%0 Book %A Institute of Medicine %E Chao, Samantha %E Anderson, Karen %E Hernandez, Lyla %T Toward Health Equity and Patient-Centeredness: Integrating Health Literacy, Disparities Reduction, and Quality Improvement: Workshop Summary %@ 978-0-309-12749-3 %D 2009 %U https://nap.nationalacademies.org/catalog/12502/toward-health-equity-and-patient-centeredness-integrating-health-literacy-disparities %> https://nap.nationalacademies.org/catalog/12502/toward-health-equity-and-patient-centeredness-integrating-health-literacy-disparities %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 102 %X To receive the greatest value for health care, it is important to focus on issues of quality and disparity, and the ability of individuals to make appropriate decisions based on basic health knowledge and services. The Forum on the Science of Health Care Quality Improvement and Implementation, the Roundtable on Health Disparities, and the Roundtable on Health Literacy jointly convened the workshop "Toward Health Equity and Patient-Centeredness: Integrating Health Literacy, Disparities Reduction, and Quality Improvement" to address these concerns. During this workshop, speakers and participants explored how equity in care delivered and a focus on patients could be improved. %0 Book %A Institute of Medicine %A National Research Council %E Wizemann, Theresa M. %E Anderson, Karen M. %T Focusing on Children's Health: Community Approaches to Addressing Health Disparities: Workshop Summary %@ 978-0-309-13785-0 %D 2009 %U https://nap.nationalacademies.org/catalog/12637/focusing-on-childrens-health-community-approaches-to-addressing-health-disparities %> https://nap.nationalacademies.org/catalog/12637/focusing-on-childrens-health-community-approaches-to-addressing-health-disparities %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %K Behavioral and Social Sciences %P 132 %X Socioeconomic conditions are known to be major determinants of health at all stages of life, from pregnancy through childhood and adulthood. "Life-course epidemiology" has added a further dimension to the understanding of the social determinants of health by showing an association between early-life socioeconomic conditions and adult health-related behaviors, morbidity, and mortality. Sensitive and critical periods of development, such as the prenatal period and early childhood, present significant opportunities to influence lifelong health. Yet simply intervening in the health system is insufficient to influence health early in the life course. Community-level approaches to affect key determinants of health are also critical. Many of these issues were raised in the 1995 National Academies book, Children's Health, the Nation's Wealth. The present volume builds upon this earlier book with presentations and examples from the field. Focusing on Children's Health describes the evidence linking early childhood life conditions and adult health; discusses the contribution of the early life course to observed racial and ethnic disparities in health; and highlights successful models that engage both community factors and health care to affect life course development. %0 Book %A Institute of Medicine %E Ulmer, Cheryl %E McFadden, Bernadette %E Nerenz, David R. %T Race, Ethnicity, and Language Data: Standardization for Health Care Quality Improvement %@ 978-0-309-14012-6 %D 2009 %U https://nap.nationalacademies.org/catalog/12696/race-ethnicity-and-language-data-standardization-for-health-care-quality %> https://nap.nationalacademies.org/catalog/12696/race-ethnicity-and-language-data-standardization-for-health-care-quality %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 286 %X The goal of eliminating disparities in health care in the United States remains elusive. Even as quality improves on specific measures, disparities often persist. Addressing these disparities must begin with the fundamental step of bringing the nature of the disparities and the groups at risk for those disparities to light by collecting health care quality information stratified by race, ethnicity and language data. Then attention can be focused on where interventions might be best applied, and on planning and evaluating those efforts to inform the development of policy and the application of resources. A lack of standardization of categories for race, ethnicity, and language data has been suggested as one obstacle to achieving more widespread collection and utilization of these data. Race, Ethnicity, and Language Data identifies current models for collecting and coding race, ethnicity, and language data; reviews challenges involved in obtaining these data, and makes recommendations for a nationally standardized approach for use in health care quality improvement. %0 Book %A Transportation Research Board %A Institute of Medicine %A National Research Council %E Parker, Lynn %E Burns, Annina Catherine %E Sanchez, Eduardo %T Local Government Actions to Prevent Childhood Obesity %@ 978-0-309-13927-4 %D 2009 %U https://nap.nationalacademies.org/catalog/12674/local-government-actions-to-prevent-childhood-obesity %> https://nap.nationalacademies.org/catalog/12674/local-government-actions-to-prevent-childhood-obesity %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %K Food and Nutrition %P 138 %X The prevalence of childhood obesity is so high in the United States that it may reduce the life expectancy of today's generation of children. While parents and other adult caregivers play a fundamental role in teaching children about healthy behaviors, even the most positive efforts can be undermined by local environments that are poorly suited to supporting healthy behaviors. For example, many communities lack ready sources of healthy food choices, such as supermarkets and grocery stores. Or they may not provide safe places for children to walk or play. In such communities, even the most motivated child or adolescent may find it difficult to act in healthy ways. Local governments—with jurisdiction over many aspects of land use, food marketing, community planning, transportation, health and nutrition programs, and other community issues—are ideally positioned to promote behaviors that will help children and adolescents reach and maintain healthy weights. Local Government Actions to Prevent Childhood Obesity presents a number of recommendations that touch on the vital role of government actions on all levels—federal, state, and local—in childhood obesity prevention. The book offers healthy eating and physical activity strategies for local governments to consider, making it an excellent resource for mayors, managers, commissioners, council members, county board members, and administrators. %0 Book %A Institute of Medicine %E Giffin, Robert %E Robinson, Sally %T Addressing the Threat of Drug-Resistant Tuberculosis: A Realistic Assessment of the Challenge: Workshop Summary %@ 978-0-309-13044-8 %D 2009 %U https://nap.nationalacademies.org/catalog/12570/addressing-the-threat-of-drug-resistant-tuberculosis-a-realistic-assessment %> https://nap.nationalacademies.org/catalog/12570/addressing-the-threat-of-drug-resistant-tuberculosis-a-realistic-assessment %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 252 %X Tuberculosis is one of the leading causes of death in the world today, with 4,500 people dying from the disease every day. Many cases of TB can be cured by available antibiotics, but some TB is resistant to multiple drugs--a major and growing threat worldwide. The Institute of Medicine's Forum on Drug Discovery, Development, and Translation hosted a workshop on November 5, 2008, to address the mounting concern of drug-resistant TB. The session brought together a wide range of international experts to discuss what is known and not known about this growing threat, and to explore possible solutions. %0 Book %A Institute of Medicine %A Institute of Medicine %T Informing the Future: Critical Issues in Health, Fifth Edition %D 2009 %U https://nap.nationalacademies.org/catalog/12709/informing-the-future-critical-issues-in-health-fifth-edition %> https://nap.nationalacademies.org/catalog/12709/informing-the-future-critical-issues-in-health-fifth-edition %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 170 %X Today, perhaps more than ever, health care is a key item on the nation's agenda. Government policy makers, health professionals, scientists, industrial and civic leaders, patient advocates, and private citizens across the social spectrum are focusing on how best to obtain a high-quality health system that is efficient and affordable in its operation and that functions well for everyone. The Institute of Medicine (IOM) regularly considers this challenge from a variety of perspectives. Recent efforts have focused on improving the organization and operation of the nation's largest health agency; working to assess what diagnostic, therapeutic, and preventive services work best; gauging the overall health of the nation's population; and identifying ways to build an even stronger foundation of evidence-based medicine that effectively captures the promise of scientific discovery and technological innovation and enables doctors, nurses, and other health professionals to provide the right care for the right patient at the right time. The body of this book illustrates the work of IOM committees in selected, major areas in recent years, followed by a description of IOM's convening and collaborative activities and fellowship programs. The last section provides a comprehensive bibliography of IOM reports published since 2007. %0 Book %A Institute of Medicine %T The U.S. Commitment to Global Health: Recommendations for the Public and Private Sectors %@ 978-0-309-13821-5 %D 2009 %U https://nap.nationalacademies.org/catalog/12642/the-us-commitment-to-global-health-recommendations-for-the-public %> https://nap.nationalacademies.org/catalog/12642/the-us-commitment-to-global-health-recommendations-for-the-public %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 296 %X Health is a highly valued, visible, and concrete investment that has the power to both save lives and enhance the credibility of the United States in the eyes of the world. While the United States has made a major commitment to global health, there remains a wide gap between existing knowledge and tools that could improve health if applied universally, and the utilization of these known tools across the globe. The U.S. Commitment to Global Health concludes that the U.S. government and U.S.-based foundations, universities, nongovernmental organizations, and commercial entities have an opportunity to improve global health. The book includes recommendations that these U.S. institutions: increase the utilization of existing interventions to achieve significant health gains; generate and share knowledge to address prevalent health problems in disadvantaged countries; invest in people, institutions, and capacity building with global partners; increase the quantity and quality of U.S. financial commitments to global health; and engage in respectful partnerships to improve global health. In doing so, the U.S. can play a major role in saving lives and improving the quality of life for millions around the world. %0 Book %A Institute of Medicine %E Whitacre, Paula Tarnapol %E Burns, Annina Catherine %E Liverman, Cathy %E Parker, Lynn %T Community Perspectives on Obesity Prevention in Children: Workshop Summaries %@ 978-0-309-14081-2 %D 2009 %U https://nap.nationalacademies.org/catalog/12705/community-perspectives-on-obesity-prevention-in-children-workshop-summaries %> https://nap.nationalacademies.org/catalog/12705/community-perspectives-on-obesity-prevention-in-children-workshop-summaries %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %K Food and Nutrition %P 112 %X As the public health threat of childhood obesity has become clear, the issue has become the focus of local, state, and national initiatives. Many of these efforts are centered on the community environment in recognition of the role of environmental factors in individual behaviors related to food and physical activity. In many communities, for example, fresh produce is not available or affordable, streets and parks are not amenable to exercise, and policies and economic choices make fast food cheaper and more convenient than healthier alternatives. Community efforts to combat obesity vary in scope and scale; overall, however, they remain fragmented, and little is known about their effectiveness. At the local level, communities are struggling to determine which obesity prevention programs to initiate and how to evaluate their impact. In this context, the Institute of Medicine held two workshops to inform current work on obesity prevention in children through input from individuals who are actively engaged in community- and policy-based obesity prevention programs. Community perspectives were elicited on the challenges involved in undertaking policy and programmatic interventions aimed at preventing childhood obesity, and on approaches to program implementation and evaluation that have shown promise. Highlights of the workshop presentations and discussions are presented in this volume. %0 Book %A Institute of Medicine %E Altevogt, Bruce M. %E Stroud, Clare %E Hanson, Sarah L. %E Hanfling, Dan %E Gostin, Lawrence O. %T Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations: A Letter Report %@ 978-0-309-14430-8 %D 2009 %U https://nap.nationalacademies.org/catalog/12749/guidance-for-establishing-crisis-standards-of-care-for-use-in-disaster-situations %> https://nap.nationalacademies.org/catalog/12749/guidance-for-establishing-crisis-standards-of-care-for-use-in-disaster-situations %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 160 %X The influenza pandemic caused by the 2009 H1N1 virus underscores the immediate and critical need to prepare for a public health emergency in which thousands, tens of thousands, or even hundreds of thousands of people suddenly seek and require medical care in communities across the United States. Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations draws from a broad spectrum of expertise—including state and local public health, emergency medicine and response, primary care, nursing, palliative care, ethics, the law, behavioral health, and risk communication—to offer guidance toward establishing standards of care that should apply to disaster situations, both naturally occurring and man-made, under conditions in which resources are scarce. This book explores two case studies that illustrate the application of the guidance and principles laid out in the report. One scenario focuses on a gradual-onset pandemic flu. The other scenario focuses on an earthquake and the particular issues that would arise during a no-notice event. Outlining current concepts and offering guidance, this book will prove an asset to state and local public health officials, health care facilities, and professionals in the development of systematic and comprehensive policies and protocols for standards of care in disasters when resources are scarce. In addition, the extensive operations section of the book provides guidance to clinicians, health care institutions, and state and local public health officials for how crisis standards of care should be implemented in a disaster situation. %0 Book %A Institute of Medicine %T The U.S. Commitment to Global Health: Recommendations for the New Administration %D 2009 %U https://nap.nationalacademies.org/catalog/12506/the-us-commitment-to-global-health-recommendations-for-the-new %> https://nap.nationalacademies.org/catalog/12506/the-us-commitment-to-global-health-recommendations-for-the-new %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 52 %X At this historic moment, the incoming Obama administration and leaders of the U.S. Congress have the opportunity to advance the welfare and prosperity of people within and beyond the borders of the United States through intensified and sustained attention to better health. The United States can improve the lives of millions around the world, while reflecting America's values and protecting and promoting the nation's interests. The Institute of Medicine-with the support of four U.S. government agencies and five private foundations-formed an independent committee to examine the United States' commitment to global health and to articulate a vision for future U.S. investments and activities in this area. %0 Book %A Institute of Medicine %T State of the USA Health Indicators: Letter Report %@ 978-0-309-12862-9 %D 2009 %U https://nap.nationalacademies.org/catalog/12534/state-of-the-usa-health-indicators-letter-report %> https://nap.nationalacademies.org/catalog/12534/state-of-the-usa-health-indicators-letter-report %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 98 %X Researchers, policymakers, sociologists and doctors have long asked how to best measure the health of a nation, yet the challenge persists. The nonprofit State of the USA, Inc. (SUSA) is taking on this challenge, demonstrating how to measure the health of the United States. The organization is developing a new website intended to provide reliable and objective facts about the U.S. in a number of key areas, including health, and to provide an interactive tool with which individuals can track the progress made in each of these areas. In 2008, SUSA asked the Institute of Medicine's Committee on the State of the USA Health Indicators to provide guidance on 20 key indicators to be used on the organization's website that would be valuable in assessing health. Each indicator was required to demonstrate: a clear importance to health or health care, the availability of reliable, high quality data to measure change in the indicators over time, the potential to be measured with federally collected data, and the capability to be broken down by geography, populations subgroups including race and ethnicity, and socioeconomic status. Taken together, the selected indicators reflect the overall health of the nation and the efficiency and efficacy of U.S. health systems. The complete list of 20 can be found in the report brief and book. %0 Book %A Institute of Medicine %E Wizemann, Theresa %E Robinson, Sally %E Giffin, Robert %T Breakthrough Business Models: Drug Development for Rare and Neglected Diseases and Individualized Therapies: Workshop Summary %@ 978-0-309-12088-3 %D 2009 %U https://nap.nationalacademies.org/catalog/12219/breakthrough-business-models-drug-development-for-rare-and-neglected-diseases %> https://nap.nationalacademies.org/catalog/12219/breakthrough-business-models-drug-development-for-rare-and-neglected-diseases %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 150 %X The process for developing new drug and biologic products is extraordinarily expensive and time-consuming. Although large pharmaceutical companies may be able to afford the cost of development because they can expect a large return on investment, organizations developing drugs to treat rare and neglected diseases are unable to rely on such returns. On June 23, 2008, the Institute of Medicine's Forum on Drug Discovery, Development, and Translation held a public workshop, "Breakthrough Business Models: Drug Development for Rare and Neglected Diseases and Individualized Therapies," which sought to explore new and innovative strategies for developing drugs for rare and neglected diseases. %0 Book %A Institute of Medicine %E Hernandez, Lyla M. %T Measures of Health Literacy: Workshop Summary %@ 978-0-309-13980-9 %D 2009 %U https://nap.nationalacademies.org/catalog/12690/measures-of-health-literacy-workshop-summary %> https://nap.nationalacademies.org/catalog/12690/measures-of-health-literacy-workshop-summary %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 142 %X Health literacy--the ability for individuals to obtain, process, and understand basic health information and services to facilitate appropriate health decisions--is increasingly recognized as an important facet of health care and health outcomes. Although research on health literacy has grown tremendously in the past decade, there is no widely agreed-upon framework for health literacy as a determinant of health outcomes. Most instruments focus on assessing an individual's health literacy, yet the scope of health literacy reaches far beyond an individual's skills and abilities. Health literacy occurs in the context of the health care system, and therefore measures of health literacy must also assess the demands and complexities of the health care systems with which patients interact. For example, measures are needed to determine how well the system has been organized so that it can be navigated by individuals with different levels of health literacy and how well health organizations are doing at making health information understandable and actionable. To examine what is known about measures of health literacy, the Institute of Medicine convened a workshop. The workshop, summarized in this volume, reviews the current status of measures of health literacy, including those used in the health care setting; discusses possible surrogate measures that might be used to assess health literacy; and explores ways in which health literacy measures can be used to assess patient-centered approaches to care. %0 Book %A National Research Council %T Sustainable Critical Infrastructure Systems: A Framework for Meeting 21st Century Imperatives: Report of a Workshop %@ 978-0-309-13792-8 %D 2009 %U https://nap.nationalacademies.org/catalog/12638/sustainable-critical-infrastructure-systems-a-framework-for-meeting-21st-century %> https://nap.nationalacademies.org/catalog/12638/sustainable-critical-infrastructure-systems-a-framework-for-meeting-21st-century %I The National Academies Press %C Washington, DC %G English %K Engineering and Technology %K Earth Sciences %P 82 %X For the people of the United States, the 20th century was one of unprecedented population growth, economic development, and improved quality of life. The critical infrastructure systems-water, wastewater, power, transportation, and telecommunications-built in the 20th century have become so much a part of modern life that they are taken for granted. By 2030, 60 million more Americans will expect these systems to deliver essential services. Large segments and components of the nation's critical infrastructure systems are now 50 to 100 years old, and their performance and condition are deteriorating. Improvements are clearly necessary. However, approaching infrastructure renewal by continuing to use the same processes, practices, technologies, and materials that were developed in the 20th century will likely yield the same results: increasing instances of service disruptions, higher operating and repair costs, and the possibility of catastrophic, cascading failures. If the nation is to meet some of the important challenges of the 21st century, a new paradigm for the renewal of critical infrastructure systems is needed. This book discusses the essential components of this new paradigm, and outlines a framework to ensure that ongoing activities, knowledge, and technologies can be aligned and leveraged to help meet multiple national objectives. %0 Book %A National Research Council %A Institute of Medicine %T Depression in Parents, Parenting, and Children: Opportunities to Improve Identification, Treatment, and Prevention %@ 978-0-309-12178-1 %D 2009 %U https://nap.nationalacademies.org/catalog/12565/depression-in-parents-parenting-and-children-opportunities-to-improve-identification %> https://nap.nationalacademies.org/catalog/12565/depression-in-parents-parenting-and-children-opportunities-to-improve-identification %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %K Behavioral and Social Sciences %P 488 %X Depression is a widespread condition affecting approximately 7.5 million parents in the U.S. each year and may be putting at least 15 million children at risk for adverse health outcomes. Based on evidentiary studies, major depression in either parent can interfere with parenting quality and increase the risk of children developing mental, behavioral and social problems. Depression in Parents, Parenting, and Children highlights disparities in the prevalence, identification, treatment, and prevention of parental depression among different sociodemographic populations. It also outlines strategies for effective intervention and identifies the need for a more interdisciplinary approach that takes biological, psychological, behavioral, interpersonal, and social contexts into consideration. A major challenge to the effective management of parental depression is developing a treatment and prevention strategy that can be introduced within a two-generation framework, conducive for parents and their children. Thus far, both the federal and state response to the problem has been fragmented, poorly funded, and lacking proper oversight. This study examines options for widespread implementation of best practices as well as strategies that can be effective in diverse service settings for diverse populations of children and their families. The delivery of adequate screening and successful detection and treatment of a depressive illness and prevention of its effects on parenting and the health of children is a formidable challenge to modern health care systems. This study offers seven solid recommendations designed to increase awareness about and remove barriers to care for both the depressed adult and prevention of effects in the child. The report will be of particular interest to federal health officers, mental and behavioral health providers in diverse parts of health care delivery systems, health policy staff, state legislators, and the general public. %0 Book %A Institute of Medicine %E Ulmer, Cheryl %E Wolman, Dianne Miller %E Johns, Michael M.E. %T Resident Duty Hours: Enhancing Sleep, Supervision, and Safety %@ 978-0-309-12776-9 %D 2009 %U https://nap.nationalacademies.org/catalog/12508/resident-duty-hours-enhancing-sleep-supervision-and-safety %> https://nap.nationalacademies.org/catalog/12508/resident-duty-hours-enhancing-sleep-supervision-and-safety %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %K Education %P 426 %X Medical residents in hospitals are often required to be on duty for long hours. In 2003 the organization overseeing graduate medical education adopted common program requirements to restrict resident workweeks, including limits to an average of 80 hours over 4 weeks and the longest consecutive period of work to 30 hours in order to protect patients and residents from unsafe conditions resulting from excessive fatigue. Resident Duty Hours provides a timely examination of how those requirements were implemented and their impact on safety, education, and the training institutions. An in-depth review of the evidence on sleep and human performance indicated a need to increase opportunities for sleep during residency training to prevent acute and chronic sleep deprivation and minimize the risk of fatigue-related errors. In addition to recommending opportunities for on-duty sleep during long duty periods and breaks for sleep of appropriate lengths between work periods, the committee also recommends enhancements of supervision, appropriate workload, and changes in the work environment to improve conditions for safety and learning. All residents, medical educators, those involved with academic training institutions, specialty societies, professional groups, and consumer/patient safety organizations will find this book useful to advocate for an improved culture of safety. %0 Book %A Institute of Medicine %E Schickedanz, Adam %T Assessing and Improving Value in Cancer Care: Workshop Summary %@ 978-0-309-13814-7 %D 2009 %U https://nap.nationalacademies.org/catalog/12644/assessing-and-improving-value-in-cancer-care-workshop-summary %> https://nap.nationalacademies.org/catalog/12644/assessing-and-improving-value-in-cancer-care-workshop-summary %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 164 %X Unlike many other areas in health care, the practice of oncology presents unique challenges that make assessing and improving value especially complex. First, patients and professionals feel a well-justified sense of urgency to treat for cure, and if cure is not possible, to extend life and reduce the burden of disease. Second, treatments are often both life sparing and highly toxic. Third, distinctive payment structures for cancer medicines are intertwined with practice. Fourth, providers often face tremendous pressure to apply the newest technologies to patients who fail to respond to established treatments, even when the evidence supporting those technologies is incomplete or uncertain, and providers may be reluctant to stop toxic treatments and move to palliation, even at the end of life. Finally, the newest and most novel treatments in oncology are among the most costly in medicine. This volume summarizes the results of a workshop that addressed these issues from multiple perspectives, including those of patients and patient advocates, providers, insurers, health care researchers, federal agencies, and industry. Its broad goal was to describe value in oncology in a complete and nuanced way, to better inform decisions regarding developing, evaluating, prescribing, and paying for cancer therapeutics. %0 Book %A Institute of Medicine %E Schaeffer, Leonard D. %E Schultz, Andrea M. %E Salerno, Judith A. %T HHS in the 21st Century: Charting a New Course for a Healthier America %@ 978-0-309-12796-7 %D 2009 %U https://nap.nationalacademies.org/catalog/12513/hhs-in-the-21st-century-charting-a-new-course-for %> https://nap.nationalacademies.org/catalog/12513/hhs-in-the-21st-century-charting-a-new-course-for %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 310 %X The U.S. Department of Health and Human Services (HHS) profoundly affects the lives of all Americans. Its agencies and programs protect against domestic and global health threats, assure the safety of food and drugs, advance the science of preventing and conquering disease, provide safeguards for America's vulnerable populations, and improve health for everyone. However, the department faces serious and complex obstacles, chief among them rising health care costs and a broadening range of health challenges. Over time, additional responsibilities have been layered onto the department, and other responsibilities removed, often without corresponding shifts in positions, procedures, structures, and resources. At the request of the U.S. House of Representatives Committee on Oversight and Government Reform, HHS in the 21st Century assesses whether HHS is "ideally organized" to meet the enduring and emerging health challenges facing our nation. The committee identifies many factors that affect the department's ability to address its range of responsibilities, including divergence in the missions and goals of the department's agencies, limited flexibility in spending, impending workforce shortages, difficulty in retaining skilled professionals, and challenges in effectively partnering with the private sector. %0 Book %A Institute of Medicine %E Coble, Yank %E Coussens, Christine %E Quinn, Kathleen %T Environmental Health Sciences Decision Making: Risk Management, Evidence, and Ethics: Workshop Summary %@ 978-0-309-12454-6 %D 2009 %U https://nap.nationalacademies.org/catalog/12444/environmental-health-sciences-decision-making-risk-management-evidence-and-ethics %> https://nap.nationalacademies.org/catalog/12444/environmental-health-sciences-decision-making-risk-management-evidence-and-ethics %I The National Academies Press %C Washington, DC %G English %K Environment and Environmental Studies %K Health and Medicine %P 92 %X Environmental health decision making can be a complex undertaking, as there is the need to navigate and find balance among three core elements: science, policy, and the needs of the American public. Policy makers often grapple with how to make appropriate decisions when the research is uncertain. The challenge for the policy maker is to make the right decision with the best available data in a transparent process. The Environmental Health Sciences Decision Making workshop, the first in a series, was convened to inform the Roundtable on Environmental Health Sciences, Research, and Medicine on emerging issues in risk management, "weight of evidence," and ethics that influence environmental health decision making. The workshop, summarized in this volume, included an overview of the principles underlying decision making, the role of evidence and challenges for vulnerable populations, and ethical issues of conflict of interest, scientific integrity, and transparency. The workshop engaged science interest groups, industry, government, and the academic sector. %0 Book %A National Research Council %A Institute of Medicine %E Lawrence, Robert S. %E Gootman, Jennifer Appleton %E Sim, Leslie J. %T Adolescent Health Services: Missing Opportunities %@ 978-0-309-11467-7 %D 2009 %U https://nap.nationalacademies.org/catalog/12063/adolescent-health-services-missing-opportunities %> https://nap.nationalacademies.org/catalog/12063/adolescent-health-services-missing-opportunities %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 366 %X Adolescence is a time of major transition, however, health care services in the United States today are not designed to help young people develop healthy routines, behaviors, and relationships that they can carry into their adult lives. While most adolescents at this stage of life are thriving, many of them have difficulty gaining access to necessary services; other engage in risky behaviors that can jeopardize their health during these formative years and also contribute to poor health outcomes in adulthood. Missed opportunities for disease prevention and health promotion are two major problematic features of our nation's health services system for adolescents. Recognizing that health care providers play an important role in fostering healthy behaviors among adolescents, Adolescent Health Services examines the health status of adolescents and reviews the separate and uncoordinated programs and services delivered in multiple public and private health care settings. The book provides guidance to administrators in public and private health care agencies, health care workers, guidance counselors, parents, school administrators, and policy makers on investing in, strengthening, and improving an integrated health system for adolescents.