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Though overall cancer incidence and mortality have continued to decline in recent years, cancer continues to devastate the lives of far too many Americans. In 2009 alone, 1.5 million American men, women, and children were diagnosed with cancer, and 562,000 died from the disease. There is a growing body of evidence linking environmental exposures to cancer. The Pres. Cancer Panel dedicated its 2008¿2009 activities to examining the impact of environmental factors on cancer risk. The Panel considered industrial, occupational, and agricultural exposures as well as exposures related to medical practice, military activities, modern lifestyles, and natural sources. This report presents the Panel¿s recommend. to mitigate or eliminate these barriers. Illus.
"The objective of this report is to identify and establish a roadmap on how to do that, and lay the groundwork for transforming how this Nation- from every level of government to the private sector to individual citizens and communities - pursues a real and lasting vision of preparedness. To get there will require significant change to the status quo, to include adjustments to policy, structure, and mindset"--P. 2.
Most major measures wind their way through the contemporary Congress in what Barbara Sinclair has dubbed “unorthodox lawmaking.” In this much-anticipated Fifth Edition of Unorthodox Lawmaking, Sinclair explores the full range of special procedures and processes that make up Congress’s work, as well as the reasons these unconventional routes evolved. The author introduces students to the intricacies of Congress and provides the tools to assess the relative successes and limitations of the institution. This dramatically updated revision incorporates a wealth of new cases and examples to illustrate the changes occurring in congressional process. Two entirely new case study chapters—on the 2013 government shutdown and the 2015 reauthorization of the Patriot Act—highlight Sinclair’s fresh analysis and the book is now introduced by a new foreword from noted scholar and teacher, Bruce I. Oppenheimer, reflecting on this book and Barbara Sinclair’s significant mark on the study of Congress.
This book informs readers of the needs and rationale for the integration of medical and dental care and information with an international perspective as to how and where medical and dental care separated into specific domains. It provide high level guidance on issues involved with care and data integration and how to achieve an integrated model of health care supported by integrated HIT. A patient typically expects that a visit to a dentist can usually be resolved immediately. This expectation places a premium on instant, accurate, thorough, and current information. The state-of-the-art of fully integrated (dental-medical) electronic health record (EHR) is covered and this is contrasted with the current state of dental-medical software. While dentists in the US Veterans Health Administration (VHA), the US Indian Health Service (IHS), or the US military, for example, have access to fully integrated health records, most US clinicians still gather information from separate sources via fax or phone calls. The authors provide an in-depth discussion of the role of informatics and information science in the articulation of medical and dental practices and clinical data with the focus on applied clinical informatics to improve quality of care, practice efficiency, coordination and continuity of care, communication between physicians and dentists and to provide a more comprehensive care for the patients. Lastly, the book examines advances in medical and dental research and how these may affect dentistry in the future. Most new advances in healthcare research are information-intensive.
For the past 50 years a select group of scientists has provided advice to the US President, mostly out of the public eye, on issues ranging from the deployment of weapons to the launching of rockets to the moon to the use of stem cells to cure disease. The role of the presidential science adviser came under increasing scrutiny during the administration of George W. Bush, which was highly criticized by many for its use (and some say, misuse) of science. This edited volume includes, for the first time, the reflections of the presidential science advisers from Donald Hornig who served under Lyndon B. Johnson, to John Marburger, the previous science advisor, on their roles within both government and the scientific community. It provides an intimate glimpse into the inner workings of the White House, as well as the political realities of providing advice on scientific matters to the presidential of the United States. The reflections of the advisers are supplemented with critical analysis of the role of the science adviser by several well-recognized science policy practitioners and experts. This volume will be of interest to science policy and presidential history scholars and students.
In a world where advanced knowledge is widespread and low-cost labor is readily available, U.S. advantages in the marketplace and in science and technology have begun to erode. A comprehensive and coordinated federal effort is urgently needed to bolster U.S. competitiveness and pre-eminence in these areas. This congressionally requested report by a pre-eminent committee makes four recommendations along with 20 implementation actions that federal policy-makers should take to create high-quality jobs and focus new science and technology efforts on meeting the nation's needs, especially in the area of clean, affordable energy: 1) Increase America's talent pool by vastly improving K-12 mathematics and science education; 2) Sustain and strengthen the nation's commitment to long-term basic research; 3) Develop, recruit, and retain top students, scientists, and engineers from both the U.S. and abroad; and 4) Ensure that the United States is the premier place in the world for innovation. Some actions will involve changing existing laws, while others will require financial support that would come from reallocating existing budgets or increasing them. Rising Above the Gathering Storm will be of great interest to federal and state government agencies, educators and schools, public decision makers, research sponsors, regulatory analysts, and scholars.
In the United States, approximately 14 million people have had cancer and more than 1.6 million new cases are diagnosed each year. However, more than a decade after the Institute of Medicine (IOM) first studied the quality of cancer care, the barriers to achieving excellent care for all cancer patients remain daunting. Care often is not patient-centered, many patients do not receive palliative care to manage their symptoms and side effects from treatment, and decisions about care often are not based on the latest scientific evidence. The cost of cancer care also is rising faster than many sectors of medicine--having increased to $125 billion in 2010 from $72 billion in 2004--and is projected to reach $173 billion by 2020. Rising costs are making cancer care less affordable for patients and their families and are creating disparities in patients' access to high-quality cancer care. There also are growing shortages of health professionals skilled in providing cancer care, and the number of adults age 65 and older--the group most susceptible to cancer--is expected to double by 2030, contributing to a 45 percent increase in the number of people developing cancer. The current care delivery system is poorly prepared to address the care needs of this population, which are complex due to altered physiology, functional and cognitive impairment, multiple coexisting diseases, increased side effects from treatment, and greater need for social support. Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis presents a conceptual framework for improving the quality of cancer care. This study proposes improvements to six interconnected components of care: (1) engaged patients; (2) an adequately staffed, trained, and coordinated workforce; (3) evidence-based care; (4) learning health care information technology (IT); (5) translation of evidence into clinical practice, quality measurement and performance improvement; and (6) accessible and affordable care. This report recommends changes across the board in these areas to improve the quality of care. Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis provides information for cancer care teams, patients and their families, researchers, quality metrics developers, and payers, as well as HHS, other federal agencies, and industry to reevaluate their current roles and responsibilities in cancer care and work together to develop a higher quality care delivery system. By working toward this shared goal, the cancer care community can improve the quality of life and outcomes for people facing a cancer diagnosis.