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In the United States, approximately 14 million people have had cancer and more than 1.6 million new cases are diagnosed each year. However, more than a decade after the Institute of Medicine (IOM) first studied the quality of cancer care, the barriers to achieving excellent care for all cancer patients remain daunting. Care often is not patient-centered, many patients do not receive palliative care to manage their symptoms and side effects from treatment, and decisions about care often are not based on the latest scientific evidence. The cost of cancer care also is rising faster than many sectors of medicine-having increased to $125 billion in 2010 from $72 billion in 2004-and is projected to reach $173 billion by 2020. Rising costs are making cancer care less affordable for patients and their families and are creating disparities in patients' access to high-quality cancer care. There also are growing shortages of health professionals skilled in providing cancer care, and the number of adults age 65 and older-the group most susceptible to cancer-is expected to double by 2030, contributing to a 45 percent increase in the number of people developing cancer. The current care delivery system is poorly prepared to address the care needs of this population, which are complex due to altered physiology, functional and cognitive impairment, multiple coexisting diseases, increased side effects from treatment, and greater need for social support. Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis presents a conceptual framework for improving the quality of cancer care. This study proposes improvements to six interconnected components of care: (1) engaged patients; (2) an adequately staffed, trained, and coordinated workforce; (3) evidence-based care; (4) learning health care information technology (IT); (5) translation of evidence into clinical practice, quality measurement and performance improvement; and (6) accessible and affordable care. This report recommends changes across the board in these areas to improve the quality of care. Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis provides information for cancer care teams, patients and their families, researchers, quality metrics developers, and payers, as well as HHS, other federal agencies, and industry to reevaluate their current roles and responsibilities in cancer care and work together to develop a higher quality care delivery system. By working toward this shared goal, the cancer care community can improve the quality of life and outcomes for people facing a cancer diagnosis.

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.

Cardiac arrest can strike a seemingly healthy individual of any age, race, ethnicity, or gender at any time in any location, often without warning. Cardiac arrest is the third leading cause of death in the United States, following cancer and heart disease. Four out of five cardiac arrests occur in the home, and more than 90 percent of individuals with cardiac arrest die before reaching the hospital. First and foremost, cardiac arrest treatment is a community issue - local resources and personnel must provide appropriate, high-quality care to save the life of a community member. Time between onset of arrest and provision of care is fundamental, and shortening this time is one of the best ways to reduce the risk of death and disability from cardiac arrest. Specific actions can be implemented now to decrease this time, and recent advances in science could lead to new discoveries in the causes of, and treatments for, cardiac arrest. However, specific barriers must first be addressed. Strategies to Improve Cardiac Arrest Survival examines the complete system of response to cardiac arrest in the United States and identifies opportunities within existing and new treatments, strategies, and research that promise to improve the survival and recovery of patients. The recommendations of Strategies to Improve Cardiac Arrest Survival provide high-priority actions to advance the field as a whole. This report will help citizens, government agencies, and private industry to improve health outcomes from sudden cardiac arrest across the United States.

The book is a treatment manual designed for mental health professionals who work with individuals presenting with moderate to severe forms of personality disorder. The book focuses on the broader group of patients with borderline personality organization, expanding the reach and utility of this volume.

Mitochondrial replacement techniques (MRTs) are designed to prevent the transmission of mitochondrial DNA (mtDNA) diseases from mother to child. While MRTs, if effective, could satisfy a desire of women seeking to have a genetically related child without the risk of passing on mtDNA disease, the technique raises significant ethical and social issues. It would create offspring who have genetic material from two women, something never sanctioned in humans, and would create mitochondrial changes that could be heritable (in female offspring), and therefore passed on in perpetuity. The manipulation would be performed on eggs or embryos, would affect every cell of the resulting individual, and once carried out this genetic manipulation is not reversible. Mitochondrial Replacement Techniques considers the implications of manipulating mitochondrial content both in children born to women as a result of participating in these studies and in descendants of any female offspring. This study examines the ethical and social issues related to MRTs, outlines principles that would provide a framework and foundation for oversight of MRTs, and develops recommendations to inform the Food and Drug Administration's consideration of investigational new drug applications.

This unique new guide integrates recent advances in the biopsychosocial understanding of chronic pain with state-of-the-art cognitive therapy and mindfulness techniques to offer a fresh, highly-effective MBCT approach to helping individuals manage chronic pain. - There is intense interest from clinicians, researchers and patients alike in mindfulness-based therapeutic techniques, and the integration of mindfulness theory and practice with CBT - Provides everything a therapist needs to integrate MBCT into their practice and optimize its delivery, including a manualized 8-session program and guidance on how to teach MBCT skills - Features case studies and real-world examples that help practitioners to avoid common pitfalls and optimize the delivery of MBCT for chronic pain for their own individual clients - Features links to guided meditations, client and therapist handouts and other powerful tools

Obesity poses one of the greatest public health challenges of the 21st century, creating serious health, economic, and social consequences for individuals and society. Despite acceleration in efforts to characterize, comprehend, and act on this problem, including implementation of preventive interventions, further understanding is needed on the progress and effectiveness of these interventions. Evaluating Obesity Prevention Efforts develops a concise and actionable plan for measuring the nation's progress in obesity prevention efforts-specifically, the success of policy and environmental strategies recommended in the 2012 IOM report Accelerating Progress in Obesity Prevention: Solving the Weight of the Nation . This book offers a framework that will provide guidance for systematic and routine planning, implementation, and evaluation of the advancement of obesity prevention efforts. This framework is for specific use with the goals and strategies from the 2012 report and can be used to assess the progress made in every community and throughout the country, with the ultimate goal of reducing the obesity epidemic. It offers potentially valuable guidance in improving the quality and effect of the actions being implemented. The recommendations of Evaluating Obesity Prevention Efforts focus on efforts to increase the likelihood that actions taken to prevent obesity will be evaluated, that their progress in accelerating the prevention of obesity will be monitored, and that the most promising practices will be widely disseminated.

This clinical manual provides a CBT-based psychosocial intervention for use with individuals distressed about their appearance due to a disfigurement from birth, accident or illness, or those coping with another visible difference.   * Contains a wealth of case material with specific relevance to physical health conditions that affect appearance, practical advice on assessment, and session-by-session guidance for addressing common issues * Written by leading academics and clinicians working in the management of disfigurement and rational appearance anxiety * Uses a flexible stepped-care model that allows for use by experienced CBT practitioners as well those wishing to deliver a more basic psychological intervention * Identifies the psychological factors involved in appearance anxiety while also addressing the practical concerns of living with a visible difference, such as managing the reactions of others

While iconic popular images celebrated family life during the 1950s and 1960s, American families were simultaneously regarded as potentially menacing sources of social disruption. The history of family therapy makes the complicated power of the family at midcentury vividly apparent. Clinicians developed a new approach to psychotherapy that claimed to locate the cause and treatment of mental illness in observable patterns of family interaction and communication rather than in individual psyches. Drawing on cybernetics, systems theory, and the social and behavioral sciences, they ambitiously aimed to cure schizophrenia and stop juvenile delinquency. With particular sensitivity to the importance of scientific observation and visual technologies such as one-way mirrors and training films in shaping the young field,The Pathological Familyexamines how family therapy developed against the intellectual and cultural landscape of postwar America. As Deborah Weinstein shows, the midcentury expansion of America's therapeutic culture and the postwar fixation on family life profoundly affected one another. Family therapists and other postwar commentators alike framed the promotion of democracy in the language of personality formation and psychological health forged in the crucible of the family. As therapists in this era shifted their clinical gaze to whole families, they nevertheless grappled in particular with the role played by mothers in the onset of their children's aberrant behavior. Although attitudes toward family therapy have shifted during intervening generations, the relations between family and therapeutic culture remain salient today.

This scientific book aims to introduce nuclear medicine to a larger audience, pointing out, among other things, the difficulties met by both physicians and patients when trying to access new technologies.