TY - BOOK AU - Institute of Medicine AU - National Research Council TI - Dietary Supplements: A Framework for Evaluating Safety SN - DO - 10.17226/10882 PY - 2005 UR - https://nap.nationalacademies.org/catalog/10882/dietary-supplements-a-framework-for-evaluating-safety PB - The National Academies Press CY - Washington, DC LA - English KW - Food and Nutrition KW - Conflict and Security Issues AB - The growing consumer interest in health and fitness has expanded the market for a wide range of products, from yoga mats to the multiple dietary supplements now on the market. Supplements are popular, but are they safe? Many dietary supplements are probably safe when used as recommended. However, since 1994 when Congress decided that they should be regulated as if they were foods, they are assumed to be safe unless the Food and Drug Administration can demonstrate that they pose a significant risk to the consumer. But there are many types of products that qualify as dietary supplements, and the distinctions can become muddled and vague. Manufacturers are not legally required to provide specific information about safety before marketing their products. And the sales of supplements have been steadily increasing—all together, the various types now bring in almost $16 billion per year. Given these confounding factors, what kind of information can the Food and Drug Administration use to effectively regulate dietary supplements? This book provides a framework for evaluating dietary supplement safety and protecting the health of consumers. ER - TY - BOOK AU - Institute of Medicine TI - Quality Through Collaboration: The Future of Rural Health SN - DO - 10.17226/11140 PY - 2005 UR - https://nap.nationalacademies.org/catalog/11140/quality-through-collaboration-the-future-of-rural-health PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Building on the innovative Institute of Medicine reports To Err Is Human and Crossing the Quality Chasm, Quality Through Collaboration: The Future of Rural Health offers a strategy to address the quality challenges in rural communities. Rural America is a vital, diverse component of the American community, representing nearly 20% of the population of the United States. Rural communities are heterogeneous and differ in population density, remoteness from urban areas, and the cultural norms of the regions of which they are a part. As a result, rural communities range in their demographics and environmental, economic, and social characteristics. These differences influence the magnitude and types of health problems these communities face. Quality Through Collaboration: The Future of Rural Health assesses the quality of health care in rural areas and provides a framework for core set of services and essential infrastructure to deliver those services to rural communities. The book recommends: Adopting an integrated approach to addressing both personal and population health needs Establishing a stronger health care quality improvement support structure to assist rural health systems and professionals Enhancing the human resource capacity of health care professionals in rural communities and expanding the preparedness of rural residents to actively engage in improving their health and health care Assuring that rural health care systems are financially stable Investing in an information and communications technology infrastructure It is critical that existing and new resources be deployed strategically, recognizing the need to improve both the quality of individual-level care and the health of rural communities and populations. ER - TY - BOOK AU - Institute of Medicine A2 - James Curran A2 - Haile Debas A2 - Monisha Arya A2 - Patrick Kelley A2 - Stacey Knobler A2 - Leslie Pray TI - Scaling Up Treatment for the Global AIDS Pandemic: Challenges and Opportunities SN - DO - 10.17226/11043 PY - 2005 UR - https://nap.nationalacademies.org/catalog/11043/scaling-up-treatment-for-the-global-aids-pandemic-challenges-and PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - An estimated forty million people carry the human immunodeficiency virus (HIV), and five million more become newly infected annually. In recent years, many HIV-infected patients in wealthy nations have enjoyed significantly longer, good-quality lives as a result of antiretroviral therapy (ART). However, most infected individuals live in the poorest regions of the world, where ART is virtually nonexistent. The consequent death toll in these regions—especially sub-Saharan Africa—is begetting economic and social collapse. To inform the multiple efforts underway to deploy antiretroviral drugs in resource-poor settings, the Institute of Medicine committee was asked to conduct an independent review and assessment of rapid scale-up ART programs. It was also asked to identify the components of effective implementation programs. At the heart of the committee's report lie five imperatives: Immediately introduce and scale up ART programs in resource-poor settings. Devise strategies to ensure high levels of patient adherence to complicated treatment regimens. Rapidly address human-resource shortages to avoid the failure of program implementation. Continuously monitor and evaluate the programs to form the most effective guidelines and treatment regimens for each population. Prepare to sustain ART for decades. ER - TY - BOOK AU - Institute of Medicine A2 - Fitzhugh Mullan A2 - Claire Panosian A2 - Patricia Cuff TI - Healers Abroad: Americans Responding to the Human Resource Crisis in HIV/AIDS SN - DO - 10.17226/11270 PY - 2005 UR - https://nap.nationalacademies.org/catalog/11270/healers-abroad-americans-responding-to-the-human-resource-crisis-in PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Healers Abroad:Americans Responding to the Human Resource Crisis in HIV/AIDS calls for the federal government to create and fund the United States Global Health Service (GHS) to mobilize the nation�s best health care professionals and other highly skilled experts to help combat HIV/AIDS in hard-hit African, Caribbean, and Southeast Asian countries. The dearth of qualified health care workers in many lowincome nations is often the biggest roadblock to mounting effective responses to public health needs. The proposal�s goal is to build the capacity of targeted countries to fight the HIV/AIDS pandemic over the long run. The GHS would be comprised of six multifaceted components. Full-time, salaried professionals would make up the organization�s pivotal �service corps,� working side-by-side with other colleagues already on the ground to provide medical care and drug therapy to affected populations while offering local counterparts training and assistance in clinical, technical, and managerial areas. ER - TY - BOOK AU - Institute of Medicine TI - Veterans and Agent Orange: Update 2004 SN - DO - 10.17226/11242 PY - 2005 UR - https://nap.nationalacademies.org/catalog/11242/veterans-and-agent-orange-update-2004 PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine KW - Conflict and Security Issues AB - Sixth in a series of congressionally mandated studies, this book is an updated review and evaluation of the available evidence regarding the statistical assoication between exposure to herbicides used in Vietnam and various adverse health outcomes suspected to be linked with such exposure. This book builds upon the information contained in the earlier books in the series: Veterans and Agent Orange: Health Effects of Herbicides Used in Vietnam (1994) Veterans and Agent Orange: Update 1996 Veterans and Agent Orange: Update 1998 Veterans and Agent Orange: Update 2000 Veterans and Agent Orange: Update 2002 Veterans and Agent Orange: Herbicides and Dioxin Exposure and Type 2 Diabetes (2000) Veterans and Agent Orange: Herbicide/Dioxin Exposure and Acute Myelogenous Leukemia in the Children of Vietnam Veterans (2002) Veterans and Agent Orange: Update 2004 focuses primarily on scientific studies and other information developed since the release of these earlier books. The previous volumes have noted that sufficient evidence exists to link chronic lymphocytic leukemia, soft-tissue sarcoma, non-Hodgkin’s lymphoma, Hodgkin’s disease, and chloracne with exposure. The books also noted that there is “limited or suggestive” evidence of an association between exposure and respiratory cancers, prostate cancer, multiple myeloma, the metabolic disorder porphyria cutanea tarda, early-onset transient peripheral neuropathies, Type 2 diabetes, and the congenital birth defect spinal bifida in veterans’ children. This volume will be critically important to both policymakers and physicians in the federal government, Vietnam veterans and their families, veterans’ organizations, researchers, and health professionals. ER - TY - BOOK AU - Institute of Medicine TI - Gulf War and Health: Volume 3: Fuels, Combustion Products, and Propellants SN - DO - 10.17226/11180 PY - 2005 UR - https://nap.nationalacademies.org/catalog/11180/gulf-war-and-health-volume-3-fuels-combustion-products-and PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - The third in a series of congressionally mandated reports on Gulf War veterans’ health, this volume evaluates the long-term, human health effects associated with exposure to selected environmental agents, pollutants, and synthetic chemical compounds believed to have been present during the Gulf War. The committee specifically evaluated the literature on hydrogen sulfide, combustion products, hydrazine and red fuming nitric acid. Both the epidemiologic and toxicologic literature were reviewed. ER - TY - BOOK AU - Institute of Medicine A2 - Stacey L. Knobler A2 - Alison Mack A2 - Adel Mahmoud A2 - Stanley M. Lemon TI - The Threat of Pandemic Influenza: Are We Ready? Workshop Summary SN - DO - 10.17226/11150 PY - 2005 UR - https://nap.nationalacademies.org/catalog/11150/the-threat-of-pandemic-influenza-are-we-ready-workshop-summary PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Public health officials and organizations around the world remain on high alert because of increasing concerns about the prospect of an influenza pandemic, which many experts believe to be inevitable. Moreover, recent problems with the availability and strain-specificity of vaccine for annual flu epidemics in some countries and the rise of pandemic strains of avian flu in disparate geographic regions have alarmed experts about the world's ability to prevent or contain a human pandemic. The workshop summary, The Threat of Pandemic Influenza: Are We Ready? addresses these urgent concerns. The report describes what steps the United States and other countries have taken thus far to prepare for the next outbreak of "killer flu." It also looks at gaps in readiness, including hospitals' inability to absorb a surge of patients and many nations' incapacity to monitor and detect flu outbreaks. The report points to the need for international agreements to share flu vaccine and antiviral stockpiles to ensure that the 88 percent of nations that cannot manufacture or stockpile these products have access to them. It chronicles the toll of the H5N1 strain of avian flu currently circulating among poultry in many parts of Asia, which now accounts for the culling of millions of birds and the death of at least 50 persons. And it compares the costs of preparations with the costs of illness and death that could arise during an outbreak. ER - TY - BOOK AU - National Research Council AU - Institute of Medicine A2 - Cynthia B. Lloyd TI - Growing Up Global: The Changing Transitions to Adulthood in Developing Countries SN - DO - 10.17226/11174 PY - 2005 UR - https://nap.nationalacademies.org/catalog/11174/growing-up-global-the-changing-transitions-to-adulthood-in-developing PB - The National Academies Press CY - Washington, DC LA - English KW - Behavioral and Social Sciences AB - The challenges for young people making the transition to adulthood are greater today than ever before. Globalization, with its power to reach across national boundaries and into the smallest communities, carries with it the transformative power of new markets and new technology. At the same time, globalization brings with it new ideas and lifestyles that can conflict with traditional norms and values. And while the economic benefits are potentially enormous, the actual course of globalization has not been without its critics who charge that, to date, the gains have been very unevenly distributed, generating a new set of problems associated with rising inequality and social polarization. Regardless of how the globalization debate is resolved, it is clear that as broad global forces transform the world in which the next generation will live and work, the choices that today's young people make or others make on their behalf will facilitate or constrain their success as adults. Traditional expectations regarding future employment prospects and life experiences are no longer valid. Growing Up Global examines how the transition to adulthood is changing in developing countries, and what the implications of these changes might be for those responsible for designing youth policies and programs, in particular, those affecting adolescent reproductive health. The report sets forth a framework that identifies criteria for successful transitions in the context of contemporary global changes for five key adult roles: adult worker, citizen and community participant, spouse, parent, and household manager. ER -