TY - BOOK AU - Institute of Medicine AU - National Research Council A2 - Tracy A. Lustig A2 - Steve Olson TI - Hearing Loss and Healthy Aging: Workshop Summary SN - DO - 10.17226/18735 PY - 2014 UR - https://nap.nationalacademies.org/catalog/18735/hearing-loss-and-healthy-aging-workshop-summary PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - 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. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine A2 - Dan G. Blazer A2 - Sarah Domnitz A2 - Catharyn T. Liverman TI - Hearing Health Care for Adults: Priorities for Improving Access and Affordability SN - DO - 10.17226/23446 PY - 2016 UR - https://nap.nationalacademies.org/catalog/23446/hearing-health-care-for-adults-priorities-for-improving-access-and PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - The loss of hearing - be it gradual or acute, mild or severe, present since birth or acquired in older age - can have significant effects on one's communication abilities, quality of life, social participation, and health. Despite this, many people with hearing loss do not seek or receive hearing health care. The reasons are numerous, complex, and often interconnected. For some, hearing health care is not affordable. For others, the appropriate services are difficult to access, or individuals do not know how or where to access them. Others may not want to deal with the stigma that they and society may associate with needing hearing health care and obtaining that care. Still others do not recognize they need hearing health care, as hearing loss is an invisible health condition that often worsens gradually over time. In the United States, an estimated 30 million individuals (12.7 percent of Americans ages 12 years or older) have hearing loss. Globally, hearing loss has been identified as the fifth leading cause of years lived with disability. Successful hearing health care enables individuals with hearing loss to have the freedom to communicate in their environments in ways that are culturally appropriate and that preserve their dignity and function. Hearing Health Care for Adults focuses on improving the accessibility and affordability of hearing health care for adults of all ages. This study examines the hearing health care system, with a focus on non-surgical technologies and services, and offers recommendations for improving access to, the affordability of, and the quality of hearing health care for adults of all ages. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine A2 - Lisa Bain A2 - Chanel Matney A2 - Clare Stroud TI - Novel Molecular Targets for Mood Disorders and Psychosis: Proceedings of a Workshop SN - DO - 10.17226/26218 PY - 2021 UR - https://nap.nationalacademies.org/catalog/26218/novel-molecular-targets-for-mood-disorders-and-psychosis-proceedings-of PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Mood disorders - including depression and bipolar disorder - are common, disabling, and potentially lethal disorders, characterized by a shortened lifespan from comorbid medical illness and rising suicide rates. Medications for these conditions have been shown to be insufficiently effective in the majority of people who take them, and there remains a tremendous unmet medical need. Recent advances towards understanding the mechanisms of action for psychiatric medicines have led to the identification of potential novel molecular targets and agents for treating mood disorders. While these promising avenues for further investigation have re-energized scientific research in this area, many open questions remain. In response to this interest, the National Academies of Sciences, Engineering, and Medicine's Forum on Neuroscience and Nervous System Disorders convened a workshop in March 2021, Novel Molecular Targets for Mood Disorders and Psychosis. The goal of this workshop was to explore the landscape of novel pharmacologic treatments for psychiatric disorders, review the challenges and opportunities that have been highlighted by the development of recently approved drugs, and reflect on how to apply those lessons learned towards current and future efforts to identify and validate additional novel molecular targets. With a grounding in the personal experiences of patients living with depression and schizophrenia, workshop participants discussed the scientific, clinical, technological, regulatory, and ethical considerations of this topic. Examples of drug classes discussed in the workshop include antagonists for NMDA (N-methyl-D-aspartate) receptors and GABA (gamma-aminobutyric acid) receptors, as well as modulators for muscarinic and serotonergic receptors. This publication summarizes the presentations and discussions from the workshop. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine TI - Evaluating Hearing Loss for Individuals with Cochlear Implants SN - DO - 10.17226/26057 PY - 2021 UR - https://nap.nationalacademies.org/catalog/26057/evaluating-hearing-loss-for-individuals-with-cochlear-implants PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - The U.S. Social Security Administration (SSA) administers programs that provide disability benefits. Once SSA establishes the presence of a severe impairment, it determines whether the impairment meets the criteria in the Listing of Impairments (Listings) that qualify a candidate for disability benefits. The current Listings that address hearing loss treated with cochlear implantation contain criteria that evaluate hearing ability through a speech recognition test called the Hearing in Noise Test (HINT). Since its development in 1994, the HINT has been widely used to measure cochlear implant candidacy and postoperative outcomes. However, the test characteristics, the state of cochlear implant technology, and the environment that made the HINT a common choice of assessment in 1994 are different in 2021. The HINT has several limitations in its characteristics and deviation from its intended use. At the request of SSA, the National Academies of Sciences, Engineering, and Medicine convened a consensus study committee to identify and recommend generalized testing procedures and criteria for evaluating the level of functional hearing ability needed to make a disability determination in adults and children after cochlear implantation. The committee's report, Evaluating Hearing Loss for Individuals with Cochlear Implants, details and supports its findings, conclusions, and recommendations based on published evidence and professional judgment. ER - TY - BOOK AU - National Research Council A2 - Catherine Lord A2 - James P. McGee TI - Educating Children with Autism SN - DO - 10.17226/10017 PY - 2001 UR - https://nap.nationalacademies.org/catalog/10017/educating-children-with-autism PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Autism is a word most of us are familiar with. But do we really know what it means? Children with autism are challenged by the most essential human behaviors. They have difficulty interacting with other people—often failing to see people as people rather than simply objects in their environment. They cannot easily communicate ideas and feelings, have great trouble imagining what others think or feel, and in some cases spend their lives speechless. They frequently find it hard to make friends or even bond with family members. Their behavior can seem bizarre. Education is the primary form of treatment for this mysterious condition. This means that we place important responsibilities on schools, teachers and children's parents, as well as the other professionals who work with children with autism. With the passage of the Individuals with Disabilities Education Act of 1975, we accepted responsibility for educating children who face special challenges like autism. While we have since amassed a substantial body of research, researchers have not adequately communicated with one another, and their findings have not been integrated into a proven curriculum. Educating Children with Autism outlines an interdisciplinary approach to education for children with autism. The committee explores what makes education effective for the child with autism and identifies specific characteristics of programs that work. Recommendations are offered for choosing educational content and strategies, introducing interaction with other children, and other key areas. This book examines some fundamental issues, including: How children's specific diagnoses should affect educational assessment and planning How we can support the families of children with autism Features of effective instructional and comprehensive programs and strategies How we can better prepare teachers, school staffs, professionals, and parents to educate children with autism What policies at the federal, state, and local levels will best ensure appropriate education, examining strategies and resources needed to address the rights of children with autism to appropriate education. Children with autism present educators with one of their most difficult challenges. Through a comprehensive examination of the scientific knowledge underlying educational practices, programs, and strategies, Educating Children with Autism presents valuable information for parents, administrators, advocates, researchers, and policy makers. ER - TY - BOOK AU - Institute of Medicine A2 - Rebecca Koehler A2 - Erin E. Wilhelm A2 - Ira Shoulson TI - Cognitive Rehabilitation Therapy for Traumatic Brain Injury: Evaluating the Evidence SN - DO - 10.17226/13220 PY - 2011 UR - https://nap.nationalacademies.org/catalog/13220/cognitive-rehabilitation-therapy-for-traumatic-brain-injury-evaluating-the-evidence PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Traumatic brain injury (TBI) may affect 10 million people worldwide. It is considered the "signature wound" of the conflicts in Iraq and Afghanistan. These injuries result from a bump or blow to the head, or from external forces that cause the brain to move within the head, such as whiplash or exposure to blasts. TBI can cause an array of physical and mental health concerns and is a growing problem, particularly among soldiers and veterans because of repeated exposure to violent environments. One form of treatment for TBI is cognitive rehabilitation therapy (CRT), a patient-specific, goal-oriented approach to help patients increase their ability to process and interpret information. The Department of Defense asked the IOM to conduct a study to determine the effectiveness of CRT for treatment of TBI. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine A2 - Alan M. Jette A2 - Carol Mason Spicer A2 - Jennifer Lalitha Flaubert TI - The Promise of Assistive Technology to Enhance Activity and Work Participation SN - DO - 10.17226/24740 PY - 2017 UR - https://nap.nationalacademies.org/catalog/24740/the-promise-of-assistive-technology-to-enhance-activity-and-work-participation PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - The U.S. Census Bureau has reported that 56.7 million Americans had some type of disability in 2010, which represents 18.7 percent of the civilian noninstitutionalized population included in the 2010 Survey of Income and Program Participation. The U.S. Social Security Administration (SSA) provides disability benefits through the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. As of December 2015, approximately 11 million individuals were SSDI beneficiaries, and about 8 million were SSI beneficiaries. SSA currently considers assistive devices in the nonmedical and medical areas of its program guidelines. During determinations of substantial gainful activity and income eligibility for SSI benefits, the reasonable cost of items, devices, or services applicants need to enable them to work with their impairment is subtracted from eligible earnings, even if those items or services are used for activities of daily living in addition to work. In addition, SSA considers assistive devices in its medical disability determination process and assessment of work capacity. The Promise of Assistive Technology to Enhance Activity and Work Participation provides an analysis of selected assistive products and technologies, including wheeled and seated mobility devices, upper-extremity prostheses, and products and technologies selected by the committee that pertain to hearing and to communication and speech in adults. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine A2 - Paul A. Volberding A2 - Carol Mason Spicer A2 - Jennifer Lalitha Flaubert TI - Functional Assessment for Adults with Disabilities SN - DO - 10.17226/25376 PY - 2019 UR - https://nap.nationalacademies.org/catalog/25376/functional-assessment-for-adults-with-disabilities PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - 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. ER - TY - BOOK AU - National Research Council TI - Tinnitus: Facts, Theories, and Treatments SN - DO - 10.17226/81 PY - 1982 UR - https://nap.nationalacademies.org/catalog/81/tinnitus-facts-theories-and-treatments PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine ER - TY - BOOK AU - National Research Council A2 - Robert A. Dobie A2 - Susan B. Van Hemel TI - Hearing Loss: Determining Eligibility for Social Security Benefits SN - DO - 10.17226/11099 PY - 2005 UR - https://nap.nationalacademies.org/catalog/11099/hearing-loss-determining-eligibility-for-social-security-benefits PB - The National Academies Press CY - Washington, DC LA - English KW - Behavioral and Social Sciences AB - Millions of Americans experience some degree of hearing loss. The Social Security Administration (SSA) operates programs that provide cash disability benefits to people with permanent impairments like hearing loss, if they can show that their impairments meet stringent SSA criteria and their earnings are below an SSA threshold. The National Research Council convened an expert committee at the request of the SSA to study the issues related to disability determination for people with hearing loss. This volume is the product of that study. Hearing Loss: Determining Eligibility for Social Security Benefits reviews current knowledge about hearing loss and its measurement and treatment, and provides an evaluation of the strengths and weaknesses of the current processes and criteria. It recommends changes to strengthen the disability determination process and ensure its reliability and fairness. The book addresses criteria for selection of pure tone and speech tests, guidelines for test administration, testing of hearing in noise, special issues related to testing children, and the difficulty of predicting work capacity from clinical hearing test results. It should be useful to audiologists, otolaryngologists, disability advocates, and others who are concerned with people who have hearing loss. ER - TY - BOOK AU - Institute of Medicine A2 - Larry E. Humes A2 - Lois M. Joellenbeck A2 - Jane S. Durch TI - Noise and Military Service: Implications for Hearing Loss and Tinnitus SN - DO - 10.17226/11443 PY - 2006 UR - https://nap.nationalacademies.org/catalog/11443/noise-and-military-service-implications-for-hearing-loss-and-tinnitus PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - The Institute of Medicine carried out a study mandated by Congress and sponsored by the Department of Veterans Affairs to provide an assessment of several issues related to noise-induced hearing loss and tinnitus associated with service in the Armed Forces since World War II. The resulting book, Noise and Military Service: Implications for Hearing Loss and Tinnitus, presents findings on the presence of hazardous noise in military settings, levels of noise exposure necessary to cause hearing loss or tinnitus, risk factors for noise-induced hearing loss and tinnitus, the timing of the effects of noise exposure on hearing, and the adequacy of military hearing conservation programs and audiometric testing. The book stresses the importance of conducting hearing tests (audiograms) at the beginning and end of military service for all military personnel and recommends several steps aimed at improving the military services’ prevention of and surveillance for hearing loss and tinnitus. The book also identifies research needs, emphasizing topics specifically related to military service. ER - TY - BOOK AU - Institute of Medicine TI - Returning Home from Iraq and Afghanistan: Assessment of Readjustment Needs of Veterans, Service Members, and Their Families SN - DO - 10.17226/13499 PY - 2013 UR - https://nap.nationalacademies.org/catalog/13499/returning-home-from-iraq-and-afghanistan-assessment-of-readjustment-needs PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - As of December 2012, Operation Enduring Freedom (OEF) in Afghanistan and Operation Iraqi Freedom (OIF) in Iraq have resulted in the deployment of about 2.2 million troops; there have been 2,222 US fatalities in OEF and Operation New Dawn (OND)1 and 4,422 in OIF. The numbers of wounded US troops exceed 16,000 in Afghanistan and 32,000 in Iraq. In addition to deaths and morbidity, the operations have unforeseen consequences that are yet to be fully understood. In contrast with previous conflicts, the all-volunteer military has experienced numerous deployments of individual service members; has seen increased deployments of women, parents of young children, and reserve and National Guard troops; and in some cases has been subject to longer deployments and shorter times at home between deployments. Numerous reports in the popular press have made the public aware of issues that have pointed to the difficulty of military personnel in readjusting after returning from Iraq and Afghanistan. Many of those who have served in OEF and OIF readjust with few difficulties, but others have problems in readjusting to home, reconnecting with family members, finding employment, and returning to school. In response to the return of large numbers of veterans from Iraq and Afghanistan with physical-health and mental-health problems and to the growing readjustment needs of active duty service members, veterans, and their family members, Congress included Section 1661 of the National Defense Authorization Act for fiscal year 2008. That section required the secretary of defense, in consultation with the secretary of veterans affairs, to enter into an agreement with the National Academies for a study of the physical-health, mental-health, and other readjustment needs of members and former members of the armed forces who were deployed in OIF or OEF, their families, and their communities as a result of such deployment. The study consisted of two phases. The Phase 1 task was to conduct a preliminary assessment. The Phase 2 task was to provide a comprehensive assessment of the physical, psychologic, social, and economic effects of deployment on and identification of gaps in care for members and former members, their families, and their communities. The Phase 1 report was completed in March 2010 and delivered to the Department of Defense (DOD), the Department of Veterans Affairs (VA), and the relevant committees of the House of Representatives and the Senate. The secretaries of DOD and VA responded to the Phase 1 report in September 2010. Returning Home from Iraq and Afghanistan: Assessment of Readjustment Needs of Veterans, Service Members, and Their Families fulfills the requirement for Phase 2. ER - TY - BOOK AU - National Academy of Sciences TI - Biographical Memoirs: Volume 89 SN - DO - 10.17226/12042 PY - 2007 UR - https://nap.nationalacademies.org/catalog/12042/biographical-memoirs-volume-89 PB - The National Academies Press CY - Washington, DC LA - English KW - Biography and Autobiography AB - On March 3, 1863, Abraham Lincoln signed the Act of Incorporation that brought the National Academy of Sciences into being. In accordance with that original charter, the Academy is a private, honorary organization of scientists, elected for outstanding contributions to knowledge, who can be called upon to advise the federal government. As an institution the Academy's goal is to work toward increasing scientific knowledge and to further the use of that knowledge for the general good. The Biographical Memoirs, begun in 1877, are a series of volumes containing the life histories and selected bibliographies of deceased members of the Academy. Colleagues familiar with the discipline and the subject's work prepare the essays. These volumes, then, contain a record of the life and work of our most distinguished leaders in the sciences, as witnessed and interpreted by their colleagues and peers. They form a biographical history of science in America—an important part of our nation's contribution to the intellectual heritage of the world. ER - TY - BOOK AU - Institute of Medicine TI - Gulf War and Health: Volume 9: Long-Term Effects of Blast Exposures SN - DO - 10.17226/18253 PY - 2014 UR - https://nap.nationalacademies.org/catalog/18253/gulf-war-and-health-volume-9-long-term-effects-of PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Since the United States began combat operations in Afghanistan in October 2001 and then in Iraq in March 2003, the numbers of US soldiers killed exceed 6,700 and of US soldiers wounded 50,500. Although all wars since World War I have involved the use of explosives by the enemy, the wars in Afghanistan and Iraq differ from previous wars in which the United States has been involved because of the enemy's use of improvised explosive devices (IEDs). The use of IEDs has led to an injury landscape different from that in prior US wars. The signature injury of the Afghanistan and Iraq wars is blast injury. Numerous US soldiers have returned home with devastating blast injuries and they continue to experience many challenges in readjusting to civilian life. Gulf War and Health, Volume 9 is an assessment of the relevant scientific information and draws conclusions regarding the strength of the evidence of an association between exposure to blast and health effects. The report also includes recommendations for research most likely to provide VA with knowledge that can be used to inform decisions on how to prevent blast injuries, how to diagnose them effectively, and how to manage, treat, and rehabilitate victims of battlefield traumas in the immediate aftermath of a blast and in the long term. ER - TY - BOOK AU - Institute of Medicine A2 - Dan G. Blazer A2 - Kristine Yaffe A2 - Catharyn T. Liverman TI - Cognitive Aging: Progress in Understanding and Opportunities for Action SN - DO - 10.17226/21693 PY - 2015 UR - https://nap.nationalacademies.org/catalog/21693/cognitive-aging-progress-in-understanding-and-opportunities-for-action PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - For most Americans, staying "mentally sharp" as they age is a very high priority. Declines in memory and decision-making abilities may trigger fears of Alzheimer's disease or other neurodegenerative diseases. However, cognitive aging is a natural process that can have both positive and negative effects on cognitive function in older adults - effects that vary widely among individuals. At this point in time, when the older population is rapidly growing in the United States and across the globe, it is important to examine what is known about cognitive aging and to identify and promote actions that individuals, organizations, communities, and society can take to help older adults maintain and improve their cognitive health. Cognitive Aging assesses the public health dimensions of cognitive aging with an emphasis on definitions and terminology, epidemiology and surveillance, prevention and intervention, education of health professionals, and public awareness and education. This report makes specific recommendations for individuals to reduce the risks of cognitive decline with aging. Aging is inevitable, but there are actions that can be taken by individuals, families, communities, and society that may help to prevent or ameliorate the impact of aging on the brain, understand more about its impact, and help older adults live more fully and independent lives. Cognitive aging is not just an individual or a family or a health care system challenge. It is an issue that affects the fabric of society and requires actions by many and varied stakeholders. Cognitive Aging offers clear steps that individuals, families, communities, health care providers and systems, financial organizations, community groups, public health agencies, and others can take to promote cognitive health and to help older adults live fuller and more independent lives. Ultimately, this report calls for a societal commitment to cognitive aging as a public health issue that requires prompt action across many sectors. ER - TY - BOOK AU - National Research Council A2 - Nathaniel I. Durlach A2 - Anne S. Mavor TI - Virtual Reality: Scientific and Technological Challenges SN - DO - 10.17226/4761 PY - 1995 UR - https://nap.nationalacademies.org/catalog/4761/virtual-reality-scientific-and-technological-challenges PB - The National Academies Press CY - Washington, DC LA - English KW - Computers and Information Technology KW - Conflict and Security Issues AB - Despite widespread interest in virtual reality, research and development efforts in synthetic environments (SE)—the field encompassing virtual environments, teleoperation, and hybrids—have remained fragmented. Virtual Reality is the first integrated treatment of the topic, presenting current knowledge along with thought-provoking vignettes about a future where SE is commonplace. This volume discusses all aspects of creating a system that will allow human operators to see, hear, smell, taste, move about, give commands, respond to conditions, and manipulate objects effectively in a real or virtual environment. The committee of computer scientists, engineers, and psychologists on the leading edge of SE development explores the potential applications of SE in the areas of manufacturing, medicine, education, training, scientific visualization, and teleoperation in hazardous environments. The committee also offers recommendations for development of improved SE technology, needed studies of human behavior and evaluation of SE systems, and government policy and infrastructure. ER -