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 - 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 - 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 TI - Blue Water Navy Vietnam Veterans and Agent Orange Exposure SN - DO - 10.17226/13026 PY - 2011 UR - https://nap.nationalacademies.org/catalog/13026/blue-water-navy-vietnam-veterans-and-agent-orange-exposure PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - 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. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine TI - An Approach to Evaluate the Effects of Concomitant Prescribing of Opioids and Benzodiazepines on Veteran Deaths and Suicides SN - DO - 10.17226/25532 PY - 2019 UR - https://nap.nationalacademies.org/catalog/25532/an-approach-to-evaluate-the-effects-of-concomitant-prescribing-of-opioids-and-benzodiazepines-on-veteran-deaths-and-suicides PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - 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. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine A2 - Susan J. Debad TI - Facilities Staffing Requirements for the Veterans Health Administration–Resourcing, Workforce Modeling, and Staffing: Proceedings of a Workshop SN - DO - 10.17226/25456 PY - 2019 UR - https://nap.nationalacademies.org/catalog/25456/facilities-staffing-requirements-for-the-veterans-health-administration-resourcing-workforce-modeling-and-staffing PB - The National Academies Press CY - Washington, DC LA - English KW - Behavioral and Social Sciences KW - Health and Medicine AB - In January 2019, the National Academies of Sciences, Engineering, and Medicine convened the 2-day Workshop on Resourcing, Workforce Modeling, and Staffing. This workshop is one of several data-gathering sessions to support the committee’s iterative study. The overarching goal of the study is to help the Veterans Health Administration (VHA) assess the overall resource needs of its Facilities Management Program and to develop budget and staffing methodologies. Such methodologies can provide better justification for ensuring that local VHA programs are adequately and consistently staffed to accomplish the mission and meet all requirements. This publication summarizes the presentations and discussions from the workshop. ER - TY - BOOK AU - Institute of Medicine TI - Long-Term Health Consequences of Exposure to Burn Pits in Iraq and Afghanistan SN - DO - 10.17226/13209 PY - 2011 UR - https://nap.nationalacademies.org/catalog/13209/long-term-health-consequences-of-exposure-to-burn-pits-in-iraq-and-afghanistan PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine KW - Environment and Environmental Studies AB - 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. ER - TY - BOOK AU - Institute of Medicine TI - Gulf War and Health: Volume 8: Update of Health Effects of Serving in the Gulf War SN - DO - 10.17226/12835 PY - 2010 UR - https://nap.nationalacademies.org/catalog/12835/gulf-war-and-health-volume-8-update-of-health-effects PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine KW - Conflict and Security Issues 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 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. 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 - David A. Savitz A2 - Anne N. Styka A2 - David A. Butler TI - Assessment of the Department of Veterans Affairs Airborne Hazards and Open Burn Pit Registry SN - DO - 10.17226/23677 PY - 2017 UR - https://nap.nationalacademies.org/catalog/23677/assessment-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 KW - Environment and Environmental Studies AB - 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. ER - TY - BOOK AU - Institute of Medicine A2 - Stuart Bondurant A2 - Roberta Wedge TI - Combating Tobacco Use in Military and Veteran Populations SN - DO - 10.17226/12632 PY - 2009 UR - https://nap.nationalacademies.org/catalog/12632/combating-tobacco-use-in-military-and-veteran-populations PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - The health and economic costs of tobacco use in military and veteran populations are high. In 2007, the Department of Veterans Affairs (VA) and the Department of Defense (DoD) requested that the Institute of Medicine (IOM) make recommendations on how to reduce tobacco initiation and encourage cessation in both military and veteran populations. In its 2009 report, Combating Tobacco in Military and Veteran Populations, the authoring committee concludes that to prevent tobacco initiation and encourage cessation, both DoD and VA should implement comprehensive tobacco-control programs. 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 - 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 - National Academies of Sciences, Engineering, and Medicine A2 - Laura Yoder TI - Community Interventions to Prevent Veteran Suicide: The Role of Social Determinants: Proceedings of a Virtual Symposium SN - DO - 10.17226/26638 PY - 2022 UR - https://nap.nationalacademies.org/catalog/26638/community-interventions-to-prevent-veteran-suicide-the-role-of-social PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine KW - Behavioral and Social Sciences AB - On March 28 and 29, 2022, the Board on Behavioral, Cognitive, and Sensory Sciences at the National Academies of Sciences, Engineering, and Medicine held a virtual symposium entitled Community Interventions to Prevent Veteran Suicide: The Role of Social Determinants to gain a better understanding of social determinants influencing the recent increase in suicide risk and how currently available practice guidelines can inform community-level preventive interventions, particularly those targeting veteran populations. Presenters and participants explored the relevant social, cultural, and economic factors driving changes in suicide risk among veterans and ways that current best practices for suicide prevention and treatment can be applied at the community level. This publication summarizes the presentations and discussion of the symposium. 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 - Institute of Medicine TI - Post-Vietnam Dioxin Exposure in Agent Orange-Contaminated C-123 Aircraft SN - DO - 10.17226/18848 PY - 2015 UR - https://nap.nationalacademies.org/catalog/18848/post-vietnam-dioxin-exposure-in-agent-orange-contaminated-c-123-aircraft PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - From 1972 to 1982, approximately 1,500-2,100 US Air Force Reserve personnel trained and worked on C-123 aircraft that had formerly been used to spray herbicides in Vietnam as part of Operation Ranch Hand. After becoming aware that some of the aircraft on which they had worked had previously served this purpose, some of these AF Reservists applied to the US Department of Veterans Affairs (VA) for compensatory coverage under the Agent Orange Act of 1991. The Act provides health care and disability coverage for health conditions that have been deemed presumptively service-related for herbicide exposure during the Vietnam War. The VA denied the applications on the basis that these veterans were ineligible because as non-Vietnam-era veterans or as Vietnam-era veterans without "boots on the ground" service in Vietnam, they were not covered. However, with the knowledge that some air and wipe samples taken between 1979 and 2009 from some of the C-123s used in Operation Ranch Hand showed the presence of agent orange residues, representatives of the C-123 Veterans Association began a concerted effort to reverse VA's position and obtain coverage. At the request of the VA, Post-Vietnam Dioxin Exposure in Agent Orange-Contaminated C-123 Aircraft evaluates whether or not service in these C-123s could have plausibly resulted in exposures detrimental to the health of these Air Force Reservists. The Institute of Medicine assembled an expert committee to address this question qualitatively, but in a scientific and evidence-based fashion. This report evaluates the reliability of the available information for establishing exposure and addresses and places in context whether any documented residues represent potentially harmful exposure by characterizing the amounts available and the degree to which absorption might be expected. Post-Vietnam Dioxin Exposure rejects the idea that the dioxin residues detected on interior surfaces of the C-123s were immobile and effectively inaccessible to the Reservists as a source of exposure. Accordingly, this report states with confidence that the Air Force Reservists were exposed when working in the Operation Ranch Hand C-123s and so experienced some increase in their risk of a variety of adverse responses. ER - TY - BOOK AU - Institute of Medicine TI - Gulf War and Health: Volume 7: Long-Term Consequences of Traumatic Brain Injury SN - DO - 10.17226/12436 PY - 2009 UR - https://nap.nationalacademies.org/catalog/12436/gulf-war-and-health-volume-7-long-term-consequences-of PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - 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. ER - TY - BOOK AU - Institute of Medicine AU - National Academies of Sciences, Engineering, and Medicine TI - Assessing Health Outcomes Among Veterans of Project SHAD (Shipboard Hazard and Defense) SN - DO - 10.17226/21846 PY - 2016 UR - https://nap.nationalacademies.org/catalog/21846/assessing-health-outcomes-among-veterans-of-project-shad-shipboard-hazard-and-defense PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Between 1963 and 1969, the U.S. military carried out a series of tests, termed Project SHAD (Shipboard Hazard and Defense), to evaluate the vulnerabilities of U.S. Navy ships to chemical and biological warfare agents. These tests involved use of active chemical and biological agents, stimulants, tracers, and decontaminants. Approximately 5,900 military personnel, primarily from the Navy and Marine Corps, are reported to have been included in Project SHAD testing. In the 1990s some veterans who participated in the SHAD tests expressed concerns to the Department of Veterans Affairs (VA) that they were experiencing health problems that might be the result of exposures in the testing. These concerns led to a 2002 request from VA to the Institute of Medicine (IOM) to carry out an epidemiological study of the health of SHAD veterans and a comparison population of veterans who had served on similar ships or in similar units during the same time period. In response to continuing concerns, Congress in 2010 requested an additional IOM study. This second study expands on the previous IOM work by making use of additional years of follow up and some analysis of diagnostic data from Medicare and the VA health care system. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine TI - Evaluation of the Department of Veterans Affairs Mental Health Services SN - DO - 10.17226/24915 PY - 2018 UR - https://nap.nationalacademies.org/catalog/24915/evaluation-of-the-department-of-veterans-affairs-mental-health-services PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - 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. 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 -