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There has been much polemic about affluence, consumption, and the global environment. For some observers, "consumption" is at the root of global environmental threats: wealthy individuals and societies use far too much of the earth's resource base and should scale back their appetites to preserve the environment for future generations and allow a decent life for the rest of the world. Other observers see affluence as the way to escape environmental threats: economic development increases public pressure for environmental protection and makes capital available for environmentally benign technologies. The arguments are fed by conflicting beliefs, values, hopes, and fearsâ€"but surprisingly little scientific analysis. This book demonstrates that the relationship of consumption to the environment needs careful analysis by environmental and social scientists and conveys some of the excitement of treating the issue scientifically. It poses the key empirical questions: Which kinds of consumption are environmentally significant? Which actors are responsible for that consumption? What forces cause or explain environmentally significant consumption? How can it be changed? The book presents studies that open up important issues for empirical study: Are there any signs of saturation in the demand for travel in wealthy countries? What is the relationship between environmental consumption and human well-being? To what extent do people in developing countries emulate American consumption styles? The book also suggests broad strategies that scientists and research sponsors can use to better inform future debates about the environment, development, and consumption.
Clinical research presents health care providers with information on the natural history and clinical presentations of disease as well as diagnostic and treatment options. In today's healthcare system, patients, physicians, clinicians and family caregivers often lack the sufficient scientific data and evidence they need to determine the best course of treatment for the patients' medical conditions. Initial National Priorities for Comparative Effectiveness Research(CER) is designed to fill this knowledge gap by assisting patients and healthcare providers across diverse settings in making more informed decisions. In this 2009 report, the Institute of Medicine's Committee on Comparative Effectiveness Research Prioritization establishes a working definition of CER, develops a priority list of research topics, and identifies the necessary requirements to support a robust and sustainable CER enterprise. As part of the 2009 American Recovery and Reinvestment Act, Congress appropriated $1.1 billion in federal support of CER, reflecting legislators' belief that better decisions about the use of health care could improve the public's health and reduce the cost of care. The Committee on Comparative Effectiveness Research Prioritization was successful in preparing a list 100 top priority CER topics and 10 recommendations for best practices in the field.
The National Institutes of Health (NIH) is the single largest funder of health research in the United States, and research it has supported has been pivotal to the explosion of biomedical knowledge over the past century. As NIH's success has grown, so has pressure from advocacy groups and other members of the public to devote more spending to their health concerns. In response to a request from Congress, this IOM study reviewed NIH's research priority-setting process and made recommendations for possible improvement. The committee considered the: Factors and criteria used by NIH to make funding allocations. Process by which the funding decisions are made. Mechanisms for public input. Impact of congressional statutory directives on funding decisions. Among other recommendations, the book recommends that NIH seek broader public input on decisions about how to spend its nearly $14 billion budget; it also urged the agency to create new Offices of Public Liaison in the Office of the Director and in each of the 21 research institutes to allow interested people to formally take part in the process.
This book examines methods for selecting topics and setting priorities for clinical practice guideline development and implementation. Clinical practice guidelines are "systematically defined statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances." In its assessment of processes for setting priorities, the committee considers the principles of consistency with the organization's mission, implementation feasibility, efficiency, utility of the results to the organization, and openness and defensibilityâ€"a principle that is especially important to public agencies. The volume also examines the implications of health care restructuring for priority setting and topic selection, including the link between national and local approaches to guidelines development.
In its report into how priorities are set for publicly funded research, the Science and Technology Committee calls on the Government to make a clear and unambiguous statement setting out their research funding commitments and the periods of time over which those commitments apply.