%0 Book %A Institute of Medicine %T Medical Devices and the Public's Health: The FDA 510(k) Clearance Process at 35 Years %@ 978-0-309-21242-7 %D 2011 %U https://nap.nationalacademies.org/catalog/13150/medical-devices-and-the-publics-health-the-fda-510k-clearance %> https://nap.nationalacademies.org/catalog/13150/medical-devices-and-the-publics-health-the-fda-510k-clearance %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 318 %X Medical devices that are deemed to have a moderate risk to patients generally cannot go on the market until they are cleared through the FDA 510(k) process. In recent years, individuals and organizations have expressed concern that the 510(k) process is neither making safe and effective devices available to patients nor promoting innovation in the medical-device industry. Several high-profile mass-media reports and consumer-protection groups have profiled recognized or potential problems with medical devices cleared through the 510(k) clearance process. The medical-device industry and some patients have asserted that the process has become too burdensome and is delaying or stalling the entry of important new medical devices to the market. At the request of the FDA, the Institute of Medicine (IOM) examined the 510(k) process. Medical Devices and the Public's Health examines the current 510(k) clearance process and whether it optimally protects patients and promotes innovation in support of public health. It also identifies legislative, regulatory, or administrative changes that will achieve the goals of the 510(k) clearance process. Medical Devices and the Public's Health recommends that the U.S. Food and Drug Administration gather the information needed to develop a new regulatory framework to replace the 35-year-old 510(k) clearance process for medical devices. According to the report, the FDA's finite resources are best invested in developing an integrated premarket and postmarket regulatory framework. %0 Book %A Institute of Medicine %E Wizemann, Theresa %T Public Health Effectiveness of the FDA 510(k) Clearance Process: Measuring Postmarket Performance and Other Select Topics: Workshop Report %@ 978-0-309-16206-7 %D 2011 %U https://nap.nationalacademies.org/catalog/13020/public-health-effectiveness-of-the-fda-510k-clearance-process-measuring %> https://nap.nationalacademies.org/catalog/13020/public-health-effectiveness-of-the-fda-510k-clearance-process-measuring %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 132 %X The Food and Drug Administration (FDA) is responsible for ensuring that medical devices are safe and effective before they go on the market. Section 510(k) of the Federal Food, Drug, and Cosmetic Act requires a manufacturer of medical devices to notify FDA of its intent to market a medical device at least 90 days in advance. That window of time allows FDA to evaluate whether the device is substantially equivalent to a product already legally on the market (called a predicate), in which case the device does not need to go through the premarket approval (PMA) process. As part of its assessment of the FDA's premarket clearance process for medical devices, the Institute of Medicine (IOM) held a workshop on July 28, 2010 to discuss how medical devices are monitored for safety after they are available to consumers. Its primary focus was on monitoring the safety of marketed medical devices, including FDA's postmarket surveillance activities, analysis of safety concerns that resulted in medical device recalls, and non-FDA sources of adverse-event information. Public Health Effectiveness of the FDA 501(K) Clearance Process summarizes the views of the workshop participants. %0 Book %A Institute of Medicine %E Pray, Leslie %E Pillsbury, Laura %T Leveraging Food Technology for Obesity Prevention and Reduction Efforts: Workshop Summary %@ 978-0-309-21261-8 %D 2011 %U https://nap.nationalacademies.org/catalog/13153/leveraging-food-technology-for-obesity-prevention-and-reduction-efforts-workshop %> https://nap.nationalacademies.org/catalog/13153/leveraging-food-technology-for-obesity-prevention-and-reduction-efforts-workshop %I The National Academies Press %C Washington, DC %G English %K Food and Nutrition %P 118 %X Obesity is a major public health challenge. More than one-third of the U.S. adult population is considered obese, a figure that has more than doubled since the mid-1970s. Among children, obesity rates have more than tripled over the same period. Not only is obesity associated with numerous medical complications, but it incurs significant economic cost. At its simplest, obesity is a result of an energy imbalance, with obese (and overweight) people consuming more energy (calories) than they are expending. During the last 10-20 years, behavioral scientists have made significant progress toward building an evidence base for understanding what drives energy imbalance in overweight and obese individuals. Meanwhile, food scientists have been tapping into this growing evidence base to improve existing technologies and create new technologies that can be applied to alter the food supply in ways that reduce the obesity burden on the American population. Leveraging Food Technology for Obesity Prevention and Reduction Effort examines the complexity of human eating behavior and explores ways in which the food industry can continue to leverage modern food processing technologies to influence energy intake. The report also examines the opportunities and challenges of altering the food supply--both at home and outside the home--and outlines lessons learned, best practices, and next steps. %0 Book %A Institute of Medicine %E Parker, Lynn %E Spear, Matthew %E Holovach, Nicole Ferring %E Olson, Stephen %T Legal Strategies in Childhood Obesity Prevention: Workshop Summary %@ 978-0-309-21019-5 %D 2011 %U https://nap.nationalacademies.org/catalog/13123/legal-strategies-in-childhood-obesity-prevention-workshop-summary %> https://nap.nationalacademies.org/catalog/13123/legal-strategies-in-childhood-obesity-prevention-workshop-summary %I The National Academies Press %C Washington, DC %G English %K Food and Nutrition %K Health and Medicine %P 104 %X Since 1980, childhood obesity rates have more than tripled in the United States. Recent data show that almost one-third of children over 2 years of age are already overweight or obese. While the prevalence of childhood obesity appears to have plateaued in recent years, the magnitude of the problem remains unsustainably high and represents an enormous public health concern. All options for addressing the childhood obesity epidemic must therefore be explored. In the United States, legal approaches have successfully reduced other threats to public health, such as the lack of passive restraints in automobiles and the use of tobacco. The question then arises of whether laws, regulations, and litigation can likewise be used to change practices and policies that contribute to obesity. On October 21, 2010, the Institute of Medicine (IOM) held a workshop to bring together stakeholders to discuss the current and future legal strategies aimed at combating childhood obesity. Legal Strategies in Childhood Obesity Prevention summarizes the proceedings of that workshop. The report examines the challenges involved in implementing public health initiatives by using legal strategies to elicit change. It also discusses circumstances in which legal strategies are needed and effective. This workshop was created only to explore the boundaries of potential legal approaches to address childhood obesity, and therefore, does not contain recommendations for the use of such approaches. %0 Book %A Institute of Medicine %T What You Need to Know About Infectious Disease %D 2011 %U https://nap.nationalacademies.org/catalog/13006/what-you-need-to-know-about-infectious-disease %> https://nap.nationalacademies.org/catalog/13006/what-you-need-to-know-about-infectious-disease %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 44 %X About a quarter of deaths worldwide--many of them children--are caused by infectious organisms. The World Health Organization reports that new infectious diseases are continuing to emerge and familiar ones are appearing in new locations around the globe. What's behind this trend? How can invisible organisms cause such harm? And to what extent has human behavior amplified the problem? What You Need to Know About Infectious Disease provides an overview of infectious disease, drawing on reports of the Institute of Medicine. Written for a general audience, it describes the biology, history, and future trends of some of the world's most widespread and harmful infections and explains what we need to do--as individuals and as a society--to address this global challenge. %0 Book %A Institute of Medicine %E Larson, Elaine L. %E Liverman, Catharyn T. %T Preventing Transmission of Pandemic Influenza and Other Viral Respiratory Diseases: Personal Protective Equipment for Healthcare Personnel: Update 2010 %@ 978-0-309-16254-8 %D 2011 %U https://nap.nationalacademies.org/catalog/13027/preventing-transmission-of-pandemic-influenza-and-other-viral-respiratory-diseases %> https://nap.nationalacademies.org/catalog/13027/preventing-transmission-of-pandemic-influenza-and-other-viral-respiratory-diseases %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 200 %X In 2009, the H1N1 influenza pandemic brought to the forefront the many unknowns about the virulence, spread, and nature of the virus, as well as questions regarding personal protective equipment (PPE) for healthcare personnel. In this book, the Institute of Medicine assesses the progress of PPE research and identifies future directions for PPE for healthcare personnel. %0 Book %A Institute of Medicine %E Troy, Lisa M. %E Miller, Emily Ann %E Olson, Steve %T Hunger and Obesity: Understanding a Food Insecurity Paradigm: Workshop Summary %@ 978-0-309-18742-8 %D 2011 %U https://nap.nationalacademies.org/catalog/13102/hunger-and-obesity-understanding-a-food-insecurity-paradigm-workshop-summary %> https://nap.nationalacademies.org/catalog/13102/hunger-and-obesity-understanding-a-food-insecurity-paradigm-workshop-summary %I The National Academies Press %C Washington, DC %G English %K Food and Nutrition %P 250 %X At some point during 2009, more than 17 million households in the United States had difficulty providing enough food for all their members because of a lack of resources. In more than one-third of these households, the food intake of some household members was reduced and normal eating patterns were disrupted due to limited resources. The Workshop on Understanding the Relationship Between Food Insecurity and Obesity was held to explore the biological, economic, psychosocial, and other factors that may influence the relationship between food insecurity, overweight, and obesity in the United States. Hunger and Obesity examines current concepts and research findings in the field. The report identifies information gaps, proposes alternative approaches to analyzing data, recommends new data that should be collected, and addresses the limitations of the available research. %0 Book %A Institute of Medicine %E Patlak, Margie %E Micheel, Christine %T Nanotechnology and Oncology: Workshop Summary %@ 978-0-309-16321-7 %D 2011 %U https://nap.nationalacademies.org/catalog/13037/nanotechnology-and-oncology-workshop-summary %> https://nap.nationalacademies.org/catalog/13037/nanotechnology-and-oncology-workshop-summary %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 118 %X One way scientists are working to overcome challenges in cancer treatment and improve cancer care is through nanotechnology. Nanotechnology, engineered materials that make use of the unique physical properties, presents a new array of medical prospects that will revolutionize cancer prevention, diagnosis, and treatment practices. Giving new hope to patients, practitioners, and researchers alike, nanotechnology has the potential to translate recent discoveries in cancer biology into clinical advances in oncology. While public investments in nanotechnology for cancer continue to increase, medical products based on nanotechnology are already on the market. The National Cancer Policy forum held a workshop July 12-13, 2010, to explore challenges in the use of nanotechnology in oncology. Nanotechnology and Oncology evaluates the ongoing discussion on the role of nanotechnology in cancer as it relates to risk management, treatment, and regulatory policy. Assessments on nanomedicine and the physical properties of nanomaterials were presented during the workshop, along with an appraisal of the current status of research and development efforts. %0 Book %A Institute of Medicine %E Graham, Robin %E Mancher, Michelle %E Wolman, Dianne Miller %E Greenfield, Sheldon %E Steinberg, Earl %T Clinical Practice Guidelines We Can Trust %@ 978-0-309-16422-1 %D 2011 %U https://nap.nationalacademies.org/catalog/13058/clinical-practice-guidelines-we-can-trust %> https://nap.nationalacademies.org/catalog/13058/clinical-practice-guidelines-we-can-trust %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 290 %X 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. %0 Book %A Institute of Medicine %T Climate Change, the Indoor Environment, and Health %@ 978-0-309-20941-0 %D 2011 %U https://nap.nationalacademies.org/catalog/13115/climate-change-the-indoor-environment-and-health %> https://nap.nationalacademies.org/catalog/13115/climate-change-the-indoor-environment-and-health %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %K Environment and Environmental Studies %K Engineering and Technology %P 286 %X The indoor environment affects occupants' health and comfort. Poor environmental conditions and indoor contaminants are estimated to cost the U.S. economy tens of billions of dollars a year in exacerbation of illnesses like asthma, allergic symptoms, and subsequent lost productivity. Climate change has the potential to affect the indoor environment because conditions inside buildings are influenced by conditions outside them. Climate Change, the Indoor Environment, and Health addresses the impacts that climate change may have on the indoor environment and the resulting health effects. It finds that steps taken to mitigate climate change may cause or exacerbate harmful indoor environmental conditions. The book discusses the role the Environmental Protection Agency (EPA) should take in informing the public, health professionals, and those in the building industry about potential risks and what can be done to address them. The study also recommends that building codes account for climate change projections; that federal agencies join to develop or refine protocols and testing standards for evaluating emissions from materials, furnishings, and appliances used in buildings; and that building weatherization efforts include consideration of health effects. Climate Change, the Indoor Environment, and Health is written primarily for the EPA and other federal agencies, organizations, and researchers with interests in public health; the environment; building design, construction, and operation; and climate issues. %0 Book %A Institute of Medicine %T Blue Water Navy Vietnam Veterans and Agent Orange Exposure %@ 978-0-309-16247-0 %D 2011 %U https://nap.nationalacademies.org/catalog/13026/blue-water-navy-vietnam-veterans-and-agent-orange-exposure %> https://nap.nationalacademies.org/catalog/13026/blue-water-navy-vietnam-veterans-and-agent-orange-exposure %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 158 %X Over 3 million U.S. military personnel were sent to Southeast Asia to fight in the Vietnam War. Since the end of the Vietnam War, veterans have reported numerous health effects. Herbicides used in Vietnam, in particular Agent Orange have been associated with a variety of cancers and other long term health problems from Parkinson's disease and type 2 diabetes to heart disease. Prior to 1997 laws safeguarded all service men and women deployed to Vietnam including members of the Blue Navy. Since then, the Department of Veteran Affairs (VA) has established that Vietnam veterans are automatically eligible for disability benefits should they develop any disease associated with Agent Orange exposure, however, veterans who served on deep sea vessels in Vietnam are not included. These "Blue Water Navy" veterans must prove they were exposed to Agent Orange before they can claim benefits. At the request of the VA, the Institute of Medicine (IOM) examined whether Blue Water Navy veterans had similar exposures to Agent Orange as other Vietnam veterans. Blue Water Navy Vietnam Veterans and Agent Orange Exposure comprehensively examines whether Vietnam veterans in the Blue Water Navy experienced exposures to herbicides and their contaminants by reviewing historical reports, relevant legislation, key personnel insights, and chemical analysis to resolve current debate on this issue. %0 Book %A Institute of Medicine %T Critical Needs and Gaps in Understanding Prevention, Amelioration, and Resolution of Lyme and Other Tick-Borne Diseases: The Short-Term and Long-Term Outcomes: Workshop Report %@ 978-0-309-21109-3 %D 2011 %U https://nap.nationalacademies.org/catalog/13134/critical-needs-and-gaps-in-understanding-prevention-amelioration-and-resolution-of-lyme-and-other-tick-borne-diseases %> https://nap.nationalacademies.org/catalog/13134/critical-needs-and-gaps-in-understanding-prevention-amelioration-and-resolution-of-lyme-and-other-tick-borne-diseases %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 560 %X A single tick bite can have debilitating consequences. Lyme disease is the most common disease carried by ticks in the United States, and the number of those afflicted is growing steadily. If left untreated, the diseases carried by ticks--known as tick-borne diseases--can cause severe pain, fatigue, neurological problems, and other serious health problems. The Institute of Medicine held a workshop October 11-12, 2010, to examine the state of the science in Lyme disease and other tick-borne diseases. %0 Book %A Institute of Medicine %E Choffnes, Eileen R. %E Relman, David A. %E Pray, Leslie %T The Science and Applications of Synthetic and Systems Biology: Workshop Summary %@ 978-0-309-21939-6 %D 2011 %U https://nap.nationalacademies.org/catalog/13239/the-science-and-applications-of-synthetic-and-systems-biology-workshop %> https://nap.nationalacademies.org/catalog/13239/the-science-and-applications-of-synthetic-and-systems-biology-workshop %I The National Academies Press %C Washington, DC %G English %K Biology and Life Sciences %K Conflict and Security Issues %P 570 %X Many potential applications of synthetic and systems biology are relevant to the challenges associated with the detection, surveillance, and responses to emerging and re-emerging infectious diseases. On March 14 and 15, 2011, the Institute of Medicine's (IOM's) Forum on Microbial Threats convened a public workshop in Washington, DC, to explore the current state of the science of synthetic biology, including its dependency on systems biology; discussed the different approaches that scientists are taking to engineer, or reengineer, biological systems; and discussed how the tools and approaches of synthetic and systems biology were being applied to mitigate the risks associated with emerging infectious diseases. The Science and Applications of Synthetic and Systems Biology is organized into sections as a topic-by-topic distillation of the presentations and discussions that took place at the workshop. Its purpose is to present information from relevant experience, to delineate a range of pivotal issues and their respective challenges, and to offer differing perspectives on the topic as discussed and described by the workshop participants. This report also includes a collection of individually authored papers and commentary. %0 Book %A Institute of Medicine %E Pankevich, Diana E. %E Wizemann, Theresa %E Altevogt, Bruce M. %T Sex Differences and Implications for Translational Neuroscience Research: Workshop Summary %@ 978-0-309-16124-4 %D 2011 %U https://nap.nationalacademies.org/catalog/13004/sex-differences-and-implications-for-translational-neuroscience-research-workshop-summary %> https://nap.nationalacademies.org/catalog/13004/sex-differences-and-implications-for-translational-neuroscience-research-workshop-summary %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 110 %X Biological differences between the sexes influence not only individual health but also public health, biomedical research, and health care. The Institute of Medicine held a workshop March 8-9, 2010, to discuss sex differences and their implications for translational neuroscience research, which bridges the gap between scientific discovery and application. %0 Book %A Institute of Medicine %E Suitor, Carol West %T Planning a WIC Research Agenda: Workshop Summary %@ 978-0-309-16179-4 %D 2011 %U https://nap.nationalacademies.org/catalog/13014/planning-a-wic-research-agenda-workshop-summary %> https://nap.nationalacademies.org/catalog/13014/planning-a-wic-research-agenda-workshop-summary %I The National Academies Press %C Washington, DC %G English %K Food and Nutrition %P 176 %X The time has come to initiate a new program of research on the Supplemental Nutrition Program for Women, Infants, and Children (commonly referred to as WIC). WIC is the third largest food assistance program administered by the U.S. Department of Agriculture (USDA). The program's scope is large, serving approximately 9.3 million low-income women, infants, and children at nutritional risk. Through federal grants to states, participants receive three types of benefits: 1) a supplemental food package tailored to specific age groups for infants and children; 2) nutrition education, including breastfeeding support; and 3) referrals to health services and social services. To cover program costs for fiscal year (FY) 2010, Congress appropriated $7.252 billion. Congress also appropriated $15 million for research related to the program for FY 2010. The timing of the funding for WIC research is propitious. In October 2009, USDA issued regulations that made substantial revisions to the WIC food package. These revisions are the first major change in the food package since the program's inception in 1972. Over the intervening years WIC has expanded greatly, Medicaid coverage has increased, large changes have occurred in the racial and ethnic backgrounds and socioeconomic status of WIC participants as well as in public health services, and obesity rates have increased substantially among the general population. To guide its planning for the use of the $15 million allocated for WIC research, the Food and Nutrition Service of USDA asked the Institute of Medicine to conduct a two-day public workshop on emerging research needs for WIC. As requested, the workshop included presentations and discussions to illuminate issues related to future WIC research issues, methodological challenges, and solutions. The workshop also planned for a program of research to determine the effects of WIC on maternal and child health outcomes. %0 Book %A Institute of Medicine %E Olson, Steve %T Allied Health Workforce and Services: Workshop Summary %@ 978-0-309-22059-0 %D 2011 %U https://nap.nationalacademies.org/catalog/13261/allied-health-workforce-and-services-workshop-summary %> https://nap.nationalacademies.org/catalog/13261/allied-health-workforce-and-services-workshop-summary %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 96 %X The demand for health care is growing as the nation ages and seeks to provide coverage for the millions of Americans who lack health insurance. At the same time, escalating costs have led to a variety of initiatives to make the delivery of health care more effective and efficient. The allied health workforce is critical to the success of these efforts. The IOM held a workshop May 9-10, 2011, to examine the current allied health care workforce and consider how it can contribute to improving health care access, quality, and effectiveness. %0 Book %A Institute of Medicine %T Long-Term Health Consequences of Exposure to Burn Pits in Iraq and Afghanistan %@ 978-0-309-21755-2 %D 2011 %U https://nap.nationalacademies.org/catalog/13209/long-term-health-consequences-of-exposure-to-burn-pits-in-iraq-and-afghanistan %> https://nap.nationalacademies.org/catalog/13209/long-term-health-consequences-of-exposure-to-burn-pits-in-iraq-and-afghanistan %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %K Environment and Environmental Studies %P 192 %X Many veterans returning from the conflicts in Iraq and Afghanistan have health problems they believe are related to their exposure to the smoke from the burning of waste in open-air "burn pits" on military bases. Particular controversy surrounds the burn pit used to dispose of solid waste at Joint Base Balad in Iraq, which burned up to 200 tons of waste per day in 2007. The Department of Veterans Affairs asked the IOM to form a committee to determine the long-term health effects from exposure to these burn pits. Insufficient evidence prevented the IOM committee from developing firm conclusions. This report, therefore, recommends that, along with more efficient data-gathering methods, a study be conducted that would evaluate the health status of service members from their time of deployment over many years to determine their incidence of chronic diseases. %0 Book %A Institute of Medicine %E Erdman, John %E Oria, Maria %E Pillsbury, Laura %T Nutrition and Traumatic Brain Injury: Improving Acute and Subacute Health Outcomes in Military Personnel %@ 978-0-309-21008-9 %D 2011 %U https://nap.nationalacademies.org/catalog/13121/nutrition-and-traumatic-brain-injury-improving-acute-and-subacute-health %> https://nap.nationalacademies.org/catalog/13121/nutrition-and-traumatic-brain-injury-improving-acute-and-subacute-health %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %K Food and Nutrition %P 444 %X Traumatic brain injury (TBI) accounts for up to one-third of combat-related injuries in Iraq and Afghanistan, according to some estimates. TBI is also a major problem among civilians, especially those who engage in certain sports. At the request of the Department of Defense, the IOM examined the potential role of nutrition in the treatment of and resilience against TBI. %0 Book %A Institute of Medicine %E Patel, Deepali M. %T Preventing Violence Against Women and Children: Workshop Summary %@ 978-0-309-21151-2 %D 2011 %U https://nap.nationalacademies.org/catalog/13139/preventing-violence-against-women-and-children-workshop-summary %> https://nap.nationalacademies.org/catalog/13139/preventing-violence-against-women-and-children-workshop-summary %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 236 %X Violence against women and children is a serious public health concern, with costs at multiple levels of society. Although violence is a threat to everyone, women and children are particularly susceptible to victimization because they often have fewer rights or lack appropriate means of protection. In some societies certain types of violence are deemed socially or legally acceptable, thereby contributing further to the risk to women and children. In the past decade research has documented the growing magnitude of such violence, but gaps in the data still remain. Victims of violence of any type fear stigmatization or societal condemnation and thus often hesitate to report crimes. The issue is compounded by the fact that for women and children the perpetrators are often people they know and because some countries lack laws or regulations protecting victims. Some of the data that have been collected suggest that rates of violence against women range from 15 to 71 percent in some countries and that rates of violence against children top 80 percent. These data demonstrate that violence poses a high burden on global health and that violence against women and children is common and universal. Preventing Violence Against Women and Children focuses on these elements of the cycle as they relate to interrupting this transmission of violence. Intervention strategies include preventing violence before it starts as well as preventing recurrence, preventing adverse effects (such as trauma or the consequences of trauma), and preventing the spread of violence to the next generation or social level. Successful strategies consider the context of the violence, such as family, school, community, national, or regional settings, in order to determine the best programs. %0 Book %A Institute of Medicine %T Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research %@ 978-0-309-25627-8 %D 2011 %U https://nap.nationalacademies.org/catalog/13172/relieving-pain-in-america-a-blueprint-for-transforming-prevention-care %> https://nap.nationalacademies.org/catalog/13172/relieving-pain-in-america-a-blueprint-for-transforming-prevention-care %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 382 %X 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.