For many of us, the drive to affect positive change--however vague or idiosyncratic our sense of this might be--has guided our work in higher education. We champion the pursuit of a college degree because few endeavors can match it in terms of advancing a person's economic mobility (Chetty, Friedman, Saez, Turner, and Yagan; 2017). Despite recent debates about the value of a college degree (Pew Research Center, 2017), the opportunities and financial stability awarded to those with college degrees remain apparent when they are compared to peers who have only graduated high school (Pew Research Center, 2014). And while more Americans have a college degree than ever before (Ryan and Bauman, 2016), access to a formal, post-secondary education continues to be elusive for some. Indeed, over the last ten years, analysts have projected that the cost of attending college would keep 2.4 million low-to-moderate income, college-qualified high school graduates from completing a college degree (Advisory Committee on Student Financial Assistance, 2006). During that same period, college students in the United States saw expenses related to tuition and fees increase by 63 percent, school housing costs (excluding board) increase by 51 percent, textbook prices increase by 88 percent (Bureau of Labor, 2016). Because few students can afford a college education by salary alone, 44.2 million Americans have sought financial aid via student loans. As a result, total student loan debt is now topping $1.45 trillion in the United States (Board of Governors of the Federal Reserve System, 2017), and student loan delinquency rates are averaging 11.2 percent (Federal Reserve Bank of New York, 2017). The burden of a student's financial decisions extends beyond the mere individual: society will inevitably carry the weight of this debt for years to come.

Over the last few decades, a rich and increasingly diverse practice has emerged in the art world that invites the public to touch, enter, and experience the work, whether it is in a gallery, on city streets, or in the landscape. Like architecture, many of these temporary artworks aspire to alter viewers' experience of the environment. An installation is usually the end product for an artist, but for architects it can also be a preliminary step in an ongoing design process. Like paper projects designed in the absence of "real" architecture, installations offer architects another way to engage in issues critical to their practice. Direct experimentation with architecture's material and social dimensions engages the public around issues in the built environment that concern them and expands the ways that architecture can participate in and impact people's everyday lives. The first survey of its kind, Installations by Architects features fifty of the most significant projects from the last twenty-five years by today's most exciting architects, including Anderson Anderson, Philip Beesley, Diller + Scofidio, John Hejduk, Dan Hoffman, and Kuth/Ranieri Architects. Projects are grouped in critical areas of discussion under the themes of tectonics, body, nature, memory, and public space. Each project is supplemented by interviews with the project architects and the discussions of critics and theorists situated within a larger intellectual context. There is no doubt that installations will continue to play a critical role in the practice of architecture. Installations by Architects aims to contribute to the role of installations in sharpening our understanding of the built environment.

A guide for educators to incorporate computational thinking—a set of cognitive skills applied to problem solving—into a broad range of subjects. Computational thinking—a set of mental and cognitive tools applied to problem solving—is a fundamental skill that all of us (and not just computer scientists) draw on. Educators have found that computational thinking enhances learning across a range of subjects and reinforces students’ abilities in reading, writing, and arithmetic. This book offers a guide for incorporating computational thinking into middle school and high school classrooms, presenting a series of activities, projects, and tasks that employ a range of pedagogical practices and cross a variety of content areas. As students problem solve, communicate, persevere, work as a team, and learn from mistakes, they develop a concrete understanding of the abstract principles used in computer science to create code and other digital artifacts. The book guides students and teachers to integrate computer programming with visual art and geometry, generating abstract expressionist–style images; construct topological graphs that represent the relationships between characters in such literary works as Harry Potter and the Sorcerer’s Stone and Romeo and Juliet; apply Newtonian physics to the creation of computer games; and locate, analyze, and present empirical data relevant to social and political issues. Finally, the book lists a variety of classroom resources, including the programming languages Scratch (free to all) and Codesters (free to teachers). An accompanying website contains the executable programs used in the book’s activities.

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.

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 sets forth a national agendaâ€"with state and local implicationsâ€"for reducing medical errors and improving patient safety through the design of a safer health system. This volume reveals the often startling statistics of medical error and the disparity between the incidence of error and public perception of it, given many patients' expectations that the medical profession always performs perfectly. A careful examination is made of how the surrounding forces of legislation, regulation, and market activity influence the quality of care provided by health care organizations and then looks at their handling of medical mistakes. Using a detailed case study, the book reviews the current understanding of why these mistakes happen. A key theme is that legitimate liability concerns discourage reporting of errorsâ€"which begs the question, "How can we learn from our mistakes?" Balancing regulatory versus market-based initiatives and public versus private efforts, the Institute of Medicine presents wide-ranging recommendations for improving patient safety, in the areas of leadership, improved data collection and analysis, and development of effective systems at the level of direct patient care. To Err Is Human asserts that the problem is not bad people in health careâ€"it is that good people are working in bad systems that need to be made safer. Comprehensive and straightforward, this book offers a clear prescription for raising the level of patient safety in American health care. It also explains how patients themselves can influence the quality of care that they receive once they check into the hospital. This book will be vitally important to federal, state, and local health policy makers and regulators, health professional licensing officials, hospital administrators, medical educators and students, health caregivers, health journalists, patient advocatesâ€"as well as patients themselves. First in a series of publications from the Quality of Health Care in America, a project initiated by the Institute of Medicine

As a kid, Noam Chomsky handed out the Daily Mirror at his uncle's newsstand on 72nd Street, inadvertently finding himself in a buzzing intellectual and political hub for European immigrants in New York. Iranian human rights Nobelist Shirin Ebadi and her husband signed their own legal contract, attempting to restore equality to their marriage after the Iranian Revolution effectively erased the legal rights of women. Elizabeth Warren set out to expose those frauds declaring bankruptcy and taking advantage of the system-only to discover, in her research, a very different story of hard-working middle-class families facing economic collapse in the absence of a social safety net. While studying at Oxford, a young Tariq Ali made a bet with a friend that he could work the Vietnam War into every single answer on his final exams. In this rousing, thoughtful, often funny, and always inspiring volume, a diverse and impressive group of thinkers reflect on those formative experiences that shaped their own political commitments. A fascinating new window into the revealing links between the personal and the political, Political Awakenings will engage readers across generations.

The Institute of Medicine study Crossing the Quality Chasm (2001) recommended that an interdisciplinary summit be held to further reform of health professions education in order to enhance quality and patient safety. Health Professions Education: A Bridge to Quality is the follow up to that summit, held in June 2002, where 150 participants across disciplines and occupations developed ideas about how to integrate a core set of competencies into health professions education. These core competencies include patient-centered care, interdisciplinary teams, evidence-based practice, quality improvement, and informatics. This book recommends a mix of approaches to health education improvement, including those related to oversight processes, the training environment, research, public reporting, and leadership. Educators, administrators, and health professionals can use this book to help achieve an approach to education that better prepares clinicians to meet both the needs of patients and the requirements of a changing health care system.

Chronic pain costs the nation up to $635 billion each year in medical treatment and lost productivity. The 2010 Patient Protection and Affordable Care Act required the Department of Health and Human Services (HHS) to enlist the Institute of Medicine (IOM) in examining pain as a public health problem. In this report, the IOM offers a blueprint for action in transforming prevention, care, education, and research, with the goal of providing relief for people with pain in America. To reach the vast multitude of people with various types of pain, the nation must adopt a population-level prevention and management strategy. The IOM recommends that HHS develop a comprehensive plan with specific goals, actions, and timeframes. Better data are needed to help shape efforts, especially on the groups of people currently underdiagnosed and undertreated, and the IOM encourages federal and state agencies and private organizations to accelerate the collection of data on pain incidence, prevalence, and treatments. Because pain varies from patient to patient, healthcare providers should increasingly aim at tailoring pain care to each person's experience, and self-management of pain should be promoted. In addition, because there are major gaps in knowledge about pain across health care and society alike, the IOM recommends that federal agencies and other stakeholders redesign education programs to bridge these gaps. Pain is a major driver for visits to physicians, a major reason for taking medications, a major cause of disability, and a key factor in quality of life and productivity. Given the burden of pain in human lives, dollars, and social consequences, relieving pain should be a national priority.

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 are analyzed. How to intervene? Unequal Treatment offers recommendations for improvements in medical care financing, allocation of care, availability of language translation, community-based care, and other arenas. The committee highlights the potential of cross-cultural education to improve provider-patient communication and offers a detailed look at how to integrate cross-cultural learning within the health professions. The book concludes with recommendations for data collection and research initiatives. Unequal Treatment will be vitally important to health care policymakers, administrators, providers, educators, and students as well as advocates for people of color.

Myalgic encephalomyelitis (ME) and chronic fatigue syndrome (CFS) are serious, debilitating conditions that affect millions of people in the United States and around the world. ME/CFS can cause significant impairment and disability. Despite substantial efforts by researchers to better understand ME/CFS, there is no known cause or effective treatment. Diagnosing the disease remains a challenge, and patients often struggle with their illness for years before an identification is made. Some health care providers have been skeptical about the serious physiological - rather than psychological - nature of the illness. Once diagnosed, patients often complain of receiving hostility from their health care provider as well as being subjected to treatment strategies that exacerbate their symptoms. Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome proposes new diagnostic clinical criteria for ME/CFS and a new term for the illness - systemic exertion intolerance disease(SEID). According to this report, the term myalgic encephalomyelitis does not accurately describe this illness, and the term chronic fatigue syndrome can result in trivialization and stigmatization for patients afflicted with this illness. Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome stresses that SEID is a medical - not a psychiatric or psychological - illness. This report lists the major symptoms of SEID and recommends a diagnostic process.One of the report's most important conclusions is that a thorough history, physical examination, and targeted work-up are necessary and often sufficient for diagnosis. The new criteria will allow a large percentage of undiagnosed patients to receive an accurate diagnosis and appropriate care. Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome will be a valuable resource to promote the prompt diagnosis of patients with this complex, multisystem, and often devastating disorder; enhance public understanding; and provide a firm foundation for future improvements in diagnosis and treatment.