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Difficulty measuring the effects of disaster preparedness has prevented a proper accounting of its benefits, says a paper published by the Institute of Medicine. "In principle, we could evaluate the effectiveness of an investment in preparedness with appropriate measures of outcomes such as response times, property saved, etc.," the paper (.pdf) says. But because emergencies are relatively rare and so different from each other, researchers rely on case studies or other qualitative methods, instead of empirical studies. The authors of the paper, dated Jan. 7, are two emergency medicine professors--Jesse Pines of George Washington University and Seth Seabury of the University of Southern California--and William Pilkington, the public health director for Cabarrus County, N.C.

In the aftermath following the terrorist attacks on September 11, 2001, federal agencies and law enforcement drove home the need for increased information sharing and improved performance throughout the intelligence community. The information failures that plagued the system previous to the attacks demonstrated the consequences of division during a crisis. Had well-run fusion centers been available at the start of this century, the deadliest terrorist attack in history would have resulted in a different outcome.

"This is an example of great restraint and excellent police work in dealing with a mental health issue where the outcome could have been much different," Bob Gualtieri said. Sachse, 54, has been with the sheriff's office since March 17, 2004. He received Crisis Intervention Training the following year. The training is designed to teach deputies how to recognize mental health issues and to deal with them in the most effective manner, according to the sheriff's office.

The outcome of the year's flurry of gun control legislative activity was similarly mixed, as this timeline of some of the most headline-making bills - and the fallout from them - demonstrates.