Author: United States. Congress. House. Committee on Government Reform. Subcommittee on National Security, Veterans Affairs, and International Relations
Author: United States. Congress. House. Committee on Government Reform. Subcommittee on National Security, Veterans Affairs, and International Relations
The loss of hearing - be it gradual or acute, mild or severe, present since birth or acquired in older age - can have significant effects on one's communication abilities, quality of life, social participation, and health. Despite this, many people with hearing loss do not seek or receive hearing health care. The reasons are numerous, complex, and often interconnected. For some, hearing health care is not affordable. For others, the appropriate services are difficult to access, or individuals do not know how or where to access them. Others may not want to deal with the stigma that they and society may associate with needing hearing health care and obtaining that care. Still others do not recognize they need hearing health care, as hearing loss is an invisible health condition that often worsens gradually over time. In the United States, an estimated 30 million individuals (12.7 percent of Americans ages 12 years or older) have hearing loss. Globally, hearing loss has been identified as the fifth leading cause of years lived with disability. Successful hearing health care enables individuals with hearing loss to have the freedom to communicate in their environments in ways that are culturally appropriate and that preserve their dignity and function. Hearing Health Care for Adults focuses on improving the accessibility and affordability of hearing health care for adults of all ages. This study examines the hearing health care system, with a focus on non-surgical technologies and services, and offers recommendations for improving access to, the affordability of, and the quality of hearing health care for adults of all ages.
Author: United States. Congress. House. Committee on Government Reform. Subcommittee on National Security, Veterans Affairs, and International Relations
Second in a series of publications from the Institute of Medicine's Quality of Health Care in America project Today's health care providers have more research findings and more technology available to them than ever before. Yet recent reports have raised serious doubts about the quality of health care in America. Crossing the Quality Chasm makes an urgent call for fundamental change to close the quality gap. This book recommends a sweeping redesign of the American health care system and provides overarching principles for specific direction for policymakers, health care leaders, clinicians, regulators, purchasers, and others. In this comprehensive volume the committee offers: A set of performance expectations for the 21st century health care system. A set of 10 new rules to guide patient-clinician relationships. A suggested organizing framework to better align the incentives inherent in payment and accountability with improvements in quality. Key steps to promote evidence-based practice and strengthen clinical information systems. Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change.
Provides an account, from the point of view of the U.S. Army forces employed, of the 1990-91 Persian Gulf War, from the Iraqi invasion of Kuwait to the withdrawal of coalition forces from southeastern Iraq. It focuses on the Army's part in this war, particularly the activities of the Headquarters, Third Army, and the Army Forces Central Command (ARCENT). It looks especially at the activities of the VII Corps, which executed ARCENT's main effort in the theater ground force schwerpunkt -- General Schwarzkopf's "Great Wheel." This is not an official history; the author speaks in his own voice and makes his own judgments. Maps.
Wilson Greatbatch, an electrical engineer in Buffalo, NY, had a brilliant idea and the technical know-how to turn his idea into a practical device, for which millions of people today are grateful. This is the story of the first pacemaker by the man who invented it. Intrigued by electronics from the time he was a boy, Greatbatch earned a degree in electrical engineering from Cornell University. It was during his time at Cornell that he first became interested in the medical applications of electronic devices. He learned about the problem of heart blocking at Cornell and knew it was fixable in principle, but at the time the vacuum-tube technology was impractical for medical use. By the 1950s he was teaching at the University of Buffalo School of Electrical Engineering and the first silicon transistors had just been invented. While using one of the new $90 transistors on another project Greatbatch discovered by accident, as he describes it, the proper design for a blocking oscillator that he immediately knew would work as a pacemaker. He soon interested Dr. William Chardack, chief of surgery at the Veteran''s Administration Hospital in Buffalo, in the project, and by 1958 they were conducting animal experiments. Greatbatch quit his job and for the next two years devoted full-time in his wood-heated barn workshop to building one pacemaker after another. During this time he built fifty pacemakers, forty of which went into animal experiments. By 1960 he and a team of surgeons and engineers had gained enough knowledge from the trial and error of the animal experiments to feel ready to begin implanting the remaining ten devices in people. The first trials went well and Greatbatch''s device extended the lives of many of these seriously ill patients by decades. What followed were years of hard work refining the battery and electrode technology, marketing the pacemaker to an initially skeptical medical community, and keeping the company that manufactured the device profitable. Reminiscent of Edison''s many dogged attempts to find the right solution in pursuit of an ingenious idea, The Making of the Pacemaker is a human-interest story at its best and also an important firsthand account for the medical archives of an invention that today saves millions of lives.