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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.
"They will melt like snowflakes in the sun," said one observer of nineteenth-century Irish emigrants to America. Not only did they not melt, they formed one of the most extensive and persistent ethnic subcultures in American history. Dennis Clark now offers an insightful analysis of the social means this group has used to perpetuate its distinctiveness amid the complexity of American urban life. Basing his study on family stories, oral interviews, organizational records, census data, radio scripts, and the recollections of revolutionaries and intellectuals, Clark offers an absorbing panorama that shows how identity, organization, communication, and leadership have combined to create the Irish-American tradition. In his pages we see gifted storytellers, tough dockworkers, scribbling editors, and colorful actresses playing their roles in the Irish-American saga. As Clark shows, the Irish have defended and extended their self-image by cultivating their ethnic identity through transmission of family memories and by correcting community portrayals of themselves in the press and theatre. They have strengthened their ethnic ties by mutual association in the labor force and professions and in response to social problems. And they have created a network of communications ranging from 150 years of Irish newspapers to America's longest-running ethnic radio show and a circuit of university teaching about Irish literature and history. From this framework of subcultural activity has arisen a fascinating gallery of leadership that has expressed and symbolized the vitality of the Irish-American experience. Although Clark draws his primary material from Philadelphia, he relates it to other cities to show that even though Irish communities have differed they have shared common fundamentals of social development. His study constitutes a pathbreaking theoretical explanation of the dynamics of Irish-American life.
The Handbook of Health Social Work provides a comprehensive and evidence-based overview of contemporary social work practice in health care. Written from a wellness perspective, the chapters cover the spectrum of health social work settings with contributions from a wide range of experts. The resulting resource offers both a foundation for social work practice in health care and a guide for strategy, policy, and program development in proactive and actionable terms. Three sections present the material: The Foundations of Social Work in Health Care provides information that is basic and central to the operations of social workers in health care, including conceptual underpinnings; the development of the profession; the wide array of roles performed by social workers in health care settings; ethical issues and decision - making in a variety of arenas; public health and social work; health policy and social work; and the understanding of community factors in health social work. Health Social Work Practice: A Spectrum of Critical Considerations delves into critical practice issues such as theories of health behavior; assessment; effective communication with both clients and other members of health care teams; intersections between health and mental health; the effects of religion and spirituality on health care; family and health; sexuality in health care; and substance abuse. Health Social Work: Selected Areas of Practice presents a range of examples of social work practice, including settings that involve older adults; nephrology; oncology; chronic diseases such as diabetes, heart disease, and HIV/AIDS; genetics; end of life care; pain management and palliative care; and alternative treatments and traditional healers. The first book of its kind to unite the entire body of health social work knowledge, the Handbook of Health Social Work is a must-read for social work educators, administrators, students, and practitioners.
Ghulam Bombaywala sells bagels in Houston. Demetrios dishes up pizza in Connecticut. The Wangs serve tacos in Los Angeles. How ethnicity has influenced American eating habits—and thus, the make-up and direction of the American cultural mainstream—is the story told in We Are What We Eat. It is a complex tale of ethnic mingling and borrowing, of entrepreneurship and connoisseurship, of food as a social and political symbol and weapon—and a thoroughly entertaining history of our culinary tradition of multiculturalism. The story of successive generations of Americans experimenting with their new neighbors’ foods highlights the marketplace as an important arena for defining and expressing ethnic identities and relationships. We Are What We Eat follows the fortunes of dozens of enterprising immigrant cooks and grocers, street hawkers and restaurateurs who have cultivated and changed the tastes of native-born Americans from the seventeenth century to the present. It also tells of the mass corporate production of foods like spaghetti, bagels, corn chips, and salsa, obliterating their ethnic identities. The book draws a surprisingly peaceful picture of American ethnic relations, in which “Americanized” foods like Spaghetti-Os happily coexist with painstakingly pure ethnic dishes and creative hybrids. Donna Gabaccia invites us to consider: If we are what we eat, who are we? Americans’ multi-ethnic eating is a constant reminder of how widespread, and mutually enjoyable, ethnic interaction has sometimes been in the United States. Amid our wrangling over immigration and tribal differences, it reveals that on a basic level, in the way we sustain life and seek pleasure, we are all multicultural.