Common diseases cost the developing world an enormous amount in terms of human life, health, and productivity, as well as lost economic potential. New and effective vaccines could not only improve the quality of life for millions of residents in developing countries, they could also contribute substantially to further economic development. Using data from the World Health Organization and other international agencies, this book analyzes disease burdens, pathogen descriptions, geographic distribution of diseases, probable vaccine target populations, alternative control measures and treatments, and future prospects for vaccine development. New Vaccine Development provides valuable insight into immunological and international health policy priorities.

New Vaccine Development: Establishing Priorities: Volume II, Diseases of Importance in Developing Countries

Medical Books

Division of Health Promotion and Disease Prevention

Board on Population Health and Public Health Practice

INSTITUTE OF MEDICINE

Division of International Health

Administration & Medicine Economics

National Academies Press

The early to mid-1990s saw a large surge in U.S. cigar consumption, including premium cigars. Based on recent import data, premium cigar use may be increasing, though they currently make up a small percent of the total U.S. cigar market. Premium cigars have also been the subject of legal and regulatory efforts for the past decade. In 1998, the National Cancer Institute undertook a comprehensive review of available knowledge about cigars - the only one to date. The resulting research recommendations have largely not been addressed, and many of the identified information gaps persist. Furthermore, there is no single, consistent definition of premium cigars, making research challenging. 
In response, the Food and Drug Administration (FDA) and the National Institutes of Health commissioned the National Academies of Sciences, Engineering, and Medicine to convene a committee of experts to address this issue. The resulting report, Premium Cigars: Patterns of Use, Marketing, and Health Effects, includes 13 findings, 24 conclusions, and nine priority research recommendations and assesses the state of evidence on premium cigar characteristics, current patterns of use, marketing and perceptions of the product, and short- long-term health effects.

Premium Cigars: Patterns of Use, Marketing, and Health Effects

National Academies of Sciences, Engineering, and Medicine

Health and Medicine Division

Committee on Patterns of Use and Health Effects of "Premium Cigars" and Priority Research

Community Power in Population Health Improvement: Proceedings of a Workshop

Roundtable on Population Health Improvement

The United States faces an alarmingly high rate of maternal morbidity and mortality, distinguishing it from other high-income countries that have achieved decreases in these rates in recent years. U.S. maternal morbidity and mortality rates are disproportionate across racial, ethnic, socioeconomic, and geographic groups. Statistics on maternal health outcomes reveal that there are challenges to protecting both the lives and future health of birthing people and their children. Recognizing the urgency of this growing problem, the National Academies Board on Population Health and Public Health Practice convened a 2-day virtual workshop, Advancing Maternal Health Equity and Reducing Maternal Mortality. The workshop examined the current state of maternal health in the United States and explored the factors needed to help communities and health care systems become more effective in reducing maternal morbidity and mortality and improving health outcomes through the fourth trimester. This publication summarizes the presentations and discussions of the workshop.

Advancing Maternal Health Equity and Reducing Maternal Morbidity and Mortality: Proceedings of a Workshop

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.  Table of ContentsFront MatterExecutive Summary1 Introduction2 Context and Content of the CDC Quarantine Station Expansion Plan3 Today's CDC Quarantine Stations at U.S. Ports of Entry4 Bridge from Present to Future: Vision and RecommendationsAppendix A: Human Resources at U.S. Ports of Entry to Protect the Public's Health: Interim Letter ReportAppendix B: Agendas of Open Sessions of Committee MeetingsAppendix C: Methodology Used by the Division of Global Migration and Quarantine to Select Sites for New Quarantine StationsAppendix D: Commissioned Paper on US Seaports and the CDC Quarantine Station SystemAppendix E: Microbial Threats of Public Health Significance Originating in Animals or Animal Products at U.S. Ports of EntryAppendix F: International Legal Considerations for the Quarantine Station ExpansionAppendix G: Excerpts from a Standard Memorandum of Agreement Between CDC and Local HospitalsAppendix H: Committee Biographies

Quarantine Stations at Ports of Entry: Protecting the Public's Health (Coronavirus Resources)

Engineering & Transportation

Board on Global Health

Committee on Measures to Enhance the Effectiveness of the CDC Quarantine Station Expansion Plan for U.S. Ports of Entry

Transportation

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. Table of Contents <ul>
<li>FrontMatter</li>
<li>Summary</li>
<li>Introduction</li>
<li>1 Environmental Health in Rural America</li>
<li>2 The Social Environment in Rural America</li>
<li>3 The Role of the Natural Environment in Rural America</li>
<li>4 The Built Environment and Health in Rural Areas</li>
<li>References</li>
<li>A Workshop Agenda</li>
<li>B Speakers and Panelists</li>
<li>C Meeting Participants</li>
</ul>

Rebuilding the Unity of Health and the Environment in Rural America: Workshop Summary

Roundtable on Environmental Health Sciences, Research, and Medicine

Health, Fitness & Dieting

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. Table of Contents <ul>
<li>Front Matter</li>
<li>Summary</li>
<li>1 Introduction</li>
<li>2 Methodology</li>
<li>3 Infectious Diseseases Endemic to Southwest and South-central Asia the have Long-Term Adverse Health Outcomes</li>
<li>4 Infectious Diseases Diagnosed in U.S. Troops Who Served in the Persian Gulf War, Operation Enduring Freedom, or Operation Iraqi Freedom</li>
<li>5 Levels of Association Between Select Diseases and Long-Term Adverse Health Outcomes</li>
<li>6 Diseases and Agents of Special Concern to Veterans of the Gulf War, Operation Iraqi Freedom, and Operation Enduring Freedom</li>
<li>A Biographical Sketches for Members of the Committee</li>
<li>Index</li>
</ul>

Gulf War and Health: Volume 5: Infectious Diseases

History

Committee on Gulf War and Health: Infectious Diseases

Middle East

In 1998, in response to the growing concerns that many returning Gulf War veterans began reporting numerous health problems that they believed to be associated with their service in the Persian Gulf, Congress passed two laws which directed the Secretary of Veterans Affairs to enter into a contract with the National Academy of Sciences. They were tasked 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 associated with Gulf War service. In addition, the Institute of Medicine of the National Academy of Sciences provided conclusions to these studies that were considered when making decisions about compensation to veterans. 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. Table of Contents <ul>
<li>Front Matter</li>
<li>Summary</li>
<li>1 Introduction</li>
<li>2 Exposures in the Persian Gulf</li>
<li>3 Considerations in Identifying and Evaluating the Literature</li>
<li>4 Major Cohort Studies</li>
<li>5 Health Outcomes</li>
<li>6 Conclusions and Recommendations</li>
<li>Index</li>
</ul>

Gulf War and Health: Volume 4: Health Effects of Serving in the Gulf War

Committee on Gulf War and Health: A Review of the Medical Literature Relative to the Gulf War Veterans' Health

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. Table of Contents <ul>
<li>Front Matter</li>
<li>SUMMARY</li>
<li>1 INTRODUCTION</li>
<li>2 CONSIDERATIONS IN IDENTIFYING AND EVALUATING THE LITERATURE</li>
<li>3 DEPLOYMENT-RELATED STRESSORS</li>
<li>4 THE STRESS RESPONSE</li>
<li>5 POSTTRAUMATIC STRESS DISORDER</li>
<li>6 HEALTH EFFECTS</li>
<li>7 PSYCHOSOCIAL EFFECTS</li>
<li>8 CONCLUSIONS AND RECOMMENDATIONS</li>
<li>INDEX</li>
</ul>

Gulf War and Health: Volume 6: Physiologic, Psychologic, and Psychosocial Effects of Deployment-Related Stress (Veterans Health)

Committee on Gulf War and Health: Physiologic, Psychologic, and Psychosocial Effects of Deployment-Related Stress

Mental Health

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.  Table of ContentsFront MatterSummary1 Introduction2 Diagnosis and Assessment3 Assessment InstrumentsAppendix A: Specific Questions Posed by the Department of Veterans Affairs to the Institute of MedicineAppendix B: Establishing Posttraumatic Stress Disorder as a Psychiatric DisorderAppendix C: Risk and Protective Factors

Posttraumatic Stress Disorder: Diagnosis and Assessment

Subcommittee on Posttraumatic Stress Disorder

Engineering

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