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In this report the Committee has set out key elements of its work over the 2010-15 Parliament. The Committee believes that it is crucial that select committees follow up their work and do not simply see the publication of a report as the end of the process of scrutiny. Scrutiny should not end with the Dissolution of Parliament. The Scottish Government was clear that the 2014 referendum on independence would be a once generation event, but that does not mean that the relationship between Scotland and the rest of the United Kingdom will remain unchanged. The recommendations of the Smith Agreement will be implemented during the course of the next Parliament. The major package of legislation, and the revised fiscal framework that will accompany it, will require careful and detailed scrutiny, as will any proposals to go further that the Smith Commission envisaged.
The study edition of book the Los Angeles Times called, "The most extensive review of U.S. intelligence-gathering tactics in generations." This is the complete Executive Summary of the Senate Intelligence Committee's investigation into the CIA's interrogation and detention programs -- a.k.a., The Torture Report. Based on over six million pages of secret CIA documents, the report details a covert program of secret prisons, prisoner deaths, interrogation practices, and cooperation with other foreign and domestic agencies, as well as the CIA's efforts to hide the details of the program from the White House, the Department of Justice, the Congress, and the American people. Over five years in the making, it is presented here exactly as redacted and released by the United States government on December 9, 2014, with an introduction by Daniel J. Jones, who led the Senate investigation. This special edition includes: • Large, easy-to-read format. • Almost 3,000 notes formatted as footnotes, exactly as they appeared in the original report. This allows readers to see obscured or clarifying details as they read the main text. • An introduction by Senate staffer Daniel J. Jones who led the investigation and wrote the report for the Senate Intelligence Committee, and a forward by the head of that committee, Senator Dianne Feinstein.
The rapid conversion of land to urban and suburban areas has profoundly altered how water flows during and following storm events, putting higher volumes of water and more pollutants into the nation's rivers, lakes, and estuaries. These changes have degraded water quality and habitat in virtually every urban stream system. The Clean Water Act regulatory framework for addressing sewage and industrial wastes is not well suited to the more difficult problem of stormwater discharges. This book calls for an entirely new permitting structure that would put authority and accountability for stormwater discharges at the municipal level. A number of additional actions, such as conserving natural areas, reducing hard surface cover (e.g., roads and parking lots), and retrofitting urban areas with features that hold and treat stormwater, are recommended.
Revised 04/2011 DIABETES EPIDEMIC and YOU is not a cliché! It is a mandate for the awakening of the "silent" millions worldwide with "normal" fasting blood sugars and undiagnosed diabetes. If you have a "normal" fasting blood sugar, YOU may be one of the undiagnosed millions. YES, I do mean YOU. Since Hippocrates' time, earliest diagnosis provided the greatest opportunity for treatment and cure. This book highlights the earliest identification of type 2 diabetes by utilizing the insulin assay with the oral glucose tolerance. My cumulative experience of 14,384 oral glucose tolerances with insulin assays established the earliest diagnosis of prediabetes and diabetes when the blood sugars were normal. Prediabetes is type 2 diabetes. The tolerances were separated according to age groups, from 3Ð13 years to 81Ð90+ years. Each group was further divided into normal glucose tolerances, impaired glucose tolerances, and diabetes mellitus glucose tolerances. YOU, upon testing by oral glucose tolerance, will be in one of these categories. This resource of oral glucose tolerance with insulin assay is unequaled in world medical literature. The importance of early diagnosis is that the clinical pathology of diabetes – mainly heart disease, high blood pressure, stroke, cataracts, erectile dysfunction, and other metabolic disorders – occurs not only in those with advanced diabetes, but also in those with "normal" blood sugars. YES, this could happen to YOU! When early diagnosis is coupled with specific therapy, the DIABETES EPIDEMIC will be arrested and then reversed. Early diagnosis is the goal of this book – beginning with YOU.
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.
At any point in the drug development process, systematic reviews and meta-analysis can provide important information to guide the future path of the development program and any actions that might be needed in the post-marketing setting. This report gives the rationale for why and when a meta-analysis should be considered, all in the context of regulatory decision-making, and the tasks, data collection, and analyses that need to be carried out to inform those decisions. There is increasing demand by decision-makers in health care, the bio-pharmaceutical industry, and society at large to have access to the best available evidence on benefits and risks of medicinal products. The best strategy will take an overview of all the evidence and where it is possible and sensible, combine the evidence and summarize the results. For efficacy, the outcomes generally use the same or very similar predefined events for each of the trials to be included. Most regulatory guidance and many Cochrane Collaboration reviews have usually given more attention to assessment of benefits, while issues around combining evidence on harms have not been as well-covered. However, the (inevitably) unplanned nature of the data on safety makes the process more difficult. Combining evidence on adverse events (AEs), where these were not the focus of the original studies, is more challenging than combining evidence on pre-specified benefits. This focus on AEs represents the main contribution of the current CIOMS X report. The goal of the CIOMS X report is to provide principles on appropriate application of meta-analysis in assessing safety of pharmaceutical products to inform regulatory decision-making. This report is about meta-analysis in this narrow area, but the present report should also provide conceptually helpful points to consider for a wider range of applications, such as vaccines, medical devices, veterinary medicines or even products that are combinations of medicinal products and medical devices. Although some of the content of this report describes highly technical statistical concepts and methods (in particular Chapter 4), the ambition of the working group has been to make it comprehensible to non-statisticians for its use in clinical epidemiology and regulatory science. To that end, Chapters 3 and 4, which contain the main technical statistical aspects of the appropriate design, analysis and reporting of a meta-analysis of safety data are followed by Chapter 5 with a thought process for evaluating the findings of a meta-analysis and how to communicate these.
In an increasingly globalised world with new cross-border threats to public health and widening disparities between populations, civil society actors are challenging the existing structures of global health policies. Like its critically acclaimed predecessors, this third volume of Global Health Watch covers a comprehensive range of topics, including access to medicines, mental health, water and sanitation, nutrition, and war and conflict. Unlike most documentations of global health, it also draws attention to the politics of global health and the policies and actions of key actors. Global Health Watch books are the definite independent sources of data on global health, and this third volume offers unique and essential information for anyone working in the field.