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The Prevention and Treatment of Missing Data in Clinical Trials
  • Language: en
  • Pages: 163

The Prevention and Treatment of Missing Data in Clinical Trials

Randomized clinical trials are the primary tool for evaluating new medical interventions. Randomization provides for a fair comparison between treatment and control groups, balancing out, on average, distributions of known and unknown factors among the participants. Unfortunately, these studies often lack a substantial percentage of data. This missing data reduces the benefit provided by the randomization and introduces potential biases in the comparison of the treatment groups. Missing data can arise for a variety of reasons, including the inability or unwillingness of participants to meet appointments for evaluation. And in some studies, some or all of data collection ceases when participa...

The Growth of Incarceration in the United States
  • Language: en
  • Pages: 800

The Growth of Incarceration in the United States

  • Categories: Law

After decades of stability from the 1920s to the early 1970s, the rate of imprisonment in the United States has increased fivefold during the last four decades. The U.S. penal population of 2.2 million adults is by far the largest in the world. Just under one-quarter of the world's prisoners are held in American prisons. The U.S. rate of incarceration, with nearly 1 out of every 100 adults in prison or jail, is 5 to 10 times higher than the rates in Western Europe and other democracies. The U.S. prison population is largely drawn from the most disadvantaged part of the nation's population: mostly men under age 40, disproportionately minority, and poorly educated. Prisoners often carry additi...

Intelligence Analysis for Tomorrow
  • Language: en
  • Pages: 116

Intelligence Analysis for Tomorrow

The intelligence community (IC) plays an essential role in the national security of the United States. Decision makers rely on IC analyses and predictions to reduce uncertainty and to provide warnings about everything from international diplomatic relations to overseas conflicts. In today's complex and rapidly changing world, it is more important than ever that analytic products be accurate and timely. Recognizing that need, the IC has been actively seeking ways to improve its performance and expand its capabilities. In 2008, the Office of the Director of National Intelligence (ODNI) asked the National Research Council (NRC) to establish a committee to synthesize and assess evidence from the...

To Err Is Human
  • Language: en
  • Pages: 312

To Err Is Human

Experts estimate that as many as 98,000 people die in any given year from medical errors that occur in hospitals. That's more than die from motor vehicle accidents, breast cancer, or AIDSâ€"three causes that receive far more public attention. Indeed, more people die annually from medication errors than from workplace injuries. Add the financial cost to the human tragedy, and medical error easily rises to the top ranks of urgent, widespread public problems. To Err Is Human breaks the silence that has surrounded medical errors and their consequenceâ€"but not by pointing fingers at caring health care professionals who make honest mistakes. After all, to err is human. Instead, this book se...

Crossing the Quality Chasm
  • Language: en
  • Pages: 359

Crossing the Quality Chasm

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 perfor...

Climate and Social Stress
  • Language: en
  • Pages: 253

Climate and Social Stress

Climate change can reasonably be expected to increase the frequency and intensity of a variety of potentially disruptive environmental events-slowly at first, but then more quickly. It is prudent to expect to be surprised by the way in which these events may cascade, or have far-reaching effects. During the coming decade, certain climate-related events will produce consequences that exceed the capacity of the affected societies or global systems to manage; these may have global security implications. Although focused on events outside the United States, Climate and Social Stress: Implications for Security Analysis recommends a range of research and policy actions to create a whole-of-government approach to increasing understanding of complex and contingent connections between climate and security, and to inform choices about adapting to and reducing vulnerability to climate change.

Explaining Divergent Levels of Longevity in High-Income Countries
  • Language: en
  • Pages: 200

Explaining Divergent Levels of Longevity in High-Income Countries

During the last 25 years, life expectancy at age 50 in the United States has been rising, but at a slower pace than in many other high-income countries, such as Japan and Australia. This difference is particularly notable given that the United States spends more on health care than any other nation. Concerned about this divergence, the National Institute on Aging asked the National Research Council to examine evidence on its possible causes. According to Explaining Divergent Levels of Longevity in High-Income Countries, the nation's history of heavy smoking is a major reason why lifespans in the United States fall short of those in many other high-income nations. Evidence suggests that curre...

Communities in Action
  • Language: en
  • Pages: 583

Communities in Action

In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape...

Unequal Treatment
  • Language: en
  • Pages: 781

Unequal Treatment

Racial and ethnic disparities in health care are known to reflect access to care and other issues that arise from differing socioeconomic conditions. There is, however, increasing evidence that even after such differences are accounted for, race and ethnicity remain significant predictors of the quality of health care received. In Unequal Treatment, a panel of experts documents this evidence and explores how persons of color experience the health care environment. The book examines how disparities in treatment may arise in health care systems and looks at aspects of the clinical encounter that may contribute to such disparities. Patients' and providers' attitudes, expectations, and behavior ...