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This book is the Institute of Medicine's response to the first part of the statement of task asking for a review of the 1994 National Vaccine Plan. The Committee on the Review of Priorities in the National Vaccine Plan reviewed the goals, objectives, strategies, and anticipated outcomes presented in the plan, their findings are contained in this book. In the first section of the book, the committee examines what has changed in the broader soci...

Amyotrophic lateral sclerosis (ALS) our Lou Gehrig's disease is a fatal, mostly non-familial disease that affects the nervous system of humans by causing the degeneration of nerve cells in the brain and spinal cord. The degeneration halts communication between the nervous system and voluntary muscles in the body. This leads to muscle paralysis and eventually the muscles that aid in breathing are affect, causing respiration to fail. The disease...

This report is the summary of a workshop held by The Institute of Medicine (IOM) of the National Academy of Science December 13-14, 2004 to estimate the contributions of lifestyle-related factors to preventable death. The summary of this workshop includes presentations from experts in statistical design, epidemiology, quality-of-life measures, communication, and public policy and discussions among the participants. Panels of experts addressed ...

Determinants of health - like physical activity levels and living conditions - have traditionally been the concern of public health and have not been linked closely to clinical practice. However, if standardized social and behavioral data can be incorporated into patient electronic health records (EHRs), those data can provide crucial information about factors that influence health and the effectiveness of treatment. Such information is useful...

Organizational Change to Improve Health Literacy is the summary of a workshop convened in April 2013 by the Institute of Medicine Board on Population Health and Public Health Practice Roundtable on Health Literacy. As a follow up to the 2012 discussion paper Ten Attributes of a Health Literate Health Care Organization, participants met to examine what is known about implementation of the attributes of a health literate health care organization...

Is there a sufficient evidence base for the U.S. Department of Health and Human Services (HHS) to develop a comprehensive set of physical activity guidelines for Americans? To address this question, the Institute of Medicine (IOM) held a workshop titled "Adequacy of Evidence for Physical Activity Guidelines Development" in Washington, DC on October 23-24, 2006, sponsored by HHS. The workshop summary includes the presentations and discussions o...

Biological threats like SARS and natural disasters like the tsunami in Indonesia have devastated entire regions, and quickly exhausted budgetary resources. As the field of environmental health continues to evolve, scientists and others must focus on gaining a better understanding of the links between human health and various environmental factors, and on creating new paradigms and partnerships needed to address these complex environmental heal...

Implementation of the Affordable Care Act (ACA) of 2010 will result in significant changes to the U.S. health care system. Among its many provisions, the ACA will extend access to health care coverage to millions of Americans who have been previously uninsured. Many of the newly eligible health insurance consumers will be individuals of low health literacy, some speakers of English and others more comfortable using languages other than English...

The number of women participating in clinical trials has increased during the last two decades, but women are still underrepresented in clinical trials in general. Some of the overall increase can be attributed to the greater number of women-only trials (of therapies for diseases that affect only women). Even when women are included in clinical trials, the results are often not analyzed separately by sex. On August 30, 2011, the Institute of M...

The number of people living with HIV/AIDS (PLWHA) in the United States is growing each year largely due both to advances in treatment that allow HIV-infected individuals to live longer and healthier lives and due to a steady number of new HIV infections each year. The U.S. Centers for Disease Control and Prevention (CDC) estimates that there were 1.2 million people living with HIV infection in the United States at the end of 2008, the most rec...

A single tick bite can have debilitating consequences. Lyme disease is the most common disease carried by ticks in the United States, and the number of those afflicted is growing steadily. If left untreated, the diseases carried by ticks--known as tick-borne diseases--can cause severe pain, fatigue, neurological problems, and other serious health problems. The Institute of Medicine held a workshop October 11-12, 2010, to examine the state of t...

It is as yet uncertain how the Gulf of Mexico oil spill will affect the health of clean-up workers and volunteers, residents, and visitors in the Gulf. The IOM recommends that the U.S. Department of Health and Human Services focus on researching psychological and behavioral health, exposure information to oil and dispersants, seafood safety, communication methods for health studies, and methods for conducting research in order to better unders...

The Gulf of Mexico oil spill is unprecedented not only in its size but also in the use of chemical dispersants and controlled burns to remove the oil. The National Institute of Environmental Health Sciences (NIEHS) is designing a study to investigate the health effects on clean-up workers. The IOM held a workshop to review and comment on NIEHS'o, s study protocol.

Although efforts to reduce health disparities receive attention at the national level, information on the successes of state and local efforts are often not heard. On May 11, 2009, the Institute of Medicine held a public workshop to discuss the role of state and local policy initiatives to reduce health disparities. The workshop brought together stakeholders to learn more about what works in reducing health disparities and ways to focus on loc...

Mother-to-child transmission of HIV-1 afflicts hundreds of thousands of children every year, especially in parts of the world such as sub-Saharan Africa, where HIV infection is prevalent and resources are limited. This tragic reality has spurred researchers to search for an effective, safe, and inexpensive treatment that could reduce the risk of perinatal HIV transmission. The HIVNET 012 trial was designed to provide preliminary information on...

Every year at least 1.5 million people suffer adverse effects from medication. These problems occur because people misunderstand labels, are unaware of drug interactions, or otherwise use medication improperly. The Food and Drug Administration's Safe Use Initiative seeks to identify preventable medication risks and develop solutions to them. The IOM held a workshop to discuss the FDA's Safe Use Initiative and other efforts to improve drug labe...

More than 200, 000 people in the United States living with HIV/AIDS do not know they are infected. The Institute of Medicine's Committee on HIV Screening and Access to Care held a workshop and reviewed literature to explore barriers and facilitators to more widespread HIV testing. This book contains the committee's conclusions."--Publisher's description.

The IOM held a workshop on July 28, 2008, to examine strategies for discussing health disparities in ways that engage the public and motivate change. Speakers focused on health disparities in California, which continues to see dramatic demographic shifts."--Publisher's description.

Common diseases cost the developing world an enormous amount in terms of human life, health, and productivity, as well as lost economic potential. New and effective vaccines could not only improve the quality of life for millions of residents in developing countries, they could also contribute substantially to further economic development. Using data from the World Health Organization and other international agencies, this book analyzes diseas...

Reviews scientific findings and stakeholders concerns related to the safety of the recommended childhood immunization schedule. This report identifies potential research approaches, methodologies and study designs that could inform this question, considering strengths, weaknesses as well as ethical and financial feasibility of each approach.