Rand health quarterly最新文献

The integration of artificial intelligence (AI) and biotechnology, whilst in its infancy, presents significant opportunities and risks, and proactive policy is needed to manage these emerging technologies. Whilst AI continues to have significant and broad impact, its relevance and complexity magnify when integrated with other emerging technologies. The confluence of Machine Learning (ML), a subset of AI, with gene editing (GE) in particular can foster substantial benefits as well as daunting risks that range from ethics to national security. These complex technologies have implications for multiple sectors, ranging from agriculture and medicine to economic competition and national security. Consideration of technology advancements and policies in different geographic regions, and involvement of multiple organisations further confound this complexity. As the impact of ML and GE expands, forward looking policy is needed to mitigate risks and leverage opportunities. Thus, this study explores the technological and policy implications of the intersection of ML and GE, with a focus on the United States (US), the United Kingdom (UK), China, and the European Union (EU). Analysis of technical and policy developments over time and an assessment of their current state have informed policy recommendations that can help manage beneficial use of technology advancements and their convergence, which can be applied to other sectors. This study is intended for policymakers to prompt reflection on how to best approach the convergence of the two technologies. Technical practitioners may also find it valuable as a resource to consider the type of information and policy stakeholders engage with.

The U.S. Air Force asked RAND Project AIR FORCE (PAF) to help assess the well-being of its wounded members and the quality of services provided to facilitate their recovery and reintegration. RAND PAF fielded a survey in the fall of 2016 to assess wounded airmen's functioning in the domains of physical health, mental health, interpersonal relationships, unemployment, and financial status, as well as their utilization and perceptions of Air Force nonmedical programs for wounded airmen. The authors of this study invited all 713 wounded airmen enrolled in the Air Force Wounded Warrior program to complete the survey, and 270 airmen (38 percent) completed it. One-third of airmen reported difficulty obtaining care for physical or mental health conditions, and one-quarter expressed dissatisfaction with coordination of care. Similar proportions of airmen reported barriers to care for physical and mental health conditions. Difficulty scheduling appointments was the most commonly endorsed barrier for both types of conditions. Small but notable proportions of airmen reported potential social support deficits, unemployment, and financial problems. For many of the Air Force's programs for wounded airmen, over 80 percent of program users reported overall program satisfaction. The authors recommend that the Air Force consider focusing on improving care coordination, increasing health care system capacity, continuing employment assistance, and improving marketing of programs with low uptake.

RAND Europe was commissioned by the Novo Nordisk Foundation to conduct a study on pathogen surveillance and current initiatives. The study aims to provide an overview of the pathogen surveillance space internationally and the stakeholders involved, as well as to understand the strengths and weaknesses of different initiatives, the challenges of pathogen surveillance and how they have been addressed, and how data has been used to inform public health decision making. To do this, a scoping review of pathogen surveillance initiatives was conducted, and ten case studies were developed and selected for further review following a workshop attended by the Novo Nordisk Foundation and RAND Europe study team. Interviews were conducted with individuals involved in pathogen surveillance initiatives to gather additional information to develop case studies, and expert interviews addressed gaps in the pathogen surveillance space and models that would be helpful in filling these gaps.

Like the United States as a whole, Virginia faces a significant shortage of health care workers in nursing, primary care, and behavioral health. If current trends persist, these shortages will increase across Virginia. The authors of this study identify interventions that can help the Virginia Health Workforce Development Authority (VHWDA) address these health care workforce shortages. To accomplish this goal, they applied an analytic framework to existing or potential interventions for retaining, recruiting, and improving the structural efficiency of the nursing, primary care, and behavioral health workforces in Virginia. In this study, they highlight which interventions VHWDA should prioritize based on its desired outcomes and policy goals.

In response to the widespread youth mental health crisis, some kindergarten-through-12th-grade (K-12) schools have begun employing artificial intelligence (AI)-based tools to help identify students at risk for suicide and self-harm. The adoption of AI and other types of educational technology to partially address student mental health needs has been a natural forward step for many schools during the transition to remote education. However, there is limited understanding about how such programs work, how they are implemented by schools, and how they may benefit or harm students and their families. To assist policymakers, school districts, school leaders, and others in making decisions regarding the use of these tools, the authors address these knowledge gaps by providing a preliminary examination of how AI-based suicide risk monitoring programs are implemented in K-12 schools, how stakeholders perceive the effects that the programs are having on students, and the potential benefits and risks of such tools. Using this analysis, the authors also offer recommendations for school and district leaders; state, federal, and local policymakers; and technology developers to consider as they move forward in maximizing the intended benefits and mitigating the possible risks of AI-based suicide risk monitoring programs.

Retired service members with a service-connected disability cannot always receive their full retirement pay and disability benefits because of rules against "double-dipping" from federal funding sources. Veterans' advocates have long argued that the current law is unfair and that it denies disabled veterans the full compensation that they have earned from their military service. New legislation would drop the offset that reduces retirement pay for some disabled veterans. If the Major Richard Star Act is signed into law, what would change for disabled veterans, and how many would actually see an increase in their compensation?

Global health engagement (GHE) is an integral part of the cooperation efforts of the U.S. Department of Defense (DoD) and the geographic combatant commands (GCCs) with partner nations and provides support in training and preparing their military and civilian health systems. These activities encompass a wide spectrum of engagements-military-to-military, military-to-civilian, and multilateral-and support joint missions of humanitarian aid and disaster response, deterrence, access and presence, counterterrorism, and homeland defense. Global health engagements and activities require extensive planning, funding, and resource allocation within the GCCs and component commands. For a continuously growing breadth of GHE and the need to support joint exercises with partner military and civilian medical professionals for partner capacity-building, GHE also requires a robust information technology infrastructure. In this study, the authors assess the technology and process requirements to support the life cycle of GHE activities and assessments-from planning to evaluation-and the information- and knowledge-sharing needs of the GHE community. To do so, they conducted a literature review related to GHE activities, funding sources, and stakeholders; the evolution of technology solutions to support GHE; systems in use by GHE practitioners; and technology solutions in the market, focusing particularly on cloud infrastructure and services and cloud service providers. They held discussions with GHE subject-matter experts to document and analyze GHE technology platform requirements. And they assessed the available and planned platforms according to their features, enhancements, support and maintenance, data integration, interoperability, and future road maps.

Over the past two decades, pandemic preparedness has proven to be critical to health, national, and economic security. Now, countries are investing billions of dollars in various pandemic preparedness tools, such as vaccines and broad-spectrum medical countermeasures (MCM), to address the threats arising from outbreaks. These tools not only offer protection against naturally occurring and accidental biological incidents but can also help provide some protection against deliberate biological attacks. Furthermore, pandemic preparedness has substantial economic implications for both the public and private sectors because of its connection with the biotechnology industry, an important component of the worldwide economy. With so many aspects of pandemic preparedness tied to public health, national security, and economic competition, understanding the key technology and policy trends of the major country stakeholders in this space provides valuable insights into pandemic preparedness gaps and ways of addressing them. This study provides a brief characterization of the trends and strategic implications associated with specific aspects of pandemic preparedness in the United States, China, and Russia. The authors discuss both technical and policy aspects of vaccine concepts and technologies, broad-spectrum MCM, and immunization facilitation.

Leading up to the 2020 general election, state election boards grew concerned that the coronavirus disease 2019 (COVID-19) pandemic might drive voters away from the polls or that crowded polling stations would spread the virus and lead to a wave of new cases, hospitalizations, and deaths. In an effort to safely conduct the 2020 general election, many states changed their voting laws by implementing automatic voter registration, removing excuse requirements for absentee ballots, and expanding early voting windows. These changes, meant to encourage turnout and protect public health, were expensive to implement, politically contentious, or both. But did the changes have the desired effects? This study examines the impact of voting laws on voter turnout and choice of voting method in the 2020 election and the effects of in-person voting on the spread of COVID-19.