%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 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 National Academies of Sciences, Engineering, and Medicine %T Evaluation of the Disability Determination Process for Traumatic Brain Injury in Veterans %@ 978-0-309-48686-6 %D 2019 %U https://nap.nationalacademies.org/catalog/25317/evaluation-of-the-disability-determination-process-for-traumatic-brain-injury-in-veterans %> https://nap.nationalacademies.org/catalog/25317/evaluation-of-the-disability-determination-process-for-traumatic-brain-injury-in-veterans %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 210 %X The Veterans Benefits Administration (VBA) provides disability compensation to veterans with a service-connected injury, and to receive disability compensation from the Department of Veterans Affairs (VA), a veteran must submit a claim or have a claim submitted on his or her behalf. Evaluation of the Disability Determination Process for Traumatic Brain Injury in Veterans reviews the process by which the VA assesses impairments resulting from traumatic brain injury for purposes of awarding disability compensation. This report also provides recommendations for legislative or administrative action for improving the adjudication of veterans' claims seeking entitlement to compensation for all impairments arising from a traumatic brain injury. %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 An Approach to Evaluate the Effects of Concomitant Prescribing of Opioids and Benzodiazepines on Veteran Deaths and Suicides %@ 978-0-309-49599-8 %D 2019 %U https://nap.nationalacademies.org/catalog/25532/an-approach-to-evaluate-the-effects-of-concomitant-prescribing-of-opioids-and-benzodiazepines-on-veteran-deaths-and-suicides %> https://nap.nationalacademies.org/catalog/25532/an-approach-to-evaluate-the-effects-of-concomitant-prescribing-of-opioids-and-benzodiazepines-on-veteran-deaths-and-suicides %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 110 %X Opioid prescriptions for acute and chronic pain increased dramatically from the late 1990s into the current decade in both the civilian and the Department of Veterans Affairs and Department of Defense treatment environments. Similarly, prescriptions for benzodiazepines also increased significantly for anxiety and insomnia. Combinations of opioid and benzodiazepines have proven fatal when taken concurrently, with research demonstrating this phenomenon for nearly 40 years. This issue is exacerbated within the veteran population because of higher rates of pain, anxiety and other related health issues due to military life. An evaluation of the relationship between opioid and benzodiazepine medication practices at the VA is necessary to improve treatment for mental health and combat-related trauma for veterans. An Approach to Evaluate the Effects of Concomitant Prescribing of Opioids and Benzodiazepines on Veteran Deaths and Suicides investigates the effects of opioid initiation and tapering strategies in the presence of benzodiazepines in veterans. This report explores neurobiology and the principles of addiction and tolerance, in addition to the current use of opioids and benzodiazepines for treating pain and anxiety in both the veteran and general population. It also provides a protocol to evaluate the relationship between opioid and benzodiazepine medication practices. This framework is a critical foundation for further research to improve concomitant opioid and benzodiazepine medication practices for veterans and the general population. %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 %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 National Academies of Sciences, Engineering, and Medicine %T Veterans and Agent Orange: Update 11 (2018) %@ 978-0-309-47716-1 %D 2018 %U https://nap.nationalacademies.org/catalog/25137/veterans-and-agent-orange-update-11-2018 %> https://nap.nationalacademies.org/catalog/25137/veterans-and-agent-orange-update-11-2018 %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 738 %X From 1962 to 1971, the U.S. 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 Academies of Sciences, Engineering, and Medicine 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 were conducted every two years to review newly available literature and draw conclusions from the overall evidence. Veterans and Agent Orange: Update 11 (2018) examines peer-reviewed scientific reports concerning associations between various health outcomes and exposure to TCDD and other chemicals in the herbicides used in Vietnam that were published between September 30, 2014, and December 31, 2017, and integrates this information with the previously established evidence database.