Abortion is a legal medical procedure that has been provided to millions of American women. Since the Institute of Medicine first reviewed the health implications of national legalized abortion in 1975, there has been a plethora of related scientific research, including well-designed randomized clinical trials, systematic reviews, and epidemiological studies examining abortion care. This research has focused on examining the relative safety of abortion methods and the appropriateness of methods for different clinical circumstances. With this growing body of research, earlier abortion methods have been refined, discontinued, and new approaches have been developed. The Safety and Quality of Abortion Care in the United States offers a comprehensive review of the current state of the science related to the provision of safe, high-quality abortion services in the United States. This report considers 8 research questions and presents conclusions, including gaps in research.
In one of the most provocative books ever published on America's social welfare system, economist Janet Currie argues that the modern social safety net is under attack. Unlike most books about antipoverty programs, Currie trains her focus not on cash welfare, which accounts for a small and shrinking share of federal expenditures on poor families with children, but on the staples of today's American welfare system: Medicaid, Food Stamps, Head Start, WIC, and public housing. These programs, Currie maintains, form an effective, if largely invisible and haphazard safety net, and yet they are the very programs most vulnerable to political attack and misunderstanding. This book highlights both the importance and the fragility of this safety net, arguing that, while not perfect, it is essential to fighting poverty. Currie demonstrates how America's safety net is threatened by growing budget deficits and by an erroneous public belief that antipoverty programs for children do not work and are riddled with fraud. By unearthing new empirical data, Currie makes the case that social programs for families with children are actually remarkably effective. She takes her argument one step further by offering specific reforms--detailed in each chapter--for improving these programs even more. The book concludes with an overview of an integrated safety net that would fight poverty more effectively and prevent children from slipping through holes in the net. (For example, Currie recommends the implementation of a benefit "debit card" that would provide benefits with less administrative burden on the recipient.) A complement to books such as Barbara Ehrenreich's bestselling Nickel and Dimed, which document the personal struggles of the working poor, The Invisible Safety Net provides a big-picture look at the kind of programs and solutions that would help ease those struggles. Comprehensive and authoritative, it will prompt a major reexamination of the current thinking on improving the lives of needy Americans.
How safe is our food supply? Each year the media report what appears to be growing concern related to illness caused by the food consumed by Americans. These food borne illnesses are caused by pathogenic microorganisms, pesticide residues, and food additives. Recent actions taken at the federal, state, and local levels in response to the increase in reported incidences of food borne illnesses point to the need to evaluate the food safety system in the United States. This book assesses the effectiveness of the current food safety system and provides recommendations on changes needed to ensure an effective science-based food safety system. Ensuring Safe Food discusses such important issues as: What are the primary hazards associated with the food supply? What gaps exist in the current system for ensuring a safe food supply? What effects do trends in food consumption have on food safety? What is the impact of food preparation and handling practices in the home, in food services, or in production operations on the risk of food borne illnesses? What organizational changes in responsibility or oversight could be made to increase the effectiveness of the food safety system in the United States? Current concerns associated with microbiological, chemical, and physical hazards in the food supply are discussed. The book also considers how changes in technology and food processing might introduce new risks. Recommendations are made on steps for developing a coordinated, unified system for food safety. The book also highlights areas that need additional study. Ensuring Safe Food will be important for policymakers, food trade professionals, food producers, food processors, food researchers, public health professionals, and consumers.
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
America's Health Care Safety Net explains how competition and cost issues in today's health care marketplace are posing major challenges to continued access to care for America's poor and uninsured. At a time when policymakers and providers are urgently seeking guidance, the committee recommends concrete strategies for maintaining the viability of the safety netâ€"with innovative approaches to building public attention, developing better tools for tracking the problem, and designing effective interventions. This book examines the health care safety net from the perspectives of key providers and the populations they serve, including: Components of the safety netâ€"public hospitals, community clinics, local health departments, and federal and state programs. Mounting pressures on the systemâ€"rising numbers of uninsured patients, decline in Medicaid eligibility due to welfare reform, increasing health care access barriers for minority and immigrant populations, and more. Specific consequences for providers and their patients from the competitive, managed care environmentâ€"detailing the evolution and impact of Medicaid managed care. Key issues highlighted in four populationsâ€"children with special needs, people with serious mental illness, people with HIV/AIDS, and the homeless.
In 'Writing the Nation: A Concise Introduction to American Literature 1865 to Present,' editors Amy Berke, Robert Bleil, Jordan Cofer, and Doug Davis curate a comprehensive exploration of American literary evolution from the aftermath of the Civil War to contemporary times. This anthology expertly weaves a tapestry of diverse literary styles and themes, encapsulating the dynamic shifts in American culture and identity. Through carefully selected works, the collection illustrates the rich dialogue between historical contexts and literary expression, showcasing seminal pieces that have shaped American literatures landscape. The diversity of periods and perspectives offers readers a panoramic view of the countrys literary heritage, making it a significant compilation for scholars and enthusiasts alike. The contributing authors and editors, each with robust backgrounds in American literature, bring to the table a depth of scholarly expertise and a passion for the subject matter. Their collective work reflects a broad spectrum of American life and thought, aligning with major historical and cultural movements from Realism and Modernism to Postmodernism. This anthology not only marks the evolution of American literary forms and themes but also mirrors the nations complex history and diverse narratives. 'Writing the Nation' is an essential volume for those who wish to delve into the heart of American literature. It offers readers a unique opportunity to experience the multitude of voices, styles, and themes that have shaped the countrys literary tradition. This collection represents an invaluable resource for students, scholars, and anyone interested in the development of American literature and the cultural forces that have influenced it. The anthology invites readers to engage with the vibrant dialogue among its pages, fostering a deeper understanding and appreciation of the United States' literary and cultural heritage.
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.
The United States is among the wealthiest nations in the world, but it is far from the healthiest. Although life expectancy and survival rates in the United States have improved dramatically over the past century, Americans live shorter lives and experience more injuries and illnesses than people in other high-income countries. The U.S. health disadvantage cannot be attributed solely to the adverse health status of racial or ethnic minorities or poor people: even highly advantaged Americans are in worse health than their counterparts in other, "peer" countries. In light of the new and growing evidence about the U.S. health disadvantage, the National Institutes of Health asked the National Research Council (NRC) and the Institute of Medicine (IOM) to convene a panel of experts to study the issue. The Panel on Understanding Cross-National Health Differences Among High-Income Countries examined whether the U.S. health disadvantage exists across the life span, considered potential explanations, and assessed the larger implications of the findings. U.S. Health in International Perspective presents detailed evidence on the issue, explores the possible explanations for the shorter and less healthy lives of Americans than those of people in comparable countries, and recommends actions by both government and nongovernment agencies and organizations to address the U.S. health disadvantage.
An investigative journalist offers a revealing look at how the government, private companies, and criminals use technology to indiscriminately sweep up vast amounts of our personal data, and discusses results from a number of experiments she conducted to try and protect herself.
