%0 Book %A Transportation Research Board %A National Academies of Sciences, Engineering, and Medicine %E Sanders, Arizona State University Rebecca L. %E LLC, Belinda Judelman, Sara Schooley, Toole Design Group %T Pedestrian Safety Relative to Traffic-Speed Management %D 2019 %U https://nap.nationalacademies.org/catalog/25618/pedestrian-safety-relative-to-traffic-speed-management %> https://nap.nationalacademies.org/catalog/25618/pedestrian-safety-relative-to-traffic-speed-management %I The National Academies Press %C Washington, DC %G English %K Transportation and Infrastructure %P 126 %X Measures that are effective at reducing speed, such as speed humps and mini traffic circles, are sometimes used in low-speed areas such as school zones. But they are often not recommended or allowed (via local policy) on the higher-speed streets typically associated with the highest injury severity for pedestrians.For those higher-speed streets, redesigning them to communicate lower speed, such as through a roadway-reconfiguration effort, can effectively accomplish the goal of lowering speed. In the absence of street redesign, however, another effective current solution is enforcement, and particularly automated speed enforcement (ASE) that frees police to focus on other issues and that is free from implicit or explicit bias. It is important to carefully consider community context when selecting locations to employ ASE, to avoid disproportionately burdening any historically disadvantaged communities that surround the typically high-speed streets that need to be addressed.The TRB National Cooperative Highway Research Program's NCHRP Synthesis 535: Pedestrian Safety Relative to Traffic-Speed Management aims to document what is known about strategies and countermeasures to address pedestrian safety via traffic-speed management in urban environments. For example, the City of San Francisco regularly uses curb extensions as traffic-calming devices on its streets. However, the political and land use context of each city heavily influences the types of treatments that are considered feasible for each city. Thus, the City of Los Angeles has had to find alternatives to both ASE and road diets, the latter of which have been the subject of intense public backlash in some cases.These realities—that speed management can be fraught with difficulty—have spurred creative thinking about how to work within contextual confines, resulting in some particularly noteworthy and promising practices. For example, the City of Nashville anticipated potential backlash against speed-management efforts and thus chose to work with advocacy groups to identify areas of the city desiring walkability improvements. By installing walkability improvements in those areas first, city leaders created instant wins that could be used as leverage for future projects.The authors of the synthesis found there may be a need for greater clarity about the speed-limit-setting process, as well as for greater collaboration between local and state agencies when state roads run through urban areas. In particular, it may be worth exploring whether there is a need for a framework that will foster collaboration between local and state staff on safety initiatives such as achieving flexibility in roadway design, changing laws or regulations that govern speed-limit setting, and finding a balance between local safety needs and regional mobility needs. Such a framework may support both local and state agencies attempting to address safety issues and reach larger goals as articulated through movements like Vision Zero. %0 Book %A National Academies of Sciences, Engineering, and Medicine %T Evaluation of the Disability Determination Process for Traumatic Brain Injury in Veterans %@ 978-0-309-48686-6 %D 2019 %U https://nap.nationalacademies.org/catalog/25317/evaluation-of-the-disability-determination-process-for-traumatic-brain-injury-in-veterans %> https://nap.nationalacademies.org/catalog/25317/evaluation-of-the-disability-determination-process-for-traumatic-brain-injury-in-veterans %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 210 %X The Veterans Benefits Administration (VBA) provides disability compensation to veterans with a service-connected injury, and to receive disability compensation from the Department of Veterans Affairs (VA), a veteran must submit a claim or have a claim submitted on his or her behalf. Evaluation of the Disability Determination Process for Traumatic Brain Injury in Veterans reviews the process by which the VA assesses impairments resulting from traumatic brain injury for purposes of awarding disability compensation. This report also provides recommendations for legislative or administrative action for improving the adjudication of veterans' claims seeking entitlement to compensation for all impairments arising from a traumatic brain injury. %0 Book %A National Academies of Sciences, Engineering, and Medicine %E Alper, Joe %E French, Melissa %E Wojtowicz, Alexis %T Health Systems Interventions to Prevent Firearm Injuries and Death: Proceedings of a Workshop %@ 978-0-309-48839-6 %D 2019 %U https://nap.nationalacademies.org/catalog/25354/health-systems-interventions-to-prevent-firearm-injuries-and-death-proceedings %> https://nap.nationalacademies.org/catalog/25354/health-systems-interventions-to-prevent-firearm-injuries-and-death-proceedings %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 142 %X Firearm injuries and death are a serious public health concern in the United States. Firearm-related injuries account for tens of thousands of premature deaths of adults and children each year and significantly increase the burden of injury and disability. Firearm injuries are also costly to the health system, accounting for nearly $3 billion in emergency department and inpatient care each year. The National Academies of Sciences, Engineering, and Medicine convened a workshop to examine the roles that health systems can play in addressing the epidemic of firearm violence in the United States. This publication summarizes the presentations and discussions from the workshop. %0 Book %A National Academies of Sciences, Engineering, and Medicine %T An Approach to Evaluate the Effects of Concomitant Prescribing of Opioids and Benzodiazepines on Veteran Deaths and Suicides %@ 978-0-309-49599-8 %D 2019 %U https://nap.nationalacademies.org/catalog/25532/an-approach-to-evaluate-the-effects-of-concomitant-prescribing-of-opioids-and-benzodiazepines-on-veteran-deaths-and-suicides %> https://nap.nationalacademies.org/catalog/25532/an-approach-to-evaluate-the-effects-of-concomitant-prescribing-of-opioids-and-benzodiazepines-on-veteran-deaths-and-suicides %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 110 %X Opioid prescriptions for acute and chronic pain increased dramatically from the late 1990s into the current decade in both the civilian and the Department of Veterans Affairs and Department of Defense treatment environments. Similarly, prescriptions for benzodiazepines also increased significantly for anxiety and insomnia. Combinations of opioid and benzodiazepines have proven fatal when taken concurrently, with research demonstrating this phenomenon for nearly 40 years. This issue is exacerbated within the veteran population because of higher rates of pain, anxiety and other related health issues due to military life. An evaluation of the relationship between opioid and benzodiazepine medication practices at the VA is necessary to improve treatment for mental health and combat-related trauma for veterans. An Approach to Evaluate the Effects of Concomitant Prescribing of Opioids and Benzodiazepines on Veteran Deaths and Suicides investigates the effects of opioid initiation and tapering strategies in the presence of benzodiazepines in veterans. This report explores neurobiology and the principles of addiction and tolerance, in addition to the current use of opioids and benzodiazepines for treating pain and anxiety in both the veteran and general population. It also provides a protocol to evaluate the relationship between opioid and benzodiazepine medication practices. This framework is a critical foundation for further research to improve concomitant opioid and benzodiazepine medication practices for veterans and the general population. %0 Book %A National Academies of Sciences, Engineering, and Medicine %E Leshner, Alan I. %E Mancher, Michelle %T Medications for Opioid Use Disorder Save Lives %@ 978-0-309-48648-4 %D 2019 %U https://nap.nationalacademies.org/catalog/25310/medications-for-opioid-use-disorder-save-lives %> https://nap.nationalacademies.org/catalog/25310/medications-for-opioid-use-disorder-save-lives %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 174 %X The opioid crisis in the United States has come about because of excessive use of these drugs for both legal and illicit purposes and unprecedented levels of consequent opioid use disorder (OUD). More than 2 million people in the United States are estimated to have OUD, which is caused by prolonged use of prescription opioids, heroin, or other illicit opioids. OUD is a life-threatening condition associated with a 20-fold greater risk of early death due to overdose, infectious diseases, trauma, and suicide. Mortality related to OUD continues to escalate as this public health crisis gathers momentum across the country, with opioid overdoses killing more than 47,000 people in 2017 in the United States. Efforts to date have made no real headway in stemming this crisis, in large part because tools that already exist—like evidence-based medications—are not being deployed to maximum impact. To support the dissemination of accurate patient-focused information about treatments for addiction, and to help provide scientific solutions to the current opioid crisis, this report studies the evidence base on medication assisted treatment (MAT) for OUD. It examines available evidence on the range of parameters and circumstances in which MAT can be effectively delivered and identifies additional research needed. %0 Book %A National Academies of Sciences, Engineering, and Medicine %E Volberding, Paul A. %E Spicer, Carol Mason %E Flaubert, Jennifer Lalitha %T Functional Assessment for Adults with Disabilities %@ 978-0-309-48938-6 %D 2019 %U https://nap.nationalacademies.org/catalog/25376/functional-assessment-for-adults-with-disabilities %> https://nap.nationalacademies.org/catalog/25376/functional-assessment-for-adults-with-disabilities %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 444 %X The U.S. Social Security Administration (SSA) provides disability benefits through the Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) programs. To receive SSDI or SSI disability benefits, an individual must meet the statutory definition of disability, which is "the inability to engage in any substantial gainful activity [SGA] 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." SSA uses a five-step sequential process to determine whether an adult applicant meets this definition. Functional Assessment for Adults with Disabilities examines ways to collect information about an individual's physical and mental (cognitive and noncognitive) functional abilities relevant to work requirements. This report discusses the types of information that support findings of limitations in functional abilities relevant to work requirements, and provides findings and conclusions regarding the collection of information and assessment of functional abilities relevant to work requirements.