Hospitals and nursing homes are responding to changes in the health care system by modifying staffing levels and the mix of nursing personnel. But do these changes endanger the quality of patient care? Do nursing staff suffer increased rates of injury, illness, or stress because of changing workplace demands? These questions are addressed in Nursing Staff in Hospitals and Nursing Homes, a thorough and authoritative look at today's health care system that also takes a long-term view of staffing needs for nursing as the nation moves into the next century. The committee draws fundamental conclusions about the evolving role of nurses in hospitals and nursing homes and presents recommendations about staffing decisions, nursing training, measurement of quality, reimbursement, and other areas. The volume also discusses work-related injuries, violence toward and abuse of nursing staffs, and stress among nursing personnelâ€"and examines whether these problems are related to staffing levels. Included is a readable overview of the underlying trends in health care that have given rise to urgent questions about nurse staffing: population changes, budget pressures, and the introduction of new technologies. Nursing Staff in Hospitals and Nursing Homes provides a straightforward examination of complex and sensitive issues surround the role and value of nursing on our health care system.
The Bureau, precursor to Statistics Canada, was founded in 1918 as a centralized national agency to replace piecemeal arrangements which had developed over time and no longer satisfied statistical needs. The author (who is a retired assistant chief statistician of Canada) traces its evolution and looks at the individuals who influenced it. He discusses how Canada's statistical system has coped with the country's evolution from a staple economy to a mature industrial power; the changing nature of the technology for gathering, compiling, analyzing, and disseminating information; and some notable Canadian contributions to the science and production of statistics. Annotation copyrighted by Book News, Inc., Portland, OR
Rice and the role of IRRI; IRRI and national programs; Genetic resources; Varietal improment; Advances in rice production technology; Integrating rice technology into farmers' production systems; Impact of modern rice technology; Training and communication.
The need for quality improvement and for cost saving are driving both individual choices and health system dynamics. The health services research that we need to support informed choices depends on access to data, but at the same time, individual privacy and patient-health care provider confidentiality must be protected.
The U.S. Army Health Risk Appraisal group surveyed 400,000 active duty U.S. Army personnel in the late 1990s to determine whether or not those personnel met the dietary objectives of Healthy People 2000 (HP2000), a national agenda for health promotion and disease prevention. As reported by Yore et al. (2000), Army personnel generally did not meet the HP2000 goals for nutrition even though significant progress had been made during 1991-1998. Although the specific aspects of diet that would be relevant to this Committee on Mineral Requirements for Cognitive and Physical Performance of Military Personnel are lacking, the findings from this survey suggest that there are dietary problems in the military population. The potential for adverse effects of marginal mineral deficiencies among soldiers engaged in training or military operations and the prospect of improving military performance through mineral intakes have spurred the military's interest in this area of nutrition. Mineral Requirements for Military Personnel provides background information on the current knowledge regarding soldiers' eating behaviors as well as on the physical and mental stress caused by military garrison training or operations. This report also offers facts on the mineral content of rations and its intake by military personnel and addresses the potential effects of nutrient deficiencies due to inadequate intake or higher requirements during military operations. Mineral Requirements for Military Personnel provides information and recommendations on the development and uses of MDRIs and a description of strategies to increase intake of specific minerals, whether via usual foods, fortification, or supplementation. This report features a description of the metabolism and needs for selected minerals by military personnel under garrison training, recommendations on mineral intake levels, and an assessment of mineral level adequacy in operational rations. This report also includes a prioritization of the research needed to answer information gaps and details of study designs required to gain such information.
The latest of a series of publications based on workshops sponsored by the Committee on Military Nutrition Research, this book's focus on emerging technologies for nutrition research arose from a concern among scientists at the U.S. Army Research Institute of Environmental Medicine that traditional nutrition research, using standard techniques, centered more on complex issues of the maintenance or enhancement of performance, and might not be sufficiently substantive either to measure changes in performance or to predict the effects on performance of stresses soldiers commonly experience in operational environments. The committee's task was to identify and evaluate new technologies to determine whether they could help resolve important issues in military nutrition research. The book contains the committee's summary and recommendations as well as individually authored chapters based on presentations at a 1995 workshop. Other chapters cover techniques of body composition assessment, tracer techniques for the study of metabolism, ambulatory techniques for the determination of energy expenditure, molecular and cellular approaches to nutrition, the assessment of immune function, and functional and behavioral measures of nutritional status.
The Vaccine Safety Datalink (VSD) is a large, linked database of patient information that was developed jointly by CDC and several private managed care organizations in 1991. It includes data on vaccination histories, health outcomes, and characteristics of more than 7 million patients of eight participating health organizations. Researchers from CDC and the managed care groups have used VSD information to study whether health problems are associated with vaccinations. The subsequent VSD data sharing program was launched in 2002 to allow independent, external researchers access to information in the database. In this report, the committee that was asked to review aspects of this program recommends that two new oversight groups are needed to ensure that the policies and procedures of the VSD and its data sharing program are implemented as fairly and openly as possible.
To battle the obesity epidemic in America, health care professionals and policymakers need relevant, useful data on the effectiveness of obesity prevention policies and programs. Bridging the Evidence Gap in Obesity Prevention identifies a new approach to decision making and research on obesity prevention to use a systems perspective to gain a broader understanding of the context of obesity and the many factors that influence it.
New drugs, new devices, improved surgical techniques, and innovative diagnostic procedures and equipment emerge rapidly. But development of these technologies has outpaced evaluation of their safety, efficacy, cost-effectiveness, and ethical and social consequences. This volume, which is "strongly recommended" by The New England Journal of Medicine "to all those interested in the future of the practice of medicine," examines how new discoveries can be translated into better care, and how the current system's inefficiencies prevent effective health care delivery. In addition, the book offers detailed profiles of 20 organizations currently involved in medical technology assessment, and proposes ways to organize U.S. efforts and create a coordinated national system for evaluating new medical treatments and technology.
This volume examines the current state of knowledge concerning the influence of a hot environment on nutrient requirements of military personnel. A parallel concern is ensuring that performance does not decline as a result of inadequate nutrition. The committee provides a thorough review of the literature in this area and interprets the diverse data in terms of military applications. In addition to a focus on specific nutrient needs in hot climates, the committee considers factors that might change food intake patterns and therefore overall calories. Although concern for adequate nutrition for U.S. soldiers in Saudi Arabia prompted the initiation of this project, its scope includes the nutrient needs of individuals who may be actively working in both hot-dry and hot-moist climates.
This report from the second Strategic Highway Research Program (SHRP 2), which is administered by the Transportation Research Board of the National Academies, identifies strategies that have been successfully used to expedite the planning and environmental review of transportation projects within the context of existing laws and regulations. It discusses 16 common constraints on project delivery and 24 strategies for addressing or avoiding them. While the strategies are associated with planning and environmental review, many are also applicable to design and construction.
It's obvious why only men develop prostate cancer and why only women get ovarian cancer. But it is not obvious why women are more likely to recover language ability after a stroke than men or why women are more apt to develop autoimmune diseases such as lupus. Sex differences in health throughout the lifespan have been documented. Exploring the Biological Contributions to Human Health begins to snap the pieces of the puzzle into place so that this knowledge can be used to improve health for both sexes. From behavior and cognition to metabolism and response to chemicals and infectious organisms, this book explores the health impact of sex (being male or female, according to reproductive organs and chromosomes) and gender (one's sense of self as male or female in society). Exploring the Biological Contributions to Human Health discusses basic biochemical differences in the cells of males and females and health variability between the sexes from conception throughout life. The book identifies key research needs and opportunities and addresses barriers to research. Exploring the Biological Contributions to Human Health will be important to health policy makers, basic, applied, and clinical researchers, educators, providers, and journalists-while being very accessible to interested lay readers.
The National Institute for Occupational Safety and Health (NIOSH) was established by the Occupational Safety and Health Act of 1970 (U.S. Congress, 1970). Today the agency is part of the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services. NIOSH is charged with the responsibility to "conduct . . . research, experiments, and demonstrations relating to occupational safety and health" and to develop "innovative methods, techniques, and approaches for dealing with [those] problems" (U.S. Congress, 1970). Its research targets include identifying criteria for use in setting worker exposure standards and exploring new problems that may arise in the workplace. Prevention of occupational hearing loss has been part of the NIOSH research portfolio from the time the agency was established. A principal cause of occupational hearing loss is the cumulative effect of years of exposure to hazardous noise. Exposure to certain chemicals with or without concomitant noise exposure may also contribute to occupational hearing loss. Hearing loss may impede communication in the workplace and contribute to safety hazards. Occupationally acquired hearing loss may also have an adverse effect on workers' lives beyond the workplace. No medical means are currently available to prevent or reverse it, although hearing aids are widely used and research on other treatments is ongoing. Occupational hearing loss is a serious concern, although the number of workers affected is uncertain. In September 2004, NIOSH requested that the National Academies conduct reviews of as many as 15 NIOSH programs with respect to the impact and relevance of their work in reducing workplace injury and illness and to identify future directions that their work might take. The Hearing Loss Research Program was selected by NIOSH as one of the first two programs to be reviewed. Hearing Loss Research at NIOSH examines the following issues for the Hearing Loss Research Program: (1) Progress in reducing workplace illness and injuries through occupational safety and health research, assessed on the basis of an analysis of relevant data about workplace illnesses and injuries and an evaluation of the effect that NIOSH research has had in reducing illness and injuries, (2) Progress in targeting new research to the areas of occupational safety and health most relevant to future improvements in workplace protection, and (3) Significant emerging research areas that appear especially important in terms of their relevance to the mission of NIOSH.
Decision science offers powerful insights and techniques that help people make better decisions to improve business and society. This new volume brings together the peer-reviewed papers that have been chosen as the "best of the best" by the field's leading organization, the Decision Sciences Institute. These papers, authored by respected decision science researchers and academics from around the world, will be presented at DSI's 45th Annual Meeting in Tampa, Florida in November 2014. The first book of papers ever assembled by DSI, this volume describes recent methods and approaches in the decision sciences, with a special focus on how accelerating technological innovation is driving change in the ways organizations and individuals make decisions. These papers offer actionable insights for decision-makers of all kinds, in business, public policy, non-profit organizations, and beyond. They also point to new research directions for academic researchers in decision science worldwide.
At the request of the National Institute of Standards and Technology (NIST), the National Academies of Sciences, Engineering, and Medicine has, since 1959, annually assembled panels of experts from academia, industry, medicine, and other scientific and engineering communities to assess the quality and effectiveness of the NIST measurements and standards laboratories, of which there are now seven, as well as the adequacy of the laboratories’ resources. An Assessment of the National Institute of Standards and Technology Center for Nanoscale Science and Technology: Fiscal Year 2016 assesses the scientific and technical work performed by the NIST Center for Nanoscale Science and Technology and the accomplisments, challenges, and opportunities for improvement.
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