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Review of Department of Defense Test Protocols for Combat Helmets - National Research Council - Bog - National Academies Press - Plusbog.dk

Review of Department of Defense Test Protocols for Combat Helmets - National Research Council - Bog - National Academies Press - Plusbog.dk

Combat helmets have evolved considerably over the years from those used in World War I to today's Advanced Combat Helmet. One of the key advances was the development of aramid fibers in the 1960s, which led to today's Kevlar-based helmets. The Department of Defense is continuing to invest in research to improve helmet performance, through better design and materials as well as better manufacturing processes. Review of the Department of Defense Test Protocols for Combat Helmets considers the technical issues relating to test protocols for military combat helmets. At the request of the DOD Director of Operational Test and Evaluation, this report evaluates the adequacy of the Advanced Combat Helmet test protocol for both first article testing and lot acceptance testing, including its use of the metrics of probability of no penetration and the upper tolerance limit (used to evaluate backface deformation). The report evaluates appropriate use of statistical techniques in gathering data; adequacy of current helmet testing procedures; procedures for the conduct of additional analysis of penetration and backface deformation data; and scope of characterization testing relative to the benefit of the information obtained.

DKK 344.00
1

Combat Vehicle Weight Reduction by Materials Substitution - Defense Materials Manufacturing And Infrastructure Standing Committee - Bog - National

Combat Vehicle Weight Reduction by Materials Substitution - Defense Materials Manufacturing And Infrastructure Standing Committee - Bog - National

Vehicle weight reduction is an effective strategy for reducing fuel consumption in civilian vehicles. For combat vehicles, it presents not only an important opportunity to reduce fuel use and associated logistics, but also important advantages in transport and mobility on the battlefield. Although there have been numerous efforts in the past to reduce the overall weight of combat vehicles, combat vehicle weight has continued to increase over time due to new threats and missions. On December 8 and 9, 2014, the National Academies of Sciences, Engineering, and Medicine held a workshop to explore opportunities in lightweight materials for armored vehicles. This was the ninth workshop in an ongoing series for the U.S. military on materials and manufacturing issues. The workshop discussed future advances in weight reduction by materials substitution for vehicles, including such topics as armor, structure, automotive parts, and armaments. This publication summarizes the presentations and discussions from the workshop. Table of ContentsFront MatterIntroductionPlenary Session: Combat Vehicle Weight Reduction - The U.S. Army Research ChallengeTopic 1: ArmorTopic 2: Structure and Automotive IssuesPanel Session: Implications for Armor/Structure and Automotive IssuesTopic 3: System Effects and TestingConcluding RemarksAppendixesAppendix A: Statement of TaskAppendix B: Workshop ParticipantsAppendix C: Workshop AgendaAppendix D: Acronyms

DKK 422.00
1

2022 Assessment of the DEVCOM Army Research Laboratory - Division On Engineering And Physical Sciences - Bog - National Academies Press - Plusbog.dk

2022 Assessment of the DEVCOM Army Research Laboratory - Division On Engineering And Physical Sciences - Bog - National Academies Press - Plusbog.dk

The U.S. Army Combat Capabilities Development Command (DEVCOM) Amy Research Laboratory (ARL) focuses on cutting-edge scientific discovery, technological innovation, and transition of knowledge products that offer great potential to strengthen the U.S. Army. The mission of the ARL is to operationalize science for transformational overmatch in support of persistent Army modernization. At the request of the DEVCOM Army Research Laboratory, this report provides an assessment of the scientific and technical quality of the ARL, with findings and recommendations related to the quality of ARL research, development, and analysis programs. Table of ContentsFront MatterSummary1 Introduction2 Humans in Complex Systems3 Terminal Effects4 Weapons Sciences5 Competency Conclusions and Recommendations and Crosscutting Conclusions and RecommendationsAppendixesAppendix A: Army Research Laboratory Technical Assessment Board Biographical InformationAppendix B: The U.S. Army Combat Capabilities Development Command Army Research Laboratory's 11 Competencies and Core CompetenciesAppendix C: 2022 Assessment CriteriaAppendix D: Acronyms and Abbreviations

DKK 201.00
1

Opportunities in Biotechnology for Future Army Applications - National Research Council - Bog - National Academies Press - Plusbog.dk

Opportunities in Biotechnology for Future Army Applications - National Research Council - Bog - National Academies Press - Plusbog.dk

This report surveys opportunities for future Army applications in biotechnology, including sensors, electronics and computers, materials, logistics, and medical therapeutics, by matching commercial trends and developments with enduring Army requirements. Several biotechnology areas are identified as important for the Army to exploit, either by direct funding of research or by indirect influence of commercial sources, to achieve significant gains in combat effectiveness before 2025.

DKK 351.00
1

Nutrient Composition of Rations for Short-Term, High-Intensity Combat Operations - Food And Nutrition Board - Bog - National Academies Press -

Nutrient Composition of Rations for Short-Term, High-Intensity Combat Operations - Food And Nutrition Board - Bog - National Academies Press -

Recognizing the importance of good nutrition for physical and mental status, the Department of Defense asked the Institute of Medicine to guide the design of the nutritional composition of a ration for soldiers on short-term, high-stress missions. This book considers military performance, health concerns, food intake, and food technology issues.

DKK 448.00
1

Police Strategies to Control High-Level Corruption - Division Of Behavioral And Social Sciences And Education - Bog - National Academies Press -

Police Strategies to Control High-Level Corruption - Division Of Behavioral And Social Sciences And Education - Bog - National Academies Press -

The US Department of State, Bureau of International Narcotics and Law Enforcement (INL) provides assistance and supports capacity building for criminal justice systems and police organizations in approximately 90 countries. In order to support and inform that work, this report explores high-level corruption and its effects on police organizations, as well as strategies that police can use to effectively contribute to efforts to combat that corruption. Table of ContentsFront MatterExecutive Summary1 Introduction2 Case Studies of Anti-Corruption Initiatives3 The Need to Generate KnowledgeReferencesAppendix: Biographical Sketches of Committee Members and Staff

DKK 195.00
1

Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations - Institute Of Medicine - Bog - National Academies Press - Plusbog.dk

Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations - Institute Of Medicine - Bog - National Academies Press - Plusbog.dk

Prior to the military conflicts in Iraq and Afghanistan, wars and conflicts have been characterized by such injuries as infectious diseases and catastrophic gunshot wounds. However, the signature injuries sustained by United States military personnel in these most recent conflicts are blast wounds and the psychiatric consequences to combat, particularly posttraumatic stress disorder (PTSD), which affects an estimated 13 to 20 percent of U.S. service members who have fought in Iraq or Afghanistan since 2001. PTSD is triggered by a specific traumatic event - including combat - which leads to symptoms such as persistent re-experiencing of the event; emotional numbing or avoidance of thoughts, feelings, conversations, or places associated with the trauma; and hyperarousal, such as exaggerated startle responses or difficulty concentrating. As the U.S. reduces its military involvement in the Middle East, the Departments of Defense (DoD) and Veterans Affairs (VA) anticipate that increasing numbers of returning veterans will need PTSD services. As a result, Congress asked the DoD, in consultation with the VA, to sponsor an IOM study to assess both departments' PTSD treatment programs and services. Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations: Initial Assessment is the first of two mandated reports examines some of the available programs to prevent, diagnose, treat, and rehabilitate those who have PTSD and encourages further research that can help to improve PTSD care.

DKK 390.00
1

Equipping Tomorrow's Military Force - Board On Manufacturing And Engineering Design - Bog - National Academies Press - Plusbog.dk

Equipping Tomorrow's Military Force - Board On Manufacturing And Engineering Design - Bog - National Academies Press - Plusbog.dk

Owing to the expected nature of combat in 2010, U.S. military forces face a pressing need to transform themselves for rapid response to an unpredictable threat. Rapid advances in commercial technology (particularly in electronics), coupled with the easy access to commercial technology enjoyed by potential adversaries, will compel DOD and defense contractors to excel at integrating commercial technology into defense systems. This integration of commercial and military manufacturing (ICMM) has begun on a small scale. By 2010, it needs to increase substantially if U.S. forces are to retain a technological edge. This report assesses the opportunities for increased ICMM in 2010 and beyond, identifies barriers, and recommends strategies for overcoming them.

DKK 305.00
1

Reducing the Logistics Burden for the Army After Next - National Research Council - Bog - National Academies Press - Plusbog.dk

Reducing the Logistics Burden for the Army After Next - National Research Council - Bog - National Academies Press - Plusbog.dk

This study assesses the potential of new technology to reduce logistics support requirements for future Army combat systems. It describes and recommends areas of research and technology development in which the Army should invest now to field systems that will reduce logistics burdens and provide desired capabilities for an "Army After Next (AAN) battle force" in 2025. Table of ContentsFront MatterExecutive Summary1 Introduction2 Military Logistics and the Army After Next Requirements3 Logistics Trade-Off Analysis4 Fuel and Energy5 Operational and Tactical Mobility6 Engagement7 Reliability Concepts8 Soldier Sustainment9 Joint Force Research and Development10 Investment Strategy for Research and Technology Development11 Conclusions and RecommendationsReferencesAppendicesA Statement of TaskB Meetings and ActivitiesC Technologies for Materials Selection and DesignD Materials Options for Fuel Efficiency and ProtectionE Duty Cycles and Fuel Economy of Hybrid VehiclesF Situational Awareness

DKK 520.00
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U.S. Army Futures Command Research Program Realignment - Board On Army Research And Development - Bog - National Academies Press - Plusbog.dk

U.S. Army Futures Command Research Program Realignment - Board On Army Research And Development - Bog - National Academies Press - Plusbog.dk

The U.S. Army Futures Command (AFC) leads a continuous effort to modernize and innovate to support future warfighters. AFC now oversees Combat Capability Development Command and has recently reorganized certain research offices, laboratories, and engineering centers. In response to this realignment, the Senate Armed Services Committee asked the National Academies' Board on Army Research and Development to examine these research portfolio changes and assess their impact. This report investigates and assesses the Army's strategy behind the realignment, discusses the issues with stakeholders, and makes recommendations to ensure the alignment meets with Army modernization priorities. Table of ContentsFront MatterSummary1 Introduction and Background2 Analysis of Army S&T Authorities and Funding3 Innovation and WorkforceAppendixesAppendix A: Committee Member Biographical InformationAppendix B: Data-Gathering Session AgendasAppendix C: AcronymsAppendix D: Statutory Roles of AFC and ASA (ALT)Appendix E: Budget Activity Definitions

DKK 240.00
1

Nutrition and Traumatic Brain Injury - Trauma Committee On Nutrition - Bog - National Academies Press - Plusbog.dk

Nutrition and Traumatic Brain Injury - Trauma Committee On Nutrition - Bog - National Academies Press - Plusbog.dk

Traumatic brain injury (TBI) accounts for up to one-third of combat-related injuries in Iraq and Afghanistan, according to some estimates. TBI is also a major problem among civilians, especially those who engage in certain sports. At the request of the Department of Defense, the IOM examined the potential role of nutrition in the treatment of and resilience against TBI. Table of ContentsFront MatterSummaryPart I: Background1 Introduction2 Nutrition in Clinical Practice Guidelines for Traumatic Brain Injury3 Understanding Pathophysiological ChangesPart II: Nutrition and TBI4 Approach for Selecting Nutritional Interventions: Mechanistic Targets5 Acquiring Resilience to TBI Prior to Injury6 Energy and Protein Needs During Early Feeding Following Traumatic Brain Injury7 Antioxidants8 Branched-Chain Amino Acids9 Choline10 Creatine11 Ketogenic Diet12 Magnesium13 Eicosapentaenoic Acid (EPA) and Docosahexaenoic Acid (DHA)14 Polyphenols15 Vitamin D16 ZincPart III: Recommendations17 Summary of RecommendationsAppendixesAppendix A: AgendaAppendix B: Evidence-Based Guidelines for Traumatic Brain InjuryAppendix C: Workshop Speakers' PapersAppendix D: GlossaryAppendix E: AcronymsAppendix F: Committee Member Biographical Sketches

DKK 507.00
1

Public Health Lessons for Non-Vaccine Influenza Interventions - National Academy Of Medicine - Bog - National Academies Press - Plusbog.dk

Public Health Lessons for Non-Vaccine Influenza Interventions - National Academy Of Medicine - Bog - National Academies Press - Plusbog.dk

The COVID-19 pandemic has challenged the world's preparedness for a respiratory virus event. While the world has been combating COVID-19, seasonal and pandemic influenza remain imminent global health threats. Non-vaccine public health control measures can combat emerging and ongoing influenza outbreaks by mitigating viral spread. Public Health Lessons for Non-Vaccine Influenza Interventions examines provides conclusions and recommendations from an expert committee on how to leverage the knowledge gained from the COVID-19 pandemic to optimize the use of public health interventions other than vaccines to decrease the toll of future seasonal and potentially pandemic influenza. It considers the effectiveness of public health efforts such as use of masks and indoor spacing, use of treatments such as monoclonal antibodies, and public health communication campaigns. Table of ContentsFront MatterSummary1 Introduction2 Surveillance3 Effectiveness of Non-Vaccine Control Measures4 Implementation of Non-Vaccine Control Measures5 Therapeutics6 Concluding ThoughtsAppendix A: Committee and Staff BiographiesAppendix B: Public Meeting AgendasAppendix C: Study Approach

DKK 344.00
1

Priorities for GEOINT Research at the National Geospatial-Intelligence Agency - Mapping Science Committee - Bog - National Academies Press -

Priorities for GEOINT Research at the National Geospatial-Intelligence Agency - Mapping Science Committee - Bog - National Academies Press -

The National Geospatial-Intelligence Agency (NGA) provides geospatial intelligence (GEOINT) to support national security, both as a national intelligence and a combat support agency. In the post-9/11 world, the need for faster and more accurate geospatial intelligence is increasing. GEOINT uses imagery and geospatial data and information to provide knowledge for planning, decisions, and action. For example, data from satellites, pilotless aircraft and ground sensors are integrated with maps and other intelligence data to provide location information on a potential target. This report defines 12 hard problems in geospatial science that NGA must resolve in order to evolve their capabilities to meet future needs. Many of the hard research problems are related to integration of data collected from an ever-growing variety of sensors and non-spatial data sources, and analysis of spatial data collected during a sequence of time (spatio-temporal data). The report also suggests promising approaches in geospatial science and related disciplines for meeting these challenges. The results of this study are intended to help NGA prioritize geospatial science research directions.

DKK 318.00
1

A National Trauma Care System - Health And Medicine Division - Bog - National Academies Press - Plusbog.dk

A National Trauma Care System - Health And Medicine Division - Bog - National Academies Press - Plusbog.dk

Advances in trauma care have accelerated over the past decade, spurred by the significant burden of injury from the wars in Afghanistan and Iraq. Between 2005 and 2013, the case fatality rate for United States service members injured in Afghanistan decreased by nearly 50 percent, despite an increase in the severity of injury among U.S. troops during the same period of time. But as the war in Afghanistan ends, knowledge and advances in trauma care developed by the Department of Defense (DoD) over the past decade from experiences in Afghanistan and Iraq may be lost. This would have implications for the quality of trauma care both within the DoD and in the civilian setting, where adoption of military advances in trauma care has become increasingly common and necessary to improve the response to multiple civilian casualty events. Intentional steps to codify and harvest the lessons learned within the military's trauma system are needed to ensure a ready military medical force for future combat and to prevent death from survivable injuries in both military and civilian systems. This will require partnership across military and civilian sectors and a sustained commitment from trauma system leaders at all levels to assure that the necessary knowledge and tools are not lost. A National Trauma Care System defines the components of a learning health system necessary to enable continued improvement in trauma care in both the civilian and the military sectors. This report provides recommendations to ensure that lessons learned over the past decade from the military's experiences in Afghanistan and Iraq are sustained and built upon for future combat operations and translated into the U.S. civilian system. Table of ContentsFront MatterAbstractSummaryPart I: Introduction, Overview, and Framework1 Introduction2 Overview of Contemporary Civilian and Military Trauma Systems3 A Framework for a Learning Trauma Care SystemPart II: Assessment4 Generating and Applying Knowledge to Improve Trauma Outcomes5 Creating and Sustaining an Expert Trauma Care Workforce6 Delivering Patient-Centered Trauma Care7 Leveraging Leadership and Fostering a Culture of LearningPart III: Recommendations8 A Vision for a National Trauma Care SystemAppendixesAppendix A: Case StudiesAppendix B: Committee Collective Analysis of Case StudiesAppendix C: MilitaryCivilian Exchange of Knowledge and Practices in Trauma CareAppendix D: Military and Civilian Trauma Care in the Context of a Continuously Learning Health SystemAppendix E: Public Committee Meeting AgendasAppendix F: Committee Biosketches

DKK 448.00
1

The Role of Protein and Amino Acids in Sustaining and Enhancing Performance - Institute Of Medicine - Bog - National Academies Press - Plusbog.dk

The Role of Protein and Amino Acids in Sustaining and Enhancing Performance - Institute Of Medicine - Bog - National Academies Press - Plusbog.dk

It is a commonly held belief that athletes, particularly body builders, have greater requirements for dietary protein than sedentary individuals. However, the evidence in support of this contention is controversial. This book is the latest in a series of publications designed to inform both civilian and military scientists and personnel about issues related to nutrition and military service. Among the many other stressors they experience, soldiers face unique nutritional demands during combat. Of particular concern is the role that dietary protein might play in controlling muscle mass and strength, response to injury and infection, and cognitive performance. The first part of the book contains the committee's summary of the workshop, responses to the Army's questions, conclusions, and recommendations. The remainder of the book contains papers contributed by speakers at the workshop on such topics as, the effects of aging and hormones on regulation of muscle mass and function, alterations in protein metabolism due to the stress of injury or infection, the role of individual amino acids, the components of proteins, as neurotransmitters, hormones, and modulators of various physiological processes, and the efficacy and safety considerations associated with dietary supplements aimed at enhancing performance.

DKK 643.00
1

Responsible Research with Biological Select Agents and Toxins - Board On Life Sciences - Bog - National Academies Press - Plusbog.dk

Responsible Research with Biological Select Agents and Toxins - Board On Life Sciences - Bog - National Academies Press - Plusbog.dk

The effort to understand and combat infectious diseases has, during the centuries, produced many key advances in science and medicine--including the development of vaccines, drugs, and other treatments. A subset of this research is conducted with agents that, like anthrax, not only pose a severe threat to the health of humans, plants, and animals but can also be used for ill-intended purposes. Such agents have been listed by the government as biological select agents and toxins. The 2001 anthrax letter attacks prompted the creation of new regulations aimed at increasing security for research with dangerous pathogens. The outcome of the anthrax letter investigation has raised concern about whether these measures are adequate. Responsible Research with Biological Select Agents and Toxins evaluates both the physical security of select agent laboratories and personnel reliability measures designed to ensure the trustworthiness of those with access to biological select agents and toxins. The book offers a set of guiding principles and recommended changes to minimize security risk and facilitate the productivity of research. The book recommends fostering a culture of trust and responsibility in the laboratory, engaging the community in oversight of the Select Agent Program, and enhancing the operation of the Select Agent Program.

DKK 360.00
1

Gulf War and Health - Committee On Gulf War And Health - Bog - National Academies Press - Plusbog.dk

Gulf War and Health - Committee On Gulf War And Health - Bog - National Academies Press - Plusbog.dk

Since the United States began combat operations in Afghanistan in October 2001 and then in Iraq in March 2003, the numbers of US soldiers killed exceed 6,700 and of US soldiers wounded 50,500. Although all wars since World War I have involved the use of explosives by the enemy, the wars in Afghanistan and Iraq differ from previous wars in which the United States has been involved because of the enemy's use of improvised explosive devices (IEDs). The use of IEDs has led to an injury landscape different from that in prior US wars. The signature injury of the Afghanistan and Iraq wars is blast injury. Numerous US soldiers have returned home with devastating blast injuries and they continue to experience many challenges in readjusting to civilian life. Gulf War and Health, Volume 9 is an assessment of the relevant scientific information and draws conclusions regarding the strength of the evidence of an association between exposure to blast and health effects. The report also includes recommendations for research most likely to provide VA with knowledge that can be used to inform decisions on how to prevent blast injuries, how to diagnose them effectively, and how to manage, treat, and rehabilitate victims of battlefield traumas in the immediate aftermath of a blast and in the long term.

DKK 472.00
1

The Context of Military Environments - Division Of Behavioral And Social Sciences And Education - Bog - National Academies Press - Plusbog.dk

The Context of Military Environments - Division Of Behavioral And Social Sciences And Education - Bog - National Academies Press - Plusbog.dk

The United States Army faces a variety of challenges to maintain a ready and capable force into the future. Missions are increasingly diverse, ranging from combat and counterinsurgency to negotiation, reconstruction, and stability operations, and require a variety of personnel and skill sets to execute. Missions often demand rapid decision-making and coordination with others in novel ways, so that personnel are not simply following a specific set of tactical orders but rather need to understand broader strategic goals and choose among courses of action. Like any workforce, the Army is diverse in terms of demographic characteristics such as gender and race, with increasing pressure to ensure equal opportunities across all demographic parties. With these challenges comes the urgent need to better understand how contextual factors influence soldier and small unit behavior and mission performance. Recognizing the need to develop a portfolio of research to better understand the influence of social and organizational factors on the behavior of individuals and small units, the U.S. Army Research Institute (ARI) requested the National Research Council's Board on Behavioral, Cognitive, and Sensory Sciences to outline a productive and innovative collection of future basic science research projects to improve Amy mission performance for immediate implementation and lasting over the next 10-20 years. This report presents recommendations for a program of basic scientific research on the roles of social and organizational contextual factors, such as organizational institutions, culture, and norms, as determinants and moderators of the performance of individual soldiers and small units. The Context of Military Environments: Basic Research Opportunities on Social and Organizational Factors synthesizes and assesses basic research opportunities in the behavioral and social sciences related to social and organizational factors that comprise the context of individual and small unit behavior in military environments. This report focuses on tactical operations of small units and their leaders, to include the full spectrum of unique military environments including: major combat operations, stability/support operations, peacekeeping, and military observer missions, as well as headquarters support units. This report identifies key contextual factors that shape individual and small unit behavior and assesses the state of the science regarding these factors. The Context of Military Environments recommends an agenda for ARI's future research in order to maximize the effectiveness of U.S. Army personnel policies and practices of selection, recruitment, and assignment as well as career development in training and leadership. The report also specifies the basic research funding level needed to implement the recommended agenda for future ARI research. Table of ContentsFront MatterSummary1 Introduction and Framework for Research Agenda2 Norms in Military Environments3 Environmental Transitions4 Contextual Leadership5 Distinct Sources of Power and Status in Diversified Army Units6 Multiteam Systems as the Context for Individuals and Teams7 Longitudinal Survey Data for Empirical Research on Military Environments8 The Research Agenda: Conclusions and RecommendationsAppendix: Biographical Sketches of Committee Members and Staff

DKK 266.00
1

Improved Operational Testing and Evaluation - Division Of Behavioral And Social Sciences And Education - Bog - National Academies Press - Plusbog.dk

Improved Operational Testing and Evaluation - Division Of Behavioral And Social Sciences And Education - Bog - National Academies Press - Plusbog.dk

The U.S. Army Test and Evaluation Command (ATEC) is responsible for the operational testing and evaluation of Army systems in development. ATEC requested that the National Research Council form the Panel on Operational Test Design and Evaluation of the Interim Armored Vehicle (Stryker) to explore three issues concerning the initial operation test plans for the Stryker/Interim Brigade Combat Team (IBCT). First, the panel was asked to examine the measures selected to assess the performance and effectiveness of the Stryker/IBCT in comparison both to requirements and to the baseline system. Second, the panel was asked to review the test design for the Stryker/IBCT initial operational test to see whether it is consistent with best practices. Third, the panel was asked to identify the advantages and disadvantages of techniques for combining operational test data with data from other sources and types of use. In this report the panel presents findings, conclusions, and recommendations pertaining to the first two issues: measures of performance and effectiveness, and test design. The panel intends to prepare a second report that discusses techniques for combining information. Table of ContentsFront MatterExecutive Summary1. Introduction2. Test Process3. Test Measures4. Statistical Design5. Data Analysis6. Assessing the IBCT/Stryker Operational Test in a Broad ContextReferencesAppendix A: Letter Report of the Panel to the Army Test and Evalution CommandAppendix B: Force Exchange Ratio, Historical Win Probability, and Winning with Decisive ForceAppendix C: Biographical Sketches of Panel Members and Staff

DKK 286.00
1

Data Integration in Learning Health Care Systems for Traumatic Brain Injury - Health And Medicine Division - Bog - National Academies Press -

Data Integration in Learning Health Care Systems for Traumatic Brain Injury - Health And Medicine Division - Bog - National Academies Press -

Traumatic brain injuries (TBI) affect millions of Americans each year, causing symptoms that can be debilitating and long-lasting and resulting in physical, cognitive, emotional, and financial ramifications. The complexity and heterogeneity of TBI make it challenging to target the right interventions to the right patient at the right time. For those who do receive care, unlinked health records, fragmented care delivery, and gaps in medical surveillance means many questions remain unanswered about TBI prevalence, comorbidities, adverse outcome risk factors, and long-term outcomes. To help address this challenge, learning health care systems that bidirectionally exchange data and insights across clinical research, care services, and public health have been identified as key to improving patient outcomes. To help move the field forward, the National Academies Forum on Traumatic Brain Injury hosted a public workshop to explore the role of learning health systems in advancing TBI research and care. This Proceedings of a Workshop summarizes discussions and key messages from the workshop. Table of ContentsFront Matter1 Introduction2 Lived Experiences3 The Learning Health System4 Use of Learning Health Care Systems to Improve Care for Traumatic Brain Injury5 Examples of Learning Health Care Systems in Traumatic Brain Injury6 Data Capture, Surveillance, and Supporting Long-Term Care Needs7 Using Learning Health Care Systems to Combat Inequitable Outcomes in Traumatic Brain InjuryAppendix A: ReferencesAppendix B: Workshop Statement of TaskAppendix C: Workshop AgendaAppendix D: Planning Committee, Speaker, and Moderator Biographies

DKK 201.00
1

An Approach to Evaluate the Effects of Concomitant Prescribing of Opioids and Benzodiazepines on Veteran Deaths and Suicides - Health And Medicine

An Approach to Evaluate the Effects of Concomitant Prescribing of Opioids and Benzodiazepines on Veteran Deaths and Suicides - Health And Medicine

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. Table of ContentsFront MatterSummary1 Introduction2 Specifying the Target Trial3 Observational Emulationof the Target Trials and Practical Considerations

DKK 318.00
1