Download or read book Dying in America written by Institute of Medicine and published by National Academies Press. This book was released on 2015-03-19 with total page 470 pages. Available in PDF, EPUB and Kindle. Book excerpt: For patients and their loved ones, no care decisions are more profound than those made near the end of life. Unfortunately, the experience of dying in the United States is often characterized by fragmented care, inadequate treatment of distressing symptoms, frequent transitions among care settings, and enormous care responsibilities for families. According to this report, the current health care system of rendering more intensive services than are necessary and desired by patients, and the lack of coordination among programs increases risks to patients and creates avoidable burdens on them and their families. Dying in America is a study of the current state of health care for persons of all ages who are nearing the end of life. Death is not a strictly medical event. Ideally, health care for those nearing the end of life harmonizes with social, psychological, and spiritual support. All people with advanced illnesses who may be approaching the end of life are entitled to access to high-quality, compassionate, evidence-based care, consistent with their wishes. Dying in America evaluates strategies to integrate care into a person- and family-centered, team-based framework, and makes recommendations to create a system that coordinates care and supports and respects the choices of patients and their families. The findings and recommendations of this report will address the needs of patients and their families and assist policy makers, clinicians and their educational and credentialing bodies, leaders of health care delivery and financing organizations, researchers, public and private funders, religious and community leaders, advocates of better care, journalists, and the public to provide the best care possible for people nearing the end of life.
Download or read book Fostering Integrity in Research written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2018-01-13 with total page 327 pages. Available in PDF, EPUB and Kindle. Book excerpt: The integrity of knowledge that emerges from research is based on individual and collective adherence to core values of objectivity, honesty, openness, fairness, accountability, and stewardship. Integrity in science means that the organizations in which research is conducted encourage those involved to exemplify these values in every step of the research process. Understanding the dynamics that support â€" or distort â€" practices that uphold the integrity of research by all participants ensures that the research enterprise advances knowledge. The 1992 report Responsible Science: Ensuring the Integrity of the Research Process evaluated issues related to scientific responsibility and the conduct of research. It provided a valuable service in describing and analyzing a very complicated set of issues, and has served as a crucial basis for thinking about research integrity for more than two decades. However, as experience has accumulated with various forms of research misconduct, detrimental research practices, and other forms of misconduct, as subsequent empirical research has revealed more about the nature of scientific misconduct, and because technological and social changes have altered the environment in which science is conducted, it is clear that the framework established more than two decades ago needs to be updated. Responsible Science served as a valuable benchmark to set the context for this most recent analysis and to help guide the committee's thought process. Fostering Integrity in Research identifies best practices in research and recommends practical options for discouraging and addressing research misconduct and detrimental research practices.
Download or read book Conducting Biosocial Surveys written by National Research Council and published by National Academies Press. This book was released on 2010-10-02 with total page 124 pages. Available in PDF, EPUB and Kindle. Book excerpt: Recent years have seen a growing tendency for social scientists to collect biological specimens such as blood, urine, and saliva as part of large-scale household surveys. By combining biological and social data, scientists are opening up new fields of inquiry and are able for the first time to address many new questions and connections. But including biospecimens in social surveys also adds a great deal of complexity and cost to the investigator's task. Along with the usual concerns about informed consent, privacy issues, and the best ways to collect, store, and share data, researchers now face a variety of issues that are much less familiar or that appear in a new light. In particular, collecting and storing human biological materials for use in social science research raises additional legal, ethical, and social issues, as well as practical issues related to the storage, retrieval, and sharing of data. For example, acquiring biological data and linking them to social science databases requires a more complex informed consent process, the development of a biorepository, the establishment of data sharing policies, and the creation of a process for deciding how the data are going to be shared and used for secondary analysis-all of which add cost to a survey and require additional time and attention from the investigators. These issues also are likely to be unfamiliar to social scientists who have not worked with biological specimens in the past. Adding to the attraction of collecting biospecimens but also to the complexity of sharing and protecting the data is the fact that this is an era of incredibly rapid gains in our understanding of complex biological and physiological phenomena. Thus the tradeoffs between the risks and opportunities of expanding access to research data are constantly changing. Conducting Biosocial Surveys offers findings and recommendations concerning the best approaches to the collection, storage, use, and sharing of biospecimens gathered in social science surveys and the digital representations of biological data derived therefrom. It is aimed at researchers interested in carrying out such surveys, their institutions, and their funding agencies.
Download or read book Research Priorities for Airborne Particulate Matter written by National Research Council and published by National Academies Press. This book was released on 2001-06-13 with total page 188 pages. Available in PDF, EPUB and Kindle. Book excerpt: Regulatory standards are already on the books at the the U.S. Environmental Protection Agency (EPA) to address health risks posed by inhaling tiny particles from smoke, vehicle exhaust, and other sources. At the same time, Congress and EPA have initiated a multimillion dollar research effort to better understand the sources of these airborne particles, the levels of exposure to people, and the ways that these particles cause damage. To provide independent guidance to the EPA, Congress asked the National Research Council to study the relevant issues. The result is a series of four reports on the particulate-matter research program. The first two books offered a conceptual framework for a national research program, identified the 10 most critical research needs, and described the recommended timing and estimated costs of such research. This, the third volume, begins the task of assessing the progress made in implementing the research program. The National Research Council ultimately concludes that the ongoing program is appropriately addressing many of the key uncertainties. However, it also identifies a number of critical specific subjects that should be given greater attention. Research Priorities for Airborne Particulate Matter focuses on the most current and planned research projects with an eye toward the fourth and final report, which will contain an updated assessment.
Download or read book Assessment of the Results of External Independent Reviews for U S Department of Energy Projects written by National Research Council and published by National Academies Press. This book was released on 2007-04-10 with total page 74 pages. Available in PDF, EPUB and Kindle. Book excerpt: Peer review is an essential component of engineering practice and other scientific and technical undertakings. Peer reviews are conducted to ensure that activities are technically adequate, competently performed, and properly documented; to validate assumptions, calculations, and extrapolations; and to assess alternative interpretations, methodologies, acceptance criteria, and other aspects of the work products and the documentation that support them. Effective peer reviews are conducted in an environment of mutual respect, recognizing the contributions of all participants. Their primary objective is to help the project team achieve its goals. Reviews also contribute to quality assurance, risk management, and overall improvement of the management process. The U.S. Department of Energy (DOE) conducts different types of peer reviews at the different stages of a project, including reviews to assess risks and other factors related to design, safety, cost estimates, value engineering, and project management. Independent project reviews (IPRs) are conducted by federal staff not directly affiliated with the project or program and management and operations (M&O) contractors. External independent reviews (EIRs) are overseen by the Office of Engineering and Construction Management and conducted by contractors external to the department. EIRs are the primary focus of this report. However, the committee found that, in many cases, IPRs are explicitly used as preparation for or as preliminary reviews prior to EIRs. Thus, because IPRs are integral to the review process in DOE, they are also discussed because they might have an effect on EIRs. In October 2000, DOE issued Order 413.3, Program and Project Management for the Acquisition of Capital Assets (DOE, 2000). The order established a series of five critical decisions (CDs), or major milestones, that require senior management review and approval to ensure that a project satisfies applicable mission, design, security, and safety requirements: approve mission need, approve alternative selection and cost range, approve performance baseline, approve start of construction, and approve start of operations or project closeout. Assessment of the Results of External Independent Reviews for U. S. Department of Energy Projects summarizes the results.
Download or read book Engaging Schools written by Institute of Medicine and published by National Academies Press. This book was released on 2003-12-21 with total page 303 pages. Available in PDF, EPUB and Kindle. Book excerpt: When it comes to motivating people to learn, disadvantaged urban adolescents are usually perceived as a hard sell. Yet, in a recent MetLife survey, 89 percent of the low-income students claimed "I really want to learn" applied to them. What is it about the school environmentâ€"pedagogy, curriculum, climate, organizationâ€"that encourages or discourages engagement in school activities? How do peers, family, and community affect adolescents' attitudes towards learning? Engaging Schools reviews current research on what shapes adolescents' school engagement and motivation to learnâ€"including new findings on students' sense of belongingâ€"and looks at ways these can be used to reform urban high schools. This book discusses what changes hold the greatest promise for increasing students' motivation to learn in these schools. It looks at various approaches to reform through different methods of instruction and assessment, adjustments in school size, vocational teaching, and other key areas. Examples of innovative schools, classrooms, and out-of-school programs that have proved successful in getting high school kids excited about learning are also included.
Download or read book The Small Business Innovation Research Program written by National Research Council and published by National Academies Press. This book was released on 2000-11-30 with total page 362 pages. Available in PDF, EPUB and Kindle. Book excerpt: In 1992, Congress for the first time explicitly directed the federal agencies making SBIR grants to use commercial potential as a criterion for granting SBIR awards. In response, the Department of Defense developed the SBIR Fast Track initiative, which provides expedited decision-making for SBIR awards to companies that have commitments from outside vendors. To verify the effectiveness of this initiative, the DoD asked the STEP Board to assess the operation of Fast Track. This volume of original field research includes case studies comparing Fast Track and non-Fast Track firms, a large survey of SBIR awardees, and statistical analyses of the impact of regular SBIR and Fast Track awards. Collectively, the commissioned papers and the findings and recommendations represent a significant contribution to our understanding of the SBIR program.
Download or read book Funding Smithsonian Scientific Research written by National Research Council and published by National Academies Press. This book was released on 2003-02-28 with total page 100 pages. Available in PDF, EPUB and Kindle. Book excerpt: This report assesses whether the Smithsonian Institution should continue to receive direct federal appropriations for its scientific research programs or if this funding should be transferred to a peer-reviewed program open to all researchers in another agency. The report concludes that the National Museum of Natural History, the National Zoological Park, and the Smithsonian Center for Materials Research and Education in Suitland should remain exempt from having to compete for federal research dollars because they make unique contributions to the scientific and museum communities. Three other Smithsonian research programs should continue to receive federal funding since they are performing science of the highest quality and already compete for much of their government research money.
Download or read book Understanding the Educational and Career Pathways of Engineers written by National Academy of Engineering and published by National Academies Press. This book was released on 2019-01-26 with total page 223 pages. Available in PDF, EPUB and Kindle. Book excerpt: Engineering skills and knowledge are foundational to technological innovation and development that drive long-term economic growth and help solve societal challenges. Therefore, to ensure national competitiveness and quality of life it is important to understand and to continuously adapt and improve the educational and career pathways of engineers in the United States. To gather this understanding it is necessary to study the people with the engineering skills and knowledge as well as the evolving system of institutions, policies, markets, people, and other resources that together prepare, deploy, and replenish the nation's engineering workforce. This report explores the characteristics and career choices of engineering graduates, particularly those with a BS or MS degree, who constitute the vast majority of degreed engineers, as well as the characteristics of those with non-engineering degrees who are employed as engineers in the United States. It provides insight into their educational and career pathways and related decision making, the forces that influence their decisions, and the implications for major elements of engineering education-to-workforce pathways.
Download or read book Decision Making in the U S Department of Energy s Environmental Management Office of Science and Technology written by National Research Council and published by National Academies Press. This book was released on 1999-08-12 with total page 229 pages. Available in PDF, EPUB and Kindle. Book excerpt: Printbegrænsninger: Der kan printes 10 sider ad gangen og max. 40 sider pr. session.
Download or read book Risk Assessment and Management at Deseret Chemical Depot and the Tooele Chemical Agent Disposal Facility written by National Research Council and published by National Academies Press. This book was released on 1997-10-04 with total page 98 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Time for Business Key findings and recommendations written by and published by . This book was released on 1996 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Clinical Practice Guidelines We Can Trust written by Institute of Medicine and published by National Academies Press. This book was released on 2011-06-16 with total page 217 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.
Download or read book Promoting Health written by Institute of Medicine and published by National Academies Press. This book was released on 2000-02-01 with total page 507 pages. Available in PDF, EPUB and Kindle. Book excerpt: At the dawn of the twenty-first century, Americans enjoyed better overall health than at any other time in the nation's history. Rapid advancements in medical technologies, breakthroughs in understanding the genetic underpinnings of health and ill health, improvements in the effectiveness and variety of pharmaceuticals, and other developments in biomedical research have helped develop cures for many illnesses and improve the lives of those with chronic diseases. By itself, however, biomedical research cannot address the most significant challenges to improving public health. Approximately half of all causes of mortality in the United States are linked to social and behavioral factors such as smoking, diet, alcohol use, sedentary lifestyle, and accidents. Yet less than five percent of the money spent annually on U.S. health care is devoted to reducing the risks of these preventable conditions. Behavioral and social interventions offer great promise, but as yet their potential has been relatively poorly tapped. Promoting Health identifies those promising areas of social science and behavioral research that may address public health needs. It includes 12 papersâ€"commissioned from some of the nation's leading expertsâ€"that review these issues in detail, and serves to assess whether the knowledge base of social and behavioral interventions has been useful, or could be useful, in the development of broader public health interventions.
Download or read book Formalizing the Shadow Economy in Serbia written by Gorana Krstić and published by Springer. This book was released on 2015-04-21 with total page 182 pages. Available in PDF, EPUB and Kindle. Book excerpt: The main objective of this book is to develop a strategy and policy measures to enhance the formalization of the shadow economy in order to improve the competitiveness of the economy and contribute to economic growth; it explores these issues with special reference to Serbia. The size and development of the shadow economy in Serbia and other Central and Eastern European countries are estimated using two different methods (the MIMIC method and household-tax-compliance method). Micro-estimates are based on a special survey of business entities in Serbia, which for the first time allows us to explore the shadow economy from the perspective of enterprises and entrepreneurs. The authors identify the types of shadow economy at work in business entities, the determinants of shadow economy participation, and the impact of competition from the informal sector on businesses. Readers will learn both about the potential fiscal effects of reducing the shadow economy to the levels observed in more developed countries and the effects that formalization of the shadow economy can have on economic growth.
Download or read book Evaluating Research Efficiency in the U S Environmental Protection Agency written by National Research Council and published by National Academies Press. This book was released on 2008-06-17 with total page 152 pages. Available in PDF, EPUB and Kindle. Book excerpt: A new book from the National Research Council recommends changes in how the federal government evaluates the efficiency of research at EPA and other agencies. Assessing efficiency should be considered only one part of gauging a program's quality, relevance, and effectiveness. The efficiency of research processes and that of investments should be evaluated using different approaches. Investment efficiency should examine whether an agency's R&D portfolio, including the budget, is relevant, of high quality, matches the agency's strategic plan. These evaluations require panels of experts. In contrast, process efficiency should focus on "inputs" (the people, funds, and facilities dedicated to research) and "outputs" (the services, grants, publications, monitoring, and new techniques produced by research), as well as their timelines and should be evaluated using quantitative measures. The committee recommends that the efficiency of EPA's research programs be evaluated according to the same standards used at other agencies. To ensure this, OMB should train and oversee its budget examiners so that the PART questionnaire is implemented consistently and equitably across agencies.
Download or read book Forensic Analysis written by National Research Council and published by National Academies Press. This book was released on 2004-04-26 with total page 227 pages. Available in PDF, EPUB and Kindle. Book excerpt: Since the 1960s, testimony by representatives of the Federal Bureau of Investigation in thousands of criminal cases has relied on evidence from Compositional Analysis of Bullet Lead (CABL), a forensic technique that compares the elemental composition of bullets found at a crime scene to the elemental composition of bullets found in a suspect's possession. Different from ballistics techniques that compare striations on the barrel of a gun to those on a recovered bullet, CABL is used when no gun is recovered or when bullets are too small or mangled to observe striations. Forensic Analysis: Weighing Bullet Lead Evidence assesses the scientific validity of CABL, finding that the FBI should use a different statistical analysis for the technique and that, given variations in bullet manufacturing processes, expert witnesses should make clear the very limited conclusions that CABL results can support. The report also recommends that the FBI take additional measures to ensure the validity of CABL results, which include improving documentation, publishing details, and improving on training and oversight.
