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Chronic pain costs the nation up to $635 billion each year in medical treatment and lost productivity. The 2010 Patient Protection and Affordable Care Act required the Department of Health and Human Services (HHS) to enlist the Institute of Medicine (IOM) in examining pain as a public health problem. In this report, the IOM offers a blueprint for action in transforming prevention, care, education, and research, with the goal of providing relief for people with pain in America. To reach the vast multitude of people with various types of pain, the nation must adopt a population-level prevention and management strategy. The IOM recommends that HHS develop a comprehensive plan with specific goals, actions, and timeframes. Better data are needed to help shape efforts, especially on the groups of people currently underdiagnosed and undertreated, and the IOM encourages federal and state agencies and private organizations to accelerate the collection of data on pain incidence, prevalence, and treatments. Because pain varies from patient to patient, healthcare providers should increasingly aim at tailoring pain care to each person's experience, and self-management of pain should be promoted. In addition, because there are major gaps in knowledge about pain across health care and society alike, the IOM recommends that federal agencies and other stakeholders redesign education programs to bridge these gaps. Pain is a major driver for visits to physicians, a major reason for taking medications, a major cause of disability, and a key factor in quality of life and productivity. Given the burden of pain in human lives, dollars, and social consequences, relieving pain should be a national priority.
In 1926, highway planners laid out a ribbon of roadways connecting the nation. One of the most important wove its way across eight states, from the cities of the heartland to golden California. In The Grapes of Wrath, John Steinbeck calls it "the Mother Road." Route 66 has become a legend, celebrated in books, movies, works of art, and popular music. The interstates could not kill it. As "the Main Street of America," Route 66 had to pass through "the Gateway to the West," St. Louis. Crossing the Mississippi River, the road took many different paths through the busy city and then united to travel into the rolling hills of the Ozarks. Along the way there were mom-and-pop motels, tourist traps, roadside restaurants, a man selling frozen custard, one living with snakes, and another who claimed to be Jesse James. Their stories are here.
North American Agroforestry Explore the many benefits of alternative land-use systems with this incisive resource Humanity has become a victim of its own success. While we’ve managed to meet the needs—to one extent or another—of a large portion of the human population, we’ve often done so by ignoring the health of the natural environment we rely on to sustain our planet. And by deteriorating the quality of our air, water, and land, we’ve put into motion consequences we’ll be dealing with for generations. In the newly revised Third Edition of North American Agroforestry, an expert team of researchers delivers an authoritative and insightful exploration of an alternative land-use system that exploits the positive interactions between trees and crops when they are grown together and bridges the gap between production agriculture and natural resource management. This latest edition includes new material on urban food forests, as well as the air and soil quality benefits of agroforestry, agroforestry’s relevance in the Mexican context, and agroforestry training and education. The book also offers: A thorough introduction to the development of agroforestry as an integrated land use management strategy Comprehensive explorations of agroforestry nomenclature, concepts, and practices, as well as an agroecological foundation for temperate agroforestry Practical discussions of tree-crop interactions in temperate agroforestry, including in systems such as windbreak practices, silvopasture practices, and alley cropping practices In-depth examinations of vegetative environmental buffers for air and water quality benefits, agroforestry for wildlife habitat, agroforestry at the landscape level, and the impact of agroforestry on soil health Perfect for environmental scientists, natural resource professionals and ecologists, North American Agroforestry will also earn a place in the libraries of students and scholars of agricultural sciences interested in the potential benefits of agroforestry.