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To keep government operating smoothly, changes in public management policy and strategy usually follow the old rule of change--that it must evolve in a systematic and incremental fashion. But in today's unpredictable world of shrinking budgets, demands for better service, and greater accountability, playing by the old rules just doesn't make sense.

In this book, L. Douglas Kiel presents a framework that addresses the new chaotic reality of public management and the need for responsive change and innovation. By acknowledging the potential for positive change and renewal that can...

Although osteoporosis has been de? ned as a metabolic bone disease characterized by low bone mass and microarchitectural deterioration of bone tissue leading to enhanced bone fragility and a consequent increase in fracture risk, it is not clear that osteoporosis represents a single disease as much as a similar response of bone to different pathophysiologies. In the 1940s Fuller Albright and colleagues recognized osteoporosis of old age and distinguished it from osteoporosis associated with the postme- pausal state, as well as from osteoporosis from disuse, osteoporosis from malnutrition, and...