This book is an attempt to focus attention of Americans to the problem they pose for themselves and other immigrants in their midst. Also, the book highlights the alienation usually felt by naturalized citizens of the United States. Naturalized citizens and legal immigrants should be made to feel welcome both naturally and psychologically. Besides, early immigrants who had emigrated here from other parts of the world built the country. They just happened to be Europeans. It also highlights cycle of vicious behaviors on innocent population. No one is qualified to question anyone’s background. And no one is qualified enough to question the loyalty of another citizen just because they arrived here earlier. It is the contribution to progress and advancement of the nation, which should be the yardstick of love and loyalty. So also should payment of taxes and improvement and participation in civic duties. Overt pressure of questioning other citizens’ accents and fluency in the English language is a sore note of discord for all races inhabiting this free land. Unfortunately, this and other attitudes drove the early settlers or immigrants to the near annihilation of the original dwellers––the Cherokee and other American Indians. Racist attitudes that were the bases of the founding of this modern American nation must be discarded. Until all immigrants come to grip with the situation at hand and start treating one another with respect, and this coupled with the recognition of Native Americans rights and aspirations, the fabrics holding the nation together would sooner break apart at the seam.

Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.

This issue of Emergency Medicine Clinics focuses on Observation Medicine in the ED. Editors R. Gentry Wilkseron and Christopher Baugh have assembled an expert team of authors on topics such as: History and Principles of Observation Medicine; Observation Unit Design and Establishing an Observation Unit; Care of the Patient with Chest Pain in an Observation Unit; Care of Cardiovascular Conditions in an Observation Unit; Care of Gastrointestinal Conditions in an Observation Unit; Care of Metabolic / Endocrine Conditions in an Observation Unit; Care of Neurologic Conditions in an Observation Unit; Care of Respiratory Conditions in an Observation Unit; Care of Infectious Conditions in an Observation Unit; Care of Traumatic Conditions in an Observation Unit; Care of Extremes of Age in an Observation Unit.

Includes section "Book reviews".