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240 produkter
240 produkter
New Vaccine Development
Establishing Priorities: Volume II, Diseases of Importance in Developing Countries
Häftad, Engelska, 1986
1 957 kr
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Common diseases cost the developing world an enormous amount in terms of human life, health, and productivity, as well as lost economic potential. New and effective vaccines could not only improve the quality of life for millions of residents in developing countries, they could also contribute substantially to further economic development. Using data from the World Health Organization and other international agencies, this book analyzes disease burdens, pathogen descriptions, geographic distribution of diseases, probable vaccine target populations, alternative control measures and treatments, and future prospects for vaccine development. New Vaccine Development provides valuable insight into immunological and international health policy priorities.
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The early to mid-1990s saw a large surge in U.S. cigar consumption, including premium cigars. Based on recent import data, premium cigar use may be increasing, though they currently make up a small percent of the total U.S. cigar market. Premium cigars have also been the subject of legal and regulatory efforts for the past decade. In 1998, the National Cancer Institute undertook a comprehensive review of available knowledge about cigars - the only one to date. The resulting research recommendations have largely not been addressed, and many of the identified information gaps persist. Furthermore, there is no single, consistent definition of premium cigars, making research challenging. In response, the Food and Drug Administration (FDA) and the National Institutes of Health commissioned the National Academies of Sciences, Engineering, and Medicine to convene a committee of experts to address this issue. The resulting report, Premium Cigars: Patterns of Use, Marketing, and Health Effects, includes 13 findings, 24 conclusions, and nine priority research recommendations and assesses the state of evidence on premium cigar characteristics, current patterns of use, marketing and perceptions of the product, and short- long-term health effects.
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To explore issues related to community-driven power-building efforts to improve population health, the Roundtable on Population Health Improvement of the National Academies of Sciences, Engineering, and Medicine hosted a virtual public workshop, "Community Power in Population Health Improvement", on January 28 and 29, 2021. Participants discussed the different components and dimensions of community-led action around different population health improvement topics such as education, transportation, environmental health, healthy eating, and active living, among others. This Proceedings of a Workshop summarizes the presentations and discussion of the workshop.
Advancing Maternal Health Equity and Reducing Maternal Morbidity and Mortality
Proceedings of a Workshop
Häftad, Engelska, 2021
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The United States faces an alarmingly high rate of maternal morbidity and mortality, distinguishing it from other high-income countries that have achieved decreases in these rates in recent years. U.S. maternal morbidity and mortality rates are disproportionate across racial, ethnic, socioeconomic, and geographic groups. Statistics on maternal health outcomes reveal that there are challenges to protecting both the lives and future health of birthing people and their children.Recognizing the urgency of this growing problem, the National Academies Board on Population Health and Public Health Practice convened a 2-day virtual workshop, Advancing Maternal Health Equity and Reducing Maternal Mortality. The workshop examined the current state of maternal health in the United States and explored the factors needed to help communities and health care systems become more effective in reducing maternal morbidity and mortality and improving health outcomes through the fourth trimester. This publication summarizes the presentations and discussions of the workshop.
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Mother-to-child transmission of HIV-1 afflicts hundreds of thousands of children every year, especially in parts of the world such as sub-Saharan Africa, where HIV infection is prevalent and resources are limited. This tragic reality has spurred researchers to search for an effective, safe, and inexpensive treatment that could reduce the risk of perinatal HIV transmission. The HIVNET 012 trial was designed to provide preliminary information on the comparative safety and efficacy of two relatively simple and inexpensive short courses of oral antiretroviral treatment likely to be feasible in resource-limited settings. The resulting report identified some problems with procedures and documentation, but concluded that these issues did not compromise the results of the study. However, these issues have led to public scrutiny and continued controversy. Review of the HIVNET 012 Perinatal HIV Prevention Study critically and objectively evaluates the study's design and conduct, and assesses the impact of the initial procedural issues on the validity of the overall findings and conclusions of the trial.
Estimating the Contributions of Lifestyle-Related Factors to Preventable Death
A Workshop Summary
Häftad, Engelska, 2005
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This report is the summary of a workshop held by The Institute of Medicine (IOM) of the National Academy of Science December 13-14, 2004 to estimate the contributions of lifestyle-related factors to preventable death. The summary of this workshop includes presentations from experts in statistical design, epidemiology, quality-of-life measures, communication, and public policy and discussions among the participants. Panels of experts addressed the following topics: methodological issues when estimating the public health burden of lifestyle factors; estimating "attributable risk" in practice; alternative ways of measuring the health burden; and public policy issues.
John R. La Montagne Memorial Symposium on Pandemic Influenza Research
Meeting Proceedings
Häftad, Engelska, 2005
662 kr
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The Institute of Medicine (IOM) of the National Academies of Science held a symposium, in memory of Dr. John R. La Montagne on April 4-5, 2005, to discuss the current state of the art of research on pandemic influenza and to identify gaps in research. The symposium serves as a first step of discussion towards a combined and coordinated research effort among Department of Health and Human Services agencies, other governmental agencies, international partners and the private sector. The statement of task that guided the Symposium agenda included these specific questions: 1) What is the current state of the science on pandemic influenza research? 2) What are the pressing unmet scientific questions and technical issues? 3) What administrative, logistic or legal impediments exist that block progress towards the development of interventions to respond to pandemic influenza? 4) How can collaboration among Global health Security Action Group nations be strengthened to address unmet scientific questions and technical issues related to research on pandemic influenza? 5) What do experts believe are the most important next steps to take to advance research on pandemic influenza?The Proceedings of the John La Montagne Memorial Symposium on Pandemic Influenza Research Gaps represents a slightly edited transcript of the plenary presentations, rapporteur presentations, plenary discussion and presentation slides. This document contains the Symposium agenda, short biographies of plenary speakers, and provides a list of individuals who attended the symposium.
State of the Science and the Future of Cumulative Impact Assessment
Proceedings of a Workshop Series
Häftad, Engelska, 2025
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The National Academies of Sciences, Engineering, and Medicine assembled the ad hoc Committee on State-of-the-Science and the Future of Cumulative Impact Assessment to convene state-of-the-science workshops and develop a consensus report to advise the U.S. Environmental Protection Agency on further developing the scientific foundation underlying the practice of cumulative impact assessment. This proceedings provides a summary of a workshop series that the committee convened as part of its information-gathering activities. The series included a community-engaged workshop in New Orleans, Louisiana; a virtual Town Hall with members of the community and Tribal liaison group from across the United States; and a Tribal engagement event in Aurora, Colorado. This proceedings has been prepared by the workshop rapporteurs as a summary of what occurred during the workshops.
Rebuilding the Unity of Health and the Environment in Rural America
Workshop Summary
Häftad, Engelska, 2006
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Throughout much of its history, the United States was predominantly a rural society. The need to provide sustenance resulted in many people settling in areas where food could be raised for their families. Over the past century, however, a quiet shift from a rural to an urban society occurred, such that by 1920, for the first time, more members of our society lived in urban regions than in rural ones. This was made possible by changing agricultural practices. No longer must individuals raise their own food, and the number of person-hours and acreage required to produce food has steadily been decreasing because of technological advances, according to Roundtable member James Merchant of the University of Iowa. The Institute of Medicine's Roundtable on Environmental Health Science, Research, and Medicine held a regional workshop at the University of Iowa on November 29 and 30, 2004, to look at rural environmental health issues. Iowa, with its expanse of rural land area, growing agribusiness, aging population, and increasing immigrant population, provided an opportunity to explore environmental health in a region of the country that is not as densely populated.As many workshop participants agreed, the shifting agricultural practices as the country progresses from family operations to large-scale corporate farms will have impacts on environmental health. This report describes and summarizes the participants' presentations to the Roundtable members and the discussions that the members had with the presenters and participants at the workshop.
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The Vietnam War was fought in a jungle environment that provided cover to the enemy and made battlefield observations difficult, so military strategists used herbicides to remove foliage along key roads and waterways, defoliate areas surrounding enemy bases and supply and communications routes, and improve visibility in heavily canopied forests. The last three decades have seen an ongoing debate about the effects of this military use of herbicides and the potential adverse long-term health effects on those who may have been exposed to these herbicides. In response to these concerns, the Air Force Health Study (AFHS) was created to investigate the potential relationship between the herbicides used and the health problems of those exposed. Disposition of the Air Force Health Study assesses the scientific merit of the AFHS operations and procedures, and makes recommendations for improvement.
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In 1998, in response to the growing concerns that many returning Gulf War veterans began reporting numerous health problems that they believed to be associated with their service in the Persian Gulf, Congress passed two laws which directed the Secretary of Veterans Affairs to enter into a contract with the National Academy of Sciences. They were tasked to review and evaluate the scientific and medical literature regarding associations between illness and exposure to toxic agents, environmental or wartime hazards, and preventive medicines or vaccines associated with Gulf War service. In addition, the Institute of Medicine of the National Academy of Sciences provided conclusions to these studies that were considered when making decisions about compensation to veterans. Gulf War and Health Volume 4: Health Effects of Serving in the Gulf War summarizes in one place the current status of health effects in veterans deployed to the Persian Gulf irrespective of exposure information. This book reviews, evaluates, and summarizes both peer-reviewed scientific and medical literature addressing the health status of Gulf War veterans.
Gulf War and Health
Volume 6: Physiologic, Psychologic, and Psychosocial Effects of Deployment-Related Stress
Inbunden, Engelska, 2008
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The sixth in a series of congressionally mandated reports on Gulf War veterans' health, this volume evaluates the health effects associated with stress. Since the launch of Operation Desert Storm in 1991, there has been growing concern about the physical and psychological health of Gulf War and other veterans. In the late 1990s, Congress responded by asking the National Academy of Sciences (NAS) to review and evaluate the scientific and medical literature regarding associations between illness and exposure to toxic agents, environmental or wartime hazards, and preventive medicines or vaccines in members of the armed forces who were exposed to such agents. Deployment to a war zone has a profound impact on the lives of troops and on their family members. There are a plethora of stressors associated with deployment, including constant vigilance against unexpected attack, difficulty distinguishing enemy combatants from civilians, concerns about survival, caring for the badly injured, and witnessing the death of a person. Less traumatic but more pervasive stressors include anxiety about home life, such as loss of a job and income, impacts on relationships, and absence from family.The focus of this report, by the Institute of Medicine (IOM) Committee on Gulf War and Health: Physiologic, and Psychosocial Effects of Deployment-Related Stress, is the long-term effects of deployment-related stress. Gulf War and Health: Volume 6. Physiologic, and Psychosocial Effects of Development Related Stress evaluates the scientific literature regarding association between deployment-related stressors and health effects, and provides meaningful recommendations to remedy this problem.
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In response to growing national concern about the number of veterans who might be at risk for posttraumatic stress disorder (PTSD) as a result of their military service, the Department of Veterans Affairs (VA) asked the Institute of Medicine (IOM) to conduct a study on the diagnosis and assessment of, and treatment and compensation for PTSD. An existing IOM committee, the Committee on Gulf War and Health: Physiologic, Psychologic and Psychosocial Effects of Deployment-Related Stress, was asked to conduct the diagnosis, assessment, and treatment aspects of the study because its expertise was well-suited to the task. The committee was specifically tasked to review the scientific and medical literature related to the diagnosis and assessment of PTSD, and to review PTSD treatments (including psychotherapy and pharmacotherapy) and their efficacy. In addition, the committee was given a series of specific questions from VA regarding diagnosis, assessment, treatment, and compensation.Posttraumatic Stress Disorder is a brief elaboration of the committee's responses to VA's questions, not a detailed discussion of the procedures and tools that might be used in the diagnosis and assessment of PTSD. The committee decided to approach its task by separating diagnosis and assessment from treatment and preparing two reports. This first report focuses on diagnosis and assessment of PTSD. Given VA's request for the report to be completed within 6 months, the committee elected to rely primarily on reviews and other well-documented sources. A second report of this committee will focus on treatment for PTSD; it will be issued in December 2006. A separate committee, the Committee on Veterans' Compensation for Post Traumatic Stress Disorder, has been established to conduct the compensation study; its report is expected to be issued in December 2006.
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Amyotrophic lateral sclerosis (ALS) our Lou Gehrig's disease is a fatal, mostly non-familial disease that affects the nervous system of humans by causing the degeneration of nerve cells in the brain and spinal cord. The degeneration halts communication between the nervous system and voluntary muscles in the body. This leads to muscle paralysis and eventually the muscles that aid in breathing are affect; causing respiration to fail. The disease, which affects 20,000-30,000 men and women in the United States at any given time, has no effective treatment; most people with ALS die from respiratory failure within 5 years of the onset of symptoms. Recent epidemiologic studies report an association between the development of ALS and prior service in the U.S. military. The studies evaluated either veterans of the 1991 Persian Gulf War or veterans who served in the military in the period 1910-1982. Due to these findings, the Department of Veterans Affairs (VA) asked the National Academies to conduct an assessment of the potential relationship between military service and the later development of ALS.The project was assigned to the Institute of Medicine (IOM), which appointed a committee and gave it the task of evaluating the scientific literature on ALS in veterans. The committee began its work by identifying medical and scientific literature on ALS. PubMed, a database created and managed by the National Library of Medicine. Amyotrophic Lateral Sclerosis in Veterans; Review of the Scientific Literature presents the findings of this committee. The committee reviewed, evaluated, and summarized the scientific literature on ALS in veterans, composed primarily of peer-reviewed, published literature. This report includes the recommendations of the committee.
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In the wake of publicity and congressional attention to drug safety issues, the Food and Drug Administration (FDA) requested the Institute of Medicine assess the drug safety system. The committee reported that a lack of clear regulatory authority, chronic underfunding, organizational problems, and a scarcity of post-approval data about drugs' risks and benefits have hampered the FDA's ability to evaluate and address the safety of prescription drugs after they have reached the market. Noting that resources and therefore efforts to monitor medications' riska "benefit profiles taper off after approval, The Future of Drug Safety offers a broad set of recommendations to ensure that consideration of safety extends from before product approval through the entire time the product is marketed and used.
Global Environmental Health in the 21st Century
From Governmental Regulation to Corporate Social Responsibility: Workshop Summary
Häftad, Engelska, 2007
608 kr
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Biological threats like SARS and natural disasters like the tsunami in Indonesia have devastated entire regions, and quickly exhausted budgetary resources. As the field of environmental health continues to evolve, scientists and others must focus on gaining a better understanding of the links between human health and various environmental factors, and on creating new paradigms and partnerships needed to address these complex environmental health challenges facing society. Global Environmental Health in the 21st Century: From Governmental Regulations to Corporate Social Responsibility: Workshop Summary discusses the role of industry in environmental health, examines programs designed to improve the overall state of environmental health, and explores how governmental and corporate entities can collaborate to manage this industry. Stakeholders in both the public and private sectors are looking for viable solutions as the complexity of societal problems and risks associated with management and varying regulatory standards continue to increase.Global Environmental Health in the 21st Century draws critical links and provides insight into the current shape of global environmental health. The book recommends expanding environmental management systems (EMS) to encompass a more extensive global network. It also provides a complete assessment of the benefits and costs resulting from implementation of various environmental management systems.
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The nation has made tremendous progress in reducing tobacco use during the past 40 years. Despite extensive knowledge about successful interventions, however, approximately one-quarter of American adults still smoke. Tobacco-related illnesses and death place a huge burden on our society. Ending the Tobacco Problem generates a blueprint for the nation in the struggle to reduce tobacco use. The report reviews effective prevention and treatment interventions and considers a set of new tobacco control policies for adoption by federal and state governments. Carefully constructed with two distinct parts, the book first provides background information on the history and nature of tobacco use, developing the context for the policy blueprint proposed in the second half of the report. The report documents the extraordinary growth of tobacco use during the first half of the 20th century as well as its subsequent reversal in the mid-1960s (in the wake of findings from the Surgeon General). It also reviews the addictive properties of nicotine, delving into the factors that make it so difficult for people to quit and examines recent trends in tobacco use.In addition, an overview of the development of governmental and nongovernmental tobacco control efforts is provided. After reviewing the ethical grounding of tobacco control, the second half of the book sets forth to present a blueprint for ending the tobacco problem. The book offers broad-reaching recommendations targeting federal, state, local, nonprofit and for-profit entities. This book also identifies the benefits to society when fully implementing effective tobacco control interventions and policies.
Adequacy of Evidence for Physical Activity Guidelines Development
Workshop Summary
Häftad, Engelska, 2007
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Is there a sufficient evidence base for the U.S. Department of Health and Human Services (HHS) to develop a comprehensive set of physical activity guidelines for Americans? To address this question, the Institute of Medicine (IOM) held a workshop titled "Adequacy of Evidence for Physical Activity Guidelines Development" in Washington, DC on October 23-24, 2006, sponsored by HHS. The workshop summary includes the presentations and discussions of more than 30 experts who were asked to consider the available evidence related to physical activity and the general population, as well as special population subgroups including children and adolescents, pregnant and postpartum women, older adults, and persons with disabilities. The summary provides an overview of the specific issues of relevance in assessing the quality and breadth of the available evidence.
Environmental Public Health Impacts of Disasters
Hurricane Katrina: Workshop Summary
Häftad, Engelska, 2007
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Public health officials have the traditional responsibilities of protecting the food supply, safeguarding against communicable disease, and ensuring safe and healthful conditions for the population. Beyond this, public health today is challenged in a way that it has never been before. Starting with the 9/11 terrorist attacks, public health officers have had to spend significant amounts of time addressing the threat of terrorism to human health. Hurricane Katrina was an unprecedented disaster for the United States. During the first weeks, the enormity of the event and the sheer response needs for public health became apparent. The tragic loss of human life overshadowed the ongoing social and economic disruption in a region that was already economically depressed. Hurricane Katrina reemphasized to the public and to policy makers the importance of addressing long-term needs after a disaster.On October 20, 2005, the Institute of Medicine's Roundtable on Environmental Health Sciences, Research, and Medicine held a workshop which convened members of the scientific community to highlight the status of the recovery effort, consider the ongoing challenges in the midst of a disaster, and facilitate scientific dialogue about the impacts of Hurricane Katrina on people's health. Environmental Public Health Impacts of Disasters: Hurricane Katrina is the summary of this workshop. This report will inform the public health, first responder, and scientific communities on how the affected community can be helped in both the midterm and the near future. In addition, the report can provide guidance on how to use the information gathered about environmental health during a disaster to prepare for future events.
Green Healthcare Institutions
Health, Environment, and Economics: Workshop Summary
Häftad, Engelska, 2007
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Green Healthcare Institutions : Health, Environment, and Economics, Workshop Summary is based on the ninth workshop in a series of workshops sponsored by the Roundtable on Environmental Health Sciences, Research, and Medicine since the roundtable began meeting in 1998. When choosing workshops and activities, the roundtable looks for areas of mutual concern and also areas that need further research to develop a strong environmental science background. This workshop focused on the environmental and health impacts related to the design, construction, and operations of healthcare facilities, which are part of one of the largest service industries in the United States. Healthcare institutions are major employers with a considerable role in the community, and it is important to analyze this significant industry. The environment of healthcare facilities is unique; it has multiple stakeholders on both sides, as the givers and the receivers of care. In order to provide optimal care, more research is needed to determine the impacts of the built environment on human health.The scientific evidence for embarking on a green building agenda is not complete, and at present, scientists have limited information. Green Healthcare Institutions : Health, Environment, and Economics, Workshop Summary captures the discussions and presentations by the speakers and participants; they identified the areas in which additional research is needed, the processes by which change can occur, and the gaps in knowledge.
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Public health efforts have resulted in tremendous improvements in the health of individuals and communities. The foundation for effective public health interventions rests, in large part, on a well-trained workforce. Unfortunately there is a major shortage of public health physicians who are prepared to face today's public health challenges. Training Physicians for Public Health Careers focuses on the critical roles that physicians play in maintaining and strengthening the public health system, identifies what these physicians need to know to engage in effective public health actions, explores the kinds of training programs that can be used to prepare physicians for public health roles, and examines how these training programs can be funded. Medical schools, schools of public health, health care and public health care professionals, medical students and students of public health will find this of special interest.
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Mental disorders, including posttraumatic stress disorder (PTSD), constitute an important health care need of veterans, especially those recently separated from service. Treatment of Posttraumatic Stress Disorder: An Assessment of the Evidence takes a systematic look the efficacy of pharmacologic and psychological treatment modalities for PTSD on behalf of the Department of Veterans Affairs. By reviewing existing studies in order to draw conclusions about the strength of evidence on several types of treatment, the Committee on the Treatment of Posttraumatic Stress Disorder found that many of these studies were faulty in design and performance, and that relatively few of these studies have been conducted in populations of veterans, despite suggestions that civilian and veteran populations respond differently to various types of treatment. The committee also notes that the evidence is scarce on the acceptability, efficacy, or generalizability of treatment in ethnic and cultural minorities, as few studies stratified results by ethnic background.Despite challenges in the consistency, quality, and depth of research, the committee found the evidence sufficient to conclude the efficacy of exposure therapies in treating PTSD. The committee found the evidence inadequate to determine efficacy of different types of pharmacotherapies, of three different psychotherapy modalities, and of psychotherapy delivered in group formats. The committee also made eight critical recommendations, some in response to the VA's questions related to recovery and the length and timing of PTSD treatment, and others addressing research methodology, gaps in evidence and funding issues.
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Medications are an important component of health care, but each year their misuse results in over a million adverse drug events that lead to office and emergency room visits as well as hospitalizations and, in some cases, death. As a patient's most tangible source of information about what drug has been prescribed and how that drug is to be taken, the label on a container of prescription medication is a crucial line of defense against such medication safety problems, yet almost half of all patients misunderstand label instructions about how to take their medicines. Standardizing Medication Labels: Confusing Patients Less is the summary of a workshop, held in Washington, D.C. on October 12, 2007, that was organized to examine what is known about how medication container labeling affects patient safety and to discuss approaches to addressing identified problems.
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In early 2007, the Institute of Medicine convened the Roundtable on Health Disparities to increase the visibility of racial and ethnic health disparities as a national problem, to further the development of programs and strategies to reduce disparities, to foster the emergence of leadership on this issue, and to track promising activities and developments in health care that could lead to dramatically reducing or eliminating disparities. The Roundtable's first workshop, Challenges and Successes in Reducing Health Disparities, was held in St. Louis, Missouri, on July 31, 2007, and examined (1) the importance of differences in life expectancy within the United States, (2) the reasons for those differences, and (3) the implications of this information for programs and policy makers.
Antivirals for Pandemic Influenza
Guidance on Developing a Distribution and Dispensing Program
Häftad, Engelska, 2008
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Planning for an influenza pandemic, whether it occurs in the near or distant future, will need to take into account many constantly evolving factors. The Institute of Medicine (IOM) Committee on Implementation of Antiviral Medication Strategies for an Influenza Pandemic was asked by the Department of Health and Human Services, (DHHS) to consider best practices and policies for providing antiviral treatment and prophylaxis during a pandemic event. The committeea (TM)s report, entitled Antivirals for Pandemic Influenza: Guidance on Developing a Distribution and Dispensing Program, calls for a national and public process of creating an ethical framework for antiviral use within the context of uncertainty and scarcity. It is unclear whether antivirals will work against a pandemic strain as well as they work against seasonal influenza. Also, government stockpiles may not be sufficient for all possible uses in part because antivirals are costly and public health agencies must invest in other important activities, including other medical resources for pandemic influenza.Furthermore, the report identifies the lack of a science-based advisory body to guide decision making during the pandemic, including guidance on all dimensions of antiviral dispensing (for example, prioritization, drug safety, and antiviral resistance). The report also acknowledges the need for diverse methods and sites of dispensing, and discusses their advantages and disadvantages.
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The 1991 Persian Gulf War was considered a brief and successful military operation with few injuries and deaths. A large number of returning veterans, however, soon began reporting health problems that they believed to be associated with their service in the gulf. Under a Congressional mandate, the Institute of Medicine (IOM) is reviewing a wide array of biologic, chemical, and physical agents to determine if exposure to these agents may be responsible for the veterans' health problems. In a 2000 report, Gulf War and Health, Volume 1: Depleted Uranium, Sarin, Pyridostigmine Bromide, and Vaccines, the IOM concluded that there was not enough evidence to draw conclusions as to whether long-term health problems are associated with exposure to depleted uranium, a component of some military munitions and armor. In response to veterans' ongoing concerns and recent publications in the literature, IOM updated its 2000 report. In this most recent report, Gulf War and Health: Updated Literature Review of Depleted Uranium, the committee concluded that there is still not enough evidence to determine whether exposure to depleted uranium is associated with long-term health problems.The report was sponsored by the U.S. Department of Veterans Affairs.
Epidemiologic Studies of Veterans Exposed to Depleted Uranium
Feasibility and Design Issues
Häftad, Engelska, 2008
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Depleted uranium, a component of some weapons systems, has been in use by the U.S. military since the 1991 Gulf War. Military personnel have been exposed to depleted uranium as the result of friendly fire incidents, cleanup and salvage operations, and proximity to burning depleted uranium-containing tanks and ammunition. Under a Congressional mandate, the Department of Defense sought guidance from the Institute of Medicine in evaluating the feasibility and design of an epidemiologic study that would assess health outcomes of exposure to depleted uranium. The study committee examined several options to study health outcomes of depleted uranium exposure in military and veteran populations and concluded that it would be difficult to design a study to comprehensively assess depleted uranium-related health outcomes with currently available data. The committee further concluded that the option most likely to obtain useful information about depleted uranium-related health outcomes would be a prospective cohort study if future military operations involve exposure to depleted uranium.The book contains recommendations aimed at improving future epidemiologic studies and identifying current active-duty military personnel and veterans with potential DU exposure.
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The National Children's Study (NCS) is planned to be the largest long-term study of environmental and genetic effects on children's health ever conducted in the United States. It proposes to examine the effects of environmental influences on the health and development of approximately 100,000 children across the United States, following them from before birth until age 21. By archiving all of the data collected, the NCS is intended to provide a valuable resource for analyses conducted many years into the future. This book evaluates the research plan for the NCS, by assessing the scientific rigor of the study and the extent to which it is being carried out with methods, measures, and collection of data and specimens to maximize the scientific yield of the study. The book concludes that if the NCS is conducted as proposed, the database derived from the study should be valuable for investigating hypotheses described in the research plan as well as additional hypotheses that will evolve. Nevertheless, there are important weaknesses and shortcomings in the research plan that diminish the study's expected value below what it might be.
Initial Guidance for an Update of the National Vaccine Plan
A Letter Report to the National Vaccine Program Office
Häftad, Engelska, 2008
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This book is the Institute of Medicine's response to the first part of the statement of task asking for a review of the 1994 National Vaccine Plan. The Committee on the Review of Priorities in the National Vaccine Plan reviewed the goals, objectives, strategies, and anticipated outcomes presented in the plan; their findings are contained in this book. In the first section of the book, the committee examines what has changed in the broader social, policy, and economic context of vaccine development and immunization, and highlights several areas where noteworthy progress has been made, particularly by federal agencies. The committee acknowledges that progress in developing and delivering vaccines has benefited from essential contributions by other stakeholders, including researchers, manufacturers, state and local public health agencies, and health care providers. In the second section of the book, the committee uses what it learned from reviewing the 1994 plan and the process of preparing it to distill key elements. Based on these elements, the committee offers guidance to NVPO and its partners on developing the update to the national vaccine plan.
Gulf War and Health
Volume 7: Long-Term Consequences of Traumatic Brain Injury
Inbunden, Engelska, 2009
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The seventh in a series of congressionally mandated reports on Gulf War veterans health, this volume evaluates traumatic brain injury (TBI) and its association with long-term health affects. That many returning veterans have TBI will likely mean long-term challenges for them and their family members. Further, many veterans will have undiagnosed brain injury because not all TBIs have immediately recognized effects or are easily diagnosed with neuroimaging techniques. In an effort to detail the long term consequences of TBI, the committee read and evaluated some 1,900 studies that made up its literature base, and it developed criteria for inclusion of studies to inform its findings. It is clear that brain injury, whether penetrating or closed, has serious consequences. The committee sought to detail those consequences as clearly as possible and to provide a scientific framework to assist veterans as they return home.