TY - BOOK AU - Institute of Medicine A2 - Bernard M. Rosof A2 - Lyla M. Hernandez TI - Gulf War Veterans: Treating Symptoms and Syndromes SN - DO - 10.17226/10185 PY - 2001 UR - https://nap.nationalacademies.org/catalog/10185/gulf-war-veterans-treating-symptoms-and-syndromes PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Ten years after the end of the Gulf War, questions continue to be raised about the health of U.S. service personnel who fought in that war. A primary concern is whether Gulf War veterans are receiving effective treatments for their health problems. Section 105 of the Veterans Program Enhancement Act of 1998 mandates that the Department of Veterans Affairs (VA) ask the Institute of Medicine (IOM) to convene a committee that would identify a method for assessing treatment effectiveness and describe already-validated treatments for Gulf War veterans' health problems, including the problem of medically unexplained symptoms. The specific charge to the committee is to (1) identify and describe approaches for assessing treatment effectiveness; (2) identify illnesses and conditions among veterans of the Gulf War, using data obtained from the VA and the Department of Defense (DoD) Gulf War Registries, as well as information in published articles; and (3) for these identified conditions and illnesses, identify validated models of treatment (to the extent that such treatments exist), or identify new approaches, theories, or research on the management of patients with these conditions if validated treatment models are not available. ER - TY - BOOK AU - Institute of Medicine A2 - Rebecca Koehler A2 - Erin E. Wilhelm A2 - Ira Shoulson TI - Cognitive Rehabilitation Therapy for Traumatic Brain Injury: Evaluating the Evidence SN - DO - 10.17226/13220 PY - 2011 UR - https://nap.nationalacademies.org/catalog/13220/cognitive-rehabilitation-therapy-for-traumatic-brain-injury-evaluating-the-evidence PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - 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. ER - TY - BOOK AU - Institute of Medicine TI - Gulf War and Health: Volume 6: Physiologic, Psychologic, and Psychosocial Effects of Deployment-Related Stress SN - DO - 10.17226/11922 PY - 2008 UR - https://nap.nationalacademies.org/catalog/11922/gulf-war-and-health-volume-6-physiologic-psychologic-and-psychosocial PB - The National Academies Press CY - Washington, DC LA - English KW - Conflict and Security Issues KW - Health and Medicine AB - 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. ER - TY - BOOK AU - Institute of Medicine TI - Treatment of Posttraumatic Stress Disorder: An Assessment of the Evidence SN - DO - 10.17226/11955 PY - 2008 UR - https://nap.nationalacademies.org/catalog/11955/treatment-of-posttraumatic-stress-disorder-an-assessment-of-the-evidence PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - 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. ER - TY - BOOK AU - Institute of Medicine A2 - Abigail E. Mitchell A2 - Laura B. Sivitz A2 - Robert E. Black TI - Gulf War and Health: Volume 5: Infectious Diseases SN - DO - 10.17226/11765 PY - 2007 UR - https://nap.nationalacademies.org/catalog/11765/gulf-war-and-health-volume-5-infectious-diseases PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine KW - Conflict and Security Issues AB - 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. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine A2 - Dan G. Blazer A2 - Sarah Domnitz A2 - Catharyn T. Liverman TI - Hearing Health Care for Adults: Priorities for Improving Access and Affordability SN - DO - 10.17226/23446 PY - 2016 UR - https://nap.nationalacademies.org/catalog/23446/hearing-health-care-for-adults-priorities-for-improving-access-and PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - 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. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine A2 - Kenneth W. Kizer A2 - Suzanne Le Menestrel TI - Strengthening the Military Family Readiness System for a Changing American Society SN - DO - 10.17226/25380 PY - 2019 UR - https://nap.nationalacademies.org/catalog/25380/strengthening-the-military-family-readiness-system-for-a-changing-american-society PB - The National Academies Press CY - Washington, DC LA - English KW - Behavioral and Social Sciences AB - 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. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine TI - Reassessment of the Department of Veterans Affairs Airborne Hazards and Open Burn Pit Registry SN - DO - 10.17226/26729 PY - 2022 UR - https://nap.nationalacademies.org/catalog/26729/reassessment-of-the-department-of-veterans-affairs-airborne-hazards-and-open-burn-pit-registry PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - 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. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine TI - Gulf War and Health: Volume 11: Generational Health Effects of Serving in the Gulf War SN - DO - 10.17226/25162 PY - 2018 UR - https://nap.nationalacademies.org/catalog/25162/gulf-war-and-health-volume-11-generational-health-effects-of PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - 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. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine A2 - Alex H. Krist A2 - Jeannette South-Paul A2 - Marc Meisnere TI - Achieving Whole Health: A New Approach for Veterans and the Nation SN - DO - 10.17226/26854 PY - 2023 UR - https://nap.nationalacademies.org/catalog/26854/achieving-whole-health-a-new-approach-for-veterans-and-the PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Whole health is physical, behavioral, spiritual, and socioeconomic well-being as defined by individuals, families, and communities. Whole health care is an interprofessional, team-based approach anchored in trusted relationships to promote well-being, prevent disease, and restore health. It aligns with a person's life mission, aspiration, and purpose. It shifts the focus from a reactive disease-oriented medical care system to one that prioritizes disease prevention, health, and well-being. It changes the health care conversation from "What’s wrong with you?" to "What matters to you?"The Department of Veterans Affairs (VA), the Samueli Foundation, and the Whole Health Institute commissioned the National Academies of Sciences, Engineering, and Medicine to establish a committee to provide guidance on how to fill gaps and create processes to accelerate the transformation to whole health care for veterans, both inside and outside the VA system, and the rest of the U.S. population. The resulting report presents findings and recommendations that provide a roadmap for improving health and well-being for veterans and the nation. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine TI - Veterans and Agent Orange: Update 11 (2018) SN - DO - 10.17226/25137 PY - 2018 UR - https://nap.nationalacademies.org/catalog/25137/veterans-and-agent-orange-update-11-2018 PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - 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. ER -