TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine A2 - Laurene Graig A2 - Sylara Marie Cruz A2 - Joe Alper TI - Integrating Health Care and Social Services for People with Serious Illness: Proceedings of a Workshop SN - DO - 10.17226/25350 PY - 2019 UR - https://nap.nationalacademies.org/catalog/25350/integrating-health-care-and-social-services-for-people-with-serious-illness PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - A growing body of research indicates that social determinants of health have a significant impact on health care utilization and outcomes. Researchers and policymakers in the United States have spent decades exploring and discussing approaches to integrating health care and social services. While no nation has a truly integrated system, many other industrialized nations invest more heavily in social services than the United States, and are more effective in integrating these services with health care. Integrating health care and social services, such as accessible housing, meals and nutrition services, transportation, and caregiver training, is particularly important for those facing serious illness who typically encounter multiple chronic conditions, pain and other symptoms, functional dependency, frailty, and significant family caregiver needs. In an effort to better understand and facilitate discussions about the challenges and opportunities related to integrating health care and social services for people with serious illness, the National Academies of Sciences, Engineering, and Medicine held a full-day public workshop on July 19, 2018 in Washington, DC. The workshop featured a broad range of experts and stakeholders including researchers, policy analysts, patient and family caregiving advocates, and representatives of federal agencies. This publication summarizes the presentations and discussions from the workshop. ER - TY - BOOK AU - Institute of Medicine TI - Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research SN - DO - 10.17226/13172 PY - 2011 UR - https://nap.nationalacademies.org/catalog/13172/relieving-pain-in-america-a-blueprint-for-transforming-prevention-care PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Chronic pain costs the nation up to $635 billion each year in medical treatment and lost productivity. The 2010 Patient Protection and Affordable Care Act required the Department of Health and Human Services (HHS) to enlist the Institute of Medicine (IOM) in examining pain as a public health problem. In this report, the IOM offers a blueprint for action in transforming prevention, care, education, and research, with the goal of providing relief for people with pain in America. To reach the vast multitude of people with various types of pain, the nation must adopt a population-level prevention and management strategy. The IOM recommends that HHS develop a comprehensive plan with specific goals, actions, and timeframes. Better data are needed to help shape efforts, especially on the groups of people currently underdiagnosed and undertreated, and the IOM encourages federal and state agencies and private organizations to accelerate the collection of data on pain incidence, prevalence, and treatments. Because pain varies from patient to patient, healthcare providers should increasingly aim at tailoring pain care to each person's experience, and self-management of pain should be promoted. In addition, because there are major gaps in knowledge about pain across health care and society alike, the IOM recommends that federal agencies and other stakeholders redesign education programs to bridge these gaps. Pain is a major driver for visits to physicians, a major reason for taking medications, a major cause of disability, and a key factor in quality of life and productivity. Given the burden of pain in human lives, dollars, and social consequences, relieving pain should be a national priority. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine A2 - Lisa Bain A2 - Sheena M. Posey Norris A2 - Clare Stroud TI - Advancing Therapeutic Development for Pain and Opioid Use Disorders Through Public-Private Partnerships: Proceedings of a Workshop SN - DO - 10.17226/25060 PY - 2018 UR - https://nap.nationalacademies.org/catalog/25060/advancing-therapeutic-development-for-pain-and-opioid-use-disorders-through-public-private-partnerships PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Chronic pain is one of the most prevalent, costly, and disabling health conditions in the United States. Estimates show that more than 11 percent of the American population suffer from chronic pain, yet the federal pain research investment has been minimal. In parallel with a gradual increased recognition of the problems of treating chronic pain, the opioid epidemic has emerged as a growing public health emergency. The intersection of these two crises lies in the fact that an unintended consequence of treating pain has been an increasing number of opioid prescriptions and diversion of drugs for illicit purposes. In May 2017, the National Institutes of Health (NIH), and the National Institute on Drug Abuse announced a public–private partnership to develop solutions to the opioid crisis and cut in half the time it takes to develop non-addictive analgesics. To advance the planning of NIH’s anticipated public–private partnerships, the National Academies’ Forum on Neuroscience and Nervous Systems Disorders hosted a public workshop that brought together a diverse group of stakeholders from academia, federal agencies, advocacy organizations and companies developing therapeutics for pain and opioid use disorders. Participants discussed potential strategies to accelerate development of non-addictive pain medications and treatments for opioid use disorders. This publication summarizes the presentations and discussions from the workshop. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine A2 - Richard J. Bonnie A2 - Morgan A. Ford A2 - Jonathan K. Phillips TI - Pain Management and the Opioid Epidemic: Balancing Societal and Individual Benefits and Risks of Prescription Opioid Use SN - DO - 10.17226/24781 PY - 2017 UR - https://nap.nationalacademies.org/catalog/24781/pain-management-and-the-opioid-epidemic-balancing-societal-and-individual PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Drug overdose, driven largely by overdose related to the use of opioids, is now the leading cause of unintentional injury death in the United States. The ongoing opioid crisis lies at the intersection of two public health challenges: reducing the burden of suffering from pain and containing the rising toll of the harms that can arise from the use of opioid medications. Chronic pain and opioid use disorder both represent complex human conditions affecting millions of Americans and causing untold disability and loss of function. In the context of the growing opioid problem, the U.S. Food and Drug Administration (FDA) launched an Opioids Action Plan in early 2016. As part of this plan, the FDA asked the National Academies of Sciences, Engineering, and Medicine to convene a committee to update the state of the science on pain research, care, and education and to identify actions the FDA and others can take to respond to the opioid epidemic, with a particular focus on informing FDA's development of a formal method for incorporating individual and societal considerations into its risk-benefit framework for opioid approval and monitoring. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine A2 - Lisa Bain A2 - Sheena M. Posey Norris A2 - Clare Stroud TI - The Role of Nonpharmacological Approaches to Pain Management: Proceedings of a Workshop SN - DO - 10.17226/25406 PY - 2019 UR - https://nap.nationalacademies.org/catalog/25406/the-role-of-nonpharmacological-approaches-to-pain-management-proceedings-of PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Pain is a leading cause of disability globally. The dramatic increase in opioid prescriptions within the past decade in the United States has contributed to the opioid epidemic the country currently faces, magnifying the need for longer term solutions to treat pain. The substantial burden of pain and the ongoing opioid crisis have attracted increased attention in medical and public policy communities, resulting in a revolution in thinking about how pain is managed. This new thinking acknowledges the complexity and biopsychosocial nature of the pain experience and the need for multifaceted pain management approaches with both pharmacological and nonpharmacological therapies. The magnitude and urgency of the twin problems of chronic pain and opioid addiction, combined with the changing landscape of pain management, prompted the National Academies of Sciences, Engineering, and Medicine to convene a workshop on December 4–5, 2018, in Washington, DC. The workshop brought together a diverse group of stakeholders to discuss the current status of nonpharmacological approaches to pain management, gaps, and future directions. This publication summarizes the presentations and discussions from the workshop. 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 - Institute of Medicine TI - Pain and Disability: Clinical, Behavioral, and Public Policy Perspectives SN - DO - 10.17226/991 PY - 1987 UR - https://nap.nationalacademies.org/catalog/991/pain-and-disability-clinical-behavioral-and-public-policy-perspectives PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Pain—it is the most common complaint presented to physicians. Yet pain is subjective—it cannot be measured directly and is difficult to validate. Evaluating claims based on pain poses major problems for the Social Security Administration (SSA) and other disability insurers. This volume covers the epidemiology and physiology of pain; psychosocial contributions to pain and illness behavior; promising ways of assessing and measuring chronic pain and dysfunction; clinical aspects of prevention, diagnosis, treatment, and rehabilitation; and how the SSA's benefit structure and administrative procedures may affect pain complaints. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine TI - Framing Opioid Prescribing Guidelines for Acute Pain: Developing the Evidence SN - DO - 10.17226/25555 PY - 2020 UR - https://nap.nationalacademies.org/catalog/25555/framing-opioid-prescribing-guidelines-for-acute-pain-developing-the-evidence PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - The opioid overdose epidemic combined with the need to reduce the burden of acute pain poses a public health challenge. To address how evidence-based clinical practice guidelines for prescribing opioids for acute pain might help meet this challenge, Framing Opioid Prescribing Guidelines for Acute Pain: Developing the Evidence develops a framework to evaluate existing clinical practice guidelines for prescribing opioids for acute pain indications, recommends indications for which new evidence-based guidelines should be developed, and recommends a future research agenda to inform and enable specialty organizations to develop and disseminate evidence-based clinical practice guidelines for prescribing opioids to treat acute pain indications. The recommendations of this study will assist professional societies, health care organizations, and local, state, and national agencies to develop clinical practice guidelines for opioid prescribing for acute pain. Such a framework could inform the development of opioid prescribing guidelines and ensure systematic and standardized methods for evaluating evidence, translating knowledge, and formulating recommendations for practice. ER - TY - BOOK AU - Institute of Medicine A2 - Diana E. Pankevich A2 - Theresa Wizemann A2 - Bruce M. Altevogt TI - Sex Differences and Implications for Translational Neuroscience Research: Workshop Summary SN - DO - 10.17226/13004 PY - 2011 UR - https://nap.nationalacademies.org/catalog/13004/sex-differences-and-implications-for-translational-neuroscience-research-workshop-summary PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Biological differences between the sexes influence not only individual health but also public health, biomedical research, and health care. The Institute of Medicine held a workshop March 8-9, 2010, to discuss sex differences and their implications for translational neuroscience research, which bridges the gap between scientific discovery and application. ER - TY - BOOK AU - National Research Council TI - Recognition and Alleviation of Pain in Laboratory Animals SN - DO - 10.17226/12526 PY - 2009 UR - https://nap.nationalacademies.org/catalog/12526/recognition-and-alleviation-of-pain-in-laboratory-animals PB - The National Academies Press CY - Washington, DC LA - English KW - Biology and Life Sciences AB - The use of animals in research adheres to scientific and ethical principles that promote humane care and practice. Scientific advances in our understanding of animal physiology and behavior often require theories to be revised and standards of practice to be updated to improve laboratory animal welfare. Recognition and Alleviation of Pain in Laboratory Animals, the second of two reports revising the 1992 publication Recognition and Alleviation of Pain and Distress in Laboratory Animals from the Institute for Laboratory Animal Research (ILAR), focuses on pain experienced by animals used in research. This book aims to educate laboratory animal veterinarians; students, researchers and investigators; Institutional Animal Care and Use Committee members; and animal care staff and animal welfare officers on the current scientific and ethical issues associated with pain in laboratory animals. It evaluates pertinent scientific literature to generate practical and pragmatic guidelines for recognizing and alleviating pain in laboratory animals, focusing specifically on the following areas: physiology of pain in commonly used laboratory species; pharmacologic and non-pharmacologic principles to control pain; identification of humane endpoints; and principles for minimizing pain associated with experimental procedures. Finally, the report identifies areas in which further scientific investigation is needed to improve laboratory animal welfare. ER - TY - BOOK AU - Institute of Medicine TI - Psychological Testing in the Service of Disability Determination SN - DO - 10.17226/21704 PY - 2015 UR - https://nap.nationalacademies.org/catalog/21704/psychological-testing-in-the-service-of-disability-determination PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - The United States Social Security Administration (SSA) administers two disability programs: Social Security Disability Insurance (SSDI), for disabled individuals, and their dependent family members, who have worked and contributed to the Social Security trust funds, and Supplemental Security Income (SSSI), which is a means-tested program based on income and financial assets for adults aged 65 years or older and disabled adults and children. Both programs require that claimants have a disability and meet specific medical criteria in order to qualify for benefits. SSA establishes the presence of a medically-determined impairment in individuals with mental disorders other than intellectual disability through the use of standard diagnostic criteria, which include symptoms and signs. These impairments are established largely on reports of signs and symptoms of impairment and functional limitation. Psychological Testing in the Service of Disability Determination considers the use of psychological tests in evaluating disability claims submitted to the SSA. This report critically reviews selected psychological tests, including symptom validity tests, that could contribute to SSA disability determinations. The report discusses the possible uses of such tests and their contribution to disability determinations. Psychological Testing in the Service of Disability Determination discusses testing norms, qualifications for administration of tests, administration of tests, and reporting results. The recommendations of this report will help SSA improve the consistency and accuracy of disability determination in certain cases. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine A2 - Andrew March A2 - Amanda Wagner Gee A2 - Robert Pool A2 - Carolyn Shore TI - Innovation in Drug Research and Development for Prevalent Chronic Diseases: Proceedings of a Workshop SN - DO - 10.17226/26291 PY - 2021 UR - https://nap.nationalacademies.org/catalog/26291/innovation-in-drug-research-and-development-for-prevalent-chronic-diseases PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Investment and innovation in drug research and development (R&D) for highly prevalent chronic diseases has stalled in recent decades, despite half of all Americans living with at least one chronic disease. As a result, prevalent chronic diseases are producing immense health care costs as well as preventable suffering and death. On February 22, March 2, and March 8, 2021, the National Academies of Sciences, Engineering, and Medicine, convened a workshop to discuss barriers to innovation in this space and examine strategies and incentives to support equitable, person-centered drug R&D for prevalent chronic diseases. ER - TY - BOOK AU - National Academy of Medicine TI - First, Do No Harm: Marshaling Clinician Leadership to Counter the Opioid Epidemic SN - DO - 10.17226/27116 PY - 2017 UR - https://nap.nationalacademies.org/catalog/27116/first-do-no-harm-marshaling-clinician-leadership-to-counter-the PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - There is no question that opioid use disorder has become the fastest growing, serious, and far-reaching public health crisis facing our nation today. The growing and unprecedented opioid epidemic is a critical issue for public health and medical care throughout the country. Provisional estimates suggest that nearly 65,000 Americans died from a drug overdose in 2016, a 21% increase from the previous year and at a level higher than occurred during the peak years for deaths from HIV infection and automobile fatalities.Nearly half of opioid overdose deaths are related to medications obtained legally by prescription, sparking deep concern among leaders in the health care sector. The need is clear for clinicians, as the "gatekeepers" of opioid prescriptions, and as the front line in facilitating access to treatment for addiction, to work together with state and community leaders to reduce the impact of opioid misuse on American communities.At the request of the National Governors Association, the National Academy of Medicine convened a group of experts and field leaders to explore clinicians' roles in addressing opioid misuse and addiction. The resulting Special Publication is informed by, and builds on, initiatives and guidelines that have been stewarded by various stakeholder organizations providing leadership in addressing these issues. In the midst of evolving understanding of and experience in pain management and substance abuse, the authors offer to clinicians a set of axioms applicable both to responsible, appropriate opioid prescribing practices, and to recognition and treatment of substance use disorder. Also underscored are actions that clinicians can take to improve their skills and effectiveness in the face of the growing need, including leadership engagement to ensure that communities have the resources and tools that clinicians require to fulfill their responsibilities. ER - TY - BOOK TI - (NAS Colloquium) The Neurobiology of Pain DO - 10.17226/9630 PY - 1999 UR - https://nap.nationalacademies.org/catalog/9630/nas-colloquium-the-neurobiology-of-pain PB - The National Academies Press CY - Washington, DC LA - English KW - Biology and Life Sciences KW - Health and Medicine ER - TY - BOOK AU - Institute of Medicine TI - Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness SN - DO - 10.17226/19012 PY - 2015 UR - https://nap.nationalacademies.org/catalog/19012/beyond-myalgic-encephalomyelitischronic-fatigue-syndrome-redefining-an-illness PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Myalgic encephalomyelitis (ME) and chronic fatigue syndrome (CFS) are serious, debilitating conditions that affect millions of people in the United States and around the world. ME/CFS can cause significant impairment and disability. Despite substantial efforts by researchers to better understand ME/CFS, there is no known cause or effective treatment. Diagnosing the disease remains a challenge, and patients often struggle with their illness for years before an identification is made. Some health care providers have been skeptical about the serious physiological - rather than psychological - nature of the illness. Once diagnosed, patients often complain of receiving hostility from their health care provider as well as being subjected to treatment strategies that exacerbate their symptoms. Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome proposes new diagnostic clinical criteria for ME/CFS and a new term for the illness - systemic exertion intolerance disease(SEID). According to this report, the term myalgic encephalomyelitis does not accurately describe this illness, and the term chronic fatigue syndrome can result in trivialization and stigmatization for patients afflicted with this illness. Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome stresses that SEID is a medical - not a psychiatric or psychological - illness. This report lists the major symptoms of SEID and recommends a diagnostic process.One of the report's most important conclusions is that a thorough history, physical examination, and targeted work-up are necessary and often sufficient for diagnosis. The new criteria will allow a large percentage of undiagnosed patients to receive an accurate diagnosis and appropriate care. Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome will be a valuable resource to promote the prompt diagnosis of patients with this complex, multisystem, and often devastating disorder; enhance public understanding; and provide a firm foundation for future improvements in diagnosis and treatment. ER - TY - BOOK AU - Institute of Medicine TI - Forum on Neuroscience and Nervous System Disorders: 2013 Annual Report DO - 10.17226/26237 PY - 2014 UR - https://nap.nationalacademies.org/catalog/26237/forum-on-neuroscience-and-nervous-system-disorders-2013-annual-report PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine A2 - Erin Hammers Forstag TI - Pain Management and Prescription Opioid-Related Harms: Exploring the State of the Evidence: Proceedings of a Workshop—in Brief DO - 10.17226/23694 PY - 2016 UR - https://nap.nationalacademies.org/catalog/23694/pain-management-and-prescription-opioid-related-harms-exploring-the-state PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - On September 22, 2016, the Committee on Pain Management and Regulatory Strategies to Address Prescription Opioid Abuse held a workshop titled “Pain Management and Prescription Opioid-Related Harms: Exploring the State of the Evidence.” The purpose of this workshop was to gather information about the state of the science and potential best practices in pain management, including the evolving role of opioids in pain management; to understand the epidemiology of the prescription opioid epidemic and discuss possible strategies to address it; and to identify potential areas for future research in the field. Expert speakers were invited to give brief presentations, which were followed by open discussions among the speakers and workshop participants, including committee members. This Proceedings of a Workshop-in Brief highlights the dialogue that emerged from the individual speakers' presentations and the discussions that followed. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine TI - Selected Immune Disorders and Disability SN - DO - 10.17226/26595 PY - 2022 UR - https://nap.nationalacademies.org/catalog/26595/selected-immune-disorders-and-disability PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - The U.S. Social Security Administration (SSA) administers the Social Security Disability Insurance program and the Supplemental Security Income program. As part of their process, immune system disorders are evaluated under Listing of Impairments 14.00 for adults and 114.00 for children. At the request of the SSA, the National Academies of Sciences, Engineering, and Medicine assembled a committee to review selected conditions related to the immune system. In particular, the SSA was interested in the current status of the diagnosis, treatment, and prognosis of immune system disorders including systemic lupus erythematosus (SLE), scleroderma, polymyositis, Sjogren's syndrome/disease, and inflammatory arthritis. This report provides an overview of the current status of the diagnosis, treatment, and prognosis of these immune system disorders in the U.S. population and the relative levels of functional limitation typically associated with them, common treatments, and other considerations. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine TI - A Review of Methods for Detecting Soreness in Horses SN - DO - 10.17226/25949 PY - 2021 UR - https://nap.nationalacademies.org/catalog/25949/a-review-of-methods-for-detecting-soreness-in-horses PB - The National Academies Press CY - Washington, DC LA - English KW - Agriculture AB - During the last century and today, the Tennessee walking horse has been used primarily for pleasure and show competition. Unique and natural to the breed is a smooth four-beat "running walk" gait. In the 1950s the accentuated or exaggerated running walk, known as the "big lick" became popular at high-level competitions. The combination of exaggerated high-action step in front and long stride behind is still considered desirable in today's horse show competitions, and it is often achieved through soring. Soring is the practice of applying a substance or mechanical device to the lower limb of a horse that will create enough pain that the horse will exaggerate its gait to relieve the discomfort. In 1970 Congress put into law the Horse Protection Act (HPA) to specifically address the practice of soring by prohibiting the showing, exhibition, or sale of Tennessee walking horses that are found to be sore. Sadly, soring is still being done even after 50 years of HPA enforcement. This report reviews the methods for detecting soreness in horses, in hopes of advancing the goal of ultimately eliminating the act of soring in horses and improving the welfare of Tennessee walking horses. A Review of Methods for Detecting Soreness in Horses examines what is known about the quality and consistency of available methods to identify soreness in horses; identifies potential new and emerging methods, approaches, and technologies for detecting hoof and pastern pain and its causes; and identifies research and technology needs to improve the reliability of methods to detect soreness. This independent study will help ensure that HPA inspection protocols are based on sound scientific principles that can be applied with consistency and objectivity. ER - TY - BOOK AU - Institute of Medicine AU - National Academies of Sciences, Engineering, and Medicine A2 - Deborah Cory-Slechta A2 - Roberta Wedge TI - Gulf War and Health: Volume 10: Update of Health Effects of Serving in the Gulf War, 2016 SN - DO - 10.17226/21840 PY - 2016 UR - https://nap.nationalacademies.org/catalog/21840/gulf-war-and-health-volume-10-update-of-health-effects 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 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. ER -