The growing perception of the public and politicians that life is extremely risky has led to a dramatic and increasing interest in risk analysis. The risks may be very diverse as demonstrated by the range of subjects covered at the annual meetings of the Society for Risk Analysis. There is a need to pause and see how well the present approaches are serving the nation. The theme, "Setting National Priorities," which was chosen for the 1987 SRA Annual Meeting, reflects the concern that in dealing with individual kinds of risks, society may be more concerned with the trees than the forest. It is surprising how little attention is being given to the holistic aspects of risk. Who, for instance, is responsible for a national strategy to manage the reduction of health or other risks? Individual agencies have the responsibility for specific patterns of exposure, but these are not integrated and balanced to determine how the nation as a whole can obtain the greatest benefit for the very large investment which is made in risk-related research and analysis.

For any government agency, the distribution of available resources among problems or programs is crucially important. Agencies, however, typically lack a self-conscious process for examining priorities, much less an explicit method for defining what priorities should be. Worst Things First? illustrates the controversy that ensues when previously implicit administrative processes are made explicit and subjected to critical examination. It reveals surprising limitations to quantitative risk assessment as an instrument for precise tuning of policy judgments. The book also demonstrates the strength of political and social forces opposing the exclusive use of risk assessment in setting environmental priorities.

"The degree of complexity of the brain, mind and the environments in which humans live, would predict that mental health clinicians work in a perpetual state of uncertainty. That prediction would be wrong. To the contrary, in clinical practice our brains exhibit the same pedestrian bias towards irrational certainty. 1-5 Given the degree of complexity in the field of mental health, it is remarkable that we clinicians can assist anyone at all. Our professional training ratifies the scientific method in an attempt to protect us and those we treat from unwarranted certainty. Current training, however, appears to be inadequate to this task. The assessment and management of mental disorders, across specialists and non-specialists alike, is associated with ubiquitous feelings of certainty. Feeling certain despite the degree of inherent complexity and ambiguity. Feeling certain despite the rudimentary state of empirical knowledge. Feeling certain despite the absence of technologically objective methods to assist assessment or evaluate treatment results"--

Many coastal areas of the United States are at risk for tsunamis. After the catastrophic 2004 tsunami in the Indian Ocean, legislation was passed to expand U.S. tsunami warning capabilities. Since then, the nation has made progress in several related areas on both the federal and state levels. At the federal level, NOAA has improved the ability to detect and forecast tsunamis by expanding the sensor network. Other federal and state activities to increase tsunami safety include: improvements to tsunami hazard and evacuation maps for many coastal communities; vulnerability assessments of some coastal populations in several states; and new efforts to increase public awareness of the hazard and how to respond. Tsunami Warning and Preparedness explores the advances made in tsunami detection and preparedness, and identifies the challenges that still remain. The book describes areas of research and development that would improve tsunami education, preparation, and detection, especially with tsunamis that arrive less than an hour after the triggering event. It asserts that seamless coordination between the two Tsunami Warning Centers and clear communications to local officials and the public could create a timely and effective response to coastal communities facing a pending tsuanami. According to Tsunami Warning and Preparedness, minimizing future losses to the nation from tsunamis requires persistent progress across the broad spectrum of efforts including: risk assessment, public education, government coordination, detection and forecasting, and warning-center operations. The book also suggests designing effective interagency exercises, using professional emergency-management standards to prepare communities, and prioritizing funding based on tsunami risk.

A new release in the Quality Chasm Series, Priority Areas for National Action recommends a set of 20 priority areas that the U.S. Department of Health and Human Services and other groups in the public and private sectors should focus on to improve the quality of health care delivered to all Americans. The priority areas selected represent the entire spectrum of health care from preventive care to end of life care. They also touch on all age groups, health care settings and health care providers. Collective action in these areas could help transform the entire health care system. In addition, the report identifies criteria and delineates a process that DHHS may adopt to determine future priority areas.

Adolescents obviously do not always act in ways that serve their own best interests, even as defined by them. Sometimes their perception of their own risks, even of survival to adulthood, is larger than the reality; in other cases, they underestimate the risks of particular actions or behaviors. It is possible, indeed likely, that some adolescents engage in risky behaviors because of a perception of invulnerabilityâ€"the current conventional wisdom of adults' views of adolescent behavior. Others, however, take risks because they feel vulnerable to a point approaching hopelessness. In either case, these perceptions can prompt adolescents to make poor decisions that can put them at risk and leave them vulnerable to physical or psychological harm that may have a negative impact on their long-term health and viability. A small planning group was formed to develop a workshop on reconceptualizing adolescent risk and vulnerability. With funding from Carnegie Corporation of New York, the Workshop on Adolescent Risk and Vulnerability: Setting Priorities took place on March 13, 2001, in Washington, DC. The workshop's goal was to put into perspective the total burden of vulnerability that adolescents face, taking advantage of the growing societal concern for adolescents, the need to set priorities for meeting adolescents' needs, and the opportunity to apply decision-making perspectives to this critical area. This report summarizes the workshop.