Throughout history, perhaps no other disease has generated the level of social, scientific, and political discourse or has had the degree of cultural significance as cancer. A collective in the truest sense of the word, "cancer" is a clustering of different diseases that afflict individuals in different ways. Its burdens are equally broad and diverse, from the physical, financial, and psychological tolls it imposes on individuals to the costs it inflicts upon the nation's clinical care and public health systems, and despite decades of concerted efforts often referred to as the "war on cancer", those costs have only continued to grow over time. The causes and effects of cancer are complex?in part preventable and treatable, but also in part unknown, and perhaps even unknowable. Guiding Cancer Control defines the key principles, attributes, methods, and tools needed to achieve the goal of implementing an effective national cancer control plan. This report describes the current structure of cancer control from a local to global scale, identifies necessary goals for the system, and formulates the path towards integrated disease control systems and a cancer-free future. This framework is a crucial step in establishing an effective, efficient, and accountable system for controlling cancer and other diseases. Table of Contents Front Matter Summary 1 Complexity: From Cells to Society 2 The Current "System" of Cancer Control 3 Guiding the System of Cancer Control 4 A Path to Transformation Appendix A: Stakeholder Input Appendix B: Biographical Information Appendix C: Disclosure of Unavoidable Conflict of Interest

Medical residents in hospitals are often required to be on duty for long hours. In 2003 the organization overseeing graduate medical education adopted common program requirements to restrict resident workweeks, including limits to an average of 80 hours over 4 weeks and the longest consecutive period of work to 30 hours in order to protect patients and residents from unsafe conditions resulting from excessive fatigue. Resident Duty Hours provides a timely examination of how those requirements were implemented and their impact on safety, education, and the training institutions. An in-depth review of the evidence on sleep and human performance indicated a need to increase opportunities for sleep during residency training to prevent acute and chronic sleep deprivation and minimize the risk of fatigue-related errors. In addition to recommending opportunities for on-duty sleep during long duty periods and breaks for sleep of appropriate lengths between work periods, the committee also recommends enhancements of supervision, appropriate workload, and changes in the work environment to improve conditions for safety and learning. All residents, medical educators, those involved with academic training institutions, specialty societies, professional groups, and consumer/patient safety organizations will find this book useful to advocate for an improved culture of safety. Table of Contents Front Matter Abstract Summary 1 Background and Overview 2 Current Duty Hours and Monitoring Adherence 3 Adapting the Resident Educational and Work Environment to Duty Hour Limits 4 Improving the Resident Learning Environment 5 Impact of Duty Hours on Resident Well-Being 6 Contributors to Error in the Training Environment 7 Strategies to Reduce Fatigue Risk in Resident Work Schedules 8 System Strategies to Improve Patient Safety and Error Prevention 9 Resources to Implement Improvements for Patient Safety and Resident Training Appendix A Statement of Task Appendix B Comparison of Select Scheduling Possibilities Under Committee Recommendations and Under 2003 ACGME Duty Hour Rules Appendix C International Experiences Limiting Resident Duty Hours Appendix D Glossary, Acronyms, and Abbreviations Appendix E Committee Member Biographies Appendix F Public Meeting Agendas Index