Evidence-Based Medicine and the Changing Nature of Health Care


Book Description

Drawing on the work of the Roundtable on Evidence-Based Medicine, the 2007 IOM Annual Meeting assessed some of the rapidly occurring changes in health care related to new diagnostic and treatment tools, emerging genetic insights, the developments in information technology, and healthcare costs, and discussed the need for a stronger focus on evidence to ensure that the promise of scientific discovery and technological innovation is efficiently captured to provide the right care for the right patient at the right time. As new discoveries continue to expand the universe of medical interventions, treatments, and methods of care, the need for a more systematic approach to evidence development and application becomes increasingly critical. Without better information about the effectiveness of different treatment options, the resulting uncertainty can lead to the delivery of services that may be unnecessary, unproven, or even harmful. Improving the evidence-base for medicine holds great potential to increase the quality and efficiency of medical care. The Annual Meeting, held on October 8, 2007, brought together many of the nation's leading authorities on various aspects of the issues - both challenges and opportunities - to present their perspectives and engage in discussion with the IOM membership.




Cities Transformed


Book Description

Over the next 20 years, most low-income countries will, for the first time, become more urban than rural. Understanding demographic trends in the cities of the developing world is critical to those countries - their societies, economies, and environments. The benefits from urbanization cannot be overlooked, but the speed and sheer scale of this transformation presents many challenges. In this uniquely thorough and authoritative volume, 16 of the world's leading scholars on urban population and development have worked together to produce the most comprehensive and detailed analysis of the changes taking place in cities and their implications and impacts. They focus on population dynamics, social and economic differentiation, fertility and reproductive health, mortality and morbidity, labor force, and urban governance. As many national governments decentralize and devolve their functions, the nature of urban management and governance is undergoing fundamental transformation, with programs in poverty alleviation, health, education, and public services increasingly being deposited in the hands of untested municipal and regional governments. Cities Transformed identifies a new class of policy maker emerging to take up the growing responsibilities. Drawing from a wide variety of data sources, many of them previously inaccessible, this essential text will become the benchmark for all involved in city-level research, policy, planning, and investment decisions. The National Research Council is a private, non-profit institution based in Washington, DC, providing services to the US government, the public, and the scientific and engineering communities. The editors are members of the Council's Panel on Urban Population Dynamics.




Model Rules of Professional Conduct


Book Description

The Model Rules of Professional Conduct provides an up-to-date resource for information on legal ethics. Federal, state and local courts in all jurisdictions look to the Rules for guidance in solving lawyer malpractice cases, disciplinary actions, disqualification issues, sanctions questions and much more. In this volume, black-letter Rules of Professional Conduct are followed by numbered Comments that explain each Rule's purpose and provide suggestions for its practical application. The Rules will help you identify proper conduct in a variety of given situations, review those instances where discretionary action is possible, and define the nature of the relationship between you and your clients, colleagues and the courts.




The Arctic in the Anthropocene


Book Description

Once ice-bound, difficult to access, and largely ignored by the rest of the world, the Arctic is now front and center in the midst of many important questions facing the world today. Our daily weather, what we eat, and coastal flooding are all interconnected with the future of the Arctic. The year 2012 was an astounding year for Arctic change. The summer sea ice volume smashed previous records, losing approximately 75 percent of its value since 1980 and half of its areal coverage. Multiple records were also broken when 97 percent of Greenland's surface experienced melt conditions in 2012, the largest melt extent in the satellite era. Receding ice caps in Arctic Canada are now exposing land surfaces that have been continuously ice covered for more than 40,000 years. What happens in the Arctic has far-reaching implications around the world. Loss of snow and ice exacerbates climate change and is the largest contributor to expected global sea level rise during the next century. Ten percent of the world's fish catches comes from Arctic and sub-Arctic waters. The U.S. Geological Survey estimated that up to 13 percent of the world's remaining oil reserves are in the Arctic. The geologic history of the Arctic may hold vital clues about massive volcanic eruptions and the consequent release of massive amount of coal fly ash that is thought to have caused mass extinctions in the distant past. How will these changes affect the rest of Earth? What research should we invest in to best understand this previously hidden land, manage impacts of change on Arctic communities, and cooperate with researchers from other nations? The Arctic in the Anthropocene reviews research questions previously identified by Arctic researchers, and then highlights the new questions that have emerged in the wake of and expectation of further rapid Arctic change, as well as new capabilities to address them. This report is meant to guide future directions in U.S. Arctic research so that research is targeted on critical scientific and societal questions and conducted as effectively as possible. The Arctic in the Anthropocene identifies both a disciplinary and a cross-cutting research strategy for the next 10 to 20 years, and evaluates infrastructure needs and collaboration opportunities. The climate, biology, and society in the Arctic are changing in rapid, complex, and interactive ways. Understanding the Arctic system has never been more critical; thus, Arctic research has never been more important. This report will be a resource for institutions, funders, policy makers, and students. Written in an engaging style, The Arctic in the Anthropocene paints a picture of one of the last unknown places on this planet, and communicates the excitement and importance of the discoveries and challenges that lie ahead.




Transforming the Workforce for Children Birth Through Age 8


Book Description

Children are already learning at birth, and they develop and learn at a rapid pace in their early years. This provides a critical foundation for lifelong progress, and the adults who provide for the care and the education of young children bear a great responsibility for their health, development, and learning. Despite the fact that they share the same objective - to nurture young children and secure their future success - the various practitioners who contribute to the care and the education of children from birth through age 8 are not acknowledged as a workforce unified by the common knowledge and competencies needed to do their jobs well. Transforming the Workforce for Children Birth Through Age 8 explores the science of child development, particularly looking at implications for the professionals who work with children. This report examines the current capacities and practices of the workforce, the settings in which they work, the policies and infrastructure that set qualifications and provide professional learning, and the government agencies and other funders who support and oversee these systems. This book then makes recommendations to improve the quality of professional practice and the practice environment for care and education professionals. These detailed recommendations create a blueprint for action that builds on a unifying foundation of child development and early learning, shared knowledge and competencies for care and education professionals, and principles for effective professional learning. Young children thrive and learn best when they have secure, positive relationships with adults who are knowledgeable about how to support their development and learning and are responsive to their individual progress. Transforming the Workforce for Children Birth Through Age 8 offers guidance on system changes to improve the quality of professional practice, specific actions to improve professional learning systems and workforce development, and research to continue to build the knowledge base in ways that will directly advance and inform future actions. The recommendations of this book provide an opportunity to improve the quality of the care and the education that children receive, and ultimately improve outcomes for children.




A Roadmap to Reducing Child Poverty


Book Description

The strengths and abilities children develop from infancy through adolescence are crucial for their physical, emotional, and cognitive growth, which in turn help them to achieve success in school and to become responsible, economically self-sufficient, and healthy adults. Capable, responsible, and healthy adults are clearly the foundation of a well-functioning and prosperous society, yet America's future is not as secure as it could be because millions of American children live in families with incomes below the poverty line. A wealth of evidence suggests that a lack of adequate economic resources for families with children compromises these children's ability to grow and achieve adult success, hurting them and the broader society. A Roadmap to Reducing Child Poverty reviews the research on linkages between child poverty and child well-being, and analyzes the poverty-reducing effects of major assistance programs directed at children and families. This report also provides policy and program recommendations for reducing the number of children living in poverty in the United States by half within 10 years.




TransXML


Book Description




Statistical Physics of Non Equilibrium Quantum Phenomena


Book Description

This book provides an introduction to topics in non-equilibrium quantum statistical physics for both mathematicians and theoretical physicists. The first part introduces a kinetic equation, of Kolmogorov type, which is needed to describe an isolated atom (actually, in experiments, an ion) under the effect of a classical pumping electromagnetic field which keeps the atom in its excited state(s) together with the random emission of fluorescence photons which put it back into its ground state. The quantum kinetic theory developed in the second part is an extension of Boltzmann's classical (non-quantum) kinetic theory of a dilute gas of quantum bosons. This is the source of many interesting fundamental questions, particularly because, if the temperature is low enough, such a gas is known to have at equilibrium a transition, the Bose–Einstein transition, where a finite portion of the particles stay in the quantum ground state. An important question considered is how a Bose gas condensate develops in time if its energy is initially low enough.




Appendices to the Final EIS


Book Description




The Future of Nursing


Book Description

The Future of Nursing explores how nurses' roles, responsibilities, and education should change significantly to meet the increased demand for care that will be created by health care reform and to advance improvements in America's increasingly complex health system. At more than 3 million in number, nurses make up the single largest segment of the health care work force. They also spend the greatest amount of time in delivering patient care as a profession. Nurses therefore have valuable insights and unique abilities to contribute as partners with other health care professionals in improving the quality and safety of care as envisioned in the Affordable Care Act (ACA) enacted this year. Nurses should be fully engaged with other health professionals and assume leadership roles in redesigning care in the United States. To ensure its members are well-prepared, the profession should institute residency training for nurses, increase the percentage of nurses who attain a bachelor's degree to 80 percent by 2020, and double the number who pursue doctorates. Furthermore, regulatory and institutional obstacles-including limits on nurses' scope of practice-should be removed so that the health system can reap the full benefit of nurses' training, skills, and knowledge in patient care. In this book, the Institute of Medicine makes recommendations for an action-oriented blueprint for the future of nursing.