If terrorists released Bacillus anthracis over a large city, hundreds of thousands of people could be at risk of the deadly disease anthrax-caused by the B. anthracis spores-unless they had rapid access to antibiotic medical countermeasures (MCM). Although plans for rapidly delivering MCM to a large number of people following an anthrax attack have been greatly enhanced during the last decade, many public health authorities and policy experts fear that the nation's current systems and plans are insufficient to respond to the most challenging scenarios, such as a very large-scale anthrax attack. The U.S. Department of Health and Human Services' Office of the Assistant Secretary for Preparedness and Response commissioned the Institute of Medicine to examine the potential uses, benefits, and disadvantages of strategies for repositioning antibiotics. This involves storing antibiotics close to or in the possession of the people who would need rapid access to them should an attack occur. Prepositioning Antibiotics for Anthrax reviews the scientific evidence on the time window in which antibiotics successfully prevent anthrax and the implications for decision making about prepositioning, describes potential prepositioning strategies, and develops a framework to assist state, local, and tribal public health authorities in determining whether prepositioning strategies would be beneficial for their communities. However, based on an analysis of the likely health benefits, health risks, and relative costs of the different prepositioning strategies, the book also develops findings and recommendations to provide jurisdictions with some practical insights as to the circumstances in which different prepositioning strategies may be beneficial. Finally, the book identifies federal- and national-level actions that would facilitate the evaluation and development of prepositioning strategies. Recognizing that communities across the nation have differing needs and capabilities, the findings presented in this report are intended to assist public health officials in considering the benefits, costs, and trade-offs involved in developing alternative prepositioning strategies appropriate to their particular communities.

This report illustrates the work of IOM committees in selected, major areas in recent years, followed by a description of IOM's convening and collaborative activities and fellowship programs. The last section provides a comprehensive bibliography of IOM reports published since 2007.

Operations research tools are ideally suited to providing solutions and insights for the many problems health policy-maker's face. Indeed, a growing body of literature on health policy analysis, based on operations research methods, has emerged to address the problems mentioned above and several others. The research in this field is often multi-disciplinary, being conducted by teams that include not only operations researchers but also clinicians, economists and policy analysts. The research is also often very applied, focusing on a specific question driven by a decision-maker and many times yielding a tool to assist in future decisions. The goal of this volume was to bring together a group of papers by leading experts that could showcase the current state of the field of operations research applied to health-care policy. There are 18 chapters that illustrate the breadth of this field. The chapters use a variety of techniques, including classical operations research tools, such as optimization, queuing theory, and discrete event simulation, as well as statistics, epidemic models and decision-analytic models. The book spans the field and includes work that ranges from highly conceptual to highly applied. An example of the former is the chapter by Kimmel and Schackman on building policy models, and an example of the latter is the chapter by Coyle and colleagues on developing a Markov model for use by an organization in Ontario that makes recommendations about the funding of new drugs. The book also includes a mix of review chapters, such as the chapter by Hutton on public health response to influenza outbreaks, and original research, such as the paper by Blake and colleagues analyzing a decision by Canadian Blood Services to consolidate services. This volume could provide an excellent introduction to the field of operations research applied to health-care policy, and it could also serve as an introduction to new areas for researchers already familiar with the topic. The book is divided into six sections. The first section contains two chapters that describe several different applications of operations research in health policy and provide an excellent overview of the field. Sections 2 to 4 present policy models in three focused areas. Section 5 contains two chapters on conceptualizing and building policy models. The book concludes in Section 6 with two chapters describing work that was done with policy-makers and presenting insights gained from working directly with policy-makers.

Since 1927, Goldman-Cecil Medicine has been the world’s most influential internal medicine resource. In the ground-breaking 25th edition, your original purchase ensures you will be up-to-date without the need for a subscription. Through the new, more powerful Expert Consult eBook platform, this "living text" provides continuous updates that will integrate the latest research, guidelines, and treatments into each chapter, ensuring that the content is as current as the day this edition was first published. Goldman-Cecil Medicine offers definitive, unbiased guidance on the evaluation and management of every medical condition, presented by a veritable "Who's Who" of modern medicine. A practical, straightforward style; templated organization; evidence-based references; and robust interactive content combine to make this dynamic resource quite simply the fastest and best place to find all of the authoritative, state-of-the-art clinical answers you need. Expert Consult eBook version included with print purchase: Access continuous updates from Editor Lee Goldman, MD, who thoroughly reviews internal medicine and specialty journals, updating online content to reflect the latest guidelines and translating that evidence into treatment. Interactive Q&A section features over 1,500 board-style questions and answers to aid in preparing for certification or recertification exams. Outstanding supplementary tools include figures, tables, videos, heart and lung sounds, treatment and management algorithms, fully integrated references, and thousands of illustrations and full-color photos. Search all of the text, figures, supplementary material, and references from the book on a variety of devices and at no additional cost — Expert Consult access is included with this title! Practical, bulleted, highly templated text with easy-to-use features including flow charts and treatment boxes. New chapters on global health, cancer biology and genetics, and the human microbiome in health and disease keep you on the cutting edge of medicine. Today's most current evidence-based medicine guidelines help you form a definitive diagnosis and create the best treatment plans possible. Focused coverage of the latest developments in biology includes the specifics of current diagnosis, therapy, and medication doses. The reference of choice for every stage of your career! Goldman-Cecil Medicine is an ideal learning tool for residents, physicians, and students as well as a valuable go-to resource for experienced healthcare professionals.

Large catastrophic events, or rare acute events, may cause situations in which a local jurisdiction's medicines and medical supplies are not sufficient to provide care to the population it serves. In these cases of natural or engineered disasters, such as a terrorist attack, influenza pandemic, or earthquake, state or local authorities can request that the federal government provide assets from the Strategic National Stockpile to augment the state and local jurisdictions' resources. The Centers for Disease Control and Prevention's (CDC's) Strategic National Stockpile (SNS) is the nation's repository of antibiotics, chemical antidotes, antitoxins, vaccines, antiviral drugs, and other medical materiel designed to supplement and resupply state and local public health agencies in the event of an emergency. The materiel is intended to support national health security and is managed by the Office of Public Health Preparedness and Response's (OPHPR's) Division of Strategic National Stockpile (DSNS). The stated mission of the SNS is to prepare and support partners and provide the right resources at the right time to secure the nation's health. The National Academies of Sciences, Engineering, and Medicine organized a two-day public workshop to explore opportunities to improve the efficiency, effectiveness, and sustainable methods used by the CDC's SNS to distribute medical countermeasures and other supplies during disasters and other public health emergencies, especially those which result in disruption of physical infrastructure such as the electrical grid, central roadways, bridges, and tunnels within the impacted community. Participants explored relevant distribution lessons learned from other federal agency stockpiles and the private sector as well as opportunities to develop public-private collaborations in the purchase, warehousing, management, and distribution of medical countermeasures. This report summarizes the presentations and discussions from the workshop.

Are We the Next Endangered Species? unravels the complex web of historical events, misinformation, and the ominous convergence of bioweapons and eugenics In this thought-provoking new book, Dr. Fleming challenges us to navigate the murky waters of history, exposing parallel programs developed over the last 170 years in the United States. This riveting exploration unearths ancient civilizations that embraced slavery, sterilization, and eugenics, drawing chilling parallels to our present reality. Dr. Fleming confronts the uncomfortable truth: are we repeating the mistakes of the past while expecting different outcomes? Are we destined to replicate the errors that led to the rise of powerful individuals and organizations seeking ultimate control over others? Key revelations include the stealthy usurpation of power in the United States since the 1850s, the nation's pivotal role in developing biological and chemical weapons, and its shocking collaboration with Nazi scientists, doctors, and intelligence officers. Dr. Fleming unveils the shadowy world of covert operations, the establishment of the military-industrial complex, and the surrender of medical control to the federal government. Readers will discover the intricate pathways of biowarfare and eugenics converging with the emergence of COVID. They will learn about the gain-of-function bioweapons responsible for the pandemic and the parallel development of eugenic genetic vaccines. Fleming reveals the control wielded by the military-industrial complex and world leaders over your life, movement, property, and freedoms. This book is not just an exploration of the past or a revelation of how those in power are on the brink of realizing their ultimate control, it's a call to action. It doesn't just raise awareness—it empowers readers to understand, question, and take decisive action to halt the ominous path we're on. In a world where truth is elusive and power is coveted, this book is a beacon of knowledge, urging you to discover what you can do to stop the impending threats to our existence. The future hangs in the balance and Are We the Next Endangered Species? provides the roadmap to safeguard it.

This new textbook outlines the main theories and concepts from a variety of disciplines that support homeland security operations, structures and strategies. Following the terrorist attacks of September 11th, "homeland security" (HLS) grew in importance within the U.S. government (and around the world) and matured from a concept discussed among a relatively small cadre of policymakers and strategic thinkers to a broadly discussed issue in Congress and society with a growing academic presence. Yet the ability to discern a theory of homeland security that would support overall security strategy has been more elusive to both scholars and policymakers. This textbook aims to elucidate a grand theory of homeland security by leveraging the theoretical underpinnings of the disciplines that comprise the strategies, operations and structures of the HLS enterprise. In this way, each chapter contributes to a grand theory of homeland security as it explores a different discipline that influences or supports a domain of the homeland security enterprise. These chapters cover intelligence systems, terrorism origins and ideologies, emergency management, environmental and human security, cybersecurity policy, crime and security, global governance, risk management, public health, law and policy, technology, interagency collaboration and the sociology of security. This book will be essential reading for students of Homeland Security and Emergency Response, and recommended reading for students of terrorism, intelligence, cybersecurity, risk management and national security.

This second volume of a two-volume set focuses on specific pathogens and their mechanisms of pathogenesis as well as diagnostics, therapeutics and various strategies in the event of biological attacks. This multidisciplinary book appeals to readers from various fields, including biodefense, biosafety & biosecurity, virology, neurology, molecular biology and genetic engineering, as well as infectious disease specialists. Further, the work is of interest to basic science and applied science research scholars and experts working in the area of high-consequence or select agent virology.