Adequacy of the Comprehensive Clinical Evaluation Program A Focused Assessment (1997) / Chapter Skim
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Appendix B
Appendix B
Pages 67-78
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From page 67... ...
The recommendations are divided into This appendix was excerpted from the Institute of Medicine report [Iealth Consequences of Service During the Persian Gulf War: Initial Findings and Recommendations for Immediate Action, Washington, D.C.: National Academy Press, 1995.
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From page 68... ...
The VA Persian Gulf Health Registry should be limited and specific to gathering information to determine the types of conditions reported. The role of this registry should be clearly defined as a means for identifying and reporting illnesses among Gulf War veterans with concerns about Heir health.
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From page 69... ...
Recommendation · The Vice President of the United States should chair a committee composed of representatives from HHS, DoD, and VA to devise a plan to link data systems on health outcomes with the development of standardized health forms, the ability to access information rapidly, and an organized system of records for rapid entry into the data system. Finding 3 The characteristics of the population at risk are critical to any definitive studies of Gulf War health effects.
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From page 70... ...
There may be substantial risk from inappropriate interventions because of adverse reactions to drugs, development of resistant strains of microorganisms, or especially the diversion of attention away from more orthodox diagnoses and treatments that hold some promise of relief from symptoms of a "mystery illness." Recommendation · Decisions to provide funding, to refer patients, or to change usual operating procedures for providing financial support should be based on more solid scientific bases than has sometimes been evident in prior resource allocation. Funding should be subject to external peer review and approval.
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From page 71... ...
These studies should undergo appropriate external peer review before, during, and after data collection and analysis. · More staff should be assigned by the Persian Gulf Veterans Coordinating Board in order to monitor, collect, assemble, and make accessible when appropriate all relevant requested emerging data from studies now underway, and make periodic reports to the appropriate federal oversight authority.
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From page 72... ...
Finding 7 Initial characterizations of smoke and unburned contaminants from the oil well fires and other sources are not adequate, nor have the data available been reduced to a format usable for drawing conclusions or conducting health studies. Considerable data exist from a wide number of sources, but they have not been compiled or analyzed in any organized or efficient way.
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From page 73... ...
DoD launched recently a study of reproductive health, and the VA and DoD clinical evaluation protocols provide some surveillance of infertility, miscarriage, birth defects, and infant deaths. The design of scientific studies to address reproductive risk associated with environmental exposures is complex.
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From page 74... ...
· The Persian Gulf Veterans Coordinating Board should consider specific exposures that are most likely to adversely affect reproductive health of women, men or both, distinguishing between agents that would affect reproductive health only if exposure occurred at or around the time of critical periods during pregnancy versus those that might have effects that would persist after the cessation of exposure. As specific hypotheses linking exposure and reproductive outcomes are identified, studies that are suitable to providing more conclusive results for those associations should be designed.
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From page 75... ...
Appropriate laboratory animal studies of interactions between DEET, PB, and permethrin should be conducted. Finding 13 Reported symptoms suggestive of visceral leishmanial infections include fever, chronic fatigue, malaise, cough, intermittent diarrhea, abdominal pain, weight loss, anemia, lymphadenopathy, and splenomegaly.
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From page 76... ...
Recommendations · The DoD Joint Technology Coordination Group II has research responsibilities for infectious diseases of military importance and should give high priority to the development of a screening approach to be used under field conditions expected in deployment, and a useful diagnostic test for L tropics The board also should review the status of leishmania research, with a view toward either drafting a request for proposals for test development, or the structured coordination of existing activities.
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From page 77... ...
APPENDLYB 77 reservoirs of disease and the existence of vectors other than sand flies are questions that have been raised. Recommendations · DoD should closely monitor all information regarding ecological and clinical studies of L
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