One of the most controversial issues in environmental law and policy-and one that of considerable importance to the EPA-is the allocation of power and authority between the federal and state governments. The recent evolution in approaches of environmental enforcement highlights many of the tensions inherent in this debate. During the past several years, the federal and state governments have spent a good deal of energy attempting to "reinvent" their relationship. The shifts in federal/state enforcement relations are highly significant, with the potential to fundamentally reorder the division of authority that has existing over the past 25 years. This book thoroughly documents the changing nature of federal/state relations in enforcing environmental law. It breaks new ground in analyzing the federal/state enforcement relationship, particularly in light of the many recent developments that have occurred in this area. The author's findings provide important lessons about the interplay between federal and state efforts in other regulatory areas, and for the structure of federal/state relations generally. Professors Rechtschaffen's and Markell's clear, in-depth analysis will be essential reading for legal and regulatory experts, attorneys who are involved in environmental enforcement matters, the judiciary, legislators, political scientists, public policy experts, and anyone with an interest in environmental law and policy.
Delirium, stupor and coma are common clinical states that confront clinicians in almost every medical specialty. With appropriate diagnosis and treatment, coma can often be treated successfully. Conversely, delay in diagnosis and treatment may be lethal. This monograph provides an update on the clinical approach that was laid out in the previous 3 editions. It describes an approach for the physician at the bedside to diagnose and treat alterations of consciousness, based on pathophysiologic principles. The book begins with a description of the physiology of consciousness and the pathophysiology of disorders of consciousness. It continues with a description of the approach to a patient with a disorder of consciousness, emphasizing the bedside examination, but including the use of modern imaging techniques. The important structural and metabolic causes of coma are reviewed in detail. It then describes the emergency treatment, both medical and surgical, of patients with specific disorders of consciousness and their prognosis. New chapters describe the approach to the diagnosis of brain death and the clinical physiology of the vegetative state and minimally conscious state, as well as the ethics of dealing with such patients and their families. The book is aimed at medical students and residents, in fields from internal medicine and pediatrics to emergency medicine, surgery, neurology, neurosurgery, and psychiatry, who are likely to encounter patients with disordered states of consciousness. It includes historical background and basic neurophysiology that is important for those in the clinical neurosciences, but also lays out a practical approach to the comatose patient that is an important part of the repertoire of all clinicians who provide emergency care for patients with disorders of consciousness.
In this handbook on a growing public menace, Clifford R. Bragdon applies acoustical engineering and social science to the least understood—yet one of the most serious—environmental hazards of modern society. This book is a precision tool; it gives facts and figures, precise scientific measurements, and accurate data on what noise is, what it does, and how to combat it. The author pinpoints the noise levels—many of them illegal—of automobiles, buses, subways, airplanes, household appliances, and children's toys in numerous charts and tables and relates these data to the measurable social, physical, and psychological damage they do to human beings. He catalogues the "noise-free" claims of manufacturers of these products in an Appendix that speaks for itself. A thorough case study of an area near Philadelphia International Airport and other townships, including five hundred households, the author evaluates existing noise abatement programs on local, state, and federal levels, and finds most of them seriously inadequate. As steps toward the solution to the noise crisis, he proposes a system for rating environmental health, new approaches to community noise management, and a variety of architectural suggestions. The bibliography—probably the most complete and up-to-date source collection on the subject ever assembled—is an invaluable reference work in itself. It lists over five hundred sources, arranged in six major categories: Noise, General; Physical Effects; Psycho-Social Effects; Law; Noise Abatement; and Noise Sources. Noise Pollution is indispensable not only for the concerned citizen but for all those who can, and must, take immediate and effective action in our unquiet crisis: urban planners, architects, hospital administrators, public health officials, transportation executives, lawyers, realtors, sound engineers, manufacturers of transportation equipment and household appliances, and community leaders. It is a vital resource in dealing with the noise crisis that is destroying pleasure, lowering work performance, eroding health, causing physical injury, and even challenging basic human survival.
Evidence-Based Practice of Critical Care, edited by Drs. Clifford S. Deutschman and Patrick J. Neligan, provides objective data and expert guidance to help answer the most important questions challenging ICU physicians today. It discusses the clinical options, examines the relevant research, and presents expert recommendations on everything from acute organ failure to prevention issues. An outstanding source for "best practices" in critical care medicine, this book is a valuable framework for translating evidence into practice. Gain valuable evidence-based recommendations on key topics such as acute organ failure, infection, sepsis and inflammation, and prevention issues pointing the way to the most effective approaches. Get an overview of each question, an outline of management options, a review of the relevant evidence, areas of uncertainty, existing management guidelines, and authors’ recommendations. Navigate a full range of challenges from routine care to complicated and special situations. Find the information you need quickly with tables that summarize the available literature and recommended clinical approaches.
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One of the most controversial issues in environmental law and policy-and one that of considerable importance to the EPA-is the allocation of power and authority between the federal and state governments. The recent evolution in approaches of environmental enforcement highlights many of the tensions inherent in this debate. During the past several years, the federal and state governments have spent a good deal of energy attempting to "reinvent" their relationship. The shifts in federal/state enforcement relations are highly significant, with the potential to fundamentally reorder the division of authority that has existing over the past 25 years. This book thoroughly documents the changing nature of federal/state relations in enforcing environmental law. It breaks new ground in analyzing the federal/state enforcement relationship, particularly in light of the many recent developments that have occurred in this area. The author's findings provide important lessons about the interplay between federal and state efforts in other regulatory areas, and for the structure of federal/state relations generally. Professors Rechtschaffen's and Markell's clear, in-depth analysis will be essential reading for legal and regulatory experts, attorneys who are involved in environmental enforcement matters, the judiciary, legislators, political scientists, public policy experts, and anyone with an interest in environmental law and policy.
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