Knowing What Works in Health Care

Knowing What Works in Health Care

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2008-05-29

Total Pages: 279

ISBN-13: 0309113563

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There is currently heightened interest in optimizing health care through the generation of new knowledge on the effectiveness of health care services. The United States must substantially strengthen its capacity for assessing evidence on what is known and not known about "what works" in health care. Even the most sophisticated clinicians and consumers struggle to learn which care is appropriate and under what circumstances. Knowing What Works in Health Care looks at the three fundamental health care issues in the United States-setting priorities for evidence assessment, assessing evidence (systematic review), and developing evidence-based clinical practice guidelines-and how each of these contributes to the end goal of effective, practical health care systems. This book provides an overall vision and roadmap for improving how the nation uses scientific evidence to identify the most effective clinical services. Knowing What Works in Health Care gives private and public sector firms, consumers, health care professionals, benefit administrators, and others the authoritative, independent information required for making essential informed health care decisions.


Depression in Parents, Parenting, and Children

Depression in Parents, Parenting, and Children

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2009-10-28

Total Pages: 488

ISBN-13: 0309121787

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Depression is a widespread condition affecting approximately 7.5 million parents in the U.S. each year and may be putting at least 15 million children at risk for adverse health outcomes. Based on evidentiary studies, major depression in either parent can interfere with parenting quality and increase the risk of children developing mental, behavioral and social problems. Depression in Parents, Parenting, and Children highlights disparities in the prevalence, identification, treatment, and prevention of parental depression among different sociodemographic populations. It also outlines strategies for effective intervention and identifies the need for a more interdisciplinary approach that takes biological, psychological, behavioral, interpersonal, and social contexts into consideration. A major challenge to the effective management of parental depression is developing a treatment and prevention strategy that can be introduced within a two-generation framework, conducive for parents and their children. Thus far, both the federal and state response to the problem has been fragmented, poorly funded, and lacking proper oversight. This study examines options for widespread implementation of best practices as well as strategies that can be effective in diverse service settings for diverse populations of children and their families. The delivery of adequate screening and successful detection and treatment of a depressive illness and prevention of its effects on parenting and the health of children is a formidable challenge to modern health care systems. This study offers seven solid recommendations designed to increase awareness about and remove barriers to care for both the depressed adult and prevention of effects in the child. The report will be of particular interest to federal health officers, mental and behavioral health providers in diverse parts of health care delivery systems, health policy staff, state legislators, and the general public.


Monitoring International Labor Standards

Monitoring International Labor Standards

Author: National Research Council (U.S.). Committee on Monitoring International Labor Standards

Publisher: National Academy Press

Published: 2004-05-25

Total Pages: 316

ISBN-13:

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"The book offers a first step toward the goal of providing an empirical foundation to monitor compliance with core labor standards. It provides a roadmap to existing data sources, their relevance to defined labor standards, their utility to decision makers in charge of assessing or monitoring compliance, and the cautions necessary to understand and use the information. It is resource for anyone working on international labor issues."--BOOK JACKET.


Clinical Practice Guidelines We Can Trust

Clinical Practice Guidelines We Can Trust

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2011-06-16

Total Pages: 217

ISBN-13: 030921646X

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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.


Biotechnology Research in an Age of Terrorism

Biotechnology Research in an Age of Terrorism

Author: National Research Council

Publisher: National Academies Press

Published: 2004-03-02

Total Pages: 164

ISBN-13: 0309089778

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In recent years much has happened to justify an examination of biological research in light of national security concerns. The destructive application of biotechnology research includes activities such as spreading common pathogens or transforming them into even more lethal forms. Policymakers and the scientific community at large must put forth a vigorous and immediate response to this challenge. This new book by the National Research Council recommends that the government expand existing regulations and rely on self-governance by scientists rather than adopt intrusive new policies. One key recommendation of the report is that the government should not attempt to regulate scientific publishing but should trust scientists and journals to screen their papers for security risks, a task some journals have already taken up. With biological information and tools widely distributed, regulating only U.S. researchers would have little effect. A new International Forum on Biosecurity should encourage the adoption of similar measures around the world. Seven types of risky studies would require approval by the Institutional Biosafety Committees that already oversee recombinant DNA research at some 400 U.S. institutions. These "experiments of concern" include making an infectious agent more lethal and rendering vaccines powerless.


Protecting Student Records and Facilitating Education Research

Protecting Student Records and Facilitating Education Research

Author: National Research Council

Publisher: National Academies Press

Published: 2009-01-18

Total Pages: 106

ISBN-13: 0309127998

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Designed to protect the privacy of individual student test scores, grades, and other education records, the Family Educational Rights and Privacy Act (FERPA) of 1974 places limits the access of educational researches, and slows research not only in education but also in related fields, such as child welfare and health. Recent trends have converged to greatly increase the supply of data on student performance in public schools. Education policies now emphasize education standards and testing to measure progress toward those standards, as well as rigorous education research. At the same time, private firms and public agencies, including schools, have replaced most paper records with electronic data systems. Although these databases represent a rich source of longitudinal data, researchers' access to the individually identifiable data they contain is limited by the privacy protections of FERPA. To explore possibilities for data access and confidentiality in compliance with FERPA and with the Common Rule for the Protection of Human Subjects, the National Academies and the American Educational Research Association convened the Workshop on Protecting Student Records and Facilitating Education Research in April 2008.


Electronic Scientific, Technical, and Medical Journal Publishing and Its Implications

Electronic Scientific, Technical, and Medical Journal Publishing and Its Implications

Author: National Research Council

Publisher: National Academies Press

Published: 2005-05-24

Total Pages: 136

ISBN-13: 0309166101

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This report is the proceedings of a 2003 symposium on "Electronic Scientific, Technical, and Medical Journal Publishing and Its Implications," which brought together experts in STM publishing, both producers and users of these publications, to: (1) identify the recent technical changes in publishing, and other factors, that influence the decisions of journal publishers to produce journals electronically; (2) identify the needs of the scientific, engineering, and medical community as users of journals, whether electronic or printed; (3) discuss the responses of not-for-profit and commercial STM publishers and of other stakeholders in the STM community to the opportunities and challenges posed by the shift to electronic publishing; and (4) examine the spectrum of proposals that has been put forth to respond to the needs of users as the publishing industry shifts to electronic information production and dissemination.


Global Issues in Water, Sanitation, and Health

Global Issues in Water, Sanitation, and Health

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2009-10-25

Total Pages: 328

ISBN-13: 0309138728

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As the human population grows-tripling in the past century while, simultaneously, quadrupling its demand for water-Earth's finite freshwater supplies are increasingly strained, and also increasingly contaminated by domestic, agricultural, and industrial wastes. Today, approximately one-third of the world's population lives in areas with scarce water resources. Nearly one billion people currently lack access to an adequate water supply, and more than twice as many lack access to basic sanitation services. It is projected that by 2025 water scarcity will affect nearly two-thirds of all people on the planet. Recognizing that water availability, water quality, and sanitation are fundamental issues underlying infectious disease emergence and spread, the Institute of Medicine held a two-day public workshop, summarized in this volume. Through invited presentations and discussions, participants explored global and local connections between water, sanitation, and health; the spectrum of water-related disease transmission processes as they inform intervention design; lessons learned from water-related disease outbreaks; vulnerabilities in water and sanitation infrastructure in both industrialized and developing countries; and opportunities to improve water and sanitation infrastructure so as to reduce the risk of water-related infectious disease.


Model Rules of Professional Conduct

Model Rules of Professional Conduct

Author: American Bar Association. House of Delegates

Publisher: American Bar Association

Published: 2007

Total Pages: 216

ISBN-13: 9781590318737

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