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NASEM Publications Round-Up: March 2017

April 03, 2017

Browse all health-related publications released by the National Academies in March 2017 below. To receive updates from the NAM, please subscribe to our mailing list.

Reports document the evidence-based consensus of an authoring committee of experts. Proceedings chronicle the presentations and discussions at a workshop, symposium, or other convening event. Perspectives are individually-authored expert commentaries and discussion papers from leading voices in health and health care. 

 

Clinician Engagement for Continuous Learning

March 6, 2017 | NAM Perspective 

Participants and other stakeholders in today’s U.S. health care system are striving for the generation of new knowledge to guide care while at the same time they are also managing growing clinical and organizational complexity, directing considerable attention to curbing health care costs, and reducing inefficiencies. An important early milestone toward achieving these goals was the establishment of the Center for Medicare & Medicaid Innovation (CMMI) following the passage of the Patient Protection and Affordable Care Act (ACA) of 2010 to promote innovations in care delivery that fulfill the Triple Aim of improving health and health care at lower cost.

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What’s Killing our Children? Child and Infant Mortality among American Indians and Alaska Natives

March 7, 2017 | NAM Perspective

The very vulnerable demographic group of American Indian and Alaska Native (AIAN) youth face unique and important challenges. We need to hear from native stakeholders and experts in American Indian health about the contextual factors (poverty, low educational attainment, and substance abuse) that represent a threat to native communities in this country. To begin to mitigate that threat, researchers, opinion leaders, human services providers, and the general population need to begin to understand what is killing native children.

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Therapeutic Development in the Absence of Predictive Animal Models of Nervous System Disorders

March 10, 2017 | NASEM Proceedings of a Workshop

Despite the high prevalence and burden of nervous system disorders, development of new therapeutics lags behind other disease areas. Gaps in understanding the underlying pathophysiology, a dearth of biomarkers, and limitations in the capacity of animal models to predict drug efficacy for human brain disorders have contributed to a high rate of late stage failures in drug development and decreased investment in neuroscience research programs at pharmaceutical companies. On September 12-13, 2016, the National Academies of Sciences, Engineering, and Medicine’s Forum on Neuroscience and Nervous System Disorders hosted a public workshop to explore opportunities to accelerate drug development absent predictive animal models.

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Health Insurance and Insights from Health Literacy: Helping Consumers Understand

March 13, 2017 | NASEM Proceedings of a Workshop

The Roundtable on Health Literacy of the National Academies of Sciences, Engineering, and Medicine convened a public workshop to examine health insurance through the lens of health literacy, focusing on challenges and opportunities in helping consumers obtain, understand, and use health insurance. The workshop was the most recent health reform–related activity of the roundtable, noted Bernard Rosof of the Quality in HealthCare Advisory Group, in his opening remarks.These proceedings summarize the discussions that took place at the workshop.

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Exploring the State of the Science in the Field of Regenerative Medicine: Challenges and Opportunities for Cellular Therapies

March 15, 2017 | NASEM Proceedings of a Workshop

The Forum on Regenerative Medicine hosted its first public workshop with the goal of developing a broad understanding of the opportunities and challenges associated with regenerative medicine cellular therapies and related technologies. Stakeholder groups, including research scientists, clinicians, and representatives from patient groups and industry, presented their perspectives and participated in discussions during the workshop, which focused on an exploration of the state of the science of cell-based regenerative therapies within the larger context of patient care and policy. The workshop rapporteurs have prepared this proceedings as a factual summation of the session discussions.

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Respiratory Protection for Health Care Workers: Simplify Procedures and Improve Health

March 17, 2017 | NAM Perspective 

Health care professionals, including emergency response personnel, face unique occupational health and safety challenges, one of which is exposure to uncontrolled airborne infectious particles. To protect themselves, these professionals rely heavily on N95 filtering facepiece respirators (FFRs) which, when used appropriately, provide a known level of respiratory protection. While health care organizations are not required to use surgical N95s, there is a common misperception that surgical N95s provide health care workers with an increased level of protection over standard N95s. This misperception places workers, patients, the health care system, and national security at substantial risk.

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Implementing Evidence-Based Prevention by Communities to Promote Cognitive, Affective, and Behavioral Health in Children

March 20, 2017| NASEM Proceedings 

Communities provide the context in which programs, principles, and policies are implemented. Their needs dictate the kinds of programs that community organizers and advocates, program developers and implementers, and researchers will bring to bear on a problem. Their characteristics help determine whether a program will succeed or fail. The detailed workings of programs cannot be separated from the communities in which they are embedded. Communities also represent the front line in addressing many behavioral health conditions experienced by children, adolescents, young adults, and their families. Given the importance of communities in shaping the health and well being of young people, the National Academies of Sciences, Engineering, and Medicine held a workshop in June 2016, to examine the implementation of evidence- based prevention by communities.

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Vital Directions for Health and Health Care: Priorities from a National Academy of Medicine Initiative 

March 21, 2017 | NAM Perspective 

The United States is poised at a critical juncture in health and health care. Powerful new insights are emerging on the potential of disease and disability, but the translation of that knowledge to action is hampered by debate focused on elements of the Affordable Care Act that, while very important, will have relatively limited impact on the overall health of the population without attention to broader challenges and opportunities. The National Academy of Medicine has identified priorities central to helping the nation achieve better health at lower cost.

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Addressing Burnout, Depression, and Suicidal Ideation in the Osteopathic Profession: An Approach that Spans the Physician Life Cycle

March 24, 2017 | NAM Perspective 

Burnout, depression, and suicidal ideation are key areas of concern because of the consequences they can have on physicians as well as the patients for whom they care. The level of burnout in the medical profession has increased at an alarming rate in the past decade. Statistics reveal that about 54 percent of all physicians are burnt out (30–40 percent of employed physicians and 55–60 percent of self-employed physicians.) Students, interns, and residents also factor into the equation as reports indicate they experience burnout at a rate of 20–40 percent. According to the International Classification of Diseases, Tenth Edition (ICD-10), burnout is defined as “a state of vital exhaustion.” It manifests as emotional exhaustion that affects a person’s passion for work; ability to relate to others; sense of accomplishment or purpose; judgment; productivity; emotions; and overall health.

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Burnout, Stress, and Compassion Fatigue in Occupational Therapy Practice and Education

March 24, 2017 | NAM Perspective

Now more than ever is the time for occupational therapy educators, students, and practitioners to invest in strategies to combat burnout and stress. Current health care practice requires occupational therapy practitioners to manage many dimensions of patient care. Combining professional and educational duties with the emotional energy required for patient encounters and managing one’s personal life can create the potential for burnout and compassion fatigue and an imbalanced professional quality of life. Yuen (1990) called upon occupational therapy fieldwork educators to put more time in their formal training toward teaching experiences with their students, and to recognize potential for burnout by increasing self-awareness.

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Promoting Well-being in Psychology Graduate Students at the Individual and Systems Levels

March 24, 2017 | NAM Perspective 

More than 70 percent of psychology doctoral students report experiencing stressors that can affect their ability to fully function. Common stressors include academic responsibilities, debt, anxiety, and poor work–life balance. Lack of support from faculty, poor relationships with faculty, and cohort tension are sources of stress and negatively affect both personal and professional functioning while serving as barriers to effective coping. This can result in trainees who have difficulty developing and exhibiting the proper degree of professional competence (termed as problems with professional competence.)  These problems with professional competence can be manifested in difficulties attaining identity as a psychologist, self-awareness, and reliable clinical judgment and reflection skills, as well as developing the ability to have effective interpersonal interactions.

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Stress-induced Eating Behaviors of Health Professionals: A Registered Dietitian Nutritionist Perspective

March 24, 2017 | NAM Perspective 

For health professionals, stress and eating often combine in unhealthy ways. The stress comes early in their training and lingers throughout their careers. Anyone who has worked or trained in a hospital knows all too well the cycle of workplace stress leading some individuals to overeat and gain excess weight, which in turn leads to physical and mental stress due to the weight gain itself. Others react to stress by eating less and losing weight, which can similarly have negative consequences. Often stress comes with unhealthy food choices such as skipping meals, reliance on fast food, restricting fluid intake, or choosing foods high in sugars and fats and low in nutrients.

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An Evidence Framework for Genetic Testing

March 27, 2017 | NASEM Report 

Advances in genetics and genomics are transforming medical practice, resulting in a dramatic growth of genetic testing in the health care system. The rapid development of new technologies, however, has also brought challenges, including the need for rigorous evaluation of the validity and utility of genetic tests, questions regarding the best ways to incorporate them into medical practice, and how to weigh their cost against potential short- and long-term benefits. Within that context, the Department of Defense (DoD) Office of Health Affairs asked the National Academies of Sciences, Engineering, and Medicine to convene a committee to examine the relevant medical and scientific literature to determine the evidence base for different types of genetic tests (e.g., predictive, diagnostic, and prognostic) for patient management; and to develop a framework for decision making regarding the use of genetic tests in clinical care.

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A National Strategy for the Elimination of Hepatitis B and C: Phase Two Report 

March 28, 2017 | NASEM Report 

Each year, hepatitis B virus and hepatitis C virus cause nearly 1.5 million deaths worldwide—more than HIV, tuberculosis, and malaria. Such loss of life comes at a cost to society through the direct expense of treatment as well as through the loss of adults in their prime. In an effort to describe a strategy for eliminating viral hepatitis as a U.S. public health problem by 2030, the National Academies, with support from the Centers for Disease Control and Prevention and the U.S. Department of Health and Human Services, the American Association for the Study of Liver Diseases, the Infectious Diseases Society of America, and the National Viral Hepatitis Roundtable, convened an expert committee to outline a national strategy. The committee produced two reports. The first report, Eliminating the Public Health Problem of Hepatitis B and C in the United States: Phase One Report, concluded that both hepatitis B and C could be eliminated as a public health problem in the United States, but that there are substantial obstacles to meeting this goal. This second report, A National Strategy for the Elimination of Hepatitis B and C: Phase Two Report, recommends specific actions to hasten the end of these diseases and lays out five areas—information, interventions, service delivery, financing, and research—to consider in the national plan.

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