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Psychological Testing in the Service of Disability Determination (2015)

June 29, 2015 Comments off

Psychological Testing in the Service of Disability Determination (2015) (PDF)
Source: Institute of Medicine

The United States Social Security Administration (SSA) administers two disability programs: Social Security Disability Insurance (SSDI), for disabled individuals, and their dependent family members, who have worked and contributed to the Social Security trust funds, and Supplemental Security Income (SSSI), which is a means-tested program based on income and financial assets for adults aged 65 years or older and disabled adults and children. Both programs require that claimants have a disability and meet specific medical criteria in order to qualify for benefits. SSA establishes the presence of a medically-determined impairment in individuals with mental disorders other than intellectual disability through the use of standard diagnostic criteria, which include symptoms and signs. These impairments are established largely on reports of signs and symptoms of impairment and functional limitation.

Psychological Testing in the Service of Disability Determination considers the use of psychological tests in evaluating disability claims submitted to the SSA. This report critically reviews selected psychological tests, including symptom validity tests, that could contribute to SSA disability determinations. The report discusses the possible uses of such tests and their contribution to disability determinations. Psychological Testing in the Service of Disability Determination discusses testing norms, qualifications for administration of tests, administration of tests, and reporting results. The recommendations of this report will help SSA improve the consistency and accuracy of disability determination in certain cases.

The Neuroscience of Gaming: Workshop in Brief

May 30, 2015 Comments off

The Neuroscience of Gaming: Workshop in Brief (via NCBI Bookshelf)
Source: Institute of Medicine

More than 1.2 billion people worldwide play video games (online, via console, mobile phone, and other wireless devices), and many may be unaware that programmers often incorporate neuroscience into game design. Given the high prevalence of gaming in today’s society, the Institute of Medicine (IOM) Forum on Neuroscience and Nervous System Disorders hosted the Social Issues Roundtable at the Society for Neuroscience annual meeting on November 16, 2014, in Washington, DC, to explore the neuroscience of video games, with emphasis on relevant scientific, ethical, and societal issues. Jonathan Moreno, David and Lyn Silfen University Professor in the Department of Medical Ethics and Health Policy at the University of Pennsylvania Health System, and session moderator, noted the following objectives of the session:

1.Explore the use of neuroscience concepts in video game design, including (a) key structural features of gaming that are derived from neuroscience concepts, and (b) the physiological effects of gaming as a result of the game’s structural characteristics (e.g., reward circuitry);

2.Discuss the positive and negative uses of neuroscience in video games;

3.Review the utility of gaming and opportunities in education, training, rehabilitation, and health;

4.Discuss the adverse consequences of problematic gaming, including (a) similarities of problematic gaming to other addictive behaviors (e.g., substance use), and (b) individual characteristics that may make a gamer at risk for problematic gaming; and

5.Consider the ethical and societal underpinnings of the use of neuroscience in gaming design for developers and gamers.

The discussions highlighted the critical need for improved, evidence-based studies to comprehensively assess risks and benefits of video games, noted Moreno. In addition, a few panelists discussed the potential to create regulatory pathways for combination therapies using video games that have been shown to be efficacious in the health sector. However, several panelists asserted that the ethical and societal implications of video games should be examined closely, given the potential side effects and consequences (intended and unintended) of video games to players.

Relationships Among the Brain, the Digestive System, and Eating Behavior: Workshop Summary (2015)

May 9, 2015 Comments off

Relationships Among the Brain, the Digestive System, and Eating Behavior: Workshop Summary (2015) (PDF)
Source: Institute of Medicine

On July 9-10, 2014, the Institute of Medicine’s Food Forum hosted a public workshop to explore emerging and rapidly developing research on relationships among the brain, the digestive system, and eating behavior. Drawing on expertise from the fields of nutrition and food science, animal and human physiology and behavior, and psychology and psychiatry as well as related fields, the purpose of the workshop was to (1) review current knowledge on the relationship between the brain and eating behavior, explore the interaction between the brain and the digestive system, and consider what is known about the brain’s role in eating patterns and consumer choice; (2) evaluate current methods used to determine the impact of food on brain activity and eating behavior; and (3) identify gaps in knowledge and articulate a theoretical framework for future research. Relationships among the Brain, the Digestive System, and Eating Behavior summarizes the presentations and discussion of the workshop.
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Vital Signs: Core Metrics for Health and Health Care Progress (2015)

May 7, 2015 Comments off

Vital Signs: Core Metrics for Health and Health Care Progress (2015)
Source: Institute of Medicine

Thousands of measures are in use today to assess health and health care in the United States. Although many of these measures provide useful information, their sheer number, as well as their lack of focus, consistency, and organization, limits their overall effectiveness in improving performance of the health system. To achieve better health at a lower cost, all stakeholders – including health professionals, payers, policy makers, and members of the public – must be alert to what matters most. What are the core measures that will yield the clearest understanding and focus on better health and well-being for Americans?

Vital Signs identifies the need for a standard set of core measures as a tool for improving health in the United States. This book explains the current use of metrics in health and health care and then proposes a streamlined set of 15 standardized measures, with recommendations for their application at every level and across sectors. This structured set of measures could provide consistent benchmarks for health progress across the nation and improve system performance in the highest-priority areas.

If health care is to become more effective and more efficient then sharper attention is required on the most important elements of health care. Important, focused, and reliable core metrics are critical to this effort. Vital Signs lays the groundwork for the adoption of core measures that if systematically applied could yield better health at a lower cost for all Americans.

Measuring the Risks and Causes of Premature Death: Summary of a Workshop (2015)

April 20, 2015 Comments off

Measuring the Risks and Causes of Premature Death: Summary of a Workshop (2015)
Source: Institute of Medicine

Measuring the Risks and Causes of Premature Death is the summary of two workshops conducted by The Committee on Population of the National Research Council at the National Academies to address the data sources, science and future research needs to understand the causes of premature mortality in the United States. The workshops reviewed previous work in the field in light of new data generated as part of the work of the NRC Panel on Understanding Divergent Trends in Longevity in High-Income Countries (NRC, 2011) and the NRC/IOM Panel on Understanding Cross-National Differences Among High-Income Countries (NRC/IOM, 2013). The workshop presentations considered the state of the science of measuring the determinants of the causes of premature death, assessed the availability and quality of data sources, and charted future courses of action to improve the understanding of the causes of premature death. Presenters shared their approaches to and results of measuring premature mortality and specific risk factors, with a particular focus on those factors most amenable to improvement through public health policy. This report summarizes the presentations and discussion of both workshops.

Available Evidence Suggests That Possible Regulation of Cigarettes Not Likely to Significantly Change U.S. Illicit Tobacco Market

April 9, 2015 Comments off

Available Evidence Suggests That Possible Regulation of Cigarettes Not Likely to Significantly Change U.S. Illicit Tobacco Market
Source: National Research Council and Institute of Medicine

Although there is insufficient evidence to draw firm conclusions about how the U.S. illicit tobacco market would respond to any new regulations that modify cigarettes—for example, by lowering nicotine content—limited evidence suggests that demand for illicit versions of conventional cigarettes would be modest, says a new congressionally mandated report from the National Research Council and Institute of Medicine.

Tobacco use has declined in the past few decades due to measures such as high taxes on tobacco products and bans on advertising, though there are still more than 1 billion people worldwide who regularly use tobacco, including many who purchase their products illicitly. Illicit tobacco markets can undermine public health efforts to reduce tobacco use, while depriving governments of revenue. In the United States, the revenue losses are borne mostly by the states.

The Future of Home Health Care: Workshop Summary (2015)

March 26, 2015 Comments off

The Future of Home Health Care: Workshop Summary (2015)
Source: Institute of Medicine/National Research Council

Individuals with disabilities, chronic conditions, and functional impairments need a range of services and supports to keep living independently. However, there often is not a strong link between medical care provided in the home and the necessary social services and supports for independent living. Home health agencies and others are rising to the challenges of meeting the needs and demands of these populations to stay at home by exploring alternative models of care and payment approaches, the best use of their workforces, and technologies that can enhance independent living. All of these challenges and opportunities lead to the consideration of how home health care fits into the future health care system overall.

On September 30 and October 1, 2014, the Institute of Medicine and the National Research Council convened a public workshop on the future of home health care. The workshop brought together a spectrum of public and private stakeholders and thought leaders to improve understanding of the current role of Medicare home health care in supporting aging in place and in helping high-risk, chronically ill, and disabled Americans receive health care in their communities. Through presentations and discussion, participants explored the evolving role of Medicare home health care in caring for Americans in the future, including how to integrate Medicare home health care into new models for the delivery of care and the future health care marketplace. The workshop also considered the key policy reforms and investments in workforces, technologies, and research needed to leverage the value of home health care to support older Americans, and research priorities that can help clarify the value of home health care. This summary captures important points raised by the individual speakers and workshop participants.

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