This volume discusses the current state of the nation's blood supply?including studies of blood availability, ways of enhancing blood collection and distribution, frozen red cell technology, logistical concerns in prepositioning frozen blood, extended liquid storage of red cells, and blood substitutes. Table of Contents Front Matter I Current State of the Blood Supply II Enhancing Collections III Enhancing Distribution IV Expanding the Alternatives V Closing Remarks Appendixes

The Metropolitan Medical Response System (MMRS) program of the U. S. Department of Health and Human Services (DHHS) provides funds to major U. S. cities to help them develop plans for coping with the health and medical consequences of a terrorist attack with chemical, biological, or radiological (CBR) agents. DHHS asked the Institute of Medicine (IOM) to assist in assessing the effectiveness of the MMRS program by developing appropriate evaluation methods, tools, and processes to assess both its own management of the program and local preparedness in the cities that have participated in the program. This book provides the managers of the MMRS program and others concerned about local capabilities to cope with CBR terrorism with three evaluation tools and a three-part assessment method. The tools are a questionnaire survey eliciting feedback about the management of the MMRS program, a table of preparedness indicators for 23 essential response capabilities, and a set of three scenarios and related questions for group discussion. The assessment method described integrates document inspection, a site visit by a team of expert peer reviewers, and observations at community exercises and drills.

Radioactive isotopes and enriched stable isotopes are used widely in medicine, agriculture, industry, and science, where their application allows us to perform many tasks more accurately, more simply, less expensively, and more quickly than would otherwise be possible. Indeed, in many cases?for example, biological tracers?there is no alternative. In a stellar example of "technology transfer" that began before the term was popular, the Department of Energy (DOE) and its predecessors has supported the development and application of isotopes and their transfer to the private sector. The DOE is now at an important crossroads: Isotope production has suffered as support for DOE's laboratories has declined. In response to a DOE request, this book is an intensive examination of isotope production and availability, including the education and training of those who will be needed to sustain the flow of radioactive and stable materials from their sources to the laboratories and medical care facilities in which they are used. Chapters include an examination of enriched stable isotopes; reactor and accelerator-produced radionuclides; partnerships among industries, national laboratories, and universities; and national isotope policy. Table of Contents FRONT MATTER EXECUTIVE SUMMARY 1 INTRODUCTION 2 ENRICHED STABLE ISOTOPES 3 REACTOR-PRODUCED RADIONUCLIDES 4 ACCELERATOR-PRODUCED RADIONUCLIDES AND A NATIONAL BIOMEDICAL TRACER FACILITY 5 PUBLIC-PRIVATE PARTNERSHIP MODELS FOR NBTF 6 A NATIONAL ISOTOPE POLICY: PROPOSAL FOR A NEW WAY TO MANAGE THE NATION APPENDIXES A Waste Management B Legal Considerations C Acronyms and Abbreviations D Table of Elements E Glossary

As part of its ongoing commitment to the nation's space program, NASA's medical leadership asked the Institute of Medicine (IOM) to review specific aspects of the scientific basis, policies, and procedures associated with the Longitudinal Study of Astronaut Health (LSAH). NASA created the LSAH in 1992 to address a variety of issues, including both the health of astronauts during space flight and the longer-term health issues that might be associated with space flight and flight training.