%0 Book %A National Academies of Sciences, Engineering, and Medicine %T Respiratory Health Effects of Airborne Hazards Exposures in the Southwest Asia Theater of Military Operations %@ 978-0-309-67910-7 %D 2020 %U https://nap.nationalacademies.org/catalog/25837/respiratory-health-effects-of-airborne-hazards-exposures-in-the-southwest-asia-theater-of-military-operations %> https://nap.nationalacademies.org/catalog/25837/respiratory-health-effects-of-airborne-hazards-exposures-in-the-southwest-asia-theater-of-military-operations %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 270 %X More than 3.7 million U.S. service members have participated in operations taking place in the Southwest Asia Theater of Military Operations since 1990. These operations include the 1990-1991 Persian Gulf War, a post-war stabilization period spanning 1992 through September 2001, and the campaigns undertaken in the wake of the September 11, 2001, attacks. Deployment to Iraq, Kuwait, Saudi Arabia, Bahrain, Gulf of Aden, Gulf of Oman, Oman, Qatar, the United Arab Emirates, and Afghanistan exposed service members to a number of airborne hazards, including oil-well fire smoke, emissions from open burn pits, dust and sand suspended in the air, and exhaust from diesel vehicles. The effects of these were compounded by stressors like excessive heat and noise that are inevitable attributes of service in a combat environment. Respiratory Health Effects of Airborne Hazards Exposures in the Southwest Asia Theater of Military Operations reviews the scientific evidence regarding respiratory health outcomes in veterans of the Southwest Asia conflicts and identifies research that could feasibly be conducted to address outstanding questions and generate answers, newly emerging technologies that could aid in these efforts, and organizations that the Veterans Administration might partner with to accomplish this work. %0 Book %A Institute of Medicine %A National Academies of Sciences, Engineering, and Medicine %T Considerations for Designing an Epidemiologic Study for Multiple Sclerosis and Other Neurologic Disorders in Pre and Post 9/11 Gulf War Veterans %@ 978-0-309-38868-9 %D 2015 %U https://nap.nationalacademies.org/catalog/21870/considerations-for-designing-an-epidemiologic-study-for-multiple-sclerosis-and-other-neurologic-disorders-in-pre-and-post-911-gulf-war-veterans %> https://nap.nationalacademies.org/catalog/21870/considerations-for-designing-an-epidemiologic-study-for-multiple-sclerosis-and-other-neurologic-disorders-in-pre-and-post-911-gulf-war-veterans %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 50 %X In January 2015, the Institute of Medicine conducted a study to determine the incidence and prevalence, as well as the risk of developing multiple sclerosis (MS) and other neurologic diseases as a result of service in the 1990-1991 Persian Gulf and post 9/11 Global Operations theaters. The other neurologic diseases to be considered include: Parkinson’s disease, and brain cancers, as well as central nervous system abnormalities that are difficult to precisely diagnose. This report presents the committee’s data collection and findings. %0 Book %A National Academies of Sciences, Engineering, and Medicine %E Savitz, David A. %E Styka, Anne N. %E Butler, David A. %T Assessment of the Department of Veterans Affairs Airborne Hazards and Open Burn Pit Registry %@ 978-0-309-45117-8 %D 2017 %U https://nap.nationalacademies.org/catalog/23677/assessment-of-the-department-of-veterans-affairs-airborne-hazards-and-open-burn-pit-registry %> https://nap.nationalacademies.org/catalog/23677/assessment-of-the-department-of-veterans-affairs-airborne-hazards-and-open-burn-pit-registry %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %K Environment and Environmental Studies %P 252 %X Military operations produce a great deal of trash in an environment where standard waste management practices may be subordinated to more pressing concerns. As a result, ground forces have long relied on incineration in open-air pits as a means of getting rid of refuse. Concerns over possible adverse effects of exposure to smoke from trash burning in the theater were first expressed in the wake of the 1990–1991 Gulf War and stimulated a series of studies that indicated that exposures to smoke from oil-well fires and from other combustion sources, including waste burning, were stressors for troops. In January 2013, Congress directed the Department of Veterans Affairs (VA) to establish and maintain a registry for service members who may have been exposed to toxic airborne chemicals and fumes generated by open burn pits. Assessment of the Department of Veterans Affairs Airborne Hazards and Open Burn Pit Registry analyzes the initial months of data collected by the registry and offers recommendations on ways to improve the instrument and best use the information it collects. This report assesses the effectiveness of the VA's information gathering efforts and provides recommendations for addressing the future medical needs of the affected groups, and provides recommendations on collecting, maintaining, and monitoring information collected by the VA's Airborne Hazards and Open Burn Pit Registry. %0 Book %A National Academies of Sciences, Engineering, and Medicine %E Kizer, Kenneth W. %E Le Menestrel, Suzanne %T Strengthening the Military Family Readiness System for a Changing American Society %@ 978-0-309-48953-9 %D 2019 %U https://nap.nationalacademies.org/catalog/25380/strengthening-the-military-family-readiness-system-for-a-changing-american-society %> https://nap.nationalacademies.org/catalog/25380/strengthening-the-military-family-readiness-system-for-a-changing-american-society %I The National Academies Press %C Washington, DC %G English %K Behavioral and Social Sciences %P 384 %X The U.S. military has been continuously engaged in foreign conflicts for over two decades. The strains that these deployments, the associated increases in operational tempo, and the general challenges of military life affect not only service members but also the people who depend on them and who support them as they support the nation – their families. Family members provide support to service members while they serve or when they have difficulties; family problems can interfere with the ability of service members to deploy or remain in theater; and family members are central influences on whether members continue to serve. In addition, rising family diversity and complexity will likely increase the difficulty of creating military policies, programs and practices that adequately support families in the performance of military duties. Strengthening the Military Family Readiness System for a Changing American Society examines the challenges and opportunities facing military families and what is known about effective strategies for supporting and protecting military children and families, as well as lessons to be learned from these experiences. This report offers recommendations regarding what is needed to strengthen the support system for military families. %0 Book %A Institute of Medicine %E Mitchell, Abigail E. %E Sivitz, Laura B. %E Black, Robert E. %T Gulf War and Health: Volume 5: Infectious Diseases %@ 978-0-309-10106-6 %D 2007 %U https://nap.nationalacademies.org/catalog/11765/gulf-war-and-health-volume-5-infectious-diseases %> https://nap.nationalacademies.org/catalog/11765/gulf-war-and-health-volume-5-infectious-diseases %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %K Conflict and Security Issues %P 238 %X Infectious diseases have been a problem for military personnel throughout history. The consequences in previous conflicts have ranged from frequent illnesses disrupting daily activities and readiness to widespread deaths. Preventive measures, early diagnosis, and treatment greatly limit the exposures and acute illnesses of troops today in comparison with those in armies of the past, but infections and consequent acute illnesses still occur. Thousands of US veterans of the Persian Gulf War have reported an array of unexplained illnesses since the war ended in 1991. Many veterans have believed that the illnesses were associated with their military service in southwest Asia during the war. This volume of Gulf War and Health evaluates the scientific literature on chemical, biologic, and physical agents to which military personnel in the gulf were potentially exposed and possible long-term adverse health outcomes. %0 Book %A Institute of Medicine %T Gulf War and Health: Volume 6: Physiologic, Psychologic, and Psychosocial Effects of Deployment-Related Stress %@ 978-0-309-10177-6 %D 2008 %U https://nap.nationalacademies.org/catalog/11922/gulf-war-and-health-volume-6-physiologic-psychologic-and-psychosocial %> https://nap.nationalacademies.org/catalog/11922/gulf-war-and-health-volume-6-physiologic-psychologic-and-psychosocial %I The National Academies Press %C Washington, DC %G English %K Conflict and Security Issues %K Health and Medicine %P 358 %X 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. %0 Book %A National Academies of Sciences, Engineering, and Medicine %T Reassessment of the Department of Veterans Affairs Airborne Hazards and Open Burn Pit Registry %@ 978-0-309-69423-0 %D 2022 %U https://nap.nationalacademies.org/catalog/26729/reassessment-of-the-department-of-veterans-affairs-airborne-hazards-and-open-burn-pit-registry %> https://nap.nationalacademies.org/catalog/26729/reassessment-of-the-department-of-veterans-affairs-airborne-hazards-and-open-burn-pit-registry %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 292 %X Beginning with the 1990–1991 Gulf War, more than 3.7 million U.S. service members have been deployed to Southwest Asia, where they have been exposed to a number of airborne hazards, including oil-well fire smoke, emissions from open burn pits, dust and sand, diesel exhaust, and poor-quality ambient air. Many service members, particularly those who served in Iraq and Afghanistan, have reported health problems they attribute to their exposure to emissions from open-air burn pits on military installations. In 2013, Congress directed the Department of Veterans Affairs (VA) to establish and maintain the Airborne Hazards and Open Burn Pit (AH&OBP) Registry to "ascertain and monitor" the health effects of such exposures. This report serves as a follow-up to an initial assessment of the AH&OBP Registry completed by an independent committee of the National Academies in 2017. This reassessment does not include any strength-of-the-evidence assessments of potential relationships between exposures to burn pits or airborne hazards and health effects. Rather, this report assesses the ability of the registry to fulfill the intended purposes that Congress and VA have specified for it. %0 Book %A Institute of Medicine %T Returning Home from Iraq and Afghanistan: Preliminary Assessment of Readjustment Needs of Veterans, Service Members, and Their Families %@ 978-0-309-14763-7 %D 2010 %U https://nap.nationalacademies.org/catalog/12812/returning-home-from-iraq-and-afghanistan-preliminary-assessment-of-readjustment %> https://nap.nationalacademies.org/catalog/12812/returning-home-from-iraq-and-afghanistan-preliminary-assessment-of-readjustment %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 192 %X Nearly 1.9 million U.S. troops have been deployed to Afghanistan and Iraq since October 2001. Many service members and veterans face serious challenges in readjusting to normal life after returning home. This initial book presents findings on the most critical challenges, and lays out the blueprint for the second phase of the study to determine how best to meet the needs of returning troops and their families. %0 Book %A Institute of Medicine %T Gulf War and Health: Volume 8: Update of Health Effects of Serving in the Gulf War %@ 978-0-309-14921-1 %D 2010 %U https://nap.nationalacademies.org/catalog/12835/gulf-war-and-health-volume-8-update-of-health-effects %> https://nap.nationalacademies.org/catalog/12835/gulf-war-and-health-volume-8-update-of-health-effects %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %K Conflict and Security Issues %P 318 %X For the United States, the 1991 Persian Gulf War was a brief and successful military operation with few injuries and deaths. However, soon after returning from duty, a large number of veterans began reporting health problems they believed were associated with their service in the Gulf. At the request of Congress, the IOM is conducting an ongoing review of the evidence to determine veterans' long-term health problems and what might be causing those problems. The fourth volume in the series, released in 2006, summarizes the long-term health problems seen in Gulf War veterans. In 2008, the IOM began an update to look at existing health problems and identify possible new ones, considering evidence collected since the initial summary. In this report, the IOM determines that Gulf War service causes post-traumatic stress disorder (PTSD) and that service is associated with multisymptom illness; gastrointestinal disorders such as irritable bowel syndrome; alcohol and other substance abuse; and anxiety disorders and other psychiatric disorders. To ensure that our veterans receive the best possible care, now and in the future, the government should continue to monitor their health and conduct research to identify the best treatments to assist Gulf War veterans still suffering from persistent, unexplained illnesses. %0 Book %A Institute of Medicine %A National Academies of Sciences, Engineering, and Medicine %E Cory-Slechta, Deborah %E Wedge, Roberta %T Gulf War and Health: Volume 10: Update of Health Effects of Serving in the Gulf War, 2016 %@ 978-0-309-38041-6 %D 2016 %U https://nap.nationalacademies.org/catalog/21840/gulf-war-and-health-volume-10-update-of-health-effects %> https://nap.nationalacademies.org/catalog/21840/gulf-war-and-health-volume-10-update-of-health-effects %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 292 %X For the United States, the 1991 Persian Gulf War was a brief and successful military operation with few injuries and deaths. However, soon after returning from duty, a large number of veterans began reporting health problems they believed were associated with their service in the Gulf. At the request of Congress, the Institute of Medicine (IOM) has been conducting an ongoing review of the evidence to determine veterans' long-term health problems and potential causes. The fourth volume in the series, released in 2006, summarizes the long-term health problems seen in Gulf War veterans. In 2010, the IOM released an update that focuses on existing health problems and identifies possible new ones, considering evidence collected since the initial summary. Gulf War and Health: Volume 10 is an update of the scientific and medical literature on the health effects associated with deployment to the Gulf War that were identified in Volumes 4 and 8. This report reviews and evaluates the associations between illness and exposure to toxic agents, environmental or wartime hazards, or preventive measures and vaccines associated with Gulf War service, and provides recommendations for future research efforts on Gulf War veterans. %0 Book %A Institute of Medicine %T Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations: Final Assessment %@ 978-0-309-30173-2 %D 2014 %U https://nap.nationalacademies.org/catalog/18724/treatment-for-posttraumatic-stress-disorder-in-military-and-veteran-populations %> https://nap.nationalacademies.org/catalog/18724/treatment-for-posttraumatic-stress-disorder-in-military-and-veteran-populations %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 300 %X Posttraumatic stress disorder (PTSD) is one of the signature injuries of the U.S. conflicts in Afghanistan and Iraq, but it affects veterans of all eras. It is estimated that 7-20% of service members and veterans who served in Operation Enduring Freedom and Operation Iraqi Freedom may have the disorder. PTSD is characterized by a combination of mental health symptoms - re-experiencing of a traumatic event, avoidance of trauma-associated stimuli, adverse alterations in thoughts and mood, and hyperarousal - that last at least 1 month and impair functioning. PTSD can be lifelong and pervade all aspects of a service member's or veteran's life, including mental and physical health, family and social relationships, and employment. It is often concurrent with other health problems, such as depression, traumatic brain injury, chronic pain, substance abuse disorder, and intimate partner violence. The Department of Defense (DoD) and the Department of Veterans Affairs (VA) provide a spectrum of programs and services to screen for, diagnose, treat for, and rehabilitate service members and veterans who have or are at risk for PTSD. The 2010 National Defense Authorization Act asked the Institute of Medicine to assess those PTSD programs and services in two phases. The Phase 1 study, Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations: Initial Assessment, focused on data gathering. Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations Final Assessment is the report of the second phase of the study. This report analyzes the data received in Phase 1 specifically to determine the rates of success for each program or method. Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations Final Assessment considers what a successful PTSD management system is and whether and how such a system is being implemented by DoD and VA. This includes an assessment of what care is given and to whom, how effectiveness is measured, what types of mental health care providers are available, what influences whether a service member or veteran seeks care, and what are the costs associated with that care. This report focuses on the opportunities and challenges that DoD and VA face in developing, implementing, and evaluating services and programs in the context of achieving a high-performing system to care for service members and veterans who have PTSD. The report also identifies where gaps or new emphases might be addressed to improve prevention of, screening for, diagnosis of, and treatment and rehabilitation for the disorder. The findings and recommendations of Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations: Final Assessment will encourage DoD and VA to increase their efforts in moving toward a high-performing, comprehensive, integrated PTSD management strategy that addresses the needs of current and future service members, veterans, and their families. %0 Book %A National Academies of Sciences, Engineering, and Medicine %T Evaluation of the Department of Veterans Affairs Mental Health Services %@ 978-0-309-46657-8 %D 2018 %U https://nap.nationalacademies.org/catalog/24915/evaluation-of-the-department-of-veterans-affairs-mental-health-services %> https://nap.nationalacademies.org/catalog/24915/evaluation-of-the-department-of-veterans-affairs-mental-health-services %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 466 %X Approximately 4 million U.S. service members took part in the wars in Afghanistan and Iraq. Shortly after troops started returning from their deployments, some active-duty service members and veterans began experiencing mental health problems. Given the stressors associated with war, it is not surprising that some service members developed such mental health conditions as posttraumatic stress disorder, depression, and substance use disorder. Subsequent epidemiologic studies conducted on military and veteran populations that served in the operations in Afghanistan and Iraq provided scientific evidence that those who fought were in fact being diagnosed with mental illnesses and experiencing mental health–related outcomes—in particular, suicide—at a higher rate than the general population. This report provides a comprehensive assessment of the quality, capacity, and access to mental health care services for veterans who served in the Armed Forces in Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn. It includes an analysis of not only the quality and capacity of mental health care services within the Department of Veterans Affairs, but also barriers faced by patients in utilizing those services. %0 Book %A Institute of Medicine %T Long-Term Health Consequences of Exposure to Burn Pits in Iraq and Afghanistan %@ 978-0-309-21755-2 %D 2011 %U https://nap.nationalacademies.org/catalog/13209/long-term-health-consequences-of-exposure-to-burn-pits-in-iraq-and-afghanistan %> https://nap.nationalacademies.org/catalog/13209/long-term-health-consequences-of-exposure-to-burn-pits-in-iraq-and-afghanistan %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %K Environment and Environmental Studies %P 192 %X Many veterans returning from the conflicts in Iraq and Afghanistan have health problems they believe are related to their exposure to the smoke from the burning of waste in open-air "burn pits" on military bases. Particular controversy surrounds the burn pit used to dispose of solid waste at Joint Base Balad in Iraq, which burned up to 200 tons of waste per day in 2007. The Department of Veterans Affairs asked the IOM to form a committee to determine the long-term health effects from exposure to these burn pits. Insufficient evidence prevented the IOM committee from developing firm conclusions. This report, therefore, recommends that, along with more efficient data-gathering methods, a study be conducted that would evaluate the health status of service members from their time of deployment over many years to determine their incidence of chronic diseases. %0 Book %A National Academies of Sciences, Engineering, and Medicine %T Gulf War and Health: Volume 11: Generational Health Effects of Serving in the Gulf War %@ 978-0-309-47823-6 %D 2018 %U https://nap.nationalacademies.org/catalog/25162/gulf-war-and-health-volume-11-generational-health-effects-of %> https://nap.nationalacademies.org/catalog/25162/gulf-war-and-health-volume-11-generational-health-effects-of %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 518 %X For the United States, the 1991 Persian Gulf War was a brief and successful military operation with few injuries and deaths. However, soon after returning from duty, a large number of veterans began reporting health problems they believed were associated with their service in the Gulf. At the request of Congress, the National Academies of Sciences, Engineering, and Medicine has been conducting an ongoing review of the evidence to determine veterans' long-term health problems and potential causes. Some of the health effects identified by past reports include post-traumatic stress disorders, other mental health disorders, Gulf War illness, respiratory effects, and self-reported sexual dysfunction. Veterans' concerns regarding the impacts of deployment-related exposures on their health have grown to include potential adverse effects on the health of their children and grandchildren. These concerns now increasingly involve female veterans, as more women join the military and are deployed to war zones and areas that pose potential hazards. Gulf War and Health: Volume 11 evaluates the scientific and medical literature on reproductive and developmental effects and health outcomes associated with Gulf War and Post-9/11 exposures, and designates research areas requiring further scientific study on potential health effects in the descendants of veterans of any era. %0 Book %A Institute of Medicine %E Koehler, Rebecca %E Wilhelm, Erin E. %E Shoulson, Ira %T Cognitive Rehabilitation Therapy for Traumatic Brain Injury: Evaluating the Evidence %@ 978-0-309-21818-4 %D 2011 %U https://nap.nationalacademies.org/catalog/13220/cognitive-rehabilitation-therapy-for-traumatic-brain-injury-evaluating-the-evidence %> https://nap.nationalacademies.org/catalog/13220/cognitive-rehabilitation-therapy-for-traumatic-brain-injury-evaluating-the-evidence %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 356 %X Traumatic brain injury (TBI) may affect 10 million people worldwide. It is considered the "signature wound" of the conflicts in Iraq and Afghanistan. These injuries result from a bump or blow to the head, or from external forces that cause the brain to move within the head, such as whiplash or exposure to blasts. TBI can cause an array of physical and mental health concerns and is a growing problem, particularly among soldiers and veterans because of repeated exposure to violent environments. One form of treatment for TBI is cognitive rehabilitation therapy (CRT), a patient-specific, goal-oriented approach to help patients increase their ability to process and interpret information. The Department of Defense asked the IOM to conduct a study to determine the effectiveness of CRT for treatment of TBI. %0 Book %A Institute of Medicine %T Blue Water Navy Vietnam Veterans and Agent Orange Exposure %@ 978-0-309-16247-0 %D 2011 %U https://nap.nationalacademies.org/catalog/13026/blue-water-navy-vietnam-veterans-and-agent-orange-exposure %> https://nap.nationalacademies.org/catalog/13026/blue-water-navy-vietnam-veterans-and-agent-orange-exposure %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 158 %X Over 3 million U.S. military personnel were sent to Southeast Asia to fight in the Vietnam War. Since the end of the Vietnam War, veterans have reported numerous health effects. Herbicides used in Vietnam, in particular Agent Orange have been associated with a variety of cancers and other long term health problems from Parkinson's disease and type 2 diabetes to heart disease. Prior to 1997 laws safeguarded all service men and women deployed to Vietnam including members of the Blue Navy. Since then, the Department of Veteran Affairs (VA) has established that Vietnam veterans are automatically eligible for disability benefits should they develop any disease associated with Agent Orange exposure, however, veterans who served on deep sea vessels in Vietnam are not included. These "Blue Water Navy" veterans must prove they were exposed to Agent Orange before they can claim benefits. At the request of the VA, the Institute of Medicine (IOM) examined whether Blue Water Navy veterans had similar exposures to Agent Orange as other Vietnam veterans. Blue Water Navy Vietnam Veterans and Agent Orange Exposure comprehensively examines whether Vietnam veterans in the Blue Water Navy experienced exposures to herbicides and their contaminants by reviewing historical reports, relevant legislation, key personnel insights, and chemical analysis to resolve current debate on this issue. %0 Book %A Institute of Medicine %T Gulf War and Health: Volume 7: Long-Term Consequences of Traumatic Brain Injury %@ 978-0-309-12408-9 %D 2009 %U https://nap.nationalacademies.org/catalog/12436/gulf-war-and-health-volume-7-long-term-consequences-of %> https://nap.nationalacademies.org/catalog/12436/gulf-war-and-health-volume-7-long-term-consequences-of %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 396 %X 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. %0 Book %A National Academies of Sciences, Engineering, and Medicine %E Blazer, Dan G. %E Domnitz, Sarah %E Liverman, Catharyn T. %T Hearing Health Care for Adults: Priorities for Improving Access and Affordability %@ 978-0-309-43926-8 %D 2016 %U https://nap.nationalacademies.org/catalog/23446/hearing-health-care-for-adults-priorities-for-improving-access-and %> https://nap.nationalacademies.org/catalog/23446/hearing-health-care-for-adults-priorities-for-improving-access-and %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 324 %X The loss of hearing - be it gradual or acute, mild or severe, present since birth or acquired in older age - can have significant effects on one's communication abilities, quality of life, social participation, and health. Despite this, many people with hearing loss do not seek or receive hearing health care. The reasons are numerous, complex, and often interconnected. For some, hearing health care is not affordable. For others, the appropriate services are difficult to access, or individuals do not know how or where to access them. Others may not want to deal with the stigma that they and society may associate with needing hearing health care and obtaining that care. Still others do not recognize they need hearing health care, as hearing loss is an invisible health condition that often worsens gradually over time. In the United States, an estimated 30 million individuals (12.7 percent of Americans ages 12 years or older) have hearing loss. Globally, hearing loss has been identified as the fifth leading cause of years lived with disability. Successful hearing health care enables individuals with hearing loss to have the freedom to communicate in their environments in ways that are culturally appropriate and that preserve their dignity and function. Hearing Health Care for Adults focuses on improving the accessibility and affordability of hearing health care for adults of all ages. This study examines the hearing health care system, with a focus on non-surgical technologies and services, and offers recommendations for improving access to, the affordability of, and the quality of hearing health care for adults of all ages. %0 Book %A Institute of Medicine %T Veterans and Agent Orange: Update 2010 %@ 978-0-309-21447-6 %D 2012 %U https://nap.nationalacademies.org/catalog/13166/veterans-and-agent-orange-update-2010 %> https://nap.nationalacademies.org/catalog/13166/veterans-and-agent-orange-update-2010 %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 836 %X Because of continuing uncertainty about the long-term health effects of the sprayed herbicides on Vietnam veterans, Congress passed the Agent Orange Act of 1991. The legislation directed the Secretary of Veterans Affairs (VA) to request the Institite of Medicine to perform a comprehensive evaluation of scientific and medical information regarding the health effects of exposure to Agent Orange and other herbicides used in Vietnam to be followed by biennial updates. The 2010 update recommends further research of links between Vietnam service and specific health outcomes, most importantly COPD, tonsil cancer, melanoma, brain cancer, Alzheimer's disease, and paternally transmitted effects to offspring. %0 Book %A Institute of Medicine %T Veterans and Agent Orange: Update 2012 %@ 978-0-309-28886-6 %D 2014 %U https://nap.nationalacademies.org/catalog/18395/veterans-and-agent-orange-update-2012 %> https://nap.nationalacademies.org/catalog/18395/veterans-and-agent-orange-update-2012 %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 1006 %X From 1962 to 1971, the US military sprayed herbicides over Vietnam to strip the thick jungle canopy that could conceal opposition forces, to destroy crops that those forces might depend on, and to clear tall grasses and bushes from the perimeters of US base camps and outlying fire-support bases. Mixtures of 2,4-dichlorophenoxyacetic acid (2,4-D), 2,4,5-trichlorophenoxyacetic acid (2,4,5-T), picloram, and cacodylic acid made up the bulk of the herbicides sprayed. The main chemical mixture sprayed was Agent Orange, a 50:50 mixture of 2,4-D and 2,4,5-T. At the time of the spraying, 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), the most toxic form of dioxin, was an unintended contaminant generated during the production of 2,4,5-T and so was present in Agent Orange and some other formulations sprayed in Vietnam. Because of complaints from returning Vietnam veterans about their own health and that of their children combined with emerging toxicologic evidence of adverse effects of phenoxy herbicides and TCDD, the National Academy of Sciences (NAS) was asked to perform a comprehensive evaluation of scientific and medical information regarding the health effects of exposure to Agent Orange, other herbicides used in Vietnam, and the various components of those herbicides, including TCDD. Updated evaluations are conducted every two years to review newly available literature and draw conclusions from the overall evidence.Veterans and Agent Orange: Update 2012 reviews peer-reviewed scientific reports concerning associations between health outcomes and exposure to TCDD and other chemicals in the herbicides used in Vietnam that were published in October 2010--September 2012 and integrates this information with the previously established evidence database. This report considers whether a statistical association with herbicide exposure exists, taking into account the strength of the scientific evidence and the appropriateness of the statistical and epidemiological methods used to detect the association; the increased risk of disease among those exposed to herbicides during service in the Republic of Vietnam during the Vietnam era; and whether there exists a plausible biological mechanism or other evidence of a causal relationship between herbicide exposure and the disease.