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The Cost of Inaction for Young Children Globally: Workshop Summary (2014)

September 18, 2014 Comments off

The Cost of Inaction for Young Children Globally: Workshop Summary (2014)
Source: Institute of Medicine (IOM); National Research Council

The Cost of Inaction for Young Children Globally is the summary of a workshop hosted by the Institute of Medicine Forum on Investing in Young Children Globally in April 2014 to focus on investments in young children and the cost of inaction. Participants explored existing, new, and innovative science and research from around the world to translate this evidence into sound and strategic investments in policies and practices that will make a difference in the lives of children and their caregivers. This report discusses intersections across health, education, nutrition, living conditions, and social protection and how investments of economic, natural, social, and other resources can sustain or promote early childhood development and well-being.

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Graduate Medical Education That Meets the Nation’s Health Needs

September 11, 2014 Comments off

Graduate Medical Education That Meets the Nation’s Health Needs
Source: Institute of Medicine

Since the creation of the Medicare and Medicaid programs in 1965, the public has provided tens of billions of dollars to fund graduate medical education (GME), the period of residency and fellowship that is provided to physicians after they receive a medical degree. Although the scale of govern­ment support for physician training far exceeds that for any other profession, there is a striking absence of transparency and accountability in the GME financing system for producing the types of physicians that the nation needs.

The IOM formed an expert committee to conduct an independent review of the governance and financing of the GME system. The 21-member IOM committee concludes that there is an unquestionable imperative to assess and optimize the effectiveness of the public’s investment in GME. In its report, Graduate Medical Education That Meets the Nation’s Health Needs, the committee recommends significant changes to GME financ­ing and governance to address current deficiencies and better shape the phy­sician workforce for the future. The IOM report provides an initial road­map for reforming the Medicare GME payment system and building an infrastructure that can drive more strategic investment in the nation’s physician workforce.

Graduate Medical Education That Meets the Nation’s Health Needs

August 19, 2014 Comments off

Graduate Medical Education That Meets the Nation’s Health Needs
Source: Institute of Medicine

Since the creation of the Medicare and Medicaid programs in 1965, the public has provided tens of billions of dollars to fund graduate medical education (GME), the period of residency and fellowship that is provided to physicians after they receive a medical degree. Although the scale of govern­ment support for physician training far exceeds that for any other profession, there is a striking absence of transparency and accountability in the GME financing system for producing the types of physicians that the nation needs.

The IOM formed an expert committee to conduct an independent review of the governance and financing of the GME system. The 21-member IOM committee concludes that there is an unquestionable imperative to assess and optimize the effectiveness of the public’s investment in GME. In its report, Graduate Medical Education That Meets the Nation’s Health Needs, the committee recommends significant changes to GME financ­ing and governance to address current deficiencies and better shape the phy­sician workforce for the future. The IOM report provides an initial road­map for reforming the Medicare GME payment system and building an infrastructure that can drive more strategic investment in the nation’s physician workforce.

Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations: Final Assessment

June 23, 2014 Comments off

Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations: Final Assessment
Source: Institute of Medicine

Posttraumatic stress disorder (PTSD) is one of the signature injuries of the U.S. conflicts in Afghanistan and Iraq. An estimated 8 percent of current and former service members deployed to these areas have a PTSD diagnosis. For these men and women, readjustment from combat zone deployments and reintegration into families and communities may be significantly hampered by chronic distress and disability in physical, psychological, social, and occupational functioning.

In response to the growing PTSD burden among service members and veterans, a provision of the National Defense Authorization Act for 2010 required the Secretary of the Department of Defense (DoD), in consultation with the Secretary of the Department of Veterans Affairs (VA), to commission an IOM study to assess PTSD treatment programs and services in DoD and VA.

The IOM finds that both departments have made a sustained commitment to PTSD management and invested substantial financial and programmatic resources to provide care to service members and veterans. However, a lack of standards, reporting, and evaluation significantly compromises these efforts. The report offers recommendations and guidance for improving processes and infrastructure to allow DoD and VA to respond more strategically and effectively to the increasing prevalence of PTSD among U.S. service members and veterans.

Hearing Loss and Healthy Aging: Workshop Summary (2014)

May 27, 2014 Comments off

Hearing Loss and Healthy Aging: Workshop Summary (2014)
Source: Institute of Medicine/National Research Council

Being able to communicate is a cornerstone of healthy aging. People need to make themselves understood and to understand others to remain cognitively and socially engaged with families, friends, and other individuals. When they are unable to communicate, people with hearing impairments can become socially isolated, and social isolation can be an important driver of morbidity and mortality in older adults. Despite the critical importance of communication, many older adults have hearing loss that interferes with their social interactions and enjoyment of life. People may turn up the volume on their televisions or stereos, miss words in a conversation, go to fewer public places where it is difficult to hear, or worry about missing an alarm or notification. In other cases, hearing loss is much more severe, and people may retreat into a hard-to-reach shell. Yet fewer than one in seven older Americans with hearing loss use hearing aids, despite rapidly advancing technologies and innovative approaches to hearing health care. In addition, there may not be an adequate number of professionals trained to address the growing need for hearing health care for older adults. Further, Medicare does not cover routine hearing exams, hearing aids, or exams for fitting hearing aids, which can be prohibitively expensive for many older adults.

Hearing Loss and Healthy Aging is the summary of a workshop convened by the Forum on Aging, Disability, and Independence in January 2014 on age-related hearing loss. Researchers, advocates, policy makers, entrepreneurs, regulators, and others discussed this pressing social and public health issue. This report examines the ways in which age-related hearing loss affects healthy aging, and how the spectrum of public and private stakeholders can work together to address hearing loss in older adults as a public health issue.

Gulf War Illness and the Health of Gulf War Veterans: Research Update and Recommendations, 2009-2013

May 2, 2014 Comments off

Gulf War Illness and the Health of Gulf War Veterans: Research Update and Recommendations, 2009-2013 (PDF)
Source: Institute of Medicine (via Boston University)

Progress has been made toward understanding the physiological mechanisms that underlie Gulf War illness and identifying possible treatments, according to a report released Monday by a Congressionally mandated panel of scientific experts and veterans.

Treatment research has increased significantly since 2008, and “early results provide encouraging signs that the treatment goals identified in the 2010 Institute of Medicine report are achievable,” the Research Advisory Committee on Gulf War Veterans’ Illnesses (RAC) said in a report presented Monday to VA Secretary Eric Shinseki by the Committee’s scientific director, Roberta White, chair of environmental health at the Boston University School of Public Health.

The Institute, part of the National Academies of Sciences, had forecast that “treatments, cures, and hopefully preventions” could likely be found with the right research.

The RAC report updates scientific research published since the Committee’s landmark report in 2008, which established that Gulf War illness was a real condition, affecting as many as 250,000 veterans of the 1990-91 Gulf War.

“The conclusions of the 2008 RAC report had a substantial impact on scientific and clinical thinking about Gulf War illness, as well as the public acceptance of this disorder,” said White. The earlier report documented a number of studies that found evidence linking the illness to exposure to pesticides and pyridostigmine bromide (found in anti-nerve gas pills given to troops), as well as other toxic sources.

“Studies published since 2008 continue to support the conclusion that Gulf War illness is causally related to chemical exposures in the combat theater,” White said of the new report. “And many studies of the brain and central nervous system, using imaging, EEG and other objective measures of brain structure and function, add to the existing evidence that central nervous system dysfunction is a critical element in the disorder. Evidence also continues to point to immunological effects of Gulf War illness.”

Exposure to the nerve gas agents sarin and cyclosarin has been linked in several studies to changes in magnetic resonance imaging (MRI) that are associated with cognitive impairments — further supporting the nervous-system effects of those agents cited in the 2008 report.

Applying a Health Lens to Decision Making in Non-Health Sectors: Workshop Summary (2014)

April 25, 2014 Comments off

Applying a Health Lens to Decision Making in Non-Health Sectors: Workshop Summary (2014)
Source: Institute of Medicine

Health is influenced by a wide range of factors, many of which fall outside of the health care delivery sector. These determinants of health include, for example, the characteristics of how people live, work, learn, and play. Decision and policy making in areas such as transportation, housing, and education at different levels of government, and in the private sector, can have far-reaching impacts on health. Throughout the United States there has been increasing dialogue on incorporating a health perspective into policies, programs, and projects outside the health field.

Applying a Health Lens to Decision Making in Non-Health Sectors is the summary of a workshop convened in September 2013 by the Institute of Medicine Roundtable on Population Health Improvement to foster cross-sectoral dialogue and consider the opportunities for and barriers to improving the conditions for health in the course of achieving other societal objectives (e.g., economic development, efficient public transit). The roundtable engaged members, outside experts, and stakeholders on three core issues: supporting fruitful interaction between primary care and public health; strengthening governmental public health; and exploring community action in transforming the conditions that influence the public’s health. This report is a discussion of health in all policies approaches to promote consideration for potential health effects in policy making in many relevant domains, such as education, transportation, and housing.

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