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The passage of Citizens United by the Supreme Court in 2010 sparked a renewed debate about campaign spending by large political action committees, or Super PACs. Its ruling said that it is okay for corporations and labor unions to spend as much as they want in advertising and other methods to convince people to vote for or against a candidate. This book provides a wide range of opinions on the issue. Includes primary and secondary sources from a variety of perspectives; eyewitnesses, scientific journals, government officials, and many others.
How we produce and consume food has a bigger impact on Americans' well-being than any other human activity. The food industry is the largest sector of our economy; food touches everything from our health to the environment, climate change, economic inequality, and the federal budget. From the earliest developments of agriculture, a major goal has been to attain sufficient foods that provide the energy and the nutrients needed for a healthy, active life. Over time, food production, processing, marketing, and consumption have evolved and become highly complex. The challenges of improving the food system in the 21st century will require systemic approaches that take full account of social, economic, ecological, and evolutionary factors. Policy or business interventions involving a segment of the food system often have consequences beyond the original issue the intervention was meant to address. A Framework for Assessing Effects of the Food System develops an analytical framework for assessing effects associated with the ways in which food is grown, processed, distributed, marketed, retailed, and consumed in the United States. The framework will allow users to recognize effects across the full food system, consider all domains and dimensions of effects, account for systems dynamics and complexities, and choose appropriate methods for analysis. This report provides example applications of the framework based on complex questions that are currently under debate: consumption of a healthy and safe diet, food security, animal welfare, and preserving the environment and its resources. A Framework for Assessing Effects of the Food System describes the U.S. food system and provides a brief history of its evolution into the current system. This report identifies some of the real and potential implications of the current system in terms of its health, environmental, and socioeconomic effects along with a sense for the complexities of the system, potential metrics, and some of the data needs that are required to assess the effects. The overview of the food system and the framework described in this report will be an essential resource for decision makers, researchers, and others to examine the possible impacts of alternative policies or agricultural or food processing practices.
In the last 20 years, there has been a remarkable emergence of innovations and technological advances that are generating promising changes and opportunities for sustainable agriculture, yet at the same time the agricultural sector worldwide faces numerous daunting challenges. Not only is the agricultural sector expected to produce adequate food, fiber, and feed, and contribute to biofuels to meet the needs of a rising global population, it is expected to do so under increasingly scarce natural resources and climate change. Growing awareness of the unintended impacts associated with some agricultural production practices has led to heightened societal expectations for improved environmental, community, labor, and animal welfare standards in agriculture. Toward Sustainable Agricultural Systems in the 21st Century assesses the scientific evidence for the strengths and weaknesses of different production, marketing, and policy approaches for improving and reducing the costs and unintended consequences of agricultural production. It discusses the principles underlying farming systems and practices that could improve the sustainability. It also explores how those lessons learned could be applied to agriculture in different regional and international settings, with an emphasis on sub-Saharan Africa. By focusing on a systems approach to improving the sustainability of U.S. agriculture, this book can have a profound impact on the development and implementation of sustainable farming systems. Toward Sustainable Agricultural Systems in the 21st Century serves as a valuable resource for policy makers, farmers, experts in food production and agribusiness, and federal regulatory agencies.
Advances in medical, biomedical and health services research have reduced the level of uncertainty in clinical practice. Clinical practice guidelines (CPGs) complement this progress by establishing standards of care backed by strong scientific evidence. CPGs are statements that include recommendations intended to optimize patient care. These statements are informed by a systematic review of evidence and an assessment of the benefits and costs of alternative care options. Clinical Practice Guidelines We Can Trust examines the current state of clinical practice guidelines and how they can be improved to enhance healthcare quality and patient outcomes. Clinical practice guidelines now are ubiquitous in our healthcare system. The Guidelines International Network (GIN) database currently lists more than 3,700 guidelines from 39 countries. Developing guidelines presents a number of challenges including lack of transparent methodological practices, difficulty reconciling conflicting guidelines, and conflicts of interest. Clinical Practice Guidelines We Can Trust explores questions surrounding the quality of CPG development processes and the establishment of standards. It proposes eight standards for developing trustworthy clinical practice guidelines emphasizing transparency; management of conflict of interest ; systematic review-guideline development intersection; establishing evidence foundations for and rating strength of guideline recommendations; articulation of recommendations; external review; and updating. Clinical Practice Guidelines We Can Trust shows how clinical practice guidelines can enhance clinician and patient decision-making by translating complex scientific research findings into recommendations for clinical practice that are relevant to the individual patient encounter, instead of implementing a one size fits all approach to patient care. This book contains information directly related to the work of the Agency for Healthcare Research and Quality (AHRQ), as well as various Congressional staff and policymakers. It is a vital resource for medical specialty societies, disease advocacy groups, health professionals, private and international organizations that develop or use clinical practice guidelines, consumers, clinicians, and payers.