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Archive for the ‘Institute of Medicine’ Category

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.

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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.

Health Literacy and Numeracy: Workshop Summary (2014)

April 18, 2014 Comments off

Health Literacy and Numeracy: Workshop Summary (2014)
Source: Institute of Medicine

Although health literacy is commonly defined as an individual trait, it does not depend on the skills of individuals alone. Health literacy is the product of the interaction between individuals’ capacities and the health literacy-related demands and complexities of the health care system. Specifically, the ability to understand, evaluate, and use numbers is important to making informed health care choices.

Health Literacy and Numeracy is the summary of a workshop convened by The Institute of Medicine Roundtable on Health Literacy in July 2013 to discuss topics related to numeracy, including the effects of ill health on cognitive capacity, issues with communication of health information to the public, and communicating numeric information for decision making. This report includes a paper commissioned by the Roundtable, “Numeracy and the Affordable Care Act: Opportunities and Challenges,” that discusses research findings about people’s numeracy skill levels; the kinds of numeracy skills that are needed to select a health plan, choose treatments, and understand medication instructions; and how providers should communicate with those with low numeracy skills. The paper was featured in the workshop and served as the basis of discussion.

Understanding the Connections Between Coastal Waters and Ocean Ecosystem Services and Human Health: Workshop Summary (2014)

March 5, 2014 Comments off

Understanding the Connections Between Coastal Waters and Ocean Ecosystem Services and Human Health:
Workshop Summary (2014)

Source: Institute of Medicine

Understanding the Connections Between Coastal Waters and Ocean Ecosystem Services and Human Health discusses the connection of ecosystem services and human health. This report looks at the state of the science of the role of oceans in ensuring human health and identifies gaps and opportunities for future research. The report summarizes a workshop convened by the Institute of Medicine’s Roundtable on Environmental Health Sciences, Research, and Medicine. Participants discussed coastal waters and ocean ecosystem services in the United States in an effort to understand impacts on human health. Understanding the Connections Between Coastal Waters and Ocean Ecosystem Services and Human Health focuses on key linkages by discussing the ecosystem services provided by coastal waterways and oceans that are essential for human health and well-being; examining the major stressors that affect the ability of coastal waterways and ocean systems to provide essential services; and considering key factors that can enhance the resiliency of these systems.

Preventing Psychological Disorders in Service Members and Their Families: An Assessment of Programs

February 24, 2014 Comments off

Preventing Psychological Disorders in Service Members and Their Families: An Assessment of Programs
Source: Institute of Medicine

More than a decade of war in Iraq and Afghanistan has placed extraordinary demands on service members and their families, and many veterans have returned from the field with significant psychological impairments. Between 2000 and 2011, almost 1 million service members or former service members were diagnosed with at least 1 psychological disorder either during or after deployment; almost half of these members had multiple disorders. These conditions can hamper veterans’ ability to reconnect with family, find work, and live healthy and productive lives.

In 2013, the IOM released the congressionally mandated report Returning Home from Iraq and Afghanistan: Assessment of Readjustment Needs of Veterans, Service Members, and Their Families. Because this report focused primarily on psychological screening and treatment programs within the Department of Defense (DOD) and the Department of Veterans Affairs, DOD asked the IOM to conduct a follow-up study on DOD’s efforts to prevent psychological disorders among active-duty service members and their families. The resulting report assesses the evidence base for DOD’s existing prevention programs and makes recommendations about program development and implementation.

Discussion Framework for Clinical Trial Data Sharing: Guiding Principles, Elements, and Activities (2014)

January 30, 2014 Comments off

Discussion Framework for Clinical Trial Data Sharing: Guiding Principles, Elements, and Activities (2014)
Source: Institute of Medicine

Sharing data generated through the conduct of clinical trials offers the promise of placing evidence about the safety and efficacy of therapies and clinical interventions on a firmer basis and enhancing the benefits of clinical trials. Ultimately, such data sharing – if carried out appropriately – could lead to improved clinical care and greater public trust in clinical research and health care.

Discussion Framework for Clinical Trial Data Sharing: Guiding Principles, Elements, and Activities is part of a study of how data from clinical trials might best be shared. This document is designed as a framework for discussion and public comment. This framework is being released to stimulate reactions and comments from stakeholders and the public. The framework summarizes the committee s initial thoughts on guiding principles that underpin responsible sharing of clinical trial data, defines key elements of clinical trial data and data sharing, and describes a selected set of clinical trial data sharing activities.

Neurodegeneration: Exploring Commonalities Across Diseases: Workshop Summary

December 19, 2013 Comments off

Neurodegeneration: Exploring Commonalities Across Diseases: Workshop Summary
Source: Institute of Medicine

Neurodegeneration: Exploring Commonalities Across Diseases is the summary of a workshop hosted by the Institute of Medicine’s (IOM’s) Forum on Neuroscience and Nervous System Disorders in Spring 2012 to explore commonalities across neurodegenerative diseases such as Alzheimer’s disease, Parkinson’s disease, amyotrophic lateral sclerosis (ALS), and frontotemporal dementia (FTD). Participants from academia; pharmaceutical and biotechnology industries; government agencies such as the National Institutes of Health and the U.S. Department of Veterans Affairs (VA); patient advocacy groups; and private foundations presented and identified potential opportunities for collaboration across the respective research and development communities. This report identifies and discusses commonalities related to genetic and cellular mechanisms, identifies areas of fundamental science needed to facilitate therapeutics development, and explores areas of potential collaboration among the respective research communities.

Neurodegenerative diseases, such as Alzheimer’s disease, Parkinson’s disease, ALS, and FTD, are becoming increasingly prevalent in the United States due to an aging population. Implications are grave for quality of life and health care costs. Research on neurodegenerative diseases has expanded greatly over the past four decades. Nevertheless, fundamental questions remain about the biology of these diseases, and further insights into the mechanisms of these diseases would help to inform the development of effective means to prevent and to efficiently treat them. Recent findings have revealed certain commonalities in genetic and cellular mechanisms across neurodegenerative diseases. These findings suggest that it might be valuable – at least in some cases – to change the traditional way of studying these diseases by no longer seeing each as an independent entity, but rather as clinical variants of common cellular and molecular biological defects. This approach could help enhance basic scientific understanding of neurodegenerative disease, and could help with the development of biomarkers and new therapeutics.

Veterans and Agent Orange: Update 2012 (2013)

December 12, 2013 Comments off

Veterans and Agent Orange: Update 2012 (2013)
Source: Institute of Medicine

From 1962 to 1971, the US military sprayed herbicides over Vietnam to strip the thick jungle canopy that could conceal opposition forces, to destroy crops that those forces might depend on, and to clear tall grasses and bushes from the perimeters of US base camps and outlying fire-support bases. Mixtures of 2,4-dichlorophenoxyacetic acid (2,4-D), 2,4,5-trichlorophenoxyacetic acid (2,4,5-T), picloram, and cacodylic acid made up the bulk of the herbicides sprayed. The main chemical mixture sprayed was Agent Orange, a 50:50 mixture of 2,4-D and 2,4,5-T. At the time of the spraying, 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), the most toxic form of dioxin, was an unintended contaminant generated during the production of 2,4,5-T and so was present in Agent Orange and some other formulations sprayed in Vietnam.

Because of complaints from returning Vietnam veterans about their own health and that of their children combined with emerging toxicologic evidence of adverse effects of phenoxy herbicides and TCDD, the National Academy of Sciences (NAS) was asked to perform a comprehensive evaluation of scientific and medical information regarding the health effects of exposure to Agent Orange, other herbicides used in Vietnam, and the various components of those herbicides, including TCDD. Updated evaluations are conducted every two years to review newly available literature and draw conclusions from the overall evidence.Veterans and Agent Orange: Update 2012 reviews peer-reviewed scientific reports concerning associations between health outcomes and exposure to TCDD and other chemicals in the herbicides used in Vietnam that were published in October 2010–September 2012 and integrates this information with the previously established evidence database. This report considers whether a statistical association with herbicide exposure exists, taking into account the strength of the scientific evidence and the appropriateness of the statistical and epidemiological methods used to detect the association; the increased risk of disease among those exposed to herbicides during service in the Republic of Vietnam during the Vietnam era; and whether there exists a plausible biological mechanism or other evidence of a causal relationship between herbicide exposure and the disease.

Identifying and Addressing the Needs of Adolescents and Young Adults with Cancer: Workshop Summary

November 14, 2013 Comments off

Identifying and Addressing the Needs of Adolescents and Young Adults with Cancer: Workshop Summary
Source: Institute of Medicine

Identifying and Addressing the Needs of Adolescents and Young Adults with Cancer is the summary of a workshop convened by the Institute of Medicine’s National Cancer Policy Forum in July 2013 to facilitate discussion about gaps and challenges in caring for adolescent and young adult cancer patients and potential strategies and actions to improve the quality of their care. The workshop featured invited presentations from clinicians and other advocates working to improve the care and outcomes for the adolescent and young adult population with cancer.

Cancer is the leading disease-related cause of death in adolescents and young adults. Each year nearly 70,000 people between the ages of 15 and 39 are diagnosed with cancer, approximately 8 times more than children under age 15. This population faces a variety of unique short- and long-term health and psychosocial issues, such as difficulty reentering school, the workforce, or the dating scene; problems with infertility; cardiac, pulmonary, or other treatment repercussions; and secondary malignancies. Survivors are also at increased risk for psychiatric conditions such as anxiety, depression, substance abuse, and suicide and may have difficulty acquiring health insurance and paying for needed care. Identifying and Addressing the Needs of Adolescents and Young Adults with Cancer discusses a variety of topics important to adolescent and young adult patients with cancer, including the ways in which cancers affecting this group differ from cancers in other age groups and what that implies about the best treatments for these cancer patients. This report identifies gaps and challenges in providing optimal care to adolescent and young adult patients with cancer and to discuss potential strategies and actions to address them.

Educating the Student Body: Taking Physical Activity and Physical Education to School

November 7, 2013 Comments off

Educating the Student Body: Taking Physical Activity and Physical Education to School
Source: Institute of Medicine

Physical inactivity is a key determinant of health across the lifespan. A lack of activity increases the risk of heart disease, colon and breast cancer, diabetes mellitus, hypertension, osteoporosis, anxiety and depression and others diseases. Emerging literature has suggested that in terms of mortality, the global population health burden of physical inactivity approaches that of cigarette smoking. The prevalence and substantial disease risk associated with physical inactivity has been described as a pandemic.

The prevalence, health impact, and evidence of changeability all have resulted in calls for action to increase physical activity across the lifespan. In response to the need to find ways to make physical activity a health priority for youth, the Institute of Medicine’s Committee on Physical Activity and Physical Education in the School Environment was formed. Its purpose was to review the current status of physical activity and physical education in the school environment, including before, during, and after school, and examine the influences of physical activity and physical education on the short and long term physical, cognitive and brain, and psychosocial health and development of children and adolescents.

Educating the Student Body makes recommendations about approaches for strengthening and improving programs and policies for physical activity and physical education in the school environment. This report lays out a set of guiding principles to guide its work on these tasks. These included: recognizing the benefits of instilling life-long physical activity habits in children; the value of using systems thinking in improving physical activity and physical education in the school environment; the recognition of current disparities in opportunities and the need to achieve equity in physical activity and physical education; the importance of considering all types of school environments; the need to take into consideration the diversity of students as recommendations are developed.

This report will be of interest to local and national policymakers, school officials, teachers, and the education community, researchers, professional organizations, and parents interested in physical activity, physical education, and health for school-aged children and adolescents.

Extensive Study on Concussions in Youth Sports Finds ‘Culture of Resistance’ for Self-Reporting Injury; Not Enough Evidence to Support Claim That Helmets Reduce Concussion Risk

November 1, 2013 Comments off

Extensive Study on Concussions in Youth Sports Finds ‘Culture of Resistance’ for Self-Reporting Injury; Not Enough Evidence to Support Claim That Helmets Reduce Concussion Risk
Source: Institute of Medicine and National Research Council

Young athletes in the U.S. face a “culture of resistance” to reporting when they might have a concussion and to complying with treatment plans, which could endanger their well-being, says a new report from the Institute of Medicine and National Research Council. The report provides a broad examination of concussions in a variety of youth sports with athletes aged 5 to 21. Overall, reported concussions rates are more frequent among high school athletes than college athletes in some sports — including football, men’s lacrosse and soccer, and baseball; higher for competition than practice (except for cheerleading); and highest in football, ice hockey, lacrosse, wrestling, soccer, and women’s basketball. Concussion rates also appear higher for youths with a history of prior concussions and among female athletes.

Although the committee that wrote the report examined useful scientific information to inform its study, it discovered that research about youth concussions is limited. To address these gaps in knowledge, the committee identified several areas for further research, including establishing a national surveillance system to accurately determine the number of sports-related concussions, identifying changes in the brain following concussions in youth, conducting studies to assess the consequences and effects of concussions over a life span, and evaluating the effectiveness of sports rules and playing practices in reducing concussions.

The Evidence for Violence Prevention Across the Lifespan and Around the World: Workshop Summary (2013)

October 31, 2013 Comments off

The Evidence for Violence Prevention Across the Lifespan and Around the World: Workshop Summary (2013)
Source: Institute of Medicine/National Research Council

The Evidence for Violence Prevention Across the Lifespan and Around the World is the summary of a workshop convened in January 2013 by the Institute of Medicine’s Forum on Global Violence Prevention to explore value and application of the evidence for violence prevention across the lifespan and around the world. As part of the Forum’s mandate is to engage in multisectoral, multidirectional dialogue that explores crosscutting approaches to violence prevention, this workshop examined how existing evidence for violence prevention can continue to be expanded, disseminated, and implemented in ways that further the ultimate aims of improved individual well-being and safer communities. This report examines violence prevention interventions that have been proven to reduce different types of violence (e.g., child and elder abuse, intimate partner and sexual violence, youth and collective violence, and self-directed violence), identifies the common approaches most lacking in evidentiary support, and discusses ways that proven effective interventions can be integrated or otherwise linked with other prevention programs.

International Regulatory Harmonization Amid Globalization of Drug Development: Workshop Summary (2013)

October 30, 2013 Comments off

International Regulatory Harmonization Amid Globalization of Drug Development: Workshop Summary (2013)
Source: Institute of Medicine

The past several decades have been a time of rapid globalization in the development, manufacture, marketing, and distribution of medical products and technologies. Increasingly, research on the safety and effectiveness of new drugs is being conducted in countries with little experience in regulation of medical product development. Demand has been increasing for globally harmonized, science-based standards for the development and evaluation of the safety, quality, and efficacy of medical products. Consistency of such standards could improve the efficiency and clarity of the drug development and evaluation process and, ultimately, promote and enhance product quality and the public health.

To explore the need and prospects for greater international regulatory harmonization for drug development, the IOM Forum on Drug Discovery, Development, and Translation hosted a workshop on February 13-14, 2013. Discussions at the workshop helped identify principles, potential approaches, and strategies to advance the development or evolution of more harmonized regulatory standards. This document summarizes the workshop.

Organizational Change to Improve Health Literacy: Workshop Summary (2013)

October 29, 2013 Comments off

Organizational Change to Improve Health Literacy: Workshop Summary (2013)
Source: Institute of Medicine

Organizational Change to Improve Health Literacy is the summary of a workshop convened in April 2013 by the Institute of Medicine Board on Population Health and Public Health Practice Roundtable on Health Literacy. As a follow up to the 2012 discussion paper Ten Attributes of a Health Literate Health Care Organization, participants met to examine what is known about implementation of the attributes of a health literate health care organization and to create a network of health literacy implementers who can share information about health literacy innovations and problem solving. This report discusses implementation approaches and shares tools that could be used in implementing specific literacy strategies.

Although health literacy is commonly defined as an individual trait, there is a growing appreciation that health literacy does not depend on the skills of individuals alone. Health literacy is the product of the interaction between individuals’ capacities and the health literacy-related demands and complexities of the health care system. System changes are needed to better align health care demands with the public’s skills and abilities. Organizational Change to Improve Health Literacy focuses on changes that could be made to achieve this goal.

Elder Abuse and Its Prevention: Workshop Summary (2013)

October 24, 2013 Comments off

Elder Abuse and Its Prevention: Workshop Summary (2013)
Source: Institute of Medicine/National Research Council

Elder Abuse and Its Prevention is the summary of a workshop convened in April 2013 by the Institute of Medicine’s Forum on Global Violence Prevention. Using an ecological framework, this workshop explored the burden of elder abuse around the world, focusing on its impacts on individuals, families, communities, and societies. Additionally, the workshop addressed occurrences and co-occurrences of different types of abuse, including physical, sexual, emotional, and financial, as well as neglect. The ultimate objective was to illuminate promising global and multisectoral evidence-based approaches to the prevention of elder maltreatment. While the workshop covered scope and prevalence and unique characteristics of abuse, the intention was to move beyond what is known about elder abuse to foster discussions about how to improve prevention, intervention, and mitigation of the victims’ needs, particularly through collaborative efforts. The workshop discussions included innovative intervention models and opportunities for prevention across sectors and settings.

Violence and related forms of abuse against elders is a global public health and human rights problem with far-reaching consequences, resulting in increased death, disability, and exploitation with collateral effects on well-being. Data suggest that at least 10 percent of elders in the United States are victims of elder maltreatment every year. In low- and middle-income countries, where the burden of violence is the greatest, the figure is likely even higher. In addition, elders experiencing risk factors such as diminishing cognitive function, caregiver dependence, and social isolation are more vulnerable to maltreatment and underreporting. As the world population of adults aged 65 and older continues to grow, the implications of elder maltreatment for health care, social welfare, justice, and financial systems are great. However, despite the magnitude of global elder maltreatment, it has been an underappreciated public health problem. Elder Abuse and Its Prevention discusses the prevalence and characteristics of elder abuse around the world, risk factors for abuse and potential adverse health outcomes, and contextually specific factors, such as culture and the role of the community.

Population Health Implications of the Affordable Care Act: Workshop Summary (2013)

October 16, 2013 Comments off

Population Health Implications of the Affordable Care Act: Workshop Summary (2013)
Source: Institute of Medicine

Population Health Implications of the Affordable Care Act is the summary of a workshop convened in June 2013 by the Institute of Medicine Roundtable on Population Health Improvement to explore the likely impact on population health improvement of various provisions within the Affordable Care Act (ACA). This public workshop featured presentations and discussion of the impact of various provisions in the ACA on population health improvement.

Several provisions of the ACA offer an unprecedented opportunity to shift the focus of health experts, policy makers, and the public beyond health care delivery to the broader array of factors that play a role in shaping health outcomes. The shift includes a growing recognition that the health care delivery system is responsible for only a modest proportion of what makes and keeps Americans healthy and that health care providers and organizations could accept and embrace a richer role in communities, working in partnership with public health agencies, community-based organizations, schools, businesses, and many others to identify and solve the thorny problems that contribute to poor health.

Population Health Implications of the Affordable Care Act looks beyond narrow interpretations of population as the group of patients covered by a health plan to consider a more expansive understanding of population, one focused on the distribution of health outcomes across all individuals living within a certain set of geopolitical boundaries. In establishing the National Prevention, Health Promotion, and Public Health Council, creating a fund for prevention and public health, and requiring nonprofit hospitals to transform their concept of community benefit, the ACA has expanded the arena for interventions to improve health beyond the “doctor’s” office. Improving the health of the population – whether in a community or in the nation as a whole – requires acting to transform the places where people live, work, study, and play. This report examines the population health-oriented efforts of and interactions among public health agencies (state and local), communities, and health care delivery organizations that are beginning to facilitate such action.

Priorities for Research to Reduce the Threat of Firearm-Related Violence

October 8, 2013 Comments off

Priorities for Research to Reduce the Threat of Firearm-Related Violence
Source: Institute of Medicine & National Research Council

In 2010, more than 105,000 people were injured or killed in the United States as the result of a firearm-related incident. Recent, highly publicized, tragic mass shootings in Newtown, CT; Aurora, CO; Oak Creek, WI; and Tucson, AZ, have sharpened the American public’s interest in protecting our children and communities from the harmful effects of firearm violence. While many Americans legally use firearms for a variety of activities, fatal and nonfatal firearm violence poses a serious threat to public safety and welfare.

In January 2013, President Barack Obama issued 23 executive orders directing federal agencies to improve knowledge of the causes of firearm violence, what might help prevent it, and how to minimize its burden on public health. One of these orders directed the Centers for Disease Control and Prevention (CDC) to, along with other federal agencies, immediately begin identifying the most pressing problems in firearm violence research. The CDC and the CDC Foundation asked the IOM, in collaboration with the National Research Council, to convene a committee tasked with developing a potential research agenda that focuses on the causes of, possible interventions to, and strategies to minimize the burden of firearm-related violence. Priorities for Research to Reduce the Threat of Firearm-Related Violence focuses on the characteristics of firearm violence, risk and protective factors, interventions and strategies, the impact of gun safety technology, and the influence of video games and other media.

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