Drinking Water Distribution Systems

Drinking Water Distribution Systems

Author: National Research Council

Publisher: National Academies Press

Published: 2006-12-22

Total Pages: 404

ISBN-13: 0309133955

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Protecting and maintaining water distributions systems is crucial to ensuring high quality drinking water. Distribution systems-consisting of pipes, pumps, valves, storage tanks, reservoirs, meters, fittings, and other hydraulic appurtenances-carry drinking water from a centralized treatment plant or well supplies to consumers' taps. Spanning almost 1 million miles in the United States, distribution systems represent the vast majority of physical infrastructure for water supplies, and thus constitute the primary management challenge from both an operational and public health standpoint. Recent data on waterborne disease outbreaks suggest that distribution systems remain a source of contamination that has yet to be fully addressed. This report evaluates approaches for risk characterization and recent data, and it identifies a variety of strategies that could be considered to reduce the risks posed by water-quality deteriorating events in distribution systems. Particular attention is given to backflow events via cross connections, the potential for contamination of the distribution system during construction and repair activities, maintenance of storage facilities, and the role of premise plumbing in public health risk. The report also identifies advances in detection, monitoring and modeling, analytical methods, and research and development opportunities that will enable the water supply industry to further reduce risks associated with drinking water distribution systems.


Delivering High-Quality Cancer Care

Delivering High-Quality Cancer Care

Author: Committee on Improving the Quality of Cancer Care: Addressing the Challenges of an Aging Population

Publisher: National Academies Press

Published: 2014-01-10

Total Pages: 0

ISBN-13: 9780309286602

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In the United States, approximately 14 million people have had cancer and more than 1.6 million new cases are diagnosed each year. However, more than a decade after the Institute of Medicine (IOM) first studied the quality of cancer care, the barriers to achieving excellent care for all cancer patients remain daunting. Care often is not patient-centered, many patients do not receive palliative care to manage their symptoms and side effects from treatment, and decisions about care often are not based on the latest scientific evidence. The cost of cancer care also is rising faster than many sectors of medicine--having increased to $125 billion in 2010 from $72 billion in 2004--and is projected to reach $173 billion by 2020. Rising costs are making cancer care less affordable for patients and their families and are creating disparities in patients' access to high-quality cancer care. There also are growing shortages of health professionals skilled in providing cancer care, and the number of adults age 65 and older--the group most susceptible to cancer--is expected to double by 2030, contributing to a 45 percent increase in the number of people developing cancer. The current care delivery system is poorly prepared to address the care needs of this population, which are complex due to altered physiology, functional and cognitive impairment, multiple coexisting diseases, increased side effects from treatment, and greater need for social support. Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis presents a conceptual framework for improving the quality of cancer care. This study proposes improvements to six interconnected components of care: (1) engaged patients; (2) an adequately staffed, trained, and coordinated workforce; (3) evidence-based care; (4) learning health care information technology (IT); (5) translation of evidence into clinical practice, quality measurement and performance improvement; and (6) accessible and affordable care. This report recommends changes across the board in these areas to improve the quality of care. Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis provides information for cancer care teams, patients and their families, researchers, quality metrics developers, and payers, as well as HHS, other federal agencies, and industry to reevaluate their current roles and responsibilities in cancer care and work together to develop a higher quality care delivery system. By working toward this shared goal, the cancer care community can improve the quality of life and outcomes for people facing a cancer diagnosis.


Women and Smoking

Women and Smoking

Author: United States. Public Health Service. Office of the Surgeon General

Publisher: Office of the Surgeon General

Published: 2001

Total Pages: 696

ISBN-13:

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The second report from the U.S. Surgeon General devoted to women and smoking. Includes executive summary, chapter conclusions, full text chapters, and references.


The United Nations, Peace and Security

The United Nations, Peace and Security

Author: Ramesh Thakur

Publisher: Cambridge University Press

Published: 2006-06-08

Total Pages: 380

ISBN-13: 1139456946

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Preventing humanitarian atrocities is becoming as important for the United Nations as dealing with inter-state war. In this book, Ramesh Thakur examines the transformation in UN operations, analysing its changing role and structure. He asks why, when and how force may be used and argues that the growing gulf between legality and legitimacy is evidence of an eroded sense of international community. He considers the tension between the US, with its capacity to use force and project power, and the UN, as the centre of the international law enforcement system. He asserts the central importance of the rule of law and of a rules-based order focused on the UN as the foundation of a civilised system of international relations. This book will be of interest to students of the UN and international organisations in politics, law and international relations departments, as well as policymakers in the UN and other NGOs.