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This report serves to assess the Nation¿s progress in addressing juvenile crime. The 2007 data bring some welcome news, as the recent trend of modest increases in juvenile arrests in 2005 and 2006 has been broken. The good news is reflected not only in the 2% decline in overall juvenile arrests and the 3% decline in juvenile arrests for violent crimes from 2006 to 2007 but also in the data for most offense categories, for males and females, and for white and minority youth. However, one area that merits continued attention is disproportionate minority contact with the juvenile justice system. For example, the arrest rate for robbery among black juveniles was more than 10 times that for white youth in 2007. Charts and tables.
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
Even though youth crime rates have fallen since the mid-1990s, public fear and political rhetoric over the issue have heightened. The Columbine shootings and other sensational incidents add to the furor. Often overlooked are the underlying problems of child poverty, social disadvantage, and the pitfalls inherent to adolescent decisionmaking that contribute to youth crime. From a policy standpoint, adolescent offenders are caught in the crossfire between nurturance of youth and punishment of criminals, between rehabilitation and "get tough" pronouncements. In the midst of this emotional debate, the National Research Council's Panel on Juvenile Crime steps forward with an authoritative review of the best available data and analysis. Juvenile Crime, Juvenile Justice presents recommendations for addressing the many aspects of America's youth crime problem. This timely release discusses patterns and trends in crimes by children and adolescentsâ€"trends revealed by arrest data, victim reports, and other sources; youth crime within general crime; and race and sex disparities. The book explores desistanceâ€"the probability that delinquency or criminal activities decrease with ageâ€"and evaluates different approaches to predicting future crime rates. Why do young people turn to delinquency? Juvenile Crime, Juvenile Justice presents what we know and what we urgently need to find out about contributing factors, ranging from prenatal care, differences in temperament, and family influences to the role of peer relationships, the impact of the school policies toward delinquency, and the broader influences of the neighborhood and community. Equally important, this book examines a range of solutions: Prevention and intervention efforts directed to individuals, peer groups, and families, as well as day care-, school- and community-based initiatives. Intervention within the juvenile justice system. Role of the police. Processing and detention of youth offenders. Transferring youths to the adult judicial system. Residential placement of juveniles. The book includes background on the American juvenile court system, useful comparisons with the juvenile justice systems of other nations, and other important information for assessing this problem.
Scores of talented and dedicated people serve the forensic science community, performing vitally important work. However, they are often constrained by lack of adequate resources, sound policies, and national support. It is clear that change and advancements, both systematic and scientific, are needed in a number of forensic science disciplines to ensure the reliability of work, establish enforceable standards, and promote best practices with consistent application. Strengthening Forensic Science in the United States: A Path Forward provides a detailed plan for addressing these needs and suggests the creation of a new government entity, the National Institute of Forensic Science, to establish and enforce standards within the forensic science community. The benefits of improving and regulating the forensic science disciplines are clear: assisting law enforcement officials, enhancing homeland security, and reducing the risk of wrongful conviction and exoneration. Strengthening Forensic Science in the United States gives a full account of what is needed to advance the forensic science disciplines, including upgrading of systems and organizational structures, better training, widespread adoption of uniform and enforceable best practices, and mandatory certification and accreditation programs. While this book provides an essential call-to-action for congress and policy makers, it also serves as a vital tool for law enforcement agencies, criminal prosecutors and attorneys, and forensic science educators.
This report issues a call for urgent action to combat the growing epidemic of obesity, which now affects developing and industrialized countries alike. Adopting a public health approach, the report responds to both the enormity of health problems associated with obesity and the notorious difficulty of treating this complex, multifactorial disease. With these problems in mind, the report aims to help policy-makers introduce strategies for prevention and management that have the greatest chance of success. The importance of prevention as the most sensible strategy in developing countries, where obesity coexists with undernutrition, is repeatedly emphasized. Recommended lines of action, which reflect the consensus reached by 25 leading authorities, are based on a critical review of current scientific knowledge about the causes of obesity in both individuals and populations. While all causes are considered, major attention is given to behavioural and societal changes that have increased the energy density of diets, overwhelmed sophisticated regulatory systems that control appetite and maintain energy balance, and reduced physical activity. Specific topics discussed range from the importance of fat content in the food supply as a cause of population-wide obesity, through misconceptions about obesity held by both the medical profession and the public, to strategies for dealing with the alarming prevalence of obesity in children. "... the volume is clearly written, and carries a wealth of summary information that is likely to be invaluable for anyone interested in the public health aspects of obesity and fatness, be they students, practitioner or researcher." - Journal of Biosocial Science
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 performance expectations for the 21st century health care system. A set of 10 new rules to guide patient-clinician relationships. A suggested organizing framework to better align the incentives inherent in payment and accountability with improvements in quality. Key steps to promote evidence-based practice and strengthen clinical information systems. Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change.