Consensus
Ending the Tobacco Problem generates a blueprint for the nation in the struggle to reduce tobacco use. The report reviews effective prevention and treatment interventions and considers a set of new tobacco control policies for adoption by federal and state governments. Carefully constructed with two distinct parts, the book first provides background information on the history and nature of tobacco use, developing the context for the policy blueprint proposed in the second half of the report. The report documents the extraordinary growth of tobacco use during the first half of the 20th century as well as its subsequent reversal in the mid-1960s (in the wake of findings from the Surgeon General). It also reviews the addictive properties of nicotine, delving into the factors that make it so difficult for people to quit and examines recent trends in tobacco use. In addition, an overview of the development of governmental and nongovernmental tobacco control efforts is provided.
After reviewing the ethical grounding of tobacco control, the second half of the book sets forth to present a blueprint for ending the tobacco problem. The book offers broad-reaching recommendations targeting federal, state, local, nonprofit and for-profit entities. This book also identifies the benefits to society when fully implementing effective tobacco control interventions and policies.
732 pages
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6 x 9
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hardcover
ISBN Ebook: 0-309-10912-4
DOI:
https://doi.org/10.17226/11795
Institute of Medicine. 2007. Ending the Tobacco Problem: A Blueprint for the Nation. Washington, DC: The National Academies Press.
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Consensus
Public health efforts have resulted in tremendous improvements in the health of individuals and communities. The foundation for effective public health interventions rests, in large part, on a well-trained workforce. Unfortunately there is a major shortage of public health physicians who are prepared to face today's public health challenges.
Training Physicians for Public Health Careers focuses on the critical roles that physicians play in maintaining and strengthening the public health system, identifies what these physicians need to know to engage in effective public health actions, explores the kinds of training programs that can be used to prepare physicians for public health roles, and examines how these training programs can be funded. Medical schools, schools of public health, health care and public health care professionals, medical students and students of public health will find this of special interest.
136 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-10760-1
ISBN Ebook: 0-309-10761-X
DOI:
https://doi.org/10.17226/11915
Institute of Medicine. 2007. Training Physicians for Public Health Careers. Washington, DC: The National Academies Press.
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Workshop
Green Healthcare Institutions : Health, Environment, and Economics, Workshop Summary is based on the ninth workshop in a series of workshops sponsored by the Roundtable on Environmental Health Sciences, Research, and Medicine since the roundtable began meeting in 1998. When choosing workshops and activities, the roundtable looks for areas of mutual concern and also areas that need further research to develop a strong environmental science background.
This workshop focused on the environmental and health impacts related to the design, construction, and operations of healthcare facilities, which are part of one of the largest service industries in the United States. Healthcare institutions are major employers with a considerable role in the community, and it is important to analyze this significant industry. The environment of healthcare facilities is unique; it has multiple stakeholders on both sides, as the givers and the receivers of care. In order to provide optimal care, more research is needed to determine the impacts of the built environment on human health.
The scientific evidence for embarking on a green building agenda is not complete, and at present, scientists have limited information. Green Healthcare Institutions : Health, Environment, and Economics, Workshop Summary captures the discussions and presentations by the speakers and participants; they identified the areas in which additional research is needed, the processes by which change can occur, and the gaps in knowledge.
128 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-10592-7
ISBN Ebook: 0-309-10593-5
DOI:
https://doi.org/10.17226/11878
Institute of Medicine. 2007. Green Healthcare Institutions: Health, Environment, and Economics: Workshop Summary. Washington, DC: The National Academies Press.
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Workshop
Public health officials have the traditional responsibilities of protecting the food supply, safeguarding against communicable disease, and ensuring safe and healthful conditions for the population. Beyond this, public health today is challenged in a way that it has never been before. Starting with the 9/11 terrorist attacks, public health officers have had to spend significant amounts of time addressing the threat of terrorism to human health.
Hurricane Katrina was an unprecedented disaster for the United States. During the first weeks, the enormity of the event and the sheer response needs for public health became apparent. The tragic loss of human life overshadowed the ongoing social and economic disruption in a region that was already economically depressed. Hurricane Katrina reemphasized to the public and to policy makers the importance of addressing long-term needs after a disaster.
On October 20, 2005, the Institute of Medicine's Roundtable on Environmental Health Sciences, Research, and Medicine held a workshop which convened members of the scientific community to highlight the status of the recovery effort, consider the ongoing challenges in the midst of a disaster, and facilitate scientific dialogue about the impacts of Hurricane Katrina on people's health. Environmental Public Health Impacts of Disasters: Hurricane Katrina is the summary of this workshop. This report will inform the public health, first responder, and scientific communities on how the affected community can be helped in both the midterm and the near future. In addition, the report can provide guidance on how to use the information gathered about environmental health during a disaster to prepare for future events.
100 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-10500-5
ISBN Ebook: 0-309-66954-5
DOI:
https://doi.org/10.17226/11840
Institute of Medicine. 2007. Environmental Public Health Impacts of Disasters: Hurricane Katrina: Workshop Summary. Washington, DC: The National Academies Press.
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Workshop
Is there a sufficient evidence base for the U.S. Department of Health and Human Services (HHS) to develop a comprehensive set of physical activity guidelines for Americans? To address this question, the Institute of Medicine (IOM) held a workshop titled "Adequacy of Evidence for Physical Activity Guidelines Development" in Washington, DC on October 23-24, 2006, sponsored by HHS.
The workshop summary includes the presentations and discussions of more than 30 experts who were asked to consider the available evidence related to physical activity and the general population, as well as special population subgroups including children and adolescents, pregnant and postpartum women, older adults, and persons with disabilities. The summary provides an overview of the specific issues of relevance in assessing the quality and breadth of the available evidence.
212 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-10402-5
ISBN Ebook: 0-309-66777-1
DOI:
https://doi.org/10.17226/11819
Institute of Medicine. 2007. Adequacy of Evidence for Physical Activity Guidelines Development: Workshop Summary. Washington, DC: The National Academies Press.
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346 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-10304-5
ISBN Ebook: 0-309-66597-3
DOI:
https://doi.org/10.17226/11750
Institute of Medicine. 2007. The Future of Drug Safety: Promoting and Protecting the Health of the Public. Washington, DC: The National Academies Press.
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Workshop
Biological threats like SARS and natural disasters like the tsunami in Indonesia have devastated entire regions, and quickly exhausted budgetary resources. As the field of environmental health continues to evolve, scientists and others must focus on gaining a better understanding of the links between human health and various environmental factors, and on creating new paradigms and partnerships needed to address these complex environmental health challenges facing society. Global Environmental Health in the 21st Century: From Governmental Regulations to Corporate Social Responsibility: Workshop Summary discusses the role of industry in environmental health, examines programs designed to improve the overall state of environmental health, and explores how governmental and corporate entities can collaborate to manage this industry.
Stakeholders in both the public and private sectors are looking for viable solutions as the complexity of societal problems and risks associated with management and varying regulatory standards continue to increase. Global Environmental Health in the 21st Century draws critical links and provides insight into the current shape of global environmental health. The book recommends expanding environmental management systems (EMS) to encompass a more extensive global network. It also provides a complete assessment of the benefits and costs resulting from implementation of various environmental management systems.
126 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-10380-0
ISBN Ebook: 0-309-66702-X
DOI:
https://doi.org/10.17226/11833
Institute of Medicine. 2007. Global Environmental Health in the 21st Century: From Governmental Regulation to Corporate Social Responsibility: Workshop Summary. Washington, DC: The National Academies Press.
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Consensus
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.
238 pages
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8.5 x 11
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hardcover
ISBN Ebook: 0-309-65706-7
DOI:
https://doi.org/10.17226/11765
Institute of Medicine. 2007. Gulf War and Health: Volume 5: Infectious Diseases. Washington, DC: The National Academies Press.
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Gulf War and Health Volume 4: Health Effects of Serving in the Gulf War summarizes in one place the current status of health effects in veterans deployed to the Persian Gulf irrespective of exposure information. This book reviews, evaluates, and summarizes both peer-reviewed scientific and medical literature addressing the health status of Gulf War veterans.
292 pages
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8.5 x 11
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hardcover
ISBN Ebook: 0-309-65976-0
DOI:
https://doi.org/10.17226/11729
Institute of Medicine. 2006. Gulf War and Health: Volume 4: Health Effects of Serving in the Gulf War. Washington, DC: The National Academies Press.
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Letter
Scientists and policymakers have expressed concerns that the U.S. may soon face a pandemic in which neither vaccines nor sufficient antivirals will be available to protect the public. Some have argued that nonpharmaceutical community containment strategies may help in the absence of sufficient medical interventions. There has been some research - historical and modeling - examining the possible utility of these strategies. This report assesses the possible utility of these strategies and formulates conclusions and recommendations for policymakers. While the report's primary and intended purpose is to advise policymakers, the report will be useful in educating other stakeholders about pandemic influenza, including current state-of-affairs, state of science, and ongoing considerations for confronting the disease.
46 pages
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8.5 x 11
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ISBN Ebook: 0-309-66819-0
DOI:
https://doi.org/10.17226/11800
Institute of Medicine. 2006. Modeling Community Containment for Pandemic Influenza: A Letter Report. Washington, DC: The National Academies Press.
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Amyotrophic lateral sclerosis (ALS) our Lou Gehrig's disease is a fatal, mostly non-familial disease that affects the nervous system of humans by causing the degeneration of nerve cells in the brain and spinal cord. The degeneration halts communication between the nervous system and voluntary muscles in the body. This leads to muscle paralysis and eventually the muscles that aid in breathing are affect; causing respiration to fail. The disease, which affects 20,000-30,000 men and women in the United States at any given time, has no effective treatment; most people with ALS die from respiratory failure within 5 years of the onset of symptoms.
Recent epidemiologic studies report an association between the development of ALS and prior service in the U.S. military. The studies evaluated either veterans of the 1991 Persian Gulf War or veterans who served in the military in the period 1910-1982. Due to these findings, the Department of Veterans Affairs (VA) asked the National Academies to conduct an assessment of the potential relationship between military service and the later development of ALS. The project was assigned to the Institute of Medicine (IOM), which appointed a committee and gave it the task of evaluating the scientific literature on ALS in veterans.
The committee began its work by identifying medical and scientific literature on ALS. PubMed, a database created and managed by the National Library of Medicine. Amyotrophic Lateral Sclerosis in Veterans; Review of the Scientific Literature presents the findings of this committee. The committee reviewed, evaluated, and summarized the scientific literature on ALS in veterans, composed primarily of peer-reviewed, published literature. This report includes the recommendations of the committee.
62 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-10254-5
ISBN Ebook: 0-309-66258-3
DOI:
https://doi.org/10.17226/11757
Institute of Medicine. 2006. Amyotrophic Lateral Sclerosis in Veterans: Review of the Scientific Literature. Washington, DC: The National Academies Press.
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340 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-10169-7
ISBN Ebook: 0-309-65952-3
DOI:
https://doi.org/10.17226/11665
Institute of Medicine. 2006. Asbestos: Selected Cancers. Washington, DC: The National Academies Press.
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In response to growing national concern about the number of veterans who might be at risk for posttraumatic stress disorder (PTSD) as a result of their military service, the Department of Veterans Affairs (VA) asked the Institute of Medicine (IOM) to conduct a study on the diagnosis and assessment of, and treatment and compensation for PTSD. An existing IOM committee, the Committee on Gulf War and Health: Physiologic, Psychologic and Psychosocial Effects of Deployment-Related Stress, was asked to conduct the diagnosis, assessment, and treatment aspects of the study because its expertise was well-suited to the task. The committee was specifically tasked to review the scientific and medical literature related to the diagnosis and assessment of PTSD, and to review PTSD treatments (including psychotherapy and pharmacotherapy) and their efficacy. In addition, the committee was given a series of specific questions from VA regarding diagnosis, assessment, treatment, and compensation.
Posttraumatic Stress Disorder is a brief elaboration of the committee's responses to VA's questions, not a detailed discussion of the procedures and tools that might be used in the diagnosis and assessment of PTSD. The committee decided to approach its task by separating diagnosis and assessment from treatment and preparing two reports. This first report focuses on diagnosis and assessment of PTSD. Given VA's request for the report to be completed within 6 months, the committee elected to rely primarily on reviews and other well-documented sources. A second report of this committee will focus on treatment for PTSD; it will be issued in December 2006. A separate committee, the Committee on Veterans' Compensation for Post Traumatic Stress Disorder, has been established to conduct the compensation study; its report is expected to be issued in December 2006.
86 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-10207-3
ISBN Ebook: 0-309-66078-5
DOI:
https://doi.org/10.17226/11674
Institute of Medicine. 2006. Posttraumatic Stress Disorder: Diagnosis and Assessment. Washington, DC: The National Academies Press.
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The Vietnam War was fought in a jungle environment that provided cover to the enemy and made battlefield observations difficult, so military strategists used herbicides to remove foliage along key roads and waterways, defoliate areas surrounding enemy bases and supply and communications routes, and improve visibility in heavily canopied forests. The last three decades have seen an ongoing debate about the effects of this military use of herbicides and the potential adverse long-term health effects on those who may have been exposed to these herbicides.
In response to these concerns, the Air Force Health Study (AFHS) was created to investigate the potential relationship between the herbicides used and the health problems of those exposed. Disposition of the Air Force Health Study assesses the scientific merit of the AFHS operations and procedures, and makes recommendations for improvement.
276 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-10099-2
ISBN Ebook: 0-309-65685-0
DOI:
https://doi.org/10.17226/11590
Institute of Medicine. 2006. Disposition of the Air Force Health Study. Washington, DC: The National Academies Press.
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Workshop
Throughout much of its history, the United States was predominantly a rural society. The need to provide sustenance resulted in many people settling in areas where food could be raised for their families. Over the past century, however, a quiet shift from a rural to an urban society occurred, such that by 1920, for the first time, more members of our society lived in urban regions than in rural ones. This was made possible by changing agricultural practices. No longer must individuals raise their own food, and the number of person-hours and acreage required to produce food has steadily been decreasing because of technological advances, according to Roundtable member James Merchant of the University of Iowa.
The Institute of Medicine's Roundtable on Environmental Health Science, Research, and Medicine held a regional workshop at the University of Iowa on November 29 and 30, 2004, to look at rural environmental health issues. Iowa, with its expanse of rural land area, growing agribusiness, aging population, and increasing immigrant population, provided an opportunity to explore environmental health in a region of the country that is not as densely populated. As many workshop participants agreed, the shifting agricultural practices as the country progresses from family operations to large-scale corporate farms will have impacts on environmental health.
This report describes and summarizes the participants' presentations to the Roundtable members and the discussions that the members had with the presenters and participants at the workshop.
116 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-10047-X
ISBN Ebook: 0-309-65466-1
DOI:
https://doi.org/10.17226/11596
Institute of Medicine. 2006. Rebuilding the Unity of Health and the Environment in Rural America: Workshop Summary. Washington, DC: The National Academies Press.
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To mitigate the risks posed by microbial threats of public health significance originating abroad, the Centers for Disease Control and Prevention (CDC) places small groups of staff at major U.S. airports. These staff, their offices, and their patient isolation rooms constitute quarantine stations, which are run by CDC's Division of Global Migration and Quarantine (DGMQ).
Congress began to allocate funds in fiscal 2003 for the establishment of new quarantine stations at 17 major U.S. ports of entry that comprise airports, seaports, and land-border crossings. In a significant departure from the recent past, both the preexisting 8 quarantine stations and the new 17 are expected to play an active, anticipatory role in nationwide biosurveillance. Consequently, DGMQ asked the Institute of Medicine (IOM) to convene an expert committee to assess the present CDC quarantine stations and recommend how they should evolve to meet the challenges posed by microbial threats at the nation's gateways. DGMQ specifically requested "an assessment of the role of the federal quarantine stations, given the changes in the global environment including large increases in international travel, threats posed by bioterrorism and emerging infections, and the movement of animals and cargo." To conduct this assessment and provide recommendations, IOM convened, in October 2004, the Committee on Measures to Enhance the Effectiveness of the CDC Quarantine Station Expansion Plan for U.S. Ports of Entry.
At the sponsor's request, the committee released the interim letter report Human Resources at U.S. Ports of Entry to Protect the Public's Health in January 2005 to provide preliminary suggestions for the priority functions of a modern quarantine station, the competences necessary to carry out those functions, and the types of health professionals who have the requisite competences (Appendix A). This, the committee's final report, assesses the present role of the CDC quarantine stations and articulates a vision of their future role as a public health intervention.
334 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-09951-X
ISBN Ebook: 0-309-65313-4
DOI:
https://doi.org/10.17226/11435
Institute of Medicine. 2006. Quarantine Stations at Ports of Entry: Protecting the Public's Health. Washington, DC: The National Academies Press.
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Interim
19 pages
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8.5 x 11
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ISBN Ebook: 0-309-65583-8
DOI:
https://doi.org/10.17226/11483
Institute of Medicine. 2006. Disposition of the Air Force Health Study: Interim Letter Report. Washington, DC: The National Academies Press.
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Symposium_in_brief
The Institute of Medicine (IOM) of the National Academies of Science held a symposium, in memory of Dr. John R. La Montagne on April 4-5, 2005, to discuss the current state of the art of research on pandemic influenza and to identify gaps in research. The symposium serves as a first step of discussion towards a combined and coordinated research effort among Department of Health and Human Services agencies, other governmental agencies, international partners and the private sector. The statement of task that guided the Symposium agenda included these specific questions:
The Proceedings of the John La Montagne Memorial Symposium on Pandemic Influenza Research Gaps represents a slightly edited transcript of the plenary presentations, rapporteur presentations, plenary discussion and presentation slides. This document contains the Symposium agenda, short biographies of plenary speakers, and provides a list of individuals who attended the symposium.
214 pages
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8.5 x 11
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paperback
ISBN Paperback: 0-309-09731-2
ISBN Ebook: 0-309-65376-2
DOI:
https://doi.org/10.17226/11448
Institute of Medicine. 2005. John R. La Montagne Memorial Symposium on Pandemic Influenza Research: Meeting Proceedings. Washington, DC: The National Academies Press.
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