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A nuclear attack on a large U.S. city by terrorists—even with a low-yield improvised nuclear device (IND) of 10 kilotons or less—would cause a large number of deaths and severe injuries. The large number of injured from the detonation and radioactive fallout that would follow would be overwhelming for local emergency response and health care systems to rescue and treat, even assuming that these systems and their personnel were not themselves incapacitated by the event.The United States has been struggling for some time to address and plan for the threat of nuclear terrorism and other weapons of mass destruction that terrorists might obtain and use. The Department of Homeland Security recently contracted with the Institute of Medicine to hold a workshop, summarized in this volume, to assess medical preparedness for a nuclear detonation of up to 10 kilotons.This book provides a candid and sobering look at our current state of preparedness for an IND, and identifies several key areas in which we might begin to focus our national efforts in a way that will improve the overall level of preparedness.
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A nuclear attack on a large U.S. city by terrorists—even with a low-yield improvised nuclear device (IND) of 10 kilotons or less—would cause a large number of deaths and severe injuries. The large number of injured from the detonation and radioactive fallout that would follow would be overwhelming for local emergency response and health care systems to rescue and treat, even assuming that these systems and their personnel were not themselves incapacitated by the event.The United States has been struggling for some time to address and plan for the threat of nuclear terrorism and other weapons of mass destruction that terrorists might obtain and use. The Department of Homeland Security recently contracted with the Institute of Medicine to hold a workshop, summarized in this volume, to assess medical preparedness for a nuclear detonation of up to 10 kilotons.This book provides a candid and sobering look at our current state of preparedness for an IND, and identifies several key areas in which we might begin to focus our national efforts in a way that will improve the overall level of preparedness.
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To mitigate the risks posed by microbial threats of public health significance originating abroad, the Centers for Disease Control and Prevention (CDC) places small groups of staff at major U.S. airports. These staff, their offices, and their patient isolation rooms constitute quarantine stations, which are run by CDC''s Division of Global Migration and Quarantine (DGMQ).Congress began to allocate funds in fiscal 2003 for the establishment of new quarantine stations at 17 major U.S. ports of entry that comprise airports, seaports, and land-border crossings. In a significant departure from the recent past, both the preexisting 8 quarantine stations and the new 17 are expected to play an active, anticipatory role in nationwide biosurveillance. Consequently, DGMQ asked the Institute of Medicine (IOM) to convene an expert committee to assess the present CDC quarantine stations and recommend how they should evolve to meet the challenges posed by microbial threats at the nation''s gateways. DGMQ specifically requested "an assessment of the role of the federal quarantine stations, given the changes in the global environment including large increases in international travel, threats posed by bioterrorism and emerging infections, and the movement of animals and cargo." To conduct this assessment and provide recommendations, IOM convened, in October 2004, the Committee on Measures to Enhance the Effectiveness of the CDC Quarantine Station Expansion Plan for U.S. Ports of Entry.At the sponsor''s request, the committee released the interim letter report Human Resources at U.S. Ports of Entry to Protect the Public''s Health in January 2005 to provide preliminary suggestions for the priority functions of a modern quarantine station, the competences necessary to carry out those functions, and the types of health professionals who have the requisite competences (Appendix A). This, the committee''s final report, assesses the present role of the CDC quarantine stations and articulates a vision of their future role as a public health intervention.
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The academic biomedical research community is a hub of employment, economic productivity, and scientific progress. Academic research institutions are drivers of economic development in their local and state economies and, by extension, the national economy. Beyond the economic input that the academic biomedical research community both receives and provides, it generates knowledge that in turn affects society in myriad ways.
The United States has experienced and continues to face the threat of disasters, and, like all entities, the academic biomedical research community can be affected. Recent disasters, from hurricanes to cyber-attacks, and their consequences have shown that the investments of the federal government and of the many other entities that sponsor academic research are not uniformly secure. First and foremost, events that damage biomedical laboratories and the institutions that house them can have impacts on the safety and well-being of humans and research animals. Furthermore, disasters can affect career trajectories, scientific progress, and financial stability at the individual and institutional levels.
Strengthening the Disaster Resilience of the Academic Biomedical Research Community offers recommendations and guidance to enhance the disaster resilience of the academic biomedical research community, with a special focus on the potential actions researchers, academic research institutions, and research sponsors can take to mitigate the impact of future disasters.
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To mitigate the risks posed by microbial threats of public health significance originating abroad, the Centers for Disease Control and Prevention (CDC) places small groups of staff at major U.S. airports. These staff, their offices, and their patient isolation rooms constitute quarantine stations, which are run by CDC''s Division of Global Migration and Quarantine (DGMQ).Congress began to allocate funds in fiscal 2003 for the establishment of new quarantine stations at 17 major U.S. ports of entry that comprise airports, seaports, and land-border crossings. In a significant departure from the recent past, both the preexisting 8 quarantine stations and the new 17 are expected to play an active, anticipatory role in nationwide biosurveillance. Consequently, DGMQ asked the Institute of Medicine (IOM) to convene an expert committee to assess the present CDC quarantine stations and recommend how they should evolve to meet the challenges posed by microbial threats at the nation''s gateways. DGMQ specifically requested "an assessment of the role of the federal quarantine stations, given the changes in the global environment including large increases in international travel, threats posed by bioterrorism and emerging infections, and the movement of animals and cargo." To conduct this assessment and provide recommendations, IOM convened, in October 2004, the Committee on Measures to Enhance the Effectiveness of the CDC Quarantine Station Expansion Plan for U.S. Ports of Entry.At the sponsor''s request, the committee released the interim letter report Human Resources at U.S. Ports of Entry to Protect the Public''s Health in January 2005 to provide preliminary suggestions for the priority functions of a modern quarantine station, the competences necessary to carry out those functions, and the types of health professionals who have the requisite competences (Appendix A). This, the committee''s final report, assesses the present role of the CDC quarantine stations and articulates a vision of their future role as a public health intervention.
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Racial and ethnic inequities in health and health care impact individual well-being, contribute to millions of premature deaths, and cost the United States hundreds of billions of dollars annually. Addressing these inequities is vital to improving the health of the nation''s most disadvantaged communities—and will also help to achieve optimal health for all. In 2003, the Institute of Medicine examined these inequities in Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care.
Because disparities persist, the National Academies convened an expert committee with support from the Agency for Healthcare Research and Quality and the National Institutes of Health. The committee''s report reviews the major drivers of health care disparities, provides insight into successful and unsuccessful interventions, identifies gaps in the evidence base, and makes recommendations to advance health equity.
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