%0 Book %T Applying Advanced Information Systems to Ports and Waterways Management %@ 978-0-309-06380-7 %D 1999 %U https://nap.nationalacademies.org/catalog/6451/applying-advanced-information-systems-to-ports-and-waterways-management %> https://nap.nationalacademies.org/catalog/6451/applying-advanced-information-systems-to-ports-and-waterways-management %I The National Academies Press %C Washington, DC %G English %K Engineering and Technology %K Computers and Information Technology %P 66 %X The future safety of maritime transportation in the United States—a major factor in the nation's international trade and economic well-being—will depend heavily on the quality of port and waterways information systems. Many U.S. ports and waterways lack adequate information services, although certain elements of advanced systems are now available in some locations. Barriers to improvements in information systems include the division of responsibilities for waterways management among multiple agencies at all levels of government, a lack of coordination among the federal agencies responsible for waterways management, inadequate budgets for some critical maritime programs, the high costs of some specialized technologies, stakeholder opposition to user fees, limited access to certain key data, the incompatibility of many independently developed systems, and the absence of standards for some attractive technologies. In this report, the second phase of a three-year study by the Committee on Maritime Advanced Information Systems of the National Research Council, a strategy is presented for overcoming the major barriers and deficiencies and providing a minimum level of maritime safety information nationwide. In this phase of the study, the committee concentrated on maritime information systems that promote safety, which is the area of greatest need. The committee did not examine in detail the relationship between navigation safety and maritime transportation efficiency or evaluate information systems that promote efficiency; the committee believes, however, that these issues deserve further attention. %0 Book %A National Research Council %T Perspectives on Biodiversity: Valuing Its Role in an Everchanging World %@ 978-0-309-06581-8 %D 1999 %U https://nap.nationalacademies.org/catalog/9589/perspectives-on-biodiversity-valuing-its-role-in-an-everchanging-world %> https://nap.nationalacademies.org/catalog/9589/perspectives-on-biodiversity-valuing-its-role-in-an-everchanging-world %I The National Academies Press %C Washington, DC %G English %K Biology and Life Sciences %K Environment and Environmental Studies %P 168 %X Resource-management decisions, especially in the area of protecting and maintaining biodiversity, are usually incremental, limited in time by the ability to forecast conditions and human needs, and the result of tradeoffs between conservation and other management goals. The individual decisions may not have a major effect but can have a cumulative major effect. Perspectives on Biodiversity reviews current understanding of the value of biodiversity and the methods that are useful in assessing that value in particular circumstances. It recommends and details a list of components—including diversity of species, genetic variability within and among species, distribution of species across the ecosystem, the aesthetic satisfaction derived from diversity, and the duty to preserve and protect biodiversity. The book also recommends that more information about the role of biodiversity in sustaining natural resources be gathered and summarized in ways useful to managers. Acknowledging that decisions about biodiversity are necessarily qualitative and change over time because of the nonmarket nature of so many of the values, the committee recommends periodic reviews of management decisions. %0 Book %A National Research Council %T Science for Decisionmaking: Coastal and Marine Geology at the U.S. Geological Survey %@ 978-0-309-06584-9 %D 1999 %U https://nap.nationalacademies.org/catalog/9665/science-for-decisionmaking-coastal-and-marine-geology-at-the-us %> https://nap.nationalacademies.org/catalog/9665/science-for-decisionmaking-coastal-and-marine-geology-at-the-us %I The National Academies Press %C Washington, DC %G English %K Earth Sciences %P 124 %X The coastlines of the United States are beautiful places to live, work and play. But, they are also very fragile areas whose ecosystems are vulnerable to mismanagement. There are many complex issues facing the ocean science community at the federal, state and local levels—this report reflects the conclusions and recommendations of the National Academies drawing on discussions with USGS as well as input from potential users, clients and collaborators of the Coastal and Marine Geology Program. %0 Book %A Institute of Medicine %E Donaldson, Molla S. %T Measuring the Quality of Health Care %@ 978-0-309-06387-6 %D 1999 %U https://nap.nationalacademies.org/catalog/6418/measuring-the-quality-of-health-care %> https://nap.nationalacademies.org/catalog/6418/measuring-the-quality-of-health-care %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 42 %X The National Roundtable on Health Care Quality was established in 1995 by the Institute of Medicine. The Roundtable consists of experts formally appointed through procedures of the National Research Council (NRC) who represent both public and private-sector perspectives and appropriate areas of substantive expertise (not organizations). From the public sector, heads of appropriate Federal agencies serve. It offers a unique, nonadversarial environment to explore ongoing rapid changes in the medical marketplace and the implications of these changes for the quality of health and health care in this nation. The Roundtable has a liaison panel focused on quality of care in managed care organizations. The Roundtable convenes nationally prominent representatives of the private and public sector (regional, state and federal), academia, patients, and the health media to analyze unfolding issues concerning quality, to hold workshops and commission papers on significant topics, and when appropriate, to produce periodic statements for the nation on quality of care matters. By providing a structured opportunity for regular communication and interaction, the Roundtable fosters candid discussion among individuals who represent various sides of a given issue. %0 Book %A Institute of Medicine %E Hewitt, Maria %E Simone, Joseph V. %T Ensuring Quality Cancer Care %@ 978-0-309-06480-4 %D 1999 %U https://nap.nationalacademies.org/catalog/6467/ensuring-quality-cancer-care %> https://nap.nationalacademies.org/catalog/6467/ensuring-quality-cancer-care %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 256 %X We all want to believe that when people get cancer, they will receive medical care of the highest quality. Even as new scientific breakthroughs are announced, though, many cancer patients may be getting the wrong care, too little care, or too much care, in the form of unnecessary procedures. How close is American medicine to the ideal of quality cancer care for every person with cancer? Ensuring Quality Cancer Care provides a comprehensive picture of how cancer care is delivered in our nation, from early detection to end-of-life issues. The National Cancer Policy Board defines quality care and recommends how to monitor, measure, and extend quality care to all people with cancer. Approaches to accountability in health care are reviewed. What keeps people from getting care? The book explains how lack of medical coverage, social and economic status, patient beliefs, physician decision-making, and other factors can stand between the patient and the best possible care. The board explores how cancer care is shaped by the current focus on evidence-based medicine, the widespread adoption of managed care, where services are provided, and who provides care. Specific shortfalls in the care of breast and prostate cancer are identified. A status report on health services research is included. Ensuring Quality Cancer Care offers wide-ranging data and information in clear context. As the baby boomers approach the years when most cancer occurs, this timely volume will be of special interest to health policy makers, public and private healthcare purchasers, medical professionals, patient advocates, researchers, and people with cancer. %0 Book %A Institute of Medicine %A National Research Council %T Exposure of the American People to Iodine-131 from Nevada Nuclear-Bomb Tests: Review of the National Cancer Institute Report and Public Health Implications %@ 978-0-309-06175-9 %D 1999 %U https://nap.nationalacademies.org/catalog/6283/exposure-of-the-american-people-to-iodine-131-from-nevada-nuclear-bomb-tests %> https://nap.nationalacademies.org/catalog/6283/exposure-of-the-american-people-to-iodine-131-from-nevada-nuclear-bomb-tests %I The National Academies Press %C Washington, DC %G English %K Environment and Environmental Studies %K Health and Medicine %P 288 %X In 1997, after more than a decade of research, the National Cancer Institute (NCI) released a report which provided their assessment of radiation exposures that Americans may have received from radioactive iodine released from the atomic bomb tests conducted in Nevada during the 1950s and early 1960s. This book provides an evaluation of the soundness of the methodology used by the NCI study to estimate: Past radiation doses. Possible health consequences of exposure to iodine-131. Implications for clinical practice. Possible public health strategies—such as systematic screening for thyroid cancer—to respond to the exposures. In addition, the book provides an evaluation of the NCI estimates of the number of thyroid cancers that might result from the nuclear testing program and provides guidance on approaches the U.S. government might use to communicate with the public about Iodine-131 exposures and health risks. %0 Book %A National Research Council %T Transforming Undergraduate Education in Science, Mathematics, Engineering, and Technology %@ 978-0-309-06294-7 %D 1999 %U https://nap.nationalacademies.org/catalog/6453/transforming-undergraduate-education-in-science-mathematics-engineering-and-technology %> https://nap.nationalacademies.org/catalog/6453/transforming-undergraduate-education-in-science-mathematics-engineering-and-technology %I The National Academies Press %C Washington, DC %G English %K Education %P 126 %X Today's undergraduate students—future leaders, policymakers, teachers, and citizens, as well as scientists and engineers—will need to make important decisions based on their understanding of scientific and technological concepts. However, many undergraduates in the United States do not study science, mathematics, engineering, or technology (SME&T) for more than one year, if at all. Additionally, many of the SME&T courses that students take are focused on one discipline and often do not give students an understanding about how disciplines are interconnected or relevant to students' lives and society. To address these issues, the National Research Council convened a series of symposia and forums of representatives from SME&T educational and industrial communities. Those discussions contributed to this book, which provides six vision statements and recommendations for how to improve SME&T education for all undergraduates. The book addresses pre-college preparation for students in SME&T and the joint roles and responsibilities of faculty and administrators in arts and sciences and in schools of education to better educate teachers of K-12 mathematics, science, and technology. It suggests how colleges can improve and evaluate lower-division undergraduate courses for all students, strengthen institutional infrastructures to encourage quality teaching, and better prepare graduate students who will become future SME&T faculty. %0 Book %T Spills of Nonfloating Oils: Risk and Response %@ 978-0-309-06590-0 %D 1999 %U https://nap.nationalacademies.org/catalog/9640/spills-of-nonfloating-oils-risk-and-response %> https://nap.nationalacademies.org/catalog/9640/spills-of-nonfloating-oils-risk-and-response %I The National Academies Press %C Washington, DC %G English %K Environment and Environmental Studies %P 88 %X In the Coast Guard Authorization Act of 1996, the United States Coast Guard (USCG) was directed to assess the risk of spills for oils that may sink or be negatively buoyant, to examine and evaluate existing cleanup technologies, and to identify and appraise technological and financial barriers that could impede a prompt response to such spills. The USCG requested that the National Research Council (NRC) perform these tasks. In response to this request, the NRC established the Committee on the Marine Transportation of Heavy Oils. %0 Book %A National Research Council %E Perrin, Edward B. %E Durch, Jane S. %E Skillman, Susan M. %T Health Performance Measurement in the Public Sector: Principles and Policies for Implementing an Information Network %@ 978-0-309-06436-1 %D 1999 %U https://nap.nationalacademies.org/catalog/6487/health-performance-measurement-in-the-public-sector-principles-and-policies %> https://nap.nationalacademies.org/catalog/6487/health-performance-measurement-in-the-public-sector-principles-and-policies %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 192 %X There is growing interest in using performance measurement as a means of holding federal, state, and local health agencies accountable for their use of public funds. Health Performance Measurement in the Public Sector is the second of two books for the U.S. Department of Health and Human Services on using and improving performance measurement in publicly funded health programs and the implications for data needs and systems. This book focuses on data and information system issues at the federal, state, and local levels. Recommendations address: Policy framework for selecting performance measures and using performance measurement. Operational principles related to data and data systems that support performance measurement. Essential investments in data systems and in training and technical assistance. Research needed to improve performance measures and performance measurement. %0 Book %A Institute of Medicine %E Chrvala, Carole A., Ph.D. %E Sharfstein, Steven, M.D. %T Definition of Serious and Complex Medical Conditions %@ 978-0-309-06640-2 %D 1999 %U https://nap.nationalacademies.org/catalog/9695/definition-of-serious-and-complex-medical-conditions %> https://nap.nationalacademies.org/catalog/9695/definition-of-serious-and-complex-medical-conditions %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 128 %X In response to a request by the Health Care Financing Administration (HCFA), the Institute of Medicine proposed a study to examine definitions of serious or complex medical conditions and related issues. A seven-member committee was appointed to address these issues. Throughout the course of this study, the committee has been aware of the fact that the topic addressed by this report concerns one of the most critical issues confronting HCFA, health care plans and providers, and patients today. The Medicare+Choice regulations focus on the most vulnerable populations in need of medical care and other services—those with serious or complex medical conditions. Caring for these highly vulnerable populations poses a number of challenges. The committee believes, however, that the current state of clinical and research literature does not adequately address all of the challenges and issues relevant to the identification and care of these patients. %0 Book %A National Research Council %T Sustaining Marine Fisheries %@ 978-0-309-05526-0 %D 1999 %U https://nap.nationalacademies.org/catalog/6032/sustaining-marine-fisheries %> https://nap.nationalacademies.org/catalog/6032/sustaining-marine-fisheries %I The National Academies Press %C Washington, DC %G English %K Agriculture %K Earth Sciences %P 188 %X Fluctuations and declines in marine fish populations have caused growing concern among marine scientists, fisheries managers, commercial and recreational fishers, and the public. Sustaining Marine Fisheries explores the nature of marine ecosystems and the complex interacting factors that shape their productivity. The book documents the condition of marine fisheries today, highlighting species and geographic areas that are under particular stress. Challenges to achieving sustainability are discussed, and shortcomings of existing fisheries management and regulation are examined. The volume calls for fisheries management to adopt a broader ecosystem perspective that encompasses all relevant environmental and human influences. Sustaining Marine Fisheries offers new approaches to building workable fisheries management institutions, improving scientific data, and developing management tools. The book recommends ways to change current practices that encourage overexploitation of fish resources. It will be of special interest to marine policymakers and ecologists, fisheries regulators and managers, fisheries scientists and marine ecologists, fishers, and concerned individuals. %0 Book %A National Research Council %T From Monsoons to Microbes: Understanding the Ocean's Role in Human Health %@ 978-0-309-06569-6 %D 1999 %U https://nap.nationalacademies.org/catalog/6368/from-monsoons-to-microbes-understanding-the-oceans-role-in-human %> https://nap.nationalacademies.org/catalog/6368/from-monsoons-to-microbes-understanding-the-oceans-role-in-human %I The National Academies Press %C Washington, DC %G English %K Earth Sciences %P 160 %X What can sharks teach us about our immune system? What can horseshoe crabs show us about eyesight? The more we learn about the ocean, the more we realize how critical these vast bodies of water are to our health and well-being. Sometimes the ocean helps us, as when a marine organism yields a new medical treatment. At other times, the ocean poses the threat of coastal storm surges or toxic algal blooms. From Monsoons to Microbes offers a deeper look into the oceans that surround us, often nurturing yet sometimes harming humankind. This book explores the links among physical oceanography, public health, epidemiology, marine biology, and medicine in understanding what the ocean has to offer. It will help readers grasp such important points as: How the ocean's sweeping physical processes create long-term phenomena such as El Nino and short-term disastrous events such as tsunamis—including what communities can do to prepare. What medicines and nutritional products have come from the ocean and what the prospects are for more such discoveries. How estuaries work—where salt and fresh water meet—and what can go wrong, as in the 7,000 square mile "dead zone" at the out-flow of the Mississippi River. How the growing demand for seafood and the expansion of ocean-going transport has increased our exposure to infectious agents—and how these agents can be tracked down and fought. Why "red tides" of toxic algae suddenly appear in previously unaffected coastal areas, and what happens when algal toxins find their way into our food supply or the air we breathe. The book recommends ways we can implement exciting new technologies to monitor the physics, chemistry, and biology of the ocean to recognize change as it happens. From the impact of worldwide atmospheric warming to the significance of exotic bacteria from submarine hydrothermal vents, the ocean has many depths left to explore. %0 Book %A National Research Council %T Size Limits of Very Small Microorganisms: Proceedings of a Workshop %@ 978-0-309-06634-1 %D 1999 %U https://nap.nationalacademies.org/catalog/9638/size-limits-of-very-small-microorganisms-proceedings-of-a-workshop %> https://nap.nationalacademies.org/catalog/9638/size-limits-of-very-small-microorganisms-proceedings-of-a-workshop %I The National Academies Press %C Washington, DC %G English %K Biology and Life Sciences %P 164 %X How small can a free-living organism be? On the surface, this question is straightforward-in principle, the smallest cells can be identified and measured. But understanding what factors determine this lower limit, and addressing the host of other questions that follow on from this knowledge, require a fundamental understanding of the chemistry and ecology of cellular life. The recent report of evidence for life in a martian meteorite and the prospect of searching for biological signatures in intelligently chosen samples from Mars and elsewhere bring a new immediacy to such questions. How do we recognize the morphological or chemical remnants of life in rocks deposited 4 billion years ago on another planet? Are the empirical limits on cell size identified by observation on Earth applicable to life wherever it may occur, or is minimum size a function of the particular chemistry of an individual planetary surface? These questions formed the focus of a workshop on the size limits of very small organisms, organized by the Steering .Group for the Workshop on Size Limits of Very Small Microorganisms and held on October 22 and 23, 1998. Eighteen invited panelists, representing fields ranging from cell biology and molecular genetics to paleontology and mineralogy, joined with an almost equal number of other participants in a wide-ranging exploration of minimum cell size and the challenge of interpreting micro- and nano-scale features of sedimentary rocks found on Earth or elsewhere in the solar system. This document contains the proceedings of that workshop. It includes position papers presented by the individual panelists, arranged by panel, along with a summary, for each of the four sessions, of extensive roundtable discussions that involved the panelists as well as other workshop participants. %0 Book %A Institute of Medicine %E Haynes, M. Alfred %E Smedley, Brian D. %T The Unequal Burden of Cancer: An Assessment of NIH Research and Programs for Ethnic Minorities and the Medically Underserved %@ 978-0-309-07154-3 %D 1999 %U https://nap.nationalacademies.org/catalog/6377/the-unequal-burden-of-cancer-an-assessment-of-nih-research %> https://nap.nationalacademies.org/catalog/6377/the-unequal-burden-of-cancer-an-assessment-of-nih-research %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 352 %X We know more about cancer prevention, detection, and treatment than ever before—yet not all segments of the U.S. population have benefited to the fullest extent possible from these advances. Some ethnic minorities experience more cancer than the majority population, and poor people—no matter what their ethnicity—often lack access to adequate cancer care. This book provides an authoritative view of cancer as it is experienced by ethnic minorities and the medically underserved. It offers conclusions and recommendations in these areas: Defining and understanding special populations, and improving the collection of cancer-related data. Setting appropriate priorities for and increasing the effectiveness of specific National Institutes of Health (NIH) research programs, to ensure that special populations are represented in clinical trials. Disseminating research results to health professionals serving these populations, with sensitivity to the issues of cancer survivorship. The book provides background data on the nation's struggle against cancer, activities and expenditures of the NIH, and other relevant topics. %0 Book %A National Research Council %T Hormonally Active Agents in the Environment %@ 978-0-309-06419-4 %D 1999 %U https://nap.nationalacademies.org/catalog/6029/hormonally-active-agents-in-the-environment %> https://nap.nationalacademies.org/catalog/6029/hormonally-active-agents-in-the-environment %I The National Academies Press %C Washington, DC %G English %K Environment and Environmental Studies %K Health and Medicine %P 452 %X Some investigators have hypothesized that estrogens and other hormonally active agents found in the environment might be involved in breast cancer increases and sperm count declines in humans as well as deformities and reproductive problems seen in wildlife. This book looks in detail at the science behind the ominous prospect of "estrogen mimics" threatening health and well-being, from the level of ecosystems and populations to individual people and animals. The committee identifies research needs and offers specific recommendations to decision-makers. This authoritative volume: Critically evaluates the literature on hormonally active agents in the environment and identifies known and suspected toxicologic mechanisms and effects of fish, wildlife, and humans. Examines whether and how exposure to hormonally active agents occurs—in diet, in pharmaceuticals, from industrial releases into the environment—and why the debate centers on estrogens. Identifies significant uncertainties, limitations of knowledge, and weaknesses in the scientific literature. The book presents a wealth of information and investigates a wide range of examples across the spectrum of life that might be related to these agents. %0 Book %A Institute of Medicine %A National Research Council %E Stoto, Michael A. %E Almario, Donna A. %E McCormick, Marie C. %T Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States %@ 978-0-309-06286-2 %D 1999 %U https://nap.nationalacademies.org/catalog/6307/reducing-the-odds-preventing-perinatal-transmission-of-hiv-in-the %> https://nap.nationalacademies.org/catalog/6307/reducing-the-odds-preventing-perinatal-transmission-of-hiv-in-the %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 416 %X Thousands of HIV-positive women give birth every year. Further, because many pregnant women are not tested for HIV and therefore do not receive treatment, the number of children born with HIV is still unacceptably high. What can we do to eliminate this tragic and costly inheritance? In response to a congressional request, this book evaluates the extent to which state efforts have been effective in reducing the perinatal transmission of HIV. The committee recommends that testing HIV be a routine part of prenatal care, and that health care providers notify women that HIV testing is part of the usual array of prenatal tests and that they have an opportunity to refuse the HIV test. This approach could help both reduce the number of pediatric AIDS cases and improve treatment for mothers with AIDS. Reducing the Odds will be of special interest to federal, state, and local health policymakers, prenatal care providers, maternal and child health specialists, public health practitioners, and advocates for HIV/AIDS patients. January %0 Book %A Institute of Medicine %E Joellenbeck, Lois M. %E Russell, Philip K. %E Guze, Samuel B. %T Strategies to Protect the Health of Deployed U.S. Forces: Medical Surveillance, Record Keeping, and Risk Reduction %@ 978-0-309-06637-2 %D 1999 %U https://nap.nationalacademies.org/catalog/9711/strategies-to-protect-the-health-of-deployed-us-forces-medical %> https://nap.nationalacademies.org/catalog/9711/strategies-to-protect-the-health-of-deployed-us-forces-medical %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 296 %X Nine years after Operations Desert Shield and Desert Storm (the Gulf War) ended in June 1991, uncertainty and questions remain about illnesses reported in a substantial percentage of the 697,000 service members who were deployed. Even though it was a short conflict with very few battle casualties or immediately recognized disease or non-battle injuries, the events of the Gulf War and the experiences of the ensuing years have made clear many potentially instructive aspects of the deployment and its hazards. Since the Gulf War, several other large deployments have also occurred, including deployments to Haiti and Somalia. Major deployments to Bosnia, Southwest Asia, and, most recently, Kosovo are ongoing as this report is written. This report draws on lessons learned from some of these deployments to consider strategies to protect the health of troops in future deployments. In the spring of 1996, Deputy Secretary of Defense John White met with leadership of the National Research Council and the Institute of Medicine to explore the prospect of an independent, proactive effort to learn from lessons of the Gulf War and to develop a strategy to better protect the health of troops in future deployments. %0 Book %A National Research Council %T Sharing the Fish: Toward a National Policy on Individual Fishing Quotas %@ 978-0-309-06330-2 %D 1999 %U https://nap.nationalacademies.org/catalog/6335/sharing-the-fish-toward-a-national-policy-on-individual-fishing %> https://nap.nationalacademies.org/catalog/6335/sharing-the-fish-toward-a-national-policy-on-individual-fishing %I The National Academies Press %C Washington, DC %G English %K Agriculture %K Earth Sciences %P 436 %X Most U.S. fish stocks are fully or over-exploited, and harvesting in many fisheries far exceeds sustainable levels. The individual fishing quota (IFQ) is a relatively new instrument under which harvesting privileges are allocated to individual fishermen—innovative yet controversial for its feared effect on fishing communities and individual fishermen. Based on testimony from fishermen, regulators, environmentalists, and others, Sharing the Fish explores how IFQs might address the serious social, economic, and biologic issues raised by depleted fish stocks. In their approach to a national policy on IFQs, the panel makes direct recommendations to Congress, the Secretary of Commerce, the National Marine Fisheries Service, regional fishery management councils, state authorities, and others. This book provides definitions and examples, reviews legislation and regulations, and includes lessons learned from fisheries on the U.S. East Coast and in Alaska, and in Iceland, New Zealand, and other nations. The committee discusses the public trust doctrine, management of common-pool resources, alternative and complementary approaches to the IFQ, and more. Sharing the Fish provides straightforward answers that will be important to fishery policymakers and regulators, natural resource economists, fishery managers, environmental advocates, and concerned fishermen and their communities.