%0 Book %A Institute of Medicine %T Coverage Matters: Insurance and Health Care %@ 978-0-309-07609-8 %D 2001 %U https://nap.nationalacademies.org/catalog/10188/coverage-matters-insurance-and-health-care %> https://nap.nationalacademies.org/catalog/10188/coverage-matters-insurance-and-health-care %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 203 %X Roughly 40 million Americans have no health insurance, private or public, and the number has grown steadily over the past 25 years. Who are these children, women, and men, and why do they lack coverage for essential health care services? How does the system of insurance coverage in the U.S. operate, and where does it fail? The first of six Institute of Medicine reports that will examine in detail the consequences of having a large uninsured population, Coverage Matters: Insurance and Health Care, explores the myths and realities of who is uninsured, identifies social, economic, and policy factors that contribute to the situation, and describes the likelihood faced by members of various population groups of being uninsured. It serves as a guide to a broad range of issues related to the lack of insurance coverage in America and provides background data of use to policy makers and health services researchers. %0 Book %A Institute of Medicine %E Cohn, Felicia %E Salmon, Marla E. %E Stobo, John D. %T Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence %@ 978-0-309-07431-5 %D 2002 %U https://nap.nationalacademies.org/catalog/10127/confronting-chronic-neglect-the-education-and-training-of-health-professionals %> https://nap.nationalacademies.org/catalog/10127/confronting-chronic-neglect-the-education-and-training-of-health-professionals %I The National Academies Press %C Washington, DC %G English %K Behavioral and Social Sciences %P 368 %X As many as 20 to 25 percent of American adults—or one in every four people—have been victimized by, witnesses of, or perpetrators of family violence in their lifetimes. Family violence affects more people than cancer, yet it's an issue that receives far less attention. Surprisingly, many assume that health professionals are deliberately turning a blind eye to this traumatic social problem. The fact is, very little is being done to educate health professionals about family violence. Health professionals are often the first to encounter victims of abuse and neglect, and therefore they play a critical role in ensuring that victims—as well as perpetrators—get the help they need. Yet, despite their critical role, studies continue to describe a lack of education for health professionals about how to identify and treat family violence. And those that have been trained often say that, despite their education, they feel ill-equipped or lack support from by their employers to deal with a family violence victim, sometimes resulting in a failure to screen for abuse during a clinical encounter. Equally problematic, the few curricula in existence often lack systematic and rigorous evaluation. This makes it difficult to say whether or not the existing curricula even works. Confronting Chronic Neglect offers recommendations, such as creating education and research centers, that would help raise awareness of the problem on all levels. In addition, it recommends ways to involve health care professionals in taking some responsibility for responding to this difficult and devastating issue. Perhaps even more importantly, Confronting Chronic Neglect encourages society as a whole to share responsibility. Health professionals alone cannot solve this complex problem. Responding to victims of family violence and ultimately preventing its occurrence is a societal responsibility %0 Book %A Institute of Medicine %A National Research Council %E Hewitt, Maria %E Simone, Joseph V. %T Enhancing Data Systems to Improve the Quality of Cancer Care %@ 978-0-309-08649-3 %D 2000 %U https://nap.nationalacademies.org/catalog/9970/enhancing-data-systems-to-improve-the-quality-of-cancer-care %> https://nap.nationalacademies.org/catalog/9970/enhancing-data-systems-to-improve-the-quality-of-cancer-care %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 175 %X One of the barriers to improving the quality of cancer care in the United States is the inadequacy of data systems. Out-of-date or incomplete information about the performance of doctors, hospitals, health plans, and public agencies makes it hard to gauge the quality of care. Augmenting today's data systems could start to fill the gap. This report examines the strengths and weaknesses of current systems and makes recommendations for enhancing data systems to improve the quality of cancer care. The board's recommendations fall into three key areas: Enhance key elements of the data system infrastructure (i.e., quality-of-care measures, cancer registries and databases, data collection technologies, and analytic capacity). Expand support for analyses of quality of cancer care using existing data systems. Monitor the effectiveness of data systems to promote quality improvement within health systems. %0 Book %A Institute of Medicine %T Care Without Coverage: Too Little, Too Late %@ 978-0-309-08343-0 %D 2002 %U https://nap.nationalacademies.org/catalog/10367/care-without-coverage-too-little-too-late %> https://nap.nationalacademies.org/catalog/10367/care-without-coverage-too-little-too-late %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 212 %X Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital--based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million -- one in seven--working--age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash. %0 Book %A Institute of Medicine %E Donaldson, Molla S. %E Yordy, Karl D. %E Lohr, Kathleen N. %E Vanselow, Neal A. %T Primary Care: America's Health in a New Era %@ 978-0-309-05399-0 %D 1996 %U https://nap.nationalacademies.org/catalog/5152/primary-care-americas-health-in-a-new-era %> https://nap.nationalacademies.org/catalog/5152/primary-care-americas-health-in-a-new-era %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 416 %X Ask for a definition of primary care, and you are likely to hear as many answers as there are health care professionals in your survey. Primary Care fills this gap with a detailed definition already adopted by professional organizations and praised at recent conferences. This volume makes recommendations for improving primary care, building its organization, financing, infrastructure, and knowledge base—as well as developing a way of thinking and acting for primary care clinicians. Are there enough primary care doctors? Are they merely gatekeepers? Is the traditional relationship between patient and doctor outmoded? The committee draws conclusions about these and other controversies in a comprehensive and up-to-date discussion that covers: The scope of primary care. Its philosophical underpinnings. Its value to the patient and the community. Its impact on cost, access, and quality. This volume discusses the needs of special populations, the role of the capitation method of payment, and more. Recommendations are offered for achieving a more multidisciplinary education for primary care clinicians. Research priorities are identified. Primary Care provides a forward-thinking view of primary care as it should be practiced in the new integrated health care delivery systems—important to health care clinicians and those who train and employ them, policymakers at all levels, health care managers, payers, and interested individuals. %0 Book %A Institute of Medicine %T Medical Technology Assessment Directory: A Pilot Reference to Organizations, Assessments, and Information Resources %@ 978-0-309-03829-4 %D 1988 %U https://nap.nationalacademies.org/catalog/1090/medical-technology-assessment-directory-a-pilot-reference-to-organizations-assessments %> https://nap.nationalacademies.org/catalog/1090/medical-technology-assessment-directory-a-pilot-reference-to-organizations-assessments %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 712 %X For the first time, a single reference identifies medical technology assessment programs. A valuable guide to the field, this directory contains more than 60 profiles of programs that conduct and report on medical technology assessments. Each profile includes a listing of report citations for that program, and all the reports are indexed under major subject headings. Also included is a cross-listing of technology assessment report citations arranged by type of technology headings, brief descriptions of approximately 70 information sources of potential interest to technology assessors, and addresses and descriptions of 70 organizations with memberships, activities, publications, and other functions relevant to the medical technology assessment community. %0 Book %A National Research Council %T Report of the Committee on Paleoecology, 1935-1936: Presented at the Annual Meeting of the Division of Geology and Geography, National Research Council, May 2, 1936 %D 1936 %U https://nap.nationalacademies.org/catalog/18676/report-of-the-committee-on-paleoecology-1935-1936-presented-at-the-annual-meeting-of-the-division-of-geology-and-geography-national-research-council-may-2-1936 %> https://nap.nationalacademies.org/catalog/18676/report-of-the-committee-on-paleoecology-1935-1936-presented-at-the-annual-meeting-of-the-division-of-geology-and-geography-national-research-council-may-2-1936 %I The National Academies Press %C Washington, DC %G English %K %K Biology and Life Sciences %P 68 %0 Book %A National Research Council %T Report of the Committee on Paleoecology, 1936-1937; Presented at the Annual Meeting of the Division of Geology and Geography, National Research Council, May 1, 1937 %D 1937 %U https://nap.nationalacademies.org/catalog/18657/report-of-the-committee-on-paleoecology-1936-1937-presented-at-the-annual-meeting-of-the-division-of-geology-and-geography-national-research-council-may-1-1937 %> https://nap.nationalacademies.org/catalog/18657/report-of-the-committee-on-paleoecology-1936-1937-presented-at-the-annual-meeting-of-the-division-of-geology-and-geography-national-research-council-may-1-1937 %I The National Academies Press %C Washington, DC %G English %K %K Earth Sciences %P 68 %0 Book %T Space Studies Board Annual Report 1996 %D 1997 %U https://nap.nationalacademies.org/catalog/10175/space-studies-board-annual-report-1996 %> https://nap.nationalacademies.org/catalog/10175/space-studies-board-annual-report-1996 %I The National Academies Press %C Washington, DC %G English %P 92 %0 Book %A National Research Council %T Sustainability for the Nation: Resource Connections and Governance Linkages %@ 978-0-309-26230-9 %D 2013 %U https://nap.nationalacademies.org/catalog/13471/sustainability-for-the-nation-resource-connections-and-governance-linkages %> https://nap.nationalacademies.org/catalog/13471/sustainability-for-the-nation-resource-connections-and-governance-linkages %I The National Academies Press %C Washington, DC %G English %K Policy for Science and Technology %K Energy and Energy Conservation %P 142 %X A "sustainable society," according to one definition, "is one that can persist over generations; one that is far-seeing enough, flexible enough, and wise enough not to undermine either its physical or its social system of support." As the government sector works hard to ensure sufficient fresh water, food, energy, housing, health, and education for the nation without limiting resources for the future generations, it's clear that there is no sufficient organization to deal with sustainability issues. Each federal agency appears to have a single mandate or a single area of expertise making it difficult to tackle issues such as managing the ecosystem. Key resource domains, which include water, land, energy, and nonrenewable resources, for example, are nearly-completely connected yet different agencies exist to address only one aspect of these domains. The legendary ecologist John Muir wrote in 1911 that "when we try to pick out anything by itself, we find it hitched to everything else in the Universe." Thus, in order for the nation to be successful in sustaining its resources, "linkages" will need to be built among federal, state, and local governments; nongovernmental organizations (NGOs); and the private sector. The National Research Council (NRC) was asked by several federal agencies, foundations, and the private sector to provide guidance to the federal government on issues related to sustainability linkages. The NRC assigned the task to as committee with a wide range of expertise in government, academia, and business. The committee held public fact-finding meetings to hear from agencies and stakeholder groups; examined sustainability management examples; conducted extensive literature reviews; and more to address the issue. Sustainability for the Nation: Resource Connection and Governance Linkages is the committee's report on the issue. The report includes insight into high-priority areas for governance linkages, the challenges of managing connected systems, impediments to successful government linkages, and more. The report also features examples of government linkages which include Adaptive Management on the Platte River, Philadelphia's Green Stormwater Infrastructure, and Managing Land Use in the Mojave. %0 Book %A National Research Council %T Upstream: Salmon and Society in the Pacific Northwest %@ 978-0-309-05325-9 %D 1996 %U https://nap.nationalacademies.org/catalog/4976/upstream-salmon-and-society-in-the-pacific-northwest %> https://nap.nationalacademies.org/catalog/4976/upstream-salmon-and-society-in-the-pacific-northwest %I The National Academies Press %C Washington, DC %G English %K Agriculture %K Environment and Environmental Studies %P 472 %X The importance of salmon to the Pacific Northwest—economic, recreational, symbolic—is enormous. Generations ago, salmon were abundant from central California through Idaho, Oregon, and Washington to British Columbia and Alaska. Now they have disappeared from about 40 percent of their historical range. The decline in salmon numbers has been lamented for at least 100 years, but the issue has become more widespread and acute recently. The Endangered Species Act has been invoked, federal laws have been passed, and lawsuits have been filed. More than $1 billion has been spent to improve salmon runs—and still the populations decline. In this new volume a committee with diverse expertise explores the complications and conflicts surrounding the salmon problem—starting with available data on the status of salmon populations and an illustrative case study from Washington state's Willapa Bay. The book offers specific recommendations for salmon rehabilitation that take into account the key role played by genetic variability in salmon survival and the urgent need for habitat protection and management of fishing. The committee presents a comprehensive discussion of the salmon problem, with a wealth of informative graphs and charts and the right amount of historical perspective to clarify today's issues, including: Salmon biology and geography—their life's journey from fresh waters to the sea and back again to spawn, and their interaction with ecosystems along the way. The impacts of human activities—grazing, damming, timber, agriculture, and population and economic growth. Included is a case study of Washington state's Elwha River dam removal project. Values, attitudes, and the conflicting desires for short-term economic gain and long-term environmental health. The committee traces the roots of the salmon problem to the extractive philosophy characterizing management of land and water in the West. The impact of hatcheries, which were introduced to build fish stocks but which have actually harmed the genetic variability that wild stocks need to survive. This book offers something for everyone with an interest in the salmon issue—policymakers and regulators in the United States and Canada; environmental scientists; environmental advocates; natural resource managers; commercial, tribal, and recreational fishers; and concerned residents of the Pacific Northwest. %0 Book %T Vessel Navigation and Traffic Services for Safe and Efficient Ports and Waterways: Interim Report %D 1996 %U https://nap.nationalacademies.org/catalog/9262/vessel-navigation-and-traffic-services-for-safe-and-efficient-ports-and-waterways %> https://nap.nationalacademies.org/catalog/9262/vessel-navigation-and-traffic-services-for-safe-and-efficient-ports-and-waterways %I The National Academies Press %C Washington, DC %G English %K %P 75 %0 Book %A National Research Council %T Sea-Level Rise for the Coasts of California, Oregon, and Washington: Past, Present, and Future %@ 978-0-309-25594-3 %D 2012 %U https://nap.nationalacademies.org/catalog/13389/sea-level-rise-for-the-coasts-of-california-oregon-and-washington %> https://nap.nationalacademies.org/catalog/13389/sea-level-rise-for-the-coasts-of-california-oregon-and-washington %I The National Academies Press %C Washington, DC %G English %K Environment and Environmental Studies %K Earth Sciences %P 216 %X Tide gauges show that global sea level has risen about 7 inches during the 20th century, and recent satellite data show that the rate of sea-level rise is accelerating. As Earth warms, sea levels are rising mainly because ocean water expands as it warms; and water from melting glaciers and ice sheets is flowing into the ocean. Sea-level rise poses enormous risks to the valuable infrastructure, development, and wetlands that line much of the 1,600 mile shoreline of California, Oregon, and Washington. As those states seek to incorporate projections of sea-level rise into coastal planning, they asked the National Research Council to make independent projections of sea-level rise along their coasts for the years 2030, 2050, and 2100, taking into account regional factors that affect sea level. Sea-Level Rise for the Coasts of California, Oregon, and Washington: Past, Present, and Future explains that sea level along the U.S. west coast is affected by a number of factors. These include: climate patterns such as the El Nino, effects from the melting of modern and ancient ice sheets, and geologic processes, such as plate tectonics. Regional projections for California, Oregon, and Washington show a sharp distinction at Cape Mendocino in northern California. South of that point, sea-level rise is expected to be very close to global projections. However, projections are lower north of Cape Mendocino because the land is being pushed upward as the ocean plate moves under the continental plate along the Cascadia Subduction Zone. However, an earthquake magnitude 8 or larger, which occurs in the region every few hundred to 1,000 years, would cause the land to drop and sea level to suddenly rise. %0 Book %T Minding the Helm: Marine Navigation and Piloting %@ 978-0-309-10360-2 %D 1994 %U https://nap.nationalacademies.org/catalog/2055/minding-the-helm-marine-navigation-and-piloting %> https://nap.nationalacademies.org/catalog/2055/minding-the-helm-marine-navigation-and-piloting %I The National Academies Press %C Washington, DC %G English %K Engineering and Technology %P 530 %X Large ships transporting hazardous cargoes, notorious marine accidents, and damage to marine ecosystems from tanker spills have heightened public concern for the safe navigation of ships. This new volume offers a complete, highly readable assessment of marine navigation and piloting. It addresses the application of new technology to reduce the probability of accidents, controversies over the effectiveness of waterways management and marine pilotage, and navigational decisionmaking. The book also explores the way pilots of ships and tugs are trained, licensed, and held accountable. Minding the Helm approaches navigational safety from the perspectives of risk assessment and the integration of human, technological, and organizational systems. Air and marine traffic regulation methods are compared, including the use of vessel traffic services. With a store of current information and examples, this document will be indispensable to federal and state pilotage and licensing authorities and marine traffic regulators, the Coast Guard, pilot associations, and the shipping and towing industries. It will also interest individuals involved in waterway design, marine education, and the marine environment. %0 Book %A Institute of Medicine %A National Research Council %A National Research Council %T Improving Palliative Care: We Can Take Better Care of People With Cancer %@ 978-0-309-08984-5 %D 2003 %U https://nap.nationalacademies.org/catalog/10790/improving-palliative-care-we-can-take-better-care-of-people %> https://nap.nationalacademies.org/catalog/10790/improving-palliative-care-we-can-take-better-care-of-people %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 20 %X As a society, we have made amazing gains in being able to detect and treat cancer. Even so, about half the people who are told by their doctors that they have cancer will die within a few years. This means that every year about one million people find out that they have cancer and are treated, and about one-half million people die of cancer nationwide. So far, most cancer research and treatment has focused on trying to cure cancer. There hasn't been much attention paid to other important issues, such as pain control and taking care of other troubling symptoms. Now more and more people are aware that there are cancer care needs beyond just trying to cure it. Attention is now being paid to helping people with cancer cope better with the problems that may arise when people are being treated or as they approach death. %0 Book %A National Research Council %T Animals as Sentinels of Environmental Health Hazards %@ 978-0-309-04046-4 %D 1991 %U https://nap.nationalacademies.org/catalog/1351/animals-as-sentinels-of-environmental-health-hazards %> https://nap.nationalacademies.org/catalog/1351/animals-as-sentinels-of-environmental-health-hazards %I The National Academies Press %C Washington, DC %G English %K Environment and Environmental Studies %P 176 %X Studying animals in the environment may be a realistic and highly beneficial approach to identifying unknown chemical contaminants before they cause human harm. Animals as Sentinels of Environmental Health Hazards presents an overview of animal-monitoring programs, including detailed case studies of how animal health problems—such as the effects of DDT on wild bird populations—have led researchers to the sources of human health hazards. The authors examine the components and characteristics required for an effective animal-monitoring program, and they evaluate numerous existing programs, including in situ research, where an animal is placed in a natural setting for monitoring purposes. %0 Book %A Institute of Medicine %E Meyer, Emily Ann %E Hanna, Kathi %E Gebbie, Kristine %T Cord Blood: Establishing a National Hematopoietic Stem Cell Bank Program %@ 978-0-309-09586-0 %D 2005 %U https://nap.nationalacademies.org/catalog/11269/cord-blood-establishing-a-national-hematopoietic-stem-cell-bank-program %> https://nap.nationalacademies.org/catalog/11269/cord-blood-establishing-a-national-hematopoietic-stem-cell-bank-program %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 334 %X With the potential for self-renewal and differentiation, the possibilities for stem cells are enormous. One specific type of stem cell, the hematopoietic progenitor cell (HPC), which is derived from umbilical cord blood (as well as adult bone marrow and mobilized peripheral blood), holds particular promise. To make the most of these HPCs, the Institute of Medicine was asked to consider the optimal structure for a national cord blood program and to address pertinent issues related to maximizing the potential of stem cell technology. Cord Blood: Establishing a National Hematopoietic Stem Cell Bank Program examines: The role of cord blood in stem cell transplantation The current status of blood banks already in existence The optimal structure for the cord blood program The current use and utility of cord blood for stem cell transplants The best way to advance the use of cord blood units and make them available for research Expert advice from leaders in the fields of economics, public health, medicine, and biostatistics combine to make this very timely and topical book useful to a number of stakeholders. %0 Book %A National Research Council %T Nonnative Oysters in the Chesapeake Bay %@ 978-0-309-09052-0 %D 2004 %U https://nap.nationalacademies.org/catalog/10796/nonnative-oysters-in-the-chesapeake-bay %> https://nap.nationalacademies.org/catalog/10796/nonnative-oysters-in-the-chesapeake-bay %I The National Academies Press %C Washington, DC %G English %K Earth Sciences %K Environment and Environmental Studies %K Biology and Life Sciences %P 344 %X Nonnative Oysters in the Chesapeake Bay discusses the proposed plan to offset the dramatic decline in the bay's native oysters by introducing disease-resistant reproductive Suminoe oysters from Asia. It suggests this move should be delayed until more is known about the environmental risks, even though carefully regulated cultivation of sterile Asian oysters in contained areas could help the local industry and researchers. It is also noted that even though these oysters eat the excess algae caused by pollution, it could take decades before there are enough of them to improve water quality. %0 Book %A National Research Council %T Sediment Dredging at Superfund Megasites: Assessing the Effectiveness %@ 978-0-309-10977-2 %D 2007 %U https://nap.nationalacademies.org/catalog/11968/sediment-dredging-at-superfund-megasites-assessing-the-effectiveness %> https://nap.nationalacademies.org/catalog/11968/sediment-dredging-at-superfund-megasites-assessing-the-effectiveness %I The National Academies Press %C Washington, DC %G English %K Environment and Environmental Studies %K Earth Sciences %P 316 %X Some of the nation's estuaries, lakes and other water bodies contain contaminated sediments that can adversely affect fish and wildlife and may then find their way into people's diets. Dredging is one of the few options available for attempting to clean up contaminated sediments, but it can uncover and re-suspend buried contaminants, creating additional exposures for wildlife and people. At the request of Congress, EPA asked the National Research Council (NRC) to evaluate dredging as a cleanup technique. The book finds that, based on a review of available evidence, dredging's ability to decrease environmental and health risks is still an open question. Analysis of pre-dredging and post-dredging at about 20 sites found a wide range of outcomes in terms of surface sediment concentrations of contaminants: some sites showed increases, some no change, and some decreases in concentrations. Evaluating the potential long-term benefits of dredging will require that the U.S. Environmental Protection Agency step up monitoring activities before, during and after individual cleanups to determine whether it is working there and what combinations of techniques are most effective. %0 Book %A Institute of Medicine %T Seafood Safety %@ 978-0-309-10374-9 %D 1991 %U https://nap.nationalacademies.org/catalog/1612/seafood-safety %> https://nap.nationalacademies.org/catalog/1612/seafood-safety %I The National Academies Press %C Washington, DC %G English %K Food and Nutrition %P 452 %X Can Americans continue to add more seafood to their diets without fear of illness or even death? Seafood-caused health problems are not widespread, but consumers are at risk from seafood-borne microbes and toxins—with consequences that can range from mild enteritis to fatal illness. At a time when legislators and consumer groups are seeking a sound regulatory approach, Seafood Safety presents a comprehensive set of practical recommendations for ensuring the safety of the seafood supply. This volume presents the first-ever overview of the field, covering seafood consumption patterns, where and how seafood contamination occurs, and the effectiveness of regulation. A wealth of technical information is presented on the sources of contamination—microbes, natural toxins, and chemical pollutants—and their effects on human health. The volume evaluates methods used for risk assessment and inspection sampling.