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In 2009 the Institute of Medicine (IOM) began to assess the need for better-defined medical and public health crisis standards of care (CSC) for catastrophic disasters and public health emergencies. Over the next 10 years, the IOM defined templates for those stakeholders responsible for integrated CSC planning and implementation; created a tool kit with guidance on indicators and triggers; provided a discussion kit for stakeholders to use with their own communities to establish appropriate indicators and triggers to guide their planning; disseminated the messages and key concepts of CSC; and built on the initial efforts to refine certain elements and address remaining gaps. This current Proceedings of a Workshop captures the discussions from a 2019 workshop reviewing the successes and gaps over the last 10 years of CSC work, in order to inform the next phases of planning and implementation. Table of Contents Front Matter 1 Introduction 2 Informing the Next Stage of Crisis Standards of Care 3 Ethical and Legal Considerations 4 Crisis Standards of Care Application Across Sectors 5 Implementing Crisis Standards of Care Across Sectors References Appendix A: Workshop Agenda Appendix B: Speaker Biographies
With rapidly rising rates of mental health disorders, changing patterns of occurrence, and increasing levels of morbidity, the need for a better understanding of the developmental origins and influence of mental health on children?s behavioral health outcomes has become critical. This need for better understanding extends to both the growing prevalence of mental health disorders as well as the role and impact of neurodevelopmental pathways in their onset and expression. Addressing these changes in disease patterns and effects on children and families will require a multifaceted approach that goes beyond simply making changes to clinical care or adding personnel to the health services system. New policies, financing, and implementation can put established best practices and numerous research findings from around the country into action. The Maternal and Child Health Life Course Intervention Research Network and the Forum for Children's Well-Being at the National Academies of Sciences, Engineering, and Medicine jointly organized a webinar series to explore how mental health disorders develop over the life course, with a special emphasis on prenatal, early, middle, and later childhood development. This series centered on identifying gaps in our knowledge, exploring possible new strategies for using existing data to enhance understanding of the developmental origins of mental disorders, reviewing potential approaches to prevention and optimization, and proposing new ways of framing how to understand, address, and prevent these disorders from a life course development perspective. This publication summarizes the presentations and discussions from the series. Table of Contents Front Matter 1 Introduction 2 Overview and Trends in Children's Mental Health 3 Developmental Origins of Children's Mental Health Disorders 4 New Ways of Thinking about Children's Mental Health 5 Policy Responses to Support Children's Mental Health 6 Transforming Children's Health Care to Improve Lifelong Behavioral Health References Appendix A: Schedule of Webinars Appendix B: Biographical Sketches of Workshop Presenters and Planning Committee Members
To take stock of lessons learned from COVID-19 around the world and in the United States, the Forum on Microbial Threats held two virtual workshops during 2021. The first workshop focused on what it means to frame the response to COVID-19 through a "syndemic" approach, and what the implications would be for global recovery. The second workshop focused more broadly on key lessons and emerging data from ongoing pandemic response efforts that can be incorporated into current health systems to improve resilience and preparedness for future outbreaks. This workshop explored the long-term effects of COVID-19 on health equity, including considerations for mental health and social determinants of health. It also addressed uncertainties during a pandemic, such as trust, communication, and engagement and explored approaches to systematize recovery efforts to improve the ongoing responses and prepare for the next pandemic. Experts discussed possibilities for a post-pandemic world and a response strategy for stakeholders that ensures sustained community partnerships and prioritization of health equity. This Proceedings of a Workshop summarizes the presentations and discussions from the second workshop. Table of Contents Front Matter 1 Introduction 2 Potential Long-Term Effects of COVID-19 on Health Equity 3 Addressing Uncertainties in Pandemic Communication 4 Systematizing Recovery Efforts to Mitigate the Next Pandemic 5 Strategies for a Post-COVID World References Appendix A: Workshop Statement of Task Appendix B: Workshop Agenda Appendix C: Speaker Biographies Appendix D: Table of Strategic Actionsfrom Group One Appendix E: Table of Strategic Actions from Group Two
Adolescence is a crucial period of life for the prevention of substance use disorders. Research has shown that early intervention can significantly reduce rates of substance use disorder in adulthood. To learn more about effective family-focused interventions in primary care settings for preventing substance use disorder, the National Academies of Sciences, Engineering, and Medicine hosted a workshop on May 5-6, 2022. The proceedings from that workshop explores existing efforts to incorporate family-focused interventions into state health care policies. It also examines barriers to implementing such interventions as well as lessons learned from successful efforts to scale up these interventions. Table of Contents Front Matter 1 Introduction 2 Family-Focused Interventions in Health Care Settings 3 Barriers to and Opportunities for Program Implementation and Widespread Scale-Up 4 Federal Agency Perspectives 5 Possible Future Directions References Appendix A: Workshop Agenda Appendix B: Biosketches of Steering Committee Members and Speakers
Crisis Standards of Care (CSC) inform decisions on medical care during a large-scale crisis such as a pandemic or natural disaster, eliminating the need to make these decisions at the bedside without protections or guidance. Numerous points throughout the COVID-19 pandemic have demonstrated the necessity of this type of crisis planning. The National Academies of Sciences, Engineering, and Medicine Forum on Medical and Public Health Preparedness for Disasters and Emergencies convened a series of public workshops to examine the experiences of healthcare providers during the COVID-19 pandemic and identify lessons that can inform current and future CSC planning and implementation. The workshops examined staffing and workforce needs, planning and implementation of CSC plans, and legal, ethical, and equity considerations of CSC planning. Topics of discussion included improving coordination between the bedside and boardroom, increasing buy-in from elected officials, expanding provider engagement, and addressing health equity issues. This publication summarizes the presentation and discussion of the workshops. Table of Contents Front Matter 1 Introduction 2 Reflections, Inflections, and the Future 3 Considerations for Staffing, Effects on the Workforce, and Future Trends 4 Crisis Standards of Care: From Plans to Reality 5 Legal, Ethical, and Equity Considerations for Crisis Standards of Care 6 Looking Forward References Appendix A: Workshop Agendas Appendix B: Speaker Biosketches
While the world continues to respond to the COVID-19 pandemic, novel influenza viruses persist as a constant pandemic threat. The global response to COVID-19 has pushed the boundaries on what is possible for rapid pandemic response in several areas, including vaccine research, development, manufacturing, equitable distribution, allocation, and administration. If well understood and sufficiently adapted, these actions could be applied to future pandemic and seasonal influenza vaccine preparedness efforts. However, developing and delivering these more effective vaccines to meet the demand goes beyond simply technical challenges and includes issues across governance, financing, research, supply chain, and public engagement. To address these challenges, the National Academies of Sciences, Engineering, and Medicine convened a virtual public workshop in May of 2021 to discuss the emerging evidence on unprecedented actions related to COVID-19 that could inform and advance pandemic and seasonal influenza vaccine preparedness efforts and subsequent response. This Proceedings of a Workshop provides a high-level summary of the presentations and discussions that occurred during the workshop. Table of Contents Front Matter 1 Introduction 2 Global Coordination, Partnerships, and Financing 3 Vaccine Research and Development 4 Vaccine Distribution and Supply Chain 5 Research Translation and Communication 6 Final Remarks References Appendix A: Statement of Task Appendix B: COVID-19 Lessons to Inform Pandemic Influenza Response Appendix C: Biographical Sketches of Workshop Presenters
Transplantation of a solid organ, such as a kidney, heart, or liver, is a lifesaving procedure and is sometimes the only viable treatment for patients experiencing end-stage organ failure as a result of illness or injury. A growing prevalence of solid organ diseases in the United States is contributing to more people needing a transplant and longer wait times on the national transplant waiting list. While transplantation can lengthen a person's life, the road to recovery is difficult and complex. Transplant recipients commonly experience considerable impairments related to health factors, medication side effects, organ rejection, or other setbacks that can cause functional limitations. A spectrum of services and supports can be beneficial to patient functioning and quality of life, but patient access is variable due to individual, system, and social factors. To gain an understanding of current scientific findings in the field of solid organ transplantation, the U.S. Social Security Administration asked the National Academies of Sciences, Engineering, and Medicine's Board on Health Care Services to organize a virtual public workshop to examine disability associated with organ transplantation. The workshop, held March 22-23, 2021, focused on kidney, heart, liver, and lung transplantation, and to a lesser extent intestine transplantation. Subject-matter experts presented on clinical aspects of post-transplantation recovery and described the implications for physical, cognitive, and psychosocial functioning in adults and children. This publication summarizes the presentations and panel discussions from the workshop. Table of Contents Front Matter 1 Introduction 2 Solid Organ Transplantation in the United States and the Experiences of Organ Recipients and Their Caregivers 3 Organ Transplantation and Disability in Adults 4 Organ Transplantation and Disability in Children and Adolescents 5 Treatments, Technologies, and Interventions Affecting Function After Transplantation 6 Future Outlook for Organ Transplantation and Disability References Appendix A: Statement of Task Appendix B: Workshop Agenda Appendix C: Biographical Sketches of Workshop Planning Committee Members and Speakers
As part of the overall disability determination process, the Social Security Administration uses a step-by-step approach to understand how severe an individual's condition is and whether it meets program criteria for disability. The use of various types of biomarkers has been suggested as a way to strengthen the amount and quality of objective evidence available to the review process. At the request of the Social Security Administration, the National Academies of Sciences, Engineering, and Medicine's Board on Health Care Services organized a virtual workshop on July 21, 2020, titled The State of the Science of the Use of Biomarkers to Establish the Presence and Severity of Impairments. Workshop discussions focused on the current and potential uses for biomarkers; explored legal and ethical implications associated with biomarker use in clinical decision making; and considered the possible uses of nongenetic biomarkers as tools for the diagnosis or prognosis of the severity of specific physical and mental impairments. This publication summarizes the presentations and discussion of the workshop. Table of Contents Front Matter 1 Introduction 2 Understanding Biomarker Use and Its Potential for Determining Health and Function 3 State of the Science for Specific Impairments 4 Legal and Ethical Implications 5 Final Thoughts References Appendix A: Statement of Task Appendix B: Workshop Agenda Appendix C: Biographical Sketches of Workshop Speakers and Planning Committee Members
Adolescence is a dynamic time for both brain development and social pressures, making it a critical period to understand mental, emotional, and behavioral health, yet it is often overlooked in terms of policies and service interventions, which makes many young people feel unheard when communicating their own challenges. To explore best practices in providing and supporting adolescent health services and key messaging and communication strategies related to the mental, emotional, and behavioral health of adolescents, the National Academies of Sciences, Engineering, and Medicine's Forum for Children's Well-Being held a workshop on May 5, 2020. The workshop featured a panel of youth representatives who shared their own experiences related to mental, emotional, and behavioral health. This publication summarizes the presentation and discussion of the workshop. Table of Contents Front Matter 1 Introduction 2 Implications for the National Agenda on Fostering the Healthy Mental, Emotional, and Behavioral Development of Youth 3 Including Youth and Family Voices as a Means to Help Adolescents Flourish 4 Implementing Best Practices and Crafting Effective Messaging to Help Adolescents Flourish 5 Summary References Appendix A: Workshop Agenda Appendix B: Biographical Sketches of Workshop Presenters and Planning Committee Members Appendix C: Resources Mentioned by Speakers and Participants Throughout the Workshop Appendix D: Recommendations from "The Promise of Adolescence: Realizing Opportunity for All Youth" Appendix E: Recommendations from "Promoting Positive Adolescent Health Behaviors and Outcomes"
COVID-19 has proven among the worst public health crises in a generation. Public health emergencies (PHE) have always been anticipated. Despite the growing field of PHE preparedness and planning since the turn of the twenty-first century and the preparedness plans and exercises developed, the U.S. experienced a suboptimal national response to the emergence of COVID-19 in early 2020 compared to other countries. To explore the U.S. PHE preparedness enterprise, the National Academies Forum on Medical and Public Health Preparedness for Disasters and Emergencies convened a workshop in May 2022. They invited participants from government, NGO, and private sector organizations to consider key components, success stories, and failure points in order to identify opportunities for more effective catastrophic disaster, pandemic, and other large scale PHEs planning at the federal, state, local, tribal, and territorial levels. This Proceedings of a Workshop summarizes the discussions held during the workshop. Table of Contents Front Matter 1 Introduction 2 Public Health Emergency Planning: Lessons from Past and Present for the Future 3 Coordinating Surveillance and Medical Countermeasure Response 4 Equity, Risk Communication, and Public Engagement 5 Coordination, Government, and Leadership 6 Reflections References Appendix A: Workshop Agenda Appendix B: Speaker and Planning Committee Biosketches
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