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Many different groups of people are subject to stereotypes.
Positive stereotypes (e.g., "older and wiser") may provide a
benefit to the relevant groups. However, negative stereotypes of
aging and of disability continue to persist and, in some cases,
remain socially acceptable. Research has shown that when exposed to
negative images of aging, older persons demonstrate poor physical
and cognitive performance and function, while those who are exposed
to positive images of aging (or who have positive self-perceptions
of aging) demonstrate better performance and function. Furthermore,
an individual's expectations about and perceptions of aging can
predict future health outcomes. To better understand how
stereotypes affect older adults and individuals with disabilities,
the National Academies of Sciences, Engineering, and Medicine, with
support from AARP, convened a public workshop on October 10, 2017.
This publication summarizes the presentations and discussions from
the workshop. Table of Contents Front Matter 1 Introduction 2 Who
Is Worthy of Choice? 3 Exploring the State of the Knowledge on
Stereotypes and Their Impact 4 Disrupting Stereotypes in Practice 5
Disrupting Negative Stereotypes in the Media 6 Disrupting Negative
Stereotypes in Design 7 Closing Remarks References Appendix A:
Workshop Agenda Appendix B: Biographical Sketches of Workshop
Speakers and Moderators
Combined with the more traditional employer occupational safety and
health protection activities are newer employment-based programs to
promote better health through helping workers quit smoking, lose
weight, reduce stress, or exercise more regularly. In support of
these efforts, some employers have made changes in their policies
and facilities to support physical activity and healthier eating,
and some employers connect with community resources for health
education, health fairs, and other services. This diverse array of
activities most typically has been planned, managed, and assessed -
to the extent they exist in the workplace at all - by different,
often uncoordinated departments within the business entity. Some
employers have reconceptualized their safety, prevention, and
promotion initiatives and attempted to bring them together into a
coherent whole. The National Institute for Occupational Safety and
Health (NIOSH) has supported this integration, defining Total
Worker Health as "a strategy integrating occupational safety and
health protection with health promotion to prevent worker injury
and illness and to advance health and well-being." In May 2014,
with support from NIOSH, the Institute of Medicine organized a
workshop on Total Worker Health. Rather than a review of published
literature, this workshop sought input from a wide variety of
on-the-ground stakeholders regarding their experiences with
integrating occupational safety and health protection with health
promotion in the workplace. Promising and Best Practices in Total
Worker Health is the summary of the discussions and presentations
of the event. This report identifies prevalent and best practices
in programs that integrate occupational safety and health
protection with health promotion in small, medium, and large
workplaces; employer and employee associations; academia;
government agencies; and other stakeholder groups. Table of
Contents Front Matter 1 Introduction 2 Total Worker Health in the
Real World 3 The Value in Pursuing Total Worker Health 4 Total
Worker Health in Large Businesses 5 Total Worker Health for Small-
and Medium-Sized Businesses 6 Reactors Panel and Discussion
References Appendix A: Workshop Agenda Appendix B: Speaker and
Moderator Biographical Sketches
Every year, significant amounts of expensive drugs are discarded.
This is due in part to the growing number of prescription drugs
that are administered in variable doses (rather than fixed or flat
doses) based on a patient's weight or body size. Strict regulations
and guidance generally prohibit or severely restrict the acceptable
time frame for sharing medication from single-dose vials among
patients, and so the unused amount will typically be discarded. Due
to the current system for producing, administering, and paying for
drugs in the United States, significant - but indeterminate -
amounts of expensive prescription drugs are discarded each year. At
the request of the Centers for Medicare & Medicaid Services,
Medications in Single Dose Vials: Implications of Discarded Drugs
explores the federal health care costs, safety, and quality
concerns associated with discarded drugs that result from the
weight-based dosing of medicines contained in single-dose vials.
Table of Contents Front Matter Summary 1 Introduction 2 Single-Dose
Vials of Weight-Based Drugs 3 Scope of Discarded Drugs from
Single-Dose Vials 4 Efforts to Reduce Discarded Weight-Based Drugs
5 Discarded Weight-Based Drugs in Single-Dose Vials 6 Prescription
for Reducing Discarded Drugs Appendix A: Glossary Appendix B:
Supplemental Figures and Tables from Commissioned Analyses Appendix
C: Stakeholder Input Appendix D: Biographical Information Appendix
E: Disclosure of Unavoidable Conflicts of Interest
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
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.
Financing Long-Term Services and Supports for Individuals with
Disabilities and Older Adults is the summary of a workshop convened
in June 2013 by the Forum on Aging, Disability, and Independence of
the Institute of Medicine and the National Research Council to
examine the financing of long-term services and supports for
working-age individuals with disabilities and among individuals who
are developing disabilities as they age. The workshop covered both
older adults who acquire disabilities and younger adults with
disabilities who may acquire additional impairments as they age,
the target population of the Forum's work. The challenges
associated with financing long-term services and supports for
people with disabilities impacts all age groups. While there are
important differences between the characteristics of programs
developed for different age groups, and specific populations may
have different needs, this workshop addressed the financing sources
for long-term services and supports in general, noting specific
differences as appropriate. The financing of long-term services and
supports has become a major issue in the United States. These are
the services and supports that individuals with disabilities,
chronic conditions, and functional impairments need in order to
live independently, such as assistance with eating, bathing, and
dressing. Long-term services and supports do not include the
medical or nursing services required to manage health conditions
that may be responsible for a disabling condition. At least 11
million adults ages 18 and over receive long-term services and
supports. Only a little more than half of them - 57 percent - are
ages 65 or older. One study found that about 6 percent of people
turning 65 in 2005 could expect to have expenses of more than
$100,000 for long-term services and supports. Financing Long-Term
Services and Supports for Individuals with Disabilities and Older
Adults discusses the scope and trends of current sources of
financing for long-term services and supports for working-age
individuals with disabilities and older adults aging into
disability, including income supports and personal savings. This
report considers the role of families, business, and government in
financing long-term services and supports and discusses
implications of and opportunities for current and innovative
approaches. Table of Contents Front Matter 1 Introduction and
Themes of the Workshop 2 The Challenge 3 The Role of Individuals
and Families 4 The Role of Government 5 The Role of the Private
Sector 6 Reflections on the Workshop References Appendix A:
Workshop Agenda Appendix B: Speaker Biographical Sketches
The Institute of Medicine (IOM) and the National Research Council
(NRC) have had prominent roles in discussions of aging, disability,
and technology for decades. In 1978, Aging and Medical Education
(IOM, 1978) raised national awareness of the challenges to
physicians posed by the aging of the U.S. population. Thirty years
later, Retooling for an Aging America highlighted concerns for the
entire health care workforce in view of the aging of the
population, including the role of technology in caring for older
populations. The 1988 report The Aging Population in the 21st
Century examined social, economic, and demographic changes among
older adults, as well as many health-related topics: health
promotion and disease prevention; quality of life; health care
system financing and use; and the quality of care- especially
long-term care. In 1991, the landmark report Disability in America
laid out a national agenda to prevent disability and improve the
lives of people with disabling conditions. The 1997 report Enabling
America: Assessing the Role of Rehabilitation Science and
Engineering examined the knowledge base of rehabilitation science
and engineering and proposed ways to translate scientific findings
into interventions that produce better health. And the 2007 report
The Future of Disability in America examined progress made since
the earlier reports and looked at continuing barriers that limit
the independence, productivity, and participation in community life
of people with disabilities. All these reports were produced by
committees appointed in accordance with guidelines of the National
Academies and met multiples times to compile and review evidence,
reach consensus on conclusions and recommendations, draft a report
of the committee, and then modify that draft report in response to
comments from outside reviewers. The IOM and NRC have also held
several workshops related to aging, disability, and technology and
published summary reports, such as Technology for Adaptive Aging
and Grand Challenges of Our Aging Society. The IOM and NRC also
convene groups that take a different approach to issues of pressing
national and international importance. Often known as forums or
roundtables, these groups meet regularly to foster dialogue and
confront issues of mutual interest and concern among a broad range
of stakeholders. They can convene workshops, initiate cooperative
projects among members, commission independently authored articles,
and generate ideas for independent consensus studies. In 2012 the
IOM and NRC joined together to establish the Forum on Aging,
Disability, and Independence to provide a neutral venue for
broad-ranging discussions among the many stakeholders involved with
aging and disability. The goals of the forum are to highlight areas
in which the coordination of the aging and disability networks is
strong, examine the challenges involved in aligning the aging and
disability networks, explore new approaches for resolving problem
areas, elevate the visibility and broaden the perspectives of
stakeholders, and set the stage for future policy actions. Forum
sponsors and members include federal agencies, health professional
associations, private sector businesses, academics, and consumers.
Fostering Independence, Participation, and Healthy Aging Through
Technology summarizes this workshop. Table of Contents Front Matter
1 Introduction and Themes of the Workshop 2 The Promise of
Technology 3 Technologies to Promote Activities of Daily Living and
Independence 4 Technologies to Promote Community Integration and
Participation Through Community Design 5 Technologies to Promote
Community Integration and Participation Through Social
Connectedness 6 Health Management and Promotion 7 Reflections on
the Presentations References Appendix A: Workshop Agenda Appendix
B: Speaker Biographical Sketches
In 1996, the Institute of Medicine (IOM) released its report
Telemedicine: A Guide to Assessing Telecommunications for Health
Care. In that report, the IOM Committee on Evaluating Clinical
Applications of Telemedicine found telemedicine is similar in most
respects to other technologies for which better evidence of
effectiveness is also being demanded. Telemedicine, however, has
some special characteristics-shared with information technologies
generally-that warrant particular notice from evaluators and
decision makers.
Since that time, attention to telehealth has continued to grow in
both the public and private sectors. Peer-reviewed journals and
professional societies are devoted to telehealth, the federal
government provides grant funding to promote the use of telehealth,
and the private technology industry continues to develop new
applications for telehealth. However, barriers remain to the use of
telehealth modalities, including issues related to reimbursement,
licensure, workforce, and costs. Also, some areas of telehealth
have developed a stronger evidence base than others.
The Health Resources and Service Administration (HRSA) sponsored
the IOM in holding a workshop in Washington, DC, on August 8-9
2012, to examine how the use of telehealth technology can fit into
the U.S. health care system. HRSA asked the IOM to focus on the
potential for telehealth to serve geographically isolated
individuals and extend the reach of scarce resources while also
emphasizing the quality and value in the delivery of health care
services. This workshop summary discusses the evolution of
telehealth since 1996, including the increasing role of the private
sector, policies that have promoted or delayed the use of
telehealth, and consumer acceptance of telehealth. The Role of
Telehealth in an Evolving Health Care Environment: Workshop Summary
discusses the current evidence base for telehealth, including
available data and gaps in data; discuss how technological
developments, including mobile telehealth, electronic intensive
care units, remote monitoring, social networking, and wearable
devices, in conjunction with the push for electronic health
records, is changing the delivery of health care in rural and urban
environments. This report also summarizes actions that the U.S.
Department of Health and Human Services (HHS) can undertake to
further the use of telehealth to improve health care outcomes while
controlling costs in the current health care environment.
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. Table of Contents Front Matter 1 Introduction 2
Principles and Definitional Considerations 3 Overview of the
Current Global Regulatory Landscape 4 Areas of Need for Harmonized
Standards and Barriers to Progress in Addressing the Gaps 5
Characteristics of Harmonized Regulations and Regulatory Structures
6 Finding Solutions: Options and Systemic Approaches 7 Tactics and
Strategies for a Way Forward References Appendix A: Workshop Agenda
Appendix B: Participant Biographies
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The Future of Home Health Care - Workshop Summary (Paperback)
National Research Council, Institute of Medicine, Division on Behavioral and Social Sciences and Education, Board on Health Sciences Policy, Forum on Aging Disability and Independence; Edited by …
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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. Table of Contents Front Matter
1 Introduction 2 Home Health Care: Today and Tomorrow 3 Toward
Personal Health: Going Home and Beyond 4 Key Issues and Trends 5
The Home Health Care Workforce 6 Models of Care and Approaches to
Payment 7 Innovations in Technology 8 Making Connections 9
Reflections and Reactions References Appendix A: Workshop Agenda
Appendix B: Speaker and Moderator Biographical Sketches
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