Harnessing Full Value from the DoD Serum Repository and the Defense Medical Surveillance System


Book Description

"The Army manages the Department of Defense Serum Repository (DoDSR) of over 43 million serum samples and the associated Defense Medical Surveillance System (DMSS) database that links individual service member characteristics to these biological samples. The main mission and use of these resources has been for military health surveillance. The Army turned to RAND Arroyo Center to systematically examine current requirements and capabilities of the DoDSR and DMSS, identify gaps, and suggest strategies to improve their ability to meet current and potential future military health needs in the areas of surveillance, outbreak investigation, research, and clinical support, particularly as these relate to influenza and other infectious disease threats. The research drew information from written documents and interviews with military and civilian experts. The study identified a number of opportunities to improve the management, content, and use of the serum repository and associated database. There were six main recommendations: (1) clarify and communicate the missions of the DoDSR and DMSS both within and beyond DoD; 92) empower, structure, and resource the organizational oversight of DoDSR and DMSS so that they can fulfill the full range of their missions; (3) create an integrative data plan for comprehensive health surveillance; (4) enhance the utility of specimens; (5) plan for the next repository facility; and (6) raise awareness of and expand access to DoDSR and DMSS."--P. [4] of cover.




Respiratory Health Effects of Airborne Hazards Exposures in the Southwest Asia Theater of Military Operations


Book Description

More than 3.7 million U.S. service members have participated in operations taking place in the Southwest Asia Theater of Military Operations since 1990. These operations include the 1990-1991 Persian Gulf War, a post-war stabilization period spanning 1992 through September 2001, and the campaigns undertaken in the wake of the September 11, 2001, attacks. Deployment to Iraq, Kuwait, Saudi Arabia, Bahrain, Gulf of Aden, Gulf of Oman, Oman, Qatar, the United Arab Emirates, and Afghanistan exposed service members to a number of airborne hazards, including oil-well fire smoke, emissions from open burn pits, dust and sand suspended in the air, and exhaust from diesel vehicles. The effects of these were compounded by stressors like excessive heat and noise that are inevitable attributes of service in a combat environment. Respiratory Health Effects of Airborne Hazards Exposures in the Southwest Asia Theater of Military Operations reviews the scientific evidence regarding respiratory health outcomes in veterans of the Southwest Asia conflicts and identifies research that could feasibly be conducted to address outstanding questions and generate answers, newly emerging technologies that could aid in these efforts, and organizations that the Veterans Administration might partner with to accomplish this work.




Science, the Endless Frontier


Book Description

The classic case for why government must support science—with a new essay by physicist and former congressman Rush Holt on what democracy needs from science today Science, the Endless Frontier is recognized as the landmark argument for the essential role of science in society and government’s responsibility to support scientific endeavors. First issued when Vannevar Bush was the director of the US Office of Scientific Research and Development during the Second World War, this classic remains vital in making the case that scientific progress is necessary to a nation’s health, security, and prosperity. Bush’s vision set the course for US science policy for more than half a century, building the world’s most productive scientific enterprise. Today, amid a changing funding landscape and challenges to science’s very credibility, Science, the Endless Frontier resonates as a powerful reminder that scientific progress and public well-being alike depend on the successful symbiosis between science and government. This timely new edition presents this iconic text alongside a new companion essay from scientist and former congressman Rush Holt, who offers a brief introduction and consideration of what society needs most from science now. Reflecting on the report’s legacy and relevance along with its limitations, Holt contends that the public’s ability to cope with today’s issues—such as public health, the changing climate and environment, and challenging technologies in modern society—requires a more capacious understanding of what science can contribute. Holt considers how scientists should think of their obligation to society and what the public should demand from science, and he calls for a renewed understanding of science’s value for democracy and society at large. A touchstone for concerned citizens, scientists, and policymakers, Science, the Endless Frontier endures as a passionate articulation of the power and potential of science.




Respiratory Health Effects of Airborne Hazards Exposures in the Southwest Asia Theater of Military Operations


Book Description

More than 3.7 million U.S. service members have participated in operations taking place in the Southwest Asia Theater of Military Operations since 1990. These operations include the 1990-1991 Persian Gulf War, a post-war stabilization period spanning 1992 through September 2001, and the campaigns undertaken in the wake of the September 11, 2001, attacks. Deployment to Iraq, Kuwait, Saudi Arabia, Bahrain, Gulf of Aden, Gulf of Oman, Oman, Qatar, the United Arab Emirates, and Afghanistan exposed service members to a number of airborne hazards, including oil-well fire smoke, emissions from open burn pits, dust and sand suspended in the air, and exhaust from diesel vehicles. The effects of these were compounded by stressors like excessive heat and noise that are inevitable attributes of service in a combat environment. Respiratory Health Effects of Airborne Hazards Exposures in the Southwest Asia Theater of Military Operations reviews the scientific evidence regarding respiratory health outcomes in veterans of the Southwest Asia conflicts and identifies research that could feasibly be conducted to address outstanding questions and generate answers, newly emerging technologies that could aid in these efforts, and organizations that the Veterans Administration might partner with to accomplish this work.




Registries for Evaluating Patient Outcomes


Book Description

This User’s Guide is intended to support the design, implementation, analysis, interpretation, and quality evaluation of registries created to increase understanding of patient outcomes. For the purposes of this guide, a patient registry is an organized system that uses observational study methods to collect uniform data (clinical and other) to evaluate specified outcomes for a population defined by a particular disease, condition, or exposure, and that serves one or more predetermined scientific, clinical, or policy purposes. A registry database is a file (or files) derived from the registry. Although registries can serve many purposes, this guide focuses on registries created for one or more of the following purposes: to describe the natural history of disease, to determine clinical effectiveness or cost-effectiveness of health care products and services, to measure or monitor safety and harm, and/or to measure quality of care. Registries are classified according to how their populations are defined. For example, product registries include patients who have been exposed to biopharmaceutical products or medical devices. Health services registries consist of patients who have had a common procedure, clinical encounter, or hospitalization. Disease or condition registries are defined by patients having the same diagnosis, such as cystic fibrosis or heart failure. The User’s Guide was created by researchers affiliated with AHRQ’s Effective Health Care Program, particularly those who participated in AHRQ’s DEcIDE (Developing Evidence to Inform Decisions About Effectiveness) program. Chapters were subject to multiple internal and external independent reviews.




The Domestic and International Impacts of the 2009-H1N1 Influenza A Pandemic


Book Description

In March and early April 2009, a new, swine-origin 2009-H1N1 influenza A virus emerged in Mexico and the United States. During the first few weeks of surveillance, the virus spread by human-to-human transmission worldwide to over 30 countries. On June 11, 2009, the World Health Organization (WHO) raised the worldwide pandemic alert level to Phase 6 in response to the ongoing global spread of the novel influenza A (H1N1) virus. By October 30, 2009, the H1N1 influenza A had spread to 191 countries and resulted in 5,700 fatalities. A national emergency was declared in the United States and the swine flu joined SARS and the avian flu as pandemics of the 21st century. Vaccination is currently available, but in limited supply, and with a 60 percent effectiveness rate against the virus. The story of how this new influenza virus spread out of Mexico to other parts of North America and then on to Europe, the Far East, and now Australia and the Pacific Rim countries has its origins in the global interconnectedness of travel, trade, and tourism. Given the rapid spread of the virus, the international scientific, public health, security, and policy communities had to mobilize quickly to characterize this unique virus and address its potential effects. The World Health Organization and Centers for Disease Control have played critical roles in the surveillance, detection and responses to the H1N1 virus. The Domestic and International Impacts of the 2009-H1N1 Influenza A Pandemic: Global Challenges, Global Solutions aimed to examine the evolutionary origins of the H1N1 virus and evaluate its potential public health and socioeconomic consequences, while monitoring and mitigating the impact of a fast-moving pandemic. The rapporteurs for this workshop reported on the need for increased and geographically robust global influenza vaccine production capacities; enhanced and sustained interpandemic demand for seasonal influenza vaccines; clear "triggers" for pandemic alert levels; and accelerated research collaboration on new vaccine manufacturing techniques. This book will be an essential guide for healthcare professionals, policymakers, drug manufacturers and investigators.




Eyes Behind the Lines: US Army Long-Range Reconnaissance and Surveillance Units


Book Description

Eyes Behind the Lines: US Army Long-Range Reconnaissance and Surveillance Units is the 10th study in the Combat Studies Institute (CSI) Global War on Terrorism (GWOT) Occasional Paper series. This work is an outgrowth of concerns identified by the authors of On Point: The United States Army in Operation IRAQI FREEDOM. Specifically, these authors called into question the use of long-range surveillance (LRS) assets by commanders during that campaign and suggested an assessment ought to be made about their continuing utility and means of employment. This revision contains some important additional information the author received after this book was originally published Major (Retired) James Gebhardt, of CSI, researched and wrote this Occasional Paper with that end in view. In this study, Gebhardt surveys the US Army s historical experience with LRRP and LRS units from the 1960s Cold War and Vietnam War, through their resurgence in the 1980s and use in Operations JUST CAUSE and DESERT STORM, to the advent of the GWOT. The paper's analytical framework examines each era of LRS units in terms of doctrine, organization, training, materiel, leadership, and personnel. In doing so, the author makes a strong case for continuing the LRS capability in the Army s force structure. The variety of environments and enemies likely to be faced by the military in the GWOT continues to demand the unique human intelligence abilities of trained and organized LRS units. As the Army leads the Armed Forces of the United States in combating terrorists where they live, the lessons found in this survey remain timely and relevant.




Preparing for Future Products of Biotechnology


Book Description

Between 1973 and 2016, the ways to manipulate DNA to endow new characteristics in an organism (that is, biotechnology) have advanced, enabling the development of products that were not previously possible. What will the likely future products of biotechnology be over the next 5â€"10 years? What scientific capabilities, tools, and/or expertise may be needed by the regulatory agencies to ensure they make efficient and sound evaluations of the likely future products of biotechnology? Preparing for Future Products of Biotechnology analyzes the future landscape of biotechnology products and seeks to inform forthcoming policy making. This report identifies potential new risks and frameworks for risk assessment and areas in which the risks or lack of risks relating to the products of biotechnology are well understood.







Global Tuberculosis Report 2019


Book Description

WHO has published a global TB report every year since 1997. The main aim of the report is to provide a comprehensive and up-to-date assessment of the TB epidemic, and of progress in prevention, diagnosis and treatment of the disease, at global, regional and country levels. This is done in the context of recommended global TB strategies and targets endorsed by WHO?s Member States, broader development goals set by the United Nations (UN) and targets set in the political declaration at the first UN high-level meeting on TB (held in September 2018). The 2019 edition of the global TB report was released on 17 October 2019. The data in this report are updated annually. Please note that direct comparisons between estimates of TB disease burden in the latest report and previous reports are not appropriate. The most recent time-series of estimates are published in the 2019 global TB report.