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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

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The Healthcare Imperative - Leighanne Olsen - Bog - National Academies Press - Plusbog.dk

The United States has the highest per capita spending on health care of any industrialized nation but continually lags behind other nations in health care outcomes including life expectancy and infant mortality. National health expenditures are projected to exceed $2.5 trillion in 2009. Given healthcare's direct impact on the economy, there is a critical need to control health care spending. According to The Health Imperative: Lowering Costs and Improving Outcomes, the costs of health care have strained the federal budget, and negatively affected state governments, the private sector and individuals. Healthcare expenditures have restricted the ability of state and local governments to fund other priorities and have contributed to slowing growth in wages and jobs in the private sector. Moreover, the number of uninsured has risen from 45.7 million in 2007 to 46.3 million in 2008. The Health Imperative: Lowering Costs and Improving Outcomes identifies a number of factors driving expenditure growth including scientific uncertainty, perverse economic and practice incentives, system fragmentation, lack of patient involvement, and under-investment in population health. Experts discussed key levers for catalyzing transformation of the delivery system. A few included streamlined health insurance regulation, administrative simplification and clarification and quality and consistency in treatment. The book is an excellent guide for policymakers at all levels of government, as well as private sector healthcare workers.

DKK 708.00

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Controlling Cost Growth of NASA Earth and Space Science Missions - National Research Council - Bog - National Academies Press - Plusbog.dk

Cost and schedule growth is a problem experienced by many types of projects in many fields of endeavor. Based on prior studies of cost growth in NASA and Department of Defense projects, this book identifies specific causes of cost growth associated with NASA Earth and space science missions and provides guidance on how NASA can overcome these specific problems. The recommendations in this book focus on changes in NASA policies that would directly reduce or eliminate the cost growth of Earth and space science missions. Large cost growth is a concern for Earth and space science missions, and it can be a concern for other missions as well. If the cost growth is large enough, it can create liquidity problems for NASA's Science Mission Directorate that in turn cause cost profile changes and development delays that amplify the overall cost growth for other concurrent and/or pending missions. Addressing cost growth through the allocation of artificially high reserves is an inefficient use of resources because it unnecessarily diminishes the portfolio of planned flights. The most efficient use of resources is to establish realistic budgets and reserves and effective management processes that maximize the likelihood that mission costs will not exceed reserves. NASA is already taking action to reduce cost growth; additional steps, as recommended herein, will help improve NASA's mission planning process and achieve the goal of ensuring frequent mission opportunities for NASA Earth and space science.

DKK 208.00

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Mapping the Zone - Board On Earth Sciences And Resources Mapping Science Committee - Bog - National Academies Press - Plusbog.dk

Federal Emergency Management Agency (FEMA) Flood Insurance Rate Maps portray the height and extent to which flooding is expected to occur, and they form the basis for setting flood insurance premiums and regulating development in the floodplain. As such, they are an important tool for individuals, businesses, communities, and government agencies to understand and deal with flood hazard and flood risk. Improving map accuracy is therefore not an academic question—better maps help everyone. Making and maintaining an accurate flood map is neither simple nor inexpensive. Even after an investment of more than $1 billion to take flood maps into the digital world, only 21 percent of the population has maps that meet or exceed national flood hazard data quality thresholds. Even when floodplains are mapped with high accuracy, land development and natural changes to the landscape or hydrologic systems create the need for continuous map maintenance and updates. Mapping the Zone examines the factors that affect flood map accuracy, assesses the benefits and costs of more accurate flood maps, and recommends ways to improve flood mapping, communication, and management of flood-related data. Table of ContentsFront MatterSummary1 Introduction2 Flood Mapping and Flood Insurance3 Elevation and Height Data4 Inland Flooding5 Coastal Flooding6 Benefits and Costs of Accurate Flood Mapping7 Mapping and Risk Communication: Moving to the FutureReferencesAppendixesAppendix A: Methods for Estimating Base Flood Elevations in Approximate StudiesAppendix B: Biographical Sketches of Committee MembersAppendix C: GlossaryAppendix D: Acronyms and Abbreviations

DKK 449.00

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Indoor Exposure to Fine Particulate Matter and Practical Mitigation Approaches - Health And Medicine Division - Bog - National Academies Press -

Overwhelming evidence exists that exposure to outdoor fine particulate matter (PM2.5) is associated with a range of short-term and chronic health impacts, including asthma exacerbation, acute and chronic bronchitis, heart attacks, increased susceptibility to respiratory infections, and premature death, with the burden of these health effects falling more heavily on underserved and marginalized communities. Although less studied to date, indoor exposure to PM2.5 is also gaining attention as a potential source of adverse health effects, particularly given that Americans spend 90 percent of their lives indoors and indoor PM2.5 levels can exceed outdoor levels. To better understand the sources of indoor PM2.5, the possible health effects of exposure to indoor PM2.5, and engineering approaches and interventions to reduce those exposure risks, the National Academies of Sciences, Engineering, and Medicine convened a virtual workshop, Indoor Exposure to Fine Particulate Matter and Practical Mitigation Approaches, on April 14, 21, and 28, 2021. The workshop focused on exposures that occur in residential and school buildings and on existing and practical mitigation technologies and approaches. This publication summarizes the presentation and discussion of the workshop. Table of ContentsFront Matter1 Introduction2 Outdoor Sources of Indoor Particulate Matter3 Indoor Sources of Indoor Particulate Matter4 Day One Summary5 Health Effects of Exposure to Indoor Particulate Matter6 Indoor Exposure to Particulate Matter: Metrics and Assessment7 Day Two Summary8 Indoor Particulate Matter Exposure Control and Mitigation9 Occupant Responses to Indoor Particulate Matter10 Workshop Summary and Closing ReflectionsReferencesAppendix A: Workshop AgendaAppendix B: Biographic Sketches of Planning Committee Members and Workshop Speakers

DKK 201.00

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Health Risks of Indoor Exposure to Particulate Matter - Health And Medicine Division - Bog - National Academies Press - Plusbog.dk

The U.S. Environmental Protection Agency (EPA) defines PM as a mixture of extremely small particles and liquid droplets comprising a number of components, including "acids (such as nitrates and sulfates), organic chemicals, metals, soil or dust particles, and allergens (such as fragments of pollen and mold spores)". The health effects of outdoor exposure to particulate matter (PM) are the subject of both research attention and regulatory action. Although much less studied to date, indoor exposure to PM is gaining attention as a potential source of adverse health effects. Indoor PM can originate from outdoor particles and also from various indoor sources, including heating, cooking, and smoking. Levels of indoor PM have the potential to exceed outdoor PM levels. Understanding the major features and subtleties of indoor exposures to particles of outdoor origin can improve our understanding of the exposure–response relationship on which ambient air pollutant standards are based. The EPA's Indoor Environments Division commissioned the National Academies of Sciences, Engineering, and Medicine to hold a workshop examining the issue of indoor exposure to PM more comprehensively and considering both the health risks and possible intervention strategies. Participants discussed the ailments that are most affected by particulate matter and the attributes of the exposures that are of greatest concern, exposure modifiers, vulnerable populations, exposure assessment, risk management, and gaps in the science. This report summarizes the presentations and discussions from the workshop. Table of ContentsFront Matter1 Introduction2 Sources of Indoor Particulate Matter3 Particle Dynamics and Chemistry4 Characterizing Indoor Exposure Levels5 Exposure Mitigation6 Discussion and Summary of Day 17 Potential Health Concerns8 Interventions and Risk CommunicationReferencesAppendix A: Workshop AgendaAppendix B: Biographical Information: Workshop SpeakersAppendix C: Biographical Information: Planning Committee and Staff

DKK 331.00

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Continuing Kepler's Quest - Aeronautics And Space Engineering Board - Bog - National Academies Press - Plusbog.dk

In February 2009, the commercial communications satellite Iridium 33 collided with the Russian military communications satellite Cosmos 2251. The collision, which was not the first recorded between two satellites in orbit—but the most recent and alarming—produced thousands of pieces of debris, only a small percentage of which could be tracked by sensors located around the world. In early 2007, China tested a kinetic anti-satellite weapon against one of its own satellites, which also generated substantial amounts of space debris. These collisions highlighted the importance of maintaining accurate knowledge, and the associated uncertainty, of the orbit of each object in space. These data are needed to predict close approaches of space objects and to compute the probability of collision so that owners/operators can decide whether or not to make a collision avoidance maneuver by a spacecraft with such capability. The space object catalog currently contains more than 20,000 objects, and when the planned space fence radar becomes operational this number is expected to exceed 100,000. A key task is to determine if objects might come closer to each other, an event known as "conjunction," and the probability that they might collide. The U.S. Air Force is the primary U.S. government organization tasked with maintaining the space object catalog and data on all space objects. This is a complicated task, involving collecting data from a multitude of different sensors-many of which were not specifically designed to track orbiting objects-and fusing the tracking data along with other data, such as data from atmospheric models, to provide predictions of where objects will be in the future. The Committee for the Assessment of the U.S. Air Force's Astrodynamic Standards collected data and heard from numerous people involved in developing and maintaining the current astrodynamics standards for the Air Force Space Command (AFSPC), as well as representatives of the user community, such as NASA and commercial satellite owners and operators. Preventing collisions of space objects, regardless of their ownership, is in the national security interested of the United States. Continuing Kepler's Quest makes recommendations to the AFSPC in order for it to create and expand research programs, design and develop hardware and software, as well as determine which organizations to work with to achieve its goals. Table of ContentsFront MatterSummary1 Meeting the Mission2 Astrodynamics Algorithms3 Systems Issues4 Broader IssuesAppendix A: Committee and Staff Biographical InformationAppendix B: Acronyms and Glossary

DKK 266.00

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Returning Home from Iraq and Afghanistan - Board On The Health Of Select Populations - Bog - National Academies Press - Plusbog.dk

As of December 2012, Operation Enduring Freedom (OEF) in Afghanistan and Operation Iraqi Freedom (OIF) in Iraq have resulted in the deployment of about 2.2 million troops; there have been 2,222 US fatalities in OEF and Operation New Dawn (OND)1 and 4,422 in OIF. The numbers of wounded US troops exceed 16,000 in Afghanistan and 32,000 in Iraq. In addition to deaths and morbidity, the operations have unforeseen consequences that are yet to be fully understood. In contrast with previous conflicts, the all-volunteer military has experienced numerous deployments of individual service members; has seen increased deployments of women, parents of young children, and reserve and National Guard troops; and in some cases has been subject to longer deployments and shorter times at home between deployments. Numerous reports in the popular press have made the public aware of issues that have pointed to the difficulty of military personnel in readjusting after returning from Iraq and Afghanistan. Many of those who have served in OEF and OIF readjust with few difficulties, but others have problems in readjusting to home, reconnecting with family members, finding employment, and returning to school. In response to the return of large numbers of veterans from Iraq and Afghanistan with physical-health and mental-health problems and to the growing readjustment needs of active duty service members, veterans, and their family members, Congress included Section 1661 of the National Defense Authorization Act for fiscal year 2008. That section required the secretary of defense, in consultation with the secretary of veterans affairs, to enter into an agreement with the National Academies for a study of the physical-health, mental-health, and other readjustment needs of members and former members of the armed forces who were deployed in OIF or OEF, their families, and their communities as a result of such deployment. The study consisted of two phases. The Phase 1 task was to conduct a preliminary assessment. The Phase 2 task was to provide a comprehensive assessment of the physical, psychologic, social, and economic effects of deployment on and identification of gaps in care for members and former members, their families, and their communities. The Phase 1 report was completed in March 2010 and delivered to the Department of Defense (DOD), the Department of Veterans Affairs (VA), and the relevant committees of the House of Representatives and the Senate. The secretaries of DOD and VA responded to the Phase 1 report in September 2010. Returning Home from Iraq and Afghanistan: Assessment of Readjustment Needs of Veterans, Service Members, and Their Families fulfills the requirement for Phase 2. Table of ContentsFront MatterSummary1 Introduction2 Methods3 Characteristics of the Deployed4 Long-Term Outcomes5 Screening, Assessment, and Treatment6 Military Families7 Community Impacts of Deployment8 Socioeconomic Impacts of Deployment on Service Members and Spouses9 Access and Barriers to Care10 Proposed Data Analyses11 RecommendationsAppendix A: Legislation Framing the Committee's TaskAppendix B: Phase I SummaryAppendix C: The DoD and VA Response to the Phase I ReportAppendix D: Summary of Federally Funded Research Related to OEF and OIF PopulationsAppendix E: Individual Ethnographic Assessments of Six CommunitiesAppendix F: Sample of Government Data and Databases

DKK 435.00

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