Developing scientific and policy methods that support precautionary action in the face of uncertainty—the Institute of Medicine Committee on Agent Orange

2002 ◽  
Vol 117 (6) ◽  
pp. 534-545
Author(s):  
Joel A Tickner
Keyword(s):  
Agent Orange ◽  
Institute Of Medicine ◽  
Precautionary Action ◽  
The Face

scholarly journals Developing Scientific and Policy Methods That Support Precautionary Action in the Face of Uncertainty—The Institute of Medicine Committee on Agent Orange

2002 ◽  
Vol 117 (6) ◽  
pp. 534-545 ◽  
Author(s):  
Joel A. Tickner
Keyword(s):  
Vietnam Veterans ◽  
Scientific Information ◽  
Decision Rules ◽  
Agent Orange ◽  
Institute Of Medicine ◽  
Science And Policy ◽  
Institutional Structures ◽  
Precautionary Action ◽  
The Face ◽  
Tools And Methods

To be precautionary, decisions must be made to prevent the impacts of potentially harmful activities even though the nature and magnitude of harm have not been proven scientifically. The Institute of Medicine's Committee on the Health Effects in Vietnam Veterans of Exposures to Herbicides provides a novel example of science and policy structures that support precautionary action in the face of uncertainty. What makes this example unique is the clear set of precautionary decision rules that lowered the standard for evidence, which formed the basis for policy. These rules, established by Congress, strongly influenced the way scientific information was weighed and the subsequent compensation decisions. They encouraged committee members to think outside the confines of their disciplines and develop new tools and methods to fit their unique mandate. The result was a methodology, supported by strong institutional structures, that allowed scientists to discuss the evidence as a whole, reach decisions as a group, and clarify uncertainties.

scholarly journals The Behavioral Wellness in Pregnancy study: a randomized controlled trial of a multi-component intervention to promote appropriate weight gain

2019 ◽  
Vol 109 (4) ◽  
pp. 1071-1079
Author(s):  
Lyndi M Buckingham-Schutt ◽  
Laura D Ellingson ◽  
Spyridoula Vazou ◽  
Christina G Campbell
Keyword(s):  
Weight Gain ◽  
Gestational Weight Gain ◽  
Behavioral Intervention ◽  
Controlled Trial ◽  
Institute Of Medicine ◽  
Weight Retention ◽  
Gestational Weight ◽  
Randomized Controlled ◽  
Prepregnancy Weight ◽  
The Face

ABSTRACT Background Adequate weight gain during pregnancy is important to both maternal and fetal outcomes. To date, randomized controlled trials have not been effective at increasing the proportion of women meeting gestational weight-gain guidelines. Objectives The aim of this study was to determine whether a multi-component behavioral intervention with a Registered Dietitian Nutritionist significantly improves the proportion of women who adhere to the 2009 Institute of Medicine weight-gain guidelines. Methods Participants were randomly assigned to usual care (UC; n = 24) or intervention (n = 23) between 8 and 14 weeks of gestation. The intervention included a minimum of 6 one-on-one counseling sessions over ∼30 wk focusing on healthy diet and physical activity (PA) goals. In addition to the face-to-face visits, weekly communication via email supported healthy eating, PA, and appropriate weight gain. Gestational weight gain, PA, and diet were assessed at 8–14, 26–28, and 34–36 weeks of gestation; weight retention was measured 2 mo postpartum. Results The proportion of women meeting the guidelines was significantly greater in those receiving the intervention than UC (60.8% compared with 25.0%, OR: 4.7; 95% CI: 1.3, 16.2; P = 0.019). Furthermore, 36.4% of the intervention women were at or below their prepregnancy weight at 2 mo postpartum compared with 12.5% in the UC group (P = 0.05). Conclusions A multi-component behavioral intervention improved adherence to the 2009 Institute of Medicine weight-gain guidelines. This trial was registered with clinicaltrials.gov as NCT02168647.

Medical Practice Guidelines as Malpractice Safe Harbors: Illusion or Deceit?

2012 ◽  
Vol 40 (2) ◽  
pp. 286-300 ◽  
Author(s):  
Maxwell J. Mehlman
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Medical Practice ◽  
Medical Errors ◽  
Practice Guidelines ◽  
Practice Patterns ◽  
Institute Of Medicine ◽  
The Face ◽  
Care Costs

The idea that physicians should accept recommendations from learned colleagues on how to practice medicine is probably as old as medicine itself, but beginning around 1990, it took on new urgency in the face of rising health care costs, widespread, unjustifiable variation in practice patterns, concerns about medical errors and quality of care, and what some perceived to be perverse effects of the malpractice system. One solution put forward was practice guidelines, which the Institute of Medicine (IOM) defined as systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances.

Neurologic health outcomes and Agent Orange: Institute of Medicine report*

Neurology ◽  
1994 ◽  
Vol 44 (5) ◽  
pp. 801-801 ◽  
Author(s):  
C. G. Goetz ◽  
K. I. Bolla ◽  
S. M. Rogers
Keyword(s):  
Health Outcomes ◽  
Agent Orange ◽  
Institute Of Medicine

Why do people believe in a zero-sum economy?

2018 ◽  
Vol 41 ◽  
Author(s):  
Samuel G. B. Johnson
Keyword(s):  
Perspective Taking ◽  
Evolutionary Model ◽  
Everyday Experience ◽  
Coalitional Psychology ◽  
The Face ◽  
Zero Sum

AbstractZero-sum thinking and aversion to trade pervade our society, yet fly in the face of everyday experience and the consensus of economists. Boyer & Petersen's (B&P's) evolutionary model invokes coalitional psychology to explain these puzzling intuitions. I raise several empirical challenges to this explanation, proposing two alternative mechanisms – intuitive mercantilism (assigning value to money rather than goods) and errors in perspective-taking.

Mars: was There an Ancient Eden?

1997 ◽  
Vol 161 ◽  
pp. 203-218 ◽  
Author(s):  
Tobias C. Owen
Keyword(s):  
Positive Answer ◽  
Biogenic Elements ◽  
Habitable Zones ◽  
The Face ◽  
The Origin Of Life ◽  
Early Mars ◽  
Favorable Conditions ◽  
Open Question ◽  
Rocky Planets ◽  
Impact Erosion

AbstractThe clear evidence of water erosion on the surface of Mars suggests an early climate much more clement than the present one. Using a model for the origin of inner planet atmospheres by icy planetesimal impact, it is possible to reconstruct the original volatile inventory on Mars, starting from the thin atmosphere we observe today. Evidence for cometary impact can be found in the present abundances and isotope ratios of gases in the atmosphere and in SNC meteorites. If we invoke impact erosion to account for the present excess of129Xe, we predict an early inventory equivalent to at least 7.5 bars of CO2. This reservoir of volatiles is adequate to produce a substantial greenhouse effect, provided there is some small addition of SO2(volcanoes) or reduced gases (cometary impact). Thus it seems likely that conditions on early Mars were suitable for the origin of life – biogenic elements and liquid water were present at favorable conditions of pressure and temperature. Whether life began on Mars remains an open question, receiving hints of a positive answer from recent work on one of the Martian meteorites. The implications for habitable zones around other stars include the need to have rocky planets with sufficient mass to preserve atmospheres in the face of intensive early bombardment.

Evidence for a shear mechanism for the precipitation of γ-zirconium hydride in zirconium

1978 ◽  
Vol 36 (1) ◽  
pp. 658-659
Author(s):  
G.J.C. Carpenter
Keyword(s):  
Elevated Temperature ◽  
Strain Field ◽  
Zirconium Hydride ◽  
Zirconium Atom ◽  
Atom Diffusion ◽  
Solvus Temperature ◽  
Hexagonal Close Packed ◽  
Partial Dislocations ◽  
The Face

In zirconium-hydrogen alloys, rapid cooling from an elevated temperature causes precipitation of the face-centred tetragonal (fct) phase, γZrH, in the form of needles, parallel to the close-packed <1120>zr directions (1). With low hydrogen concentrations, the hydride solvus is sufficiently low that zirconium atom diffusion cannot occur. For example, with 6 μg/g hydrogen, the solvus temperature is approximately 370 K (2), at which only the hydrogen diffuses readily. Shears are therefore necessary to produce the crystallographic transformation from hexagonal close-packed (hep) zirconium to fct hydride.The simplest mechanism for the transformation is the passage of Shockley partial dislocations having Burgers vectors (b) of the type 1/3<0110> on every second (0001)Zr plane. If the partial dislocations are in the form of loops with the same b, the crosssection of a hydride precipitate will be as shown in fig.1. A consequence of this type of transformation is that a cumulative shear, S, is produced that leads to a strain field in the surrounding zirconium matrix, as illustrated in fig.2a.

A study of interface sliding at F.C.C.-B.C.C. boundaries in a Cu-Zn alloy

1978 ◽  
Vol 36 (1) ◽  
pp. 422-423
Author(s):  
F. Monchoux ◽  
A. Rocher ◽  
J.L. Martin
Keyword(s):  
Face Centered Cubic ◽  
Creep Tests ◽  
High Voltage Electron Microscopy ◽  
Diffusion Treatment ◽  
Voltage Electron ◽  
The Face ◽  
Face Centered ◽  
Interface Sliding ◽  
Zn Alloy ◽  
Made In

Interphase sliding is an important phenomenon of high temperature plasticity. In order to study the microstructural changes associated with it, as well as its influence on the strain rate dependence on stress and temperature, plane boundaries were obtained by welding together two polycrystals of Cu-Zn alloys having the face centered cubic and body centered cubic structures respectively following the procedure described in (1). These specimens were then deformed in shear along the interface on a creep machine (2) at the same temperature as that of the diffusion treatment so as to avoid any precipitation. The present paper reports observations by conventional and high voltage electron microscopy of the microstructure of both phases, in the vicinity of the phase boundary, after different creep tests corresponding to various deformation conditions.Foils were cut by spark machining out of the bulk samples, 0.2 mm thick. They were then electropolished down to 0.1 mm, after which a hole with thin edges was made in an area including the boundary

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