For award-winning science writer and photographer Margie Patlak, exploring the unique nature of the Maine coast opens a door to deeper ties and insights. This collection of photographs conveys the sublime sense of wonder she feels every time she visits the shore. Tides show how fleeting time is, and clouds and weather reveal greater forces that take away all illusions of control. These facets of the natural world speak a hidden language of light and color that Patlak translates with her lens. “This book made me want to experience first-hand what each of its exquisite images excited in my heart. This is not just a book, but a stunning work of art that transports the reader to the magical shores of Maine. Each photo sublimely illuminates Maine’s natural gifts to the world, be it rocky shoreline, lush woods, or fall colors. The great eye of the photographer captures both delicate details in a leaf and sweeping panoramas of shoreline and sky with equal skill, while imparting awe and a deep reverence for this sacred place.” —Steve Mandel, award-winning nature photographer whose images were displayed in the Smithsonian Natural History Museum and have appeared in the New York Times, Reader’s Digest, and many other publications. “Margie Patlak’s photographs so perfectly embody everything I adore about the coastal Maine landscape. She has remarkable talent for elevating Maine’s nuanced, natural majesty.” —Eliot Dudik, photography instructor at the College of William & Mary and award-winning photographer who has been featured in Smithsonian Magazine, the New York Times, and other publications. “Margie Patlak’s explorations of coastal Maine span scales from minuscule mushrooms of the forest floor to grand sweeps of sunrise and sunset and reveal luscious hues like autumn crimson and winter pewter. Patlak’s photographic vision distills what she calls “astonishing Maine moments” into light, islands, rocks, forests, and other elemental features. Her sparkling, compact essays introducing each section also add a science writer’s depth to the breadth of Maine landscapes, great and small.” —Award-winning photographer Lynn Teo Simarski “Wander Maine’s coast with Margie Patlak to share her open-hearted delight in all nature bestows here. Lifted from ordinary constructed, and sometimes constricted, realities, your senses will awaken to worlds of vibrant light, color and life. This immersion in nature’s resplendent designs will rekindle your sense of wonder and resettle you in creation.” —Barbara Southworth, photography workshop leader and mentor, and award-winning photographer of plants and wild places.
Winner of the American Society of Journalists and Authors Award in the memoir/autobiography category! For award-winning science writer Margie Patlak, exploring the unique nature of the Maine coast opens a door to deeper ties and insights. Watching a striped monarch caterpillar transform into a chartreuse pendant dabbed with gold, she realizes the limits of life and what is passed between generations. Tides show how fleeting time is, and clouds and weather reveal greater forces that take away all illusions of control. She also explores the continental collisions that thrust up and fractured Maine’s mountains; digs into the latest scientific thinking on how animals navigate; and exults in the dizzy dance of plankton under the microscope. Even moose, fox, and fishers reveal more than meets the eye.These facets of the natural world speak a hidden language Patlak translates with her scientific knowledge and reflection. Nature begins to speak about the nature of life.
Winner of the American Society of Journalists and Authors Award in the memoir/autobiography category! For award-winning science writer Margie Patlak, exploring the unique nature of the Maine coast opens a door to deeper ties and insights. Watching a striped monarch caterpillar transform into a chartreuse pendant dabbed with gold, she realizes the limits of life and what is passed between generations. Tides show how fleeting time is, and clouds and weather reveal greater forces that take away all illusions of control. She also explores the continental collisions that thrust up and fractured Maine’s mountains; digs into the latest scientific thinking on how animals navigate; and exults in the dizzy dance of plankton under the microscope. Even moose, fox, and fishers reveal more than meets the eye.These facets of the natural world speak a hidden language Patlak translates with her scientific knowledge and reflection. Nature begins to speak about the nature of life.
For award-winning science writer and photographer Margie Patlak, exploring the unique nature of the Maine coast opens a door to deeper ties and insights. This collection of photographs conveys the sublime sense of wonder she feels every time she visits the shore. Tides show how fleeting time is, and clouds and weather reveal greater forces that take away all illusions of control. These facets of the natural world speak a hidden language of light and color that Patlak translates with her lens. “This book made me want to experience first-hand what each of its exquisite images excited in my heart. This is not just a book, but a stunning work of art that transports the reader to the magical shores of Maine. Each photo sublimely illuminates Maine’s natural gifts to the world, be it rocky shoreline, lush woods, or fall colors. The great eye of the photographer captures both delicate details in a leaf and sweeping panoramas of shoreline and sky with equal skill, while imparting awe and a deep reverence for this sacred place.” —Steve Mandel, award-winning nature photographer whose images were displayed in the Smithsonian Natural History Museum and have appeared in the New York Times, Reader’s Digest, and many other publications. “Margie Patlak’s photographs so perfectly embody everything I adore about the coastal Maine landscape. She has remarkable talent for elevating Maine’s nuanced, natural majesty.” —Eliot Dudik, photography instructor at the College of William & Mary and award-winning photographer who has been featured in Smithsonian Magazine, the New York Times, and other publications. “Margie Patlak’s explorations of coastal Maine span scales from minuscule mushrooms of the forest floor to grand sweeps of sunrise and sunset and reveal luscious hues like autumn crimson and winter pewter. Patlak’s photographic vision distills what she calls “astonishing Maine moments” into light, islands, rocks, forests, and other elemental features. Her sparkling, compact essays introducing each section also add a science writer’s depth to the breadth of Maine landscapes, great and small.” —Award-winning photographer Lynn Teo Simarski “Wander Maine’s coast with Margie Patlak to share her open-hearted delight in all nature bestows here. Lifted from ordinary constructed, and sometimes constricted, realities, your senses will awaken to worlds of vibrant light, color and life. This immersion in nature’s resplendent designs will rekindle your sense of wonder and resettle you in creation.” —Barbara Southworth, photography workshop leader and mentor, and award-winning photographer of plants and wild places.
To explore whether soccer playing puts youths at risk for lasting brain damage, the Institute of Medicine brought together experts in head injury, sports medicine, pediatrics, and bioengineering. In a workshop entitled "Youth Soccer: Neuropsychological Consequences of Head Impact in Sports," that was held in Washington D.C. on October 12, 2001, these experts presented the scientific evidence for long-term consequences of head injury from youth sports, especially soccer, possible approaches to reduce the risks, and policy issues raised by the subject. Some of the findings presented by the speakers raised concerns, such as the high concussion rate of high school soccer players, the frequent persistence of impaired brain functions even after other symptoms of a concussion disappear, and the need for a better understanding of when it is safe for players to resume playing after they have had a concussion. But other findings were reassuring, such as studies that suggest that with the type of soccer balls used in the United States, heading is not likely to cause brain injury in youths, nor is playing soccer likely to cause permanent brain damage. This is a summary of the reports from these experts in the field, and the lively discussions that followed them. Topics covered include: causes of head injuries in soccer; how to detect a concussion; the biology of concussion; studies of soccer and football players; the role of protective headgear; and policy implications, such as how to decide when a concussed player should be allowed to return to the playing field.
Global Health Systems: Comparing Strategies for Delivering Health Services is a comprehensive overview of healthcare access and delivery in 11 developing and industrialized countries. This accessible text is designed for undergraduate and beginning graduate students in various health-related disciplines. Global Health Systems offers rich and diverse real-life case scenarios, analysis of healthcare systems in an international context, and an innovative Eight Factor Model for healthcare system evaluation. The texts integrated approach and synthesis-based organizational framework challenges learners to develop their own strategies for analysis and envision creative solutions to current healthcare crises.
The public health burden from lung cancer is substantial: it is the second most commonly diagnosed cancer and the leading cause of cancer-related deaths in the United States. Given the individual and population health burden of lung cancer, especially when it is diagnosed at later stages, there has been a push to develop and implement screening strategies for early detection. However, many factors need to be considered for broad implementation of lung cancer screening in clinical practice. Effective implementation will entail understanding the balance of potential benefits and harms of lung cancer screening, defining and reaching eligible populations, addressing health disparities, and many more considerations. In recognition of the substantial challenges to developing effective lung cancer screening programs in clinical practice, the National Academies of Sciences, Engineering, and Medicine held a workshop in June 2016. At the workshop, experts described the current evidence base for lung cancer screening, the current challenges of implementation, and opportunities to overcome them. Workshop participants also explored capacity and access issues; best practices for screening programs; assessment of patient outcomes, quality, and value in lung cancer screening; and research needs that could improve implementation efforts. This publication summarizes the presentations and discussions from the workshop.
The IOM's National Cancer Policy Forum held a workshop October 5-6, 2009, to examine how to apply the concept of a 'rapid learning health system' to the problem of cancer. This document summarizes the workshop.
Rising health care costs are a central fiscal challenge confronting the United States. National spending on health care currently accounts for 18 percent of gross domestic product (GDP), but is anticipated to increase to 25 percent of GDP by 2037. The Bipartisan Policy Center argues that "this rapid growth in health expenditures creates an unsustainable burden on America's economy, with far-reaching consequences". These consequences include crowding out many national priorities, including investments in education, infrastructure, and research; stagnation of employee wages; and decreased international competitiveness.In spite of health care costs that far exceed those of other countries, health outcomes in the United States are not considerably better. With the goal of ensuring that patients have access to high-quality, affordable cancer care, the Institute of Medicine's (IOM's) National Cancer Policy Forum convened a public workshop, Delivering Affordable Cancer Care in the 21st Century, October 8-9, 2012, in Washington, DC. Delivering Affordable Cancer Care in the 21st Century summarizes the workshop.
The NCI-sponsored cooperative groups have made important contributions to improving treatment for many types of cancer, including breast, ovarian, colorectal, and childhood cancers. Cooperative group research has been instrumental in establishing innovative treatments that improve outcomes and quality of life. Despite these successes, the Cooperative Group Program has faced a number of challenges that threaten its effectiveness. To address this problem, the National Cancer Policy Forum (NCPF) convened a workshop titled "Multi-Center Phase III Clinical Trials and NCI Cooperative Groups" in Washington, DC, on July 1-2, 2008. The purpose of the workshop was to outline the challenges that the public clinical cancer research enterprise faces, and to identify possible solutions to these challenges.
To explore whether soccer playing puts youths at risk for lasting brain damage, the Institute of Medicine brought together experts in head injury, sports medicine, pediatrics, and bioengineering. In a workshop entitled "Youth Soccer: Neuropsychological Consequences of Head Impact in Sports," that was held in Washington D.C. on October 12, 2001, these experts presented the scientific evidence for long-term consequences of head injury from youth sports, especially soccer, possible approaches to reduce the risks, and policy issues raised by the subject. Some of the findings presented by the speakers raised concerns, such as the high concussion rate of high school soccer players, the frequent persistence of impaired brain functions even after other symptoms of a concussion disappear, and the need for a better understanding of when it is safe for players to resume playing after they have had a concussion. But other findings were reassuring, such as studies that suggest that with the type of soccer balls used in the United States, heading is not likely to cause brain injury in youths, nor is playing soccer likely to cause permanent brain damage. This is a summary of the reports from these experts in the field, and the lively discussions that followed them. Topics covered include: causes of head injuries in soccer; how to detect a concussion; the biology of concussion; studies of soccer and football players; the role of protective headgear; and policy implications, such as how to decide when a concussed player should be allowed to return to the playing field.
Many ongoing changes are likely to have an impact on cancer research and care. For example, technological advances are rapidly changing the way cancer research is conducted, and the recently passed healthcare reform legislation has many implications for cancer care. Technological advances are altering the way cancer research is conducted and cancer care is delivered, and the recently passed healthcare reform legislation has many implications for cancer care. There is a growing emphasis on molecularly targeted therapies, information technology (IT), and patient-centered care, and clinical cancer research has become a global endeavor. At the same time, there are concerns about shrinking research budgets and escalating costs of cancer care. Considering such changes, the National Cancer Policy Forum (NCPF) of the Institute of Medicine held a National Cancer Policy Summit on October 25, 2010. The Summit convened key leaders in the cancer community to identify and discuss the most pressing policy issues in cancer research and cancer care. The National Cancer Policy Summit: Opportunities and Challenges in Cancer Research and Care is a summary of the summit. The report explores policy issues related to cancer research, the implementation of healthcare reform, delivery of cancer care, and cancer control and public health needs. Expert participants suggested many potential actions to provide patient-centered cancer care, to foster more collaboration, and to achieve other goals to improve research and care.
Despite spending more time and money in developing novel therapeutics, the success rate for new pharmacologic treatments has been poor. Although the research and development expenditures have grown 13 percent each year since 1970 (a 50-fold increase), the number of new drugs approved annually is no greater now than it was 50 years ago. Over the past decade, skyrocketing costs and the complexity of the scientific knowledge upon which to develop new agents have provided incentives for alternative approaches to drug development, if we are to continue to improve clinical care and reduce mortality. These challenges create opportunities for improved collaboration between industry, academia, government, and philanthropic organizations at each stage in new drug development, marketing, and implementation. Perhaps the most appropriate initial step in addressing the need for collaboration is to consider more precompetitive relationships that allow sharing of scientific information to foster drug development. While these collaborative relationships in basic and preclinical research on drug targets and the early stages of clinical testing are acknowledged to be potentially important drivers for innovation and more rapid marketing of new agents, they also raise a number of concerns that must be addressed. For example, acknowledgment of academic productivity and independence and economic competitiveness must be considered and these challenges managed to foster a culture of collaboration. At the same time, regulatory issues, the need for standardization, and intellectual property concerns must be confronted if the current models for drug development are to be refined to encourage robust participation in precompetitive collaborations. Recognizing the growing importance of precompetitive collaborations in oncology drug development, as well as the challenges these innovative collaborations pose, the National Cancer Policy Forum of the Institute of Medicine held a workshop on February 9 and 10, 2010. This book is a summary of the workshop proceedings.
One of the challenges in treating cancer is the disease's complexity and variation among patients. Cancer manifests differently in each patient, so treatments that are effective in one patient may not be effective in another. As cancer care becomes more personalized, subpopulations of individuals will be given preventive or therapeutic interventions based on their susceptibility to a particular disease or their predicted response to a specific treatment. However, before the use of personalized cancer care can reach its full potential, the health care system must resolve a number of technological, regulatory, and reimbursement issues. To explore these policy challenges, the National Cancer Policy Forum held the workshop Policy Issues in the Development of Personalized Medicine in Oncology in June 2009. Experts provided presentations on the current state of personalized medicine technology, as well as issues in the validation of, regulation of, and reimbursement for the predictive tests that underpin personalized medicine. Participants discussed the obstacles and possible solutions to further developing and using personalized medicine technologies. This document summarizes the workshop.
Scientists and clinicians seek a new paradigm that could improve the efficiency, cost-effectiveness, and overall success rate of cancer clinical trials, while maintaining the highest standards of quality. To explore innovative paradigms for cancer clinical trials and other ways to improve their quality, the National Cancer Policy Forum held a workshop, Improving the Quality of Cancer Clinical Trials, in Washington, DC. The main goals of the workshop were to examine new approaches to clinical trial design and execution that would: (1) better inform decisions and plans of those responsible for developing new cancer therapies (2) more rapidly move new diagnostic tests and treatments toward regulatory approval and use in the clinic (3) be less costly than current trials The resulting workshop summary will serve as input to the deliberations of an Institute of Medicine committee that will develop consensus-based recommendations for moving the field of cancer clinical trials forward.
Tobacco use is the leading cause of preventable death in United States, causing more than 440,000 deaths annually and resulting in $193 billion in health-related economic losses each year--$96 billion in direct medical costs and $97 billion in lost productivity. Since the first U.S. Surgeon General's report on smoking in 1964, more than 29 Surgeon General's reports, drawing on data from thousands of studies, have documented the overwhelming and conclusive biologic, epidemiologic, behavioral, and pharmacologic evidence that tobacco use is deadly. This evidence base links tobacco use to the development of multiple types of cancer and other life-threatening conditions, including cardiovascular and respiratory diseases. Smoking accounts for at least 30 percent of all cancer deaths, and 80 percent of lung cancer deaths. Despite the widespread agreement on the dangers of tobacco use and considerable success in reducing tobacco use prevalence from over 40 percent at the time of the 1964 Surgeon General's report to less than 20 percent today, recent progress in reducing tobacco use has slowed. An estimated 18.9 percent of U.S. adults smoke cigarettes, nearly one in four high school seniors smoke, and 13 percent of high school males use smokeless tobacco products. In recognition that progress in combating cancer will not be fully achieved without addressing the tobacco problem, the National Cancer Policy Forum of the Institute of Medicine (IOM) convened a public workshop, Reducing Tobacco-Related Cancer Incidence and Mortality, June 11-12, 2012 in Washington, DC. In opening remarks to the workshop participants, planning committee chair Roy Herbst, professor of medicine and of pharmacology and chief of medical oncology at Yale Cancer Center and Smilow Cancer Hospital, described the goals of the workshop, which were to examine the current obstacles to tobacco control and to discuss potential policy, outreach, and treatment strategies that could overcome these obstacles and reduce tobacco-related cancer incidence and mortality. Experts explored a number of topics, including: the changing demographics of tobacco users and the changing patterns of tobacco product use; the influence of tobacco use on cancer incidence and cancer treatment outcomes; tobacco dependence and cessation programs; federal and state level laws and regulations to curtail tobacco use; tobacco control education, messaging, and advocacy; financial and legal challenges to tobacco control efforts; and research and infrastructure needs to support tobacco control strategies, reduce tobacco related cancer incidence, and improve cancer patient outcomes. Reducing Tobacco-Related Cancer Incidence and Mortality summarizes the workshop.
Advances in biomedical research have increased our understanding of the complex nature of disease and the interaction of multiple molecular pathways involved in cancer. Combining investigational products early in their development is thought to be a promising strategy for identifying effective therapies. The IOM's National Cancer Policy Forum held a workshop to discuss challenges and identify potential solutions to improve collaboration and advance the development of combination investigational cancer therapies.
In recent years, the field of oncology has witnessed a number of technological advances, including more precise radiation therapy and minimally invasive surgical techniques. Three-dimensional (3D), stereotactic, and proton-beam radiation therapy, as well as laparoscopy and robotic surgery, can enhance clinician's ability to treat conditions that were clinically challenging with conventional technologies, and may improve clinical outcomes or reduce treatment-related problems for some patients. Both patients and physicians seek access to these new technologies, which are rapidly being adopted into standard clinical practice. Such demand is often propelled by marketing that portrays the new technologies as the "latest and greatest" treatments available. However, evidence is often lacking to support these claims, and these novel technologies usually come with higher price tags and are often used to treat patients who might have achieved similar benefits from less expensive, conventional treatment. The increased cost of novel treatments without adequate assessment of how they affect patient outcomes is a pressing concern given that inappropriate use of expensive technologies is one of the key factors that threaten the affordability of cancer care in the United States. To explore these issues further, the National Cancer Policy Forum (NCPF) of the Institute of Medicine organized a workshop in July 2015. This is the third NCPF workshop in a series examining the affordability of cancer care. Participants explored clinical benefits and comparative effectiveness of emerging advanced technologies for cancer treatment in radiation therapy and surgery and potential strategies to assess the value and promote optimal use of new technologies in cancer treatment. This report summarizes the presentations and discussions from the workshop.
Research has long sought to identify biomarkers that could detect cancer at an early stage, or predict the optimal cancer therapy for specific patients. Fueling interest in this research are recent technological advances in genomics, proteomics, and metabolomics that can enable researchers to capture the molecular fingerprints of specific cancers and fine-tune their classification according to the molecular defects they harbor. The discovery and development of new markers of cancer could potentially improve cancer screening, diagnosis, and treatment. Given the potential impact cancer biomarkers could have on the cost effectiveness of cancer detection and treatment, they could profoundly alter the economic burden of cancer as well. Despite the promise of cancer biomarkers, few biomarker-based cancer tests have entered the market, and the translation of research findings on cancer biomarkers into clinically useful tests seems to be lagging. This is perhaps not surprising given the technical, financial, regulatory, and social challenges linked to the discovery, development, validation, and incorporation of biomarker tests into clinical practice. To explore those challenges and ways to overcome them, the National Cancer Policy Forum held the conference "Developing Biomarker-Based Tools for Cancer Screening, Diagnosis and Treatment: The State of the Science, Evaluation, Implementation, and Economics" in Washington, D.C., from March 20 to 22, 2006. At this conference, experts gave presentations in one of six sessions. In addition, seven small group discussions explored the policy implications surrounding biomarker development and adoption into clinical practice. Developing Biomarker-based Tools for Developing Cancer Screening, Diagnosis, and Treatment: The State of the Science, Evaluation, Implementation, and Economics-Workshop Summary presents the conference proceedings and will be used by an Institute of Medicine (IOM) committee to develop consensus-based recommendations for moving the field of cancer biomarkers forward.
The IOM's National Cancer Policy Board estimated in 2003 that even modest efforts to implement known tactics for cancer prevention and early detection could result in up to a 29 percent drop in cancer deaths in about 20 years. The IOM's National Cancer Policy Forum, which succeeded the Board after it was disbanded in 2005, continued the Board's work to outline ways to increase screening in the U.S. On February 25 and 26, 2008, the Forum convened a workshop to discuss screening for colorectal cancer. Colorectal cancer screening remains low, despite strong evidence that screening prevents deaths. With the aim to make recommended colorectal cancer screening more widespread, the workshop discussed steps to be taken at the clinic, community, and health system levels. Workshop speakers, representing a broad spectrum of leaders in the field, identified major barriers to increased screening and described strategies to overcome these obstacles. This workshop summary highlights the information presented, as well as the subsequent discussion about actions needed to increase colorectal screening and, ultimately, to prevent more colorectal cancer deaths.
The National Cancer Policy Forum of the National Academies of Sciences, Engineering, and Medicine held a public workshop, Incorporating Weight Management and Physical Activity Throughout the Cancer Care Continuum, on February 13 and 14, 2017, in Washington, DC. The purpose of this workshop was to highlight the current evidence base, gaps in knowledge, and research needs on the associations among obesity, physical activity, weight management, and health outcomes for cancer survivors, as well as to examine the effectiveness of interventions for promoting physical activity and weight management among people living with or beyond cancer. Workshop sessions also reviewed the opportunities and challenges for providing weight management and physical activity interventions to cancer survivors. This publication summarizes the presentations and discussions from the workshop.
Recent research suggests that obesity and excess weight can play a prominent role in the incidence and progression of various cancers. Obesity results from an energy imbalance - that is, energy intake that is higher than energy expenditure - could also influence the growth of cancers. Recognizing the impact that current findings on obesity and cancer could have on future cancer prevention and care, the National Cancer policy Forum (NCPF) of the Institute of Medicine (IOM) help a 2-day workshop on "The Role of Obesity in Cancer Survival and Recurrence," in Washington, DC, on October 31 and November 1, 2011. The Role of Obesity in Cancer Survival and Recurrence: Workshop Summary reviews each presenter's latest clinical evidence on the obesity-cancer link and the molecular mechanisms that might explain that link. Clinicians, researchers, cancer survivors, and policy makers also discussed potential interventions to counter the effects of obesity on cancer, and research and policy measures needed to stem the rising tide of cancer mortality predicted by an increasingly overweight and older population worldwide. The Role of Obesity in Cancer Survival and Recurrence: Workshop Summary explores the complex web of molecular mechanisms that underlie the obesity-cancer link, the ways to design future studies to acquire the information needed to guide patient care, what to advise cancer patients about weight loss, diet, exercise, and other measures to reduce their risk of cancer progression or recurrence and policy suggestions related to research, education, and dissemination of the findings on obesity and cancer.
One way scientists are working to overcome challenges in cancer treatment and improve cancer care is through nanotechnology. Nanotechnology, engineered materials that make use of the unique physical properties, presents a new array of medical prospects that will revolutionize cancer prevention, diagnosis, and treatment practices. Giving new hope to patients, practitioners, and researchers alike, nanotechnology has the potential to translate recent discoveries in cancer biology into clinical advances in oncology. While public investments in nanotechnology for cancer continue to increase, medical products based on nanotechnology are already on the market. The National Cancer Policy forum held a workshop July 12-13, 2010, to explore challenges in the use of nanotechnology in oncology. Nanotechnology and Oncology evaluates the ongoing discussion on the role of nanotechnology in cancer as it relates to risk management, treatment, and regulatory policy. Assessments on nanomedicine and the physical properties of nanomaterials were presented during the workshop, along with an appraisal of the current status of research and development efforts.
Advances in cancer research have led to an improved understanding of the molecular mechanisms underpinning the development of cancer and how the immune system responds to cancer. This influx of research has led to an increasing number and variety of therapies in the drug development pipeline, including targeted therapies and associated biomarker tests that can select which patients are most likely to respond, and immunotherapies that harness the body's immune system to destroy cancer cells. Compared with standard chemotherapies, these new cancer therapies may demonstrate evidence of benefit and clearer distinctions between efficacy and toxicity at an earlier stage of development. However, there is a concern that the traditional processes for cancer drug development, evaluation, and regulatory approval could impede or delay the use of these promising cancer treatments in clinical practice. This has led to a number of effortsâ€"by patient advocates, the pharmaceutical industry, and the Food and Drug Administration (FDA)â€"to accelerate the review of promising new cancer therapies, especially for cancers that currently lack effective treatments. However, generating the necessary data to confirm safety and efficacy during expedited drug development programs can present a unique set of challenges and opportunities. To explore this new landscape in cancer drug development, the National Academies of Sciences, Engineering, and Medicine developed a workshop held in December 2016. This workshop convened cancer researchers, patient advocates, and representatives from industry, academia, and government to discuss challenges with traditional approaches to drug development, opportunities to improve the efficiency of drug development, and strategies to enhance the information available about a cancer therapy throughout its life cycle in order to improve its use in clinical practice. This publication summarizes the presentations and discussions from the workshop.
Margie receives a golden opportunity to live her life over again beginning at age three. Her journey is filled with many pitfalls, much jocularity and an amazing amount of lessons. Will you follow her journey as she goes through all seven levels?
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