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The regulation of potentially hazardous substances has become a controversial issue. This volume evaluates past efforts to develop and use risk assessment guidelines, reviews the experience of regulatory agencies with different administrative arrangements for risk assessment, and evaluates various proposals to modify procedures. The book's conclusions and recommendations can be applied across the entire field of environmental health.
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
For most bills in American legislatures, the issue of turf—or which committee has jurisdiction over a bill—can make all the difference. Turf governs the flow and fate of all legislation. In this innovative study, David C. King explains how jurisdictional areas for committees are created and changed in Congress. Political scientists have long maintained that jurisdictions are relatively static, changing only at times of dramatic reforms. Not so, says King. Combining quantitative evidence with interviews and case studies, he shows how on-going turf wars make jurisdictions fluid. According to King, jurisdictional change stems both from legislators seeking electoral advantage and from nonpartisan House parliamentarians referring ambiguous bills to committees with the expertise to handle the issues. King brilliantly dissects the politics of turf grabbing and at the same time shows how parliamentarians have become institutional guardians of the legislative process. Original and insightful, Turf Wars will be valuable to those interested in congressional studies and American politics more generally.
In some ways, no American city symbolizes the black struggle for civil rights more than Birmingham, Alabama. During the 1950s and 1960s, Birmingham gained national and international attention as a center of activity and unrest during the civil rights movement. Racially motivated bombings of the houses of black families who moved into new neighborhoods or who were politically active during this era were so prevalent that Birmingham earned the nickname “Bombingham.” In this critical analysis of why Birmingham became such a national flashpoint, Bobby M. Wilson argues that Alabama’s path to industrialism differed significantly from that of states in the North and Midwest. True to its antebellum roots, no other industrial city in the United States depended as much on the exploitation of black labor so early in its urban development as Birmingham. A persuasive exploration of the links between Alabama’s slaveholding order and the subsequent industrialization of the state, America’s Johannesburg demonstrates that arguments based on classical economics fail to take into account the ways in which racial issues influenced the rise of industrial capitalism.
The production and consumption of oil has emerged as a major factor in international economics in general and in regional and national development in particular. The struggle for access to oil and gas resources has become even more fierce, affecting the long-range strategic planning of the superpowers and causing a shift in the world balance of trade. Middle East Oil Crises Since 1973 is the logical sequel to Dr. Shwadran's classic, The Middle East, Oil and the Great Powers. In this new work, Dr. Shwadran delineates the changes in the power equation, the political atmosphere, and the resources of the participants since 1973. He marshals persuasive evidence to show that economic forces, narrow vision, and the absence of strategic planning were the major contributing factors for the oil crises of the past decade, rather than the Arab-Israeli war.
The Plum Book is published by the Senate Committee on Homeland Security and Governmental Affairs and House Committee on Oversight and Reform alternately after each Presidential election. The Plum Book is used to identify Presidential appointed and other positions within the Federal Government. The publication lists over 9,000 Federal civil service leadership and support positions in the legislative and executive branches of the Federal Government that may be subject to noncompetitive appointment. The duties of many such positions may involve advocacy of Administration policies and programs and the incumbents usually have a close and confidential working relationship with the agency head or other key officials. The Plum Book was first published in 1952 during the Eisenhower administration. When President Eisenhower took office, the Republican Party requested a list of government positions that President Eisenhower could fill. The next edition of the Plum Book appeared in 1960 and has since been published every four years, just after the Presidential election.