Suzanne Workman for guidance  Contact Ms. June Brockman at 953-5939 or [email protected] if you have questions about the process.

II. ALL AUTHORED WORKS MUST CONTAIN THE FOLLOWING ELEMENTS:

1) Military identification: Manuscripts and professional articles completed in an official capacity or are funded by the government must identify the author with complete name, rank, corps, and command.

Disclaimer: The following disclaimer must be included in all materials. You may copy and paste it into your document: The views expressed in this article are those of the author(s) and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense, or the United States Government.

July 2017 page 1 2) Copyright Statement: Authors of official approved manuscripts cannot enter into any agreement that offers the publication exclusive rights. Government work, articles, and manuscripts prepared by Government employees in the course of their official duties cannot be copyright protected. Most publishers recognize this copyright limitation and may have alternative acknowledgements. If your publisher has another agreement or government statement of work, attach it with your materials when submitting them for review and approval. Otherwise the following copyright statement should be attached to all Government work when submitted to civilian media for publication. You may copy it from this form and paste it to your document: I am (a military service member) (an employee of the U.S. Government). This work was prepared as part of my official duties. Title 17 U.S.C. 105 provides that “Copyright protection under this title is not available for any work of the United States Government.” Title 17 U.S.C. 101 defines a United States Government work as a work prepared by a military service member or employee of the United States Government as part of that person’s official duties. *Remove the parentheses and choose “military service member” or “employee.” Use both only if applicable.*

3) CIP Statement: Research related material must include evidence of ethics oversight (from any institution).The IRB approval statement may be placed on the title page or in the first paragraph of the methods section of the manuscript. It must also be included on posters and presentations. Remember to include the CIP number on the authored work. The NMCP statement below may be copied and pasted into your document: Research data derived from an approved Naval Medical Center, Portsmouth, Virginia IRB, protocol; number NMCP.XXXX.XXXX. Funding Acknowledgment: Funding for DoD or externally supported protocols must be acknowledged. You may copy and paste this statement into your document: This study was supported by funding from DoD [program name (e.g., CDMRP)] under award number [DAMD17-X-XXXX].

III. SPECIAL INSTRUCTIONS FOR NON-HUMAN ANIMAL PROTOCOL RELATED MATERIAL:

1) The military identification, disclaimer, copyright statement, and funding acknowledgment must be included in your authored work (see above)

2) CIP Statement: Non-human animal related research related material must include evidence of ethics oversight (from any institution).The IACUC approval statement may be placed on the title page or in the first paragraph of the methods section of the manuscript. It must also be included on posters and presentations. Remember to include the CIP number on the authored work. The NMCP statement below may be copied and pasted into your document: Research data derived from an approved Naval Medical Center Portsmouth, Virginia IACUC, protocol; number NMCP.XXXX.XXXX.

3) Animal welfare compliance statement: An animal welfare statement must be included in the methods section or on the title page to indicate that appropriate regulatory and animal welfare oversight was provided. It must also be included on posters and presentations. The statement below may be copied and pasted into your document: This study was conducted in compliance with the Animal Welfare Act and Regulations, as-well-as the principles of the Guide for the Care and Use of Laboratory Animals.

4) Animal tissue use statement: If animal tissue, rather than live animals, was used include the following:

July 2017 page 2 Animal tissue was derived from an approved IACUC protocol #NMCP.XXXX.XXXX. Use of residual animal tissue was approved by the Naval Medical Center Portsmouth, Virginia IACUC.

5) Trauma or hemorrhage related study: If an animal underwent lethal trauma and/or hemorrhage, the document must indicate that the animals were anesthetized. This can be accomplished by including the use of anesthesia in the methods section of your document.

July 2017 page 3 IV. THIS SECTION IS TO BE COMPLETED BY THE AUTHOR:

Name (Last, First, MI): Corps: Service: USN Rank: Position: E-mail: Select Phone: Pager: Publication type: Select Department: Department Head (name and rank): Deadline for approval:

Directorate: Director (name and rank): Previous approval? Select Submission title:

Journal or conference (only one per submission):

ANSWER THE FOLLOWING QUESTIONS: Yes No Is it possible that members of the media or the public will be in attendance? ☐ ☐

Does your submission include the required identification (name, rank, corps, and command)? ☐ ☐

Does it include the required disclaimer? ☐ ☐

Does it contain the required copyright statement? ☐ ☐

Have you completed the required research integrity training? ☐ ☐

IF YOUR TOPIC IS HUMAN RESEARCH RELATED COMPLETE THE FOLLOWING: Does the study have IRB Approval? ☐ ☐

PI name:

Study title: Click here to enter text.

If approved by another institution, name of institution:

The protocol number is:

Have you attached the most recent IRB approval letter or continuing review? ☐ ☐

Does it contain the required CIP (IRB approval) statement? ☐ ☐ IF YOUR TOPIC IS ANIMAL RESEARCH RELATED COMPLETE THE FOLLOWING: Does the study have IACUC approval? ☐ ☐

PI name:

Study title: Click here to enter text.

If approved by another institution, name of institution:

The protocol number is:

Have you attached the most recent IACUC approval letter or continuing review? ☐ ☐

Does it include the required CIP (IACUC approval) statement? ☐ ☐

Does it include the required animal welfare statement? ☐ ☐

If applicable, does it include the required animal tissue use statement? ☐ ☐

If hemorrhage or trauma related does the methods section mention that the animal was anesthetized? ☐ ☐

Additional Information Other DoD agency or command to which this material has been submitted for approval.

Submission Date:

Optional Comments: Click here to enter text. V. TO BE COMPLETED BY PUBLICATION OFFICER:

Department Head Recommendation: Director Recommendation: ☐ Approve ☐ Approve with comment ☐ Approve ☐ Approve with comment ☐ Return to author for revision, discussion ☐ Return to author for revision, discussion ☐ Disapprove ☐ Disapprove ☐ Forward for higher level review ☐ Forward for higher level review Comments: Comments: Name/Signature: Name/Signature: Date: Date:

Public Affairs Recommendation: CID Recommendation: ☐ Approve ☐ Approve with comment ☐ Approve ☐ Approve with comment ☐ Return to author for revision, discussion ☐ Return to author for revision, discussion ☐ Disapprove ☐ Disapprove ☐ Forward for higher level review ☐ Forward for higher level review Comments: Comments: Name/Signature: Name/Signature: Date: Date:

Attending Veterinarian Recommendation: ☐ N/A OPSEC Security Recommendation: ☐ Approve ☐ Approve with comment ☐ Approve ☐ Approve with comment ☐ Return to author for revision, discussion ☐ Return to author for revision, discussion ☐ Disapprove ☐ Disapprove ☐ Forward for higher level review ☐ Forward for higher level review Comments: Comments: Name/Signature: Name/Signature: Date: Date:

NME Recommendation: ☐ N/A BUMED Recommendation: Command Action: ☐ Approve ☐ Approve w/ comment ☐ Approve ☐ Approve w/ comment ☐ Approve ☐ Approve w/ comment ☐ Return to author for revision ☐ Return to author for revision ☐ Return to author for revision ☐ Disapprove ☐ Disapprove ☐ Disapprove ☐ Forward to BUMED ☐ Not required ☐ Forward for higher level review Comments: Comments: Comments: Name/Signature: Name/Signature: Name/Signature: Date: Date: Date:

Author Notification: Date: By: