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The Unpredictable Certainty: Information Infrastructure Through 2000
by NII 2000 Steering CommitteeWe have available an impressive array of information technology. We can transmit literature, movies, music, and talk. Government, businesses, and individuals are eager to go on-line to buy, sell, teach, learn, and more. How, then, should we go about developing an infrastructure for on- line communication among everyone everywhere? The Unpredictable Certainty explores the national information infrastructure (NII) as the collection of all public and private information services. But how and when will the NII become a reality? How will more and better services reach the home, small businesses, and remote locations? The Unpredictable Certainty examines who will finance the NII, exploring how technology companies decide to invest in deployment and the the vain search for "killer apps" (applications that drive markets). It discusses who will pay for ongoing services and how they will pay, looking at past cost/price models relevant to the future. The Unpredictable Certainty discusses the underlying technologies, appliances, and services needed before the NII becomes a reality; reviews key features of important technologies; and analyzes current levels of deployment in telephone, cable and broadcast television, and wireless systems, and the difficulties in interconnection. The volume explores the challenge of open interfaces that stimulate new applications but also facilitate competition, the trend toward the separation of infrastructure from specific services, the tension between mature services and new contenders, the growth of the Internet, and more. The roles governments at different levels might play in fostering NII deployment are outlined, including R&D and the use of information infrastructure for better delivery of government services and information.
THE ZOMBIE CURSE: A Doctor's 25-Year Journey into the Heart of the AIDS Epidemic in Haiti
by M. Fournier Daniel HerlihyThis memoir of a dedicated doctor battling the AIDS epidemic in Haiti does more than chronicle the story of a horrible disease. It is a moving tribute to the abundant courage, resilience, and dignity of a people beset by tragedy.The Zombie Curse A Doctor’s 25-Year Journey into the Heart of the AIDS Epidemic in Haiti Arthur M. Fournier, M.D., with Daniel Herlihy Dr. Art Fournier met his first AIDS patient on an autumn afternoon in 1979. Of course, neither Fournier nor his colleagues at Miami’s Jackson Memorial Hospital fully understood the chilling impact of what they were seeing. They were simply confounded by the fact that the patient failed to respond to treatment and, ultimately, died. During the next several months scores of additional patients presented themselves with similar symptoms—and met the same fate. Beyond the medical similarities, there was another bond that grouped these patients together: they were all Haitian immigrants. The zombie curse had descended on south Florida. As the AIDS epidemic unfolded around the world, Dr. Fournier witnessed the chaos, confusion, and blame that was to become associated with this baffling disease. Nothing in his background, education, or training prepared him for the journey that lay ahead. The death and misery were devastating, the disease frustrating and mysterious, and the spiritual toll as catastrophic as the physical. It soon became apparent that science alone could not win this epic battle. We follow Dr. Fournier to Haiti where he searches for ways to treat patients with AIDS—not simply the physical symptoms, but also the stereotyping and blame heaped on both the victims and even the doctors that tend to them. In large measure it is the generous spirit of a proud people that move and motivate Fournier, ultimately releasing him from his own zombie curse. This memoir of a dedicated doctor battling the AIDS epidemic in Haiti does more than chronicle the story of a horrible disease. It is a moving tribute to the abundant courage, resilience, and dignity of a people beset by tragedy.
Opportunities to Improve Opioid Use Disorder and Infectious Disease Services: Integrating Responses To A Dual Epidemic
by National Academies of Sciences Engineering MedicineOpioid use and infectious diseases are intertwined epidemics. Despite the fact that the United States is more than two decades into the opioid crisis - the cause of tens of thousands of deaths every year on its own - the health system has not sufficiently addressed the morbidity and mortality of drug use coupled with infectious diseases. This is at least in part due to traditional models of substance use disorder care wherein substance use disorder treatment is delivered independently of other medical care, thereby inhibiting the delivery of comprehensive care. As a result, the United States is experiencing a drastic increase in infectious diseases that spread with drug use. Opportunities to Improve Opioid Use Disorder and Infectious Disease Services examines current efforts to integrate care and describes barriers, such as inadequate workforce and training; lack of data integration and sharing; and stigma among people who use drugs and have also been diagnosed with an infectious disease. The conclusions and recommendations of this report will help to promote patient-centered, integrated programs to address this dual epidemic.
Enhancing Scientific Reproducibility in Biomedical Research Through Transparent Reporting: Proceedings Of A Workshop
by Engineering Medicine National Academies of SciencesSharing knowledge is what drives scientific progress - each new advance or innovation in biomedical research builds on previous observations. However, for experimental findings to be broadly accepted as credible by the scientific community, they must be verified by other researchers. An essential step is for researchers to report their findings in a manner that is understandable to others in the scientific community and provide sufficient information for others to validate the original results and build on them. In recent years, concern has been growing over a number of studies that have failed to replicate previous results and evidence from larger meta-analyses, which have pointed to the lack of reproducibility in biomedical research. On September 25 and 26, 2019, the National Academies of Science, Engineering, and Medicine hosted a public workshop in Washington, DC, to discuss the current state of transparency in the reporting of preclinical biomedical research and to explore opportunities for harmonizing reporting guidelines across journals and funding agencies. Convened jointly by the Forum on Drug Discovery, Development, and Translation; the Forum on Neuroscience and Nervous System Disorders; the National Cancer Policy Forum; and the Roundtable on Genomics and Precision Health, the workshop primarily focused on transparent reporting in preclinical research, but also considered lessons learned and best practices from clinical research reporting. This publication summarizes the presentation and discussion of the workshop.
Data Analytics and What It Means to the Materials Community: Proceedings Of A Workshop
by National Academies of Sciences, Engineering, and Medicine Division on Engineering and Physical Sciences National Materials and Manufacturing Board Defense Materials Manufacturing and Infrastructure Standing CommitteeEmerging techniques in data analytics, including machine learning and artificial intelligence, offer exciting opportunities for advancing scientific discovery and innovation in materials science. Vast repositories of experimental data and sophisticated simulations are being utilized to predict material properties, design and test new compositions, and accelerate nearly every facet of traditional materials science. How can the materials science community take advantage of these opportunities while avoiding potential pitfalls? What roadblocks may impede progress in the coming years, and how might they be addressed? To explore these issues, the Workshop on Data Analytics and What It Means to the Materials Community was organized as part of a workshop series on Defense Materials, Manufacturing, and Its Infrastructure. Hosted by the National Academies of Sciences, Engineering, and Medicine, the 2-day workshop was organized around three main topics: materials design, data curation, and emerging applications. Speakers identified promising data analytics tools and their achievements to date, as well as key challenges related to dealing with sparse data and filling data gaps; decisions around data storage, retention, and sharing; and the need to access, combine, and use data from disparate sources. Participants discussed the complementary roles of simulation and experimentation and explored the many opportunities for data informatics to increase the efficiency of materials discovery, design, and testing by reducing the amount of experimentation required. With an eye toward the ultimate goal of enabling applications, attendees considered how to ensure that the benefits of data analytics tools carry through the entire materials development process, from exploration to validation, manufacturing, and use. This publication summarizes the presentations and discussion of the workshop.
Origins, Worlds, and Life: A Decadal Strategy For Planetary Science And Astrobiology 2023-2032
by National Academies of Sciences, Engineering, and Medicine Division on Engineering and Physical Sciences Space Studies Board Committee on the Planetary Science and Astrobiology Decadal SurveyThe next decade of planetary science and astrobiology holds tremendous promise. New research will expand our understanding of our solar system’s origins, how planets form and evolve, under what conditions life can survive, and where to find potentially habitable environments in our solar system and beyond. Origins, Worlds, and Life: A Decadal Strategy for Planetary Science and Astrobiology 2023-2032 highlights key science questions, identifies priority missions, and presents a comprehensive research strategy that includes both planetary defense and human exploration. This report also recommends ways to support the profession as well as the technologies and infrastructure needed to carry out the science.
Advanced Technologies for Gas Turbines
by National Academies of Sciences Engineering MedicineLeadership in gas turbine technologies is of continuing importance as the value of gas turbine production is projected to grow substantially by 2030 and beyond. Power generation, aviation, and the oil and gas industries rely on advanced technologies for gas turbines. Market trends including world demographics, energy security and resilience, decarbonization, and customer profiles are rapidly changing and influencing the future of these industries and gas turbine technologies. Technology trends that define the technological environment in which gas turbine research and development will take place are also changing - including inexpensive, large scale computational capabilities, highly autonomous systems, additive manufacturing, and cybersecurity. It is important to evaluate how these changes influence the gas turbine industry and how to manage these changes moving forward. Advanced Technologies for Gas Turbines identifies high-priority opportunities for improving and creating advanced technologies that can be introduced into the design and manufacture of gas turbines to enhance their performance. The goals of this report are to assess the 2030 gas turbine global landscape via analysis of global leadership, market trends, and technology trends that impact gas turbine applications, develop a prioritization process, define high-priority research goals, identify high-priority research areas and topics to achieve the specified goals, and direct future research. Findings and recommendations from this report are important in guiding research within the gas turbine industry and advancing electrical power generation, commercial and military aviation, and oil and gas production.
Addressing Sickle Cell Disease: A Strategic Plan And Blueprint For Action
by National Academies of Sciences, Engineering, and Medicine Health and Medicine Division Board on Population Health and Public Health Practice Committee on Addressing Sickle Cell Disease: A Strategic Plan and Blueprint for ActionSickle cell disease (SCD) is a genetic condition that affects approximately 100,000 people in the United States and millions more globally. Individuals with SCD endure the psychological and physiological toll of repetitive pain as well as side effects from the pain treatments they undergo. Some adults with SCD report reluctance to use health care services, unless as a last resort, due to the racism and discrimination they face in the health care system. Additionally, many aspects of SCD are inadequately studied, understood, and addressed. Addressing Sickle Cell Disease examines the epidemiology, health outcomes, genetic implications, and societal factors associated with SCD and sickle cell trait (SCT). This report explores the current guidelines and best practices for the care of patients with SCD and recommends priorities for programs, policies, and research. It also discusses limitations and opportunities for developing national SCD patient registries and surveillance systems, barriers in the healthcare sector associated with SCD and SCT, and the role of patient advocacy and community engagement groups.
Population Health Science in the United States: Trends, Evidence, And Implications For Policy: Proceedings Of A Joint Symposium
by National Academies of Sciences, Engineering, and Medicine Health and Medicine Division Board on Population Health and Public Health Practice Roundtable on Population Health ImprovementOn October 3, 2018, the Roundtable on Population Health Improvement of the National Academies of Sciences, Engineering, and Medicine and the Interdisciplinary Association for Population Health Science convened a joint symposium in Washington, DC to consider the current state of population health science in the United States. At the symposium, speakers and participants reviewed the status of population health in the United States, including current trends in health and mortality, and racial, ethnic, and socioeconomic disparities; explored the complexities of policy implementation with attention to evidence generation and to surfacing and mitigating negative unintended consequences of policies for population health; and shared perspectives on finding common ground to move population health forward. This publication summarizes the presentation and discussion of the workshop.
Birth Settings in America: Outcomes, Quality, Access, And Choice
by National Academies of Sciences Engineering MedicineThe delivery of high quality and equitable care for both mothers and newborns is complex and requires efforts across many sectors. The United States spends more on childbirth than any other country in the world, yet outcomes are worse than other high-resource countries, and even worse for Black and Native American women. There are a variety of factors that influence childbirth, including social determinants such as income, educational levels, access to care, financing, transportation, structural racism and geographic variability in birth settings. It is important to reevaluate the United States' approach to maternal and newborn care through the lens of these factors across multiple disciplines. Birth Settings in America: Outcomes, Quality, Access, and Choice reviews and evaluates maternal and newborn care in the United States, the epidemiology of social and clinical risks in pregnancy and childbirth, birth settings research, and access to and choice of birth settings.
Life-Cycle Decisions for Biomedical Data: The Challenge Of Forecasting Costs
by Computer Science and Telecommunications Board Division on Engineering and Physical Sciences Policy and Global Affairs Division on Earth and Life Studies Board on Life Sciences Committee on Applied and Theoretical Statistics National Academies of Sciences, Engineering, and Medicine Board on Mathematical Sciences and Analytics Board on Research Data and Information Committee on Forecasting Costs for Preserving and Promoting Access to Biomedical DataBiomedical research results in the collection and storage of increasingly large and complex data sets. Preserving those data so that they are discoverable, accessible, and interpretable accelerates scientific discovery and improves health outcomes, but requires that researchers, data curators, and data archivists consider the long-term disposition of data and the costs of preserving, archiving, and promoting access to them. Life Cycle Decisions for Biomedical Data examines and assesses approaches and considerations for forecasting costs for preserving, archiving, and promoting access to biomedical research data. This report provides a comprehensive conceptual framework for cost-effective decision making that encourages data accessibility and reuse for researchers, data managers, data archivists, data scientists, and institutions that support platforms that enable biomedical research data preservation, discoverability, and use.
Advancing Aerial Mobility: A National Blueprint
by Division on Engineering and Physical Sciences Aeronautics and Space Engineering Board National Academies of Sciences, Engineering, and Medicine Committee on Enhancing Air Mobility—A National BlueprintAdvanced aerial mobility is a newly emerging industry that aims to develop and operate new air vehicles potentially capable of safe, reliable, and low-noise vertical flight. The world has seen a recent increase in the adoption of electric vertical lift aircraft for urban, suburban and rural operations. These new innovations and technologies change the way that we move cargo and people, affecting industries across the economy. These changes will challenge today's airspace monitoring systems and regulatory environment. The U.S. government and its regulatory agencies need technical guidance to facilitate the development of these technologies, and to create the regulatory framework to foster the growth of this vertical flight industry to the benefit of the aviation industry. Advancing Aerial Mobility evaluates the potential benefits and challenges associated with this emerging industry. This report provides recommendations that seek to foster an environment in which the nation can maintain its leading position in developing, deploying, and embracing these new technologies. This publication presents a national vision for advanced aerial mobility, market evolution, and safety and security management.
A Decadal Survey of the Social and Behavioral Sciences: A Research Agenda for Advancing Intelligence Analysis: Digest Version
by National Academies of Sciences Engineering MedicineThe Digest Version of A Decadal Survey of the Social and Behavioral Sciences: A Research Agenda for Advancing Intelligence Analysis summarizes the most important ideas from the full report for the Intelligence Community to consider in the coming decade. This volume provides an overview of the primary opportunities that research in the social and behavioral sciences offers for strengthening national security, specifically the work of the intelligence analyst, and the conclusions and recommendations of the Committee on a Decadal Survey of Social and Behavioral Sciences for Applications to National Survey. This digest version is a succinct roadmap to the critical contribution researchers from these fields make to national security.
Evidence-Based Practice for Public Health Emergency Preparedness and Response
by National Academies of Sciences, Engineering, and Medicine Health and Medicine Division Board on Population Health and Public Health Practice Board on Health Sciences Policy Committee on Evidence-Based Practices for Public Health Emergency Preparedness and ResponseWhen communities face complex public health emergencies, state local, tribal, and territorial public health agencies must make difficult decisions regarding how to effectively respond. The public health emergency preparedness and response (PHEPR) system, with its multifaceted mission to prevent, protect against, quickly respond to, and recover from public health emergencies, is inherently complex and encompasses policies, organizations, and programs. Since the events of September 11, 2001, the United States has invested billions of dollars and immeasurable amounts of human capital to develop and enhance public health emergency preparedness and infrastructure to respond to a wide range of public health threats, including infectious diseases, natural disasters, and chemical, biological, radiological, and nuclear events. Despite the investments in research and the growing body of empirical literature on a range of preparedness and response capabilities and functions, there has been no national-level, comprehensive review and grading of evidence for public health emergency preparedness and response practices comparable to those utilized in medicine and other public health fields. Evidence-Based Practice for Public Health Emergency Preparedness and Response reviews the state of the evidence on PHEPR practices and the improvements necessary to move the field forward and to strengthen the PHEPR system. This publication evaluates PHEPR evidence to understand the balance of benefits and harms of PHEPR practices, with a focus on four main areas of PHEPR: engagement with and training of community-based partners to improve the outcomes of at-risk populations after public health emergencies; activation of a public health emergency operations center; communication of public health alerts and guidance to technical audiences during a public health emergency; and implementation of quarantine to reduce the spread of contagious illness.
Stronger Food and Drug Regulatory Systems Abroad
by National Academies of Sciences Engineering MedicineEnsuring the safety of food and the quality and safety of medicines in a country is an important role of government, made more complicated by global manufacturing and international trade. By recent estimates, unsafe food kills over 400,000 people a year, a third of them children under 5, mostly in low- and middle-income countries; every year poor quality medicines cause about 70,000 excess deaths from childhood pneumonia and roughly 8,500 to 20,000 malaria deaths in sub-Saharan Africa alone. The Federal Drug Administration (FDA) Office of Global Policy and Strategy is charged with improving capacity of the agency's foreign counterpart offices and increasing understanding of the importance of regulatory systems for public health, development, and trade. At the request of the FDA, this study sets out a strategy to support good quality, wholesome food and safe, effective medical products around the world. Its goal is to build on the momentum for strengthening regulatory systems and to set a course for sustainability and continued progress. The 2012 report Ensuring Safe Food and Medical Products Through Stronger Regulatory Systems Abroad outlined strategies to secure international supply chains, emphasized capacity building and support for surveillance in low- and middle-income countries, and explored ways to facilitate work sharing among food and medical product regulatory agencies. This new study assess progress made and the current regulatory landscape.
Temporomandibular Disorders: Priorities For Research And Care
by National Academies of Sciences Engineering MedicineTemporomandibular disorders (TMDs), are a set of more than 30 health disorders associated with both the temporomandibular joints and the muscles and tissues of the jaw. TMDs have a range of causes and often co-occur with a number of overlapping medical conditions, including headaches, fibromyalgia, back pain and irritable bowel syndrome. TMDs can be transient or long-lasting and may be associated with problems that range from an occasional click of the jaw to severe chronic pain involving the entire orofacial region. Everyday activities, including eating and talking, are often difficult for people with TMDs, and many of them suffer with severe chronic pain due to this condition. Common social activities that most people take for granted, such as smiling, laughing, and kissing, can become unbearable. This dysfunction and pain, and its associated suffering, take a terrible toll on affected individuals, their families, and their friends. Individuals with TMDs often feel stigmatized and invalidated in their experiences by their family, friends, and, often, the health care community. Misjudgments and a failure to understand the nature and depths of TMDs can have severe consequences — more pain and more suffering — for individuals, their families and our society. Temporomandibular Disorders: Priorities for Research and Care calls on a number of stakeholders — across medicine, dentistry, and other fields — to improve the health and well-being of individuals with a TMD. This report addresses the current state of knowledge regarding TMD research, education and training, safety and efficacy of clinical treatments of TMDs, and burden and costs associated with TMDs. The recommendations of Temporomandibular Disorders focus on the actions that many organizations and agencies should take to improve TMD research and care and improve the overall health and well-being of individuals with a TMD.
Neuroscience Data in the Cloud: Opportunities And Challenges: Proceedings Of A Workshop
by National Academies of Sciences Engineering MedicineThe cloud model of data sharing has led to a vast increase in the quantity and complexity of data and expanded access to these data, which has attracted many more researchers, enabled multi-national neuroscience collaborations, and facilitated the development of many new tools. Yet, the cloud model has also produced new challenges related to data storage, organization, and protection. Merely switching the technical infrastructure from local repositories to cloud repositories is not enough to optimize data use. To explore the burgeoning use of cloud computing in neuroscience, the National Academies Forum on Neuroscience and Nervous System Disorders hosted a workshop on September 24, 2019. A broad range of stakeholders involved in cloud-based neuroscience initiatives and research explored the use of cloud technology to advance neuroscience research and shared approaches to address current barriers. This publication summarizes the presentation and discussion of the workshop.
Deployment of Deep Decarbonization Technologies: Proceedings Of A Workshop
by National Academies of Sciences Engineering MedicineWhile progress has been made in the development of decarbonization technologies, much work remains in scale-up and deployment. For decarbonization technologies to reach meaningful scale, real-world constraints, societal, economic, and political, must be considered. To identify the primary challenges and opportunities to deploying decarbonization technologies at scale across major sectors of the U.S. economy, the Board on Energy and Environmental Systems of the National Academies of Sciences, Engineering, and Medicine convened a workshop on July 22-23, 2019. In addition to technology-specific and sector-specific studies, the workshop considered the types of societal transformations required, as well as potential policy drivers for carbon dioxide emissions reductions. This publication summarizes the presentations and discussion of the workshop.
A Consumer Food Data System for 2030 and Beyond
by National Academies of Sciences, Engineering, and Medicine Division of Behavioral and Social Sciences and Education Committee on National Statistics Panel on Improving Consumer Data for Food and Nutrition Policy Research for the Economic Research ServicePatterns of food consumption and nutritional intake strongly affect the population's health and well-being. The Food Economics Division of USDA's Economic Research Service (ERS) engages in research and data collection to inform policy making related to the leading federal nutrition assistance programs managed by USDA's Food and Nutrition Service. The ERS uses the Consumer Food Data System to understand why people choose foods, how food assistance programs affect these choices, and the health impacts of those choices. At the request of ERS, A Consumer Food Data System for 2030 and Beyond provides a blueprint for ERS's Food Economics Division for its data strategy over the next decade. This report explores the quality of data collected, the data collection process, and the kinds of data that may be most valuable to researchers, policy makers, and program administrators going forward. The recommendations of A Consumer Food Data System for 2030 and Beyond will guide ERS to provide and sustain a multisource, interconnected, reliable data system.
Energizing Data-Driven Operations at the Tactical Edge: Challenges And Concerns
by National Academies of Sciences, Engineering, and Medicine Division on Engineering and Physical Sciences Air Force Studies Board Committee on Energy Challenges and Opportunities for Future Data-Driven Operations in the United States Air ForceSignificant efforts are ongoing within the U.S. Air Force (USAF) to improve national security and competitiveness by harnessing the growing power of information technologies, such as artificial intelligence (AI) and robotics. Product and process technologies are being researched, experimented with, and integrated into future warfighting concepts and plans. A significant part of this effort is focused on integrating operations, from the strategic to the tactical and across all lines of effort. A question that must be asked in considering these future warfighting concepts is: how will the devices that enable the knowledge-based future be powered? The abundant energy supplies that characterize peacetime operating environments may not be readily available at the far reaches of the force projections - the tactical edge - during conflict. Understanding the energy challenges associated with continued data collection, processing, storage, analysis, and communications at the tactical edge is an important part of developing the plans for meeting the future competition on the battlefield. This report identifies challenges and issues associated with energy needs at the tactical edge as well as any potential for solutions to be considered in the future to help address these challenges. The recommendations of Energizing Data-Driven Operations at the Tactical Edge address understanding these requirement needs and the cascading effects of not meeting those needs, integrating energy needs for data processing into mission and unit readiness assessments, and research into product and process technologies to address energy-efficient computation, resilience, interoperability, and alternative solutions to energy management at the tactical edge.
Effectiveness and Impacts of Dust Control Measures for Owens Lake
by National Academies of Sciences Engineering MedicineDuring the 20th century, the city of Los Angeles diverted surface water flowing into Owens Lake for water supply, transforming the large, closed-basin, saline lake into a small brine pool surrounded by dry playa. Under high winds, the exposed lakebed produced large amounts of airborne dust, resulting in the highest concentrations of airborne particulate matter with an aerodynamic diameter of 10 micrometers or less (PM10) in the United States. Since 2000, the Los Angeles Department of Water and Power, at the direction of the Great Basin Unified Air Pollution Control District, has been constructing and implementing dust control measures on the dry lakebed, with the objective of meeting the U.S. Environmental Protection Agency National Ambient Air Quality Standards for PM10 and the PM10 standards set by the state of California. Many of the dust control measures used at Owens Lake require large amounts of water, energy, and maintenance to sustain their performance. Effectiveness and Impacts of Dust Control Measures for Owens Lake evaluates the effectiveness of alternative solutions for their degree of PM10 reduction and the extent that they reduce use of water in controlling dust emissions. This report considers the associated energy and environmental and economic impacts of these proposed measures and assesses their durability and reliability.
Selected Health Conditions and Likelihood of Improvement with Treatment
by National Academies of Sciences Engineering MedicineThe Social Security Administration (SSA) administers two programs that provide disability benefits: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. SSDI provides disability benefits to people (under the full retirement age) who are no longer able to work because of a disabling medical condition. SSI provides income assistance for disabled, blind, and aged people who have limited income and resources regardless of their prior participation in the labor force. Both programs share a common disability determination process administered by SSA and state agencies as well as a common definition of disability for adults: “the inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months.” Disabled workers might receive either SSDI benefits or SSI payments, or both, depending on their recent work history and current income and assets. Disabled workers might also receive benefits from other public programs such as workers’ compensation, which insures against work-related illness or injuries occurring on the job, but those other programs have their own definitions and eligibility criteria. Selected Health Conditions and Likelihood of Improvement with Treatment identifies and defines the professionally accepted, standard measurements of outcomes improvement for medical conditions. This report also identifies specific, long-lasting medical conditions for adults in the categories of mental health disorders, cancers, and musculoskeletal disorders. Specifically, these conditions are disabling for a length of time, but typically don’t result in permanently disabling limitations; are responsive to treatment; and after a specific length of time of treatment, improve to the point at which the conditions are no longer disabling.
Social Isolation and Loneliness in Older Adults: Opportunities For The Health Care System
by Engineering Medicine National Academies of SciencesSocial isolation and loneliness are serious yet underappreciated public health risks that affect a significant portion of the older adult population. Approximately one-quarter of community-dwelling Americans aged 65 and older are considered to be socially isolated, and a significant proportion of adults in the United States report feeling lonely. People who are 50 years of age or older are more likely to experience many of the risk factors that can cause or exacerbate social isolation or loneliness, such as living alone, the loss of family or friends, chronic illness, and sensory impairments. Over a life course, social isolation and loneliness may be episodic or chronic, depending upon an individual’s circumstances and perceptions. A substantial body of evidence demonstrates that social isolation presents a major risk for premature mortality, comparable to other risk factors such as high blood pressure, smoking, or obesity. As older adults are particularly high-volume and high-frequency users of the health care system, there is an opportunity for health care professionals to identify, prevent, and mitigate the adverse health impacts of social isolation and loneliness in older adults. Social Isolation and Loneliness in Older Adults summarizes the evidence base and explores how social isolation and loneliness affect health and quality of life in adults aged 50 and older, particularly among low income, underserved, and vulnerable populations. This report makes recommendations specifically for clinical settings of health care to identify those who suffer the resultant negative health impacts of social isolation and loneliness and target interventions to improve their social conditions. Social Isolation and Loneliness in Older Adults considers clinical tools and methodologies, better education and training for the health care workforce, and dissemination and implementation that will be important for translating research into practice, especially as the evidence base for effective interventions continues to flourish.
Health Literacy and Communication Strategies in Oncology: Proceedings Of A Workshop
by National Academies of Sciences Engineering MedicineHealth literacy is a critical skill for engaging in healthy behaviors to reduce disease risk and improve health outcomes across the continuum of cancer care. However, estimates suggest that more than one-third of the U.S. adult population has low health literacy, and nearly half of all patients with cancer have difficulty understanding information about their disease or treatment. Low health literacy among patients with cancer is associated with poor health and treatment outcomes, including lower adherence to treatment, higher rates of missed appointments, and an increased risk of hospitalization. Low health literacy can also impede informed decision making, especially as cancer care becomes increasingly complex and as patients and their families take more active roles in treatment decisions. To examine opportunities to improve communication across the cancer care continuum, the National Cancer Policy Forum collaborated with the Roundtable on Health Literacy to host a workshop, Health Literacy and Communication Strategies in Oncology, July 15-16, 2019, in Washington, DC. Patients, patient advocates, clinicians, and researchers, representatives of health care organizations, academic medical centers, insurers, and federal agencies explored the challenges of achieving effective communication in cancer care. This publication summarizes the presentations and discussions of the workshop.
Heritable Human Genome Editing
by The Royal SocietyHeritable human genome editing - making changes to the genetic material of eggs, sperm, or any cells that lead to their development, including the cells of early embryos, and establishing a pregnancy - raises not only scientific and medical considerations but also a host of ethical, moral, and societal issues. Human embryos whose genomes have been edited should not be used to create a pregnancy until it is established that precise genomic changes can be made reliably and without introducing undesired changes - criteria that have not yet been met, says Heritable Human Genome Editing. From an international commission of the U.S. National Academy of Medicine, U.S. National Academy of Sciences, and the U.K.'s Royal Society, the report considers potential benefits, harms, and uncertainties associated with genome editing technologies and defines a translational pathway from rigorous preclinical research to initial clinical uses, should a country decide to permit such uses. The report specifies stringent preclinical and clinical requirements for establishing safety and efficacy, and for undertaking long-term monitoring of outcomes. Extensive national and international dialogue is needed before any country decides whether to permit clinical use of this technology, according to the report, which identifies essential elements of national and international scientific governance and oversight.