Though overall cancer incidence and mortality have continued to decline in recent years, cancer continues to devastate the lives of far too many Americans. In 2009 alone, 1.5 million American men, women, and children were diagnosed with cancer, and 562,000 died from the disease. There is a growing body of evidence linking environmental exposures to cancer. The Pres. Cancer Panel dedicated its 2008¿2009 activities to examining the impact of environmental factors on cancer risk. The Panel considered industrial, occupational, and agricultural exposures as well as exposures related to medical practice, military activities, modern lifestyles, and natural sources. This report presents the Panel¿s recommend. to mitigate or eliminate these barriers. Illus.
The report investigates the characteristics of workplace wellness programs, their prevalence and impact on employee health and medical cost, facilitators of their success, and the role of incentives in such programs. The authors employ four data collection and analysis streams: a literature review, a survey of employers, a longitudinal analysis of medical claims and wellness program data from a sample of employers, and five employer case studies.
Collaborations of physicians and researchers with industry can provide valuable benefits to society, particularly in the translation of basic scientific discoveries to new therapies and products. Recent reports and news stories have, however, documented disturbing examples of relationships and practices that put at risk the integrity of medical research, the objectivity of professional education, the quality of patient care, the soundness of clinical practice guidelines, and the public's trust in medicine. Conflict of Interest in Medical Research, Education, and Practice provides a comprehensive look at conflict of interest in medicine. It offers principles to inform the design of policies to identify, limit, and manage conflicts of interest without damaging constructive collaboration with industry. It calls for both short-term actions and long-term commitments by institutions and individuals, including leaders of academic medical centers, professional societies, patient advocacy groups, government agencies, and drug, device, and pharmaceutical companies. Failure of the medical community to take convincing action on conflicts of interest invites additional legislative or regulatory measures that may be overly broad or unduly burdensome. Conflict of Interest in Medical Research, Education, and Practice makes several recommendations for strengthening conflict of interest policies and curbing relationships that create risks with little benefit. The book will serve as an invaluable resource for individuals and organizations committed to high ethical standards in all realms of medicine.
Healthcare decision makers in search of reliable information that compares health interventions increasingly turn to systematic reviews for the best summary of the evidence. Systematic reviews identify, select, assess, and synthesize the findings of similar but separate studies, and can help clarify what is known and not known about the potential benefits and harms of drugs, devices, and other healthcare services. Systematic reviews can be helpful for clinicians who want to integrate research findings into their daily practices, for patients to make well-informed choices about their own care, for professional medical societies and other organizations that develop clinical practice guidelines. Too often systematic reviews are of uncertain or poor quality. There are no universally accepted standards for developing systematic reviews leading to variability in how conflicts of interest and biases are handled, how evidence is appraised, and the overall scientific rigor of the process. In Finding What Works in Health Care the Institute of Medicine (IOM) recommends 21 standards for developing high-quality systematic reviews of comparative effectiveness research. The standards address the entire systematic review process from the initial steps of formulating the topic and building the review team to producing a detailed final report that synthesizes what the evidence shows and where knowledge gaps remain. Finding What Works in Health Care also proposes a framework for improving the quality of the science underpinning systematic reviews. This book will serve as a vital resource for both sponsors and producers of systematic reviews of comparative effectiveness research.
The term “STEM education” refers to teaching and learning in the fields of science, technology, engineering, and mathematics. It typically includes educational activities across all grade levels—from pre-school to post-doctorate—in both formal (e.g., classrooms) and informal (e.g., afterschool programs) settings. Federal policymakers have an active and enduring interest in STEM education and the topic is frequently raised in federal science, education, workforce, national security, and immigration policy debates. For example, more than 200 bills containing the term “science education” were introduced between the 100th and 110th congresses. The United States is widely believed to perform poorly in STEM education. However, the data paint a complicated picture. By some measures, U.S. students appear to be doing quite well. For example, overall graduate enrollments in science and engineering (S&E) grew 35% over the last decade. Further, S&E enrollments for Hispanic/Latino, American Indian/Alaska Native, and African American students (all of whom are generally underrepresented in S&E) grew by 65%, 55%, and 50%, respectively. On the other hand, concerns remain about persistent academic achievement gaps between various demographic groups, STEM teacher quality, the rankings of U.S. students on international STEM assessments, foreign student enrollments and increased education attainment in other countries, and the ability of the U.S. STEM education system to meet domestic demand for STEM labor. Various attempts to assess the federal STEM education effort have produced different estimates of its scope and scale. Analysts have identified between 105 and 252 STEM education programs or activities at 13 to 15 federal agencies. Annual federal appropriations for STEM education are typically in the range of $2.8 billion to $3.4 billion. All published inventories identify the Department of Education, National Science Foundation, and Health and Human Services as key agencies in the federal effort. Over half of federal STEM education funding is intended to serve the needs of postsecondary schools and students; the remainder goes to efforts at the kindergarten-through-Grade 12 level. Much of the funding for post-secondary students is in the form of financial aid. Federal STEM education policy concerns center on issues that relate to STEM education as a whole—such as governance of the federal effort and broadening participation of underrepresented populations—as well as those that are specific to STEM education at the elementary, secondary, and postsecondary levels. Governance concerns focus on perceived duplication and lack of coordination in the federal effort; broadening participation concerns tend to highlight achievement gaps between various demographic groups. Analysts suggest a variety of policy proposals in elementary, secondary, and postsecondary STEM education. At the K-12 level, these include proposals to address teacher quality, accountability, and standards. At the post-secondary level, proposals center on efforts to remediate and retain students in STEM majors. This report is intended to serve as a primer for outlining existing STEM education policy issues and programs. It includes assessments of the federal STEM education effort and the condition of STEM education in the United States, as well as an analysis of several of the policy issues central to the contemporary federal conversation about STEM education. Appendix A contains frequently cited data and sources and Appendix B includes a selection of major STEM-related acts.
Contents: (1) National Security (NS) and the Congressional Interest; 21st Century Challenges to NS; (2) The Role of the Economy in U.S. NS; Macroecon. and Microecon. Issues in NS; (3) Economic Growth and Broad Conceptions of NS: Human Capital; Research, Innovation, Energy, and Space; (4) Globalization, Trade, Finance, and the G-20; Instability in the Global Economy; Savings and Exports; Boosting Domestic Demand Abroad; Open Foreign Markets to U.S. Products and Services; Build Cooperation with International Partners; Deterring Threats to the International Financial System; (5) Democracy, Human Rights, and Development Aid; Sustainable Development. Charts and tables. This is a print on demand publication.
Every day in the United States, children and adolescents are victims of commercial sexual exploitation and sex trafficking. Despite the serious and long-term consequences for victims as well as their families, communities, and society, efforts to prevent, identify, and respond to these crimes are largely under supported, inefficient, uncoordinated, and unevaluated. Confronting Commercial Sexual Exploitation and Sex Trafficking of Minors in the United States examines commercial sexual exploitation and sex trafficking of U.S. citizens and lawful permanent residents of the United States under age 18. According to this report, efforts to prevent, identify, and respond to these crimes require better collaborative approaches that build upon the capabilities of people and entities from a range of sectors. In addition, such efforts need to confront demand and the individuals who commit and benefit from these crimes. The report recommends increased awareness and understanding, strengthening of the law's response, strengthening of research to advance understanding and to support the development of prevention and intervention strategies, support for multi-sector and interagency collaboration, and creation of a digital information-sharing platform. A nation that is unaware of these problems or disengaged from solutions unwittingly contributes to the ongoing abuse of minors. If acted upon in a coordinated and comprehensive manner, the recommendations of Confronting Commercial Sexual Exploitation and Sex Trafficking of Minors in the United States can help advance and strengthen the nation's emerging efforts to prevent, identify, and respond to commercial sexual exploitation and sex trafficking of minors in the United States.