• 1 Introduction
• 2 Plumage
• 3 Cultivating identity
• 4 Top people are different: association and distinction in politics and religion
• 5 Caps of liberty: the oddity of democracy
• 6 Reformations, revolutions, continuity, and counter-reformations
• 7 The plumage of Britannia
• 8 Conclusion Index
• .
• (source: Nielsen Book Data)

Throughout the twentieth century, everyone from Marxists to economic individualists assumed that social and political activity was driven by the rational pursuit of material gain. Today, the fundamental importance of the cultivation and preservation of identity is finally re-emerging. This book explores the rich fabric of speech, dress, diet and the built environment from which human identity is made. Synthesising methods and ideas from numerous disciplines - including history, political science, anthropology, law and sociology - it presents a picture of human life as more than just a collection of material interests. Its ultimate aim is to show that no human activity is trivial or meaningless, that everything counts and 'plumage' matters. An open access version of this book, funded by the London School of Economics and Political Science, is available under a CC-BY licence at www.manchesteropenhive.com and www.oapen.org. -- .
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• 1. The academic biomedical research community- vital to the Nation
• 2. Impacts of prior disasters on the academic biomedical research community
• 3. Defining the academic biomedical research community in the context of disaster resilience
• 4. Foundations in community resilience and the National Preparedness System
• 5. Prevention, protection, and mitigation planning
• 6. Response and recovery planning
• 7. Disaster resilience and animal research programs
• 8. A resilent built environment for the research enterprise
• 9. Funding a resilient mission
• 10. The essential role of research sponsors
• Appendixes.

• The academic biomedical research community : vital to the nation
• Impacts of prior disasters on the academic biomedical research community
• Defining the academic biomedical research community in the context of disaster resilience
• Foundations in community resilience and the National Preparedness System
• Prevention, protection, and mitigation planning
• Response and recovery planning
• Disaster resilience and animal research programs
• A resilient built environment for the research enterprise
• Funding a resilient mission
• The essential role of research sponsors
• Appendix A. Study methods
• Appendix B. Partnerships and peer networks
• Appendix C. Laws, regulations, and standards related to academic research institutions and disaster resilience
• Appendix D. Guidance documents
• Appendix E. Florida International University : disaster resilience and Hurricane Matthew
• Appendix F. Committee biographical sketches.

The academic biomedical research community is a hub of employment, economic productivity, and scientific progress. Academic research institutions are drivers of economic development in their local and state economies and, by extension, the national economy. Beyond the economic input that the academic biomedical research community both receives and provides, it generates knowledge that in turn affects society in myriad ways. The United States has experienced and continues to face the threat of disasters, and, like all entities, the academic biomedical research community can be affected. Recent disasters, from hurricanes to cyber-attacks, and their consequences have shown that the investments of the federal government and of the many other entities that sponsor academic research are not uniformly secure. First and foremost, events that damage biomedical laboratories and the institutions that house them can have impacts on the safety and well-being of humans and research animals. Furthermore, disasters can affect career trajectories, scientific progress, and financial stability at the individual and institutional levels. Strengthening the Disaster Resilience of the Academic Biomedical Research Community offers recommendations and guidance to enhance the disaster resilience of the academic biomedical research community, with a special focus on the potential actions researchers, academic research institutions, and research sponsors can take to mitigate the impact of future disasters.
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• 1 Front Matter-- 2 Summary-- 3 1 Introduction-- 4 2 Setting the Stage-- 5 3 Producing High-Quality Economic Evidence to Inform Investments in Children, Youth, and Families-- 6 4 Context Matters-- 7 5 A Roadmap for Improving the Use of High-Quality Economic Evidence-- 8 Appendix A: Public Session Agendas-- 9 Appendix B: Biographical Sketches of Committee Members and Staff-- 10 Glossary.
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In recent years, the U.S. federal government has invested approximately $463 billion annually in interventions that affect the overall health and well-being of children and youth, while state and local budgets have devoted almost double that amount. The potential returns on these investments may not only be substantial but also have long-lasting effects for individuals and succeeding generations of their families. Ideally, those tasked with making these investments would have available to them the evidence needed to determine the cost of all required resources to fully implement and sustain each intervention, the expected returns of the investment, to what extent these returns can be measured in monetary or nonmonetary terms, and who will receive the returns and when. As a result of a number of challenges, however, such evidence may not be effectively produced or applied. Low-quality evidence and/or a failure to consider the context in which the evidence will be used may weaken societya (TM)s ability to invest wisely, and also reduce future demand for this and other types of evidence. Advancing the Power of Economic Evidence to Inform Investments in Children, Youth, and Families highlights the potential for economic evidence to inform investment decisions for interventions that support the overall health and well-being of children, youth, and families. This report describes challenges to the optimal use of economic evidence, and offers recommendations to stakeholders to promote a lasting improvement in its quality, utility, and use.
(source: Nielsen Book Data)

• 1 Front Matter-- 2 Summary-- 3 1 Introduction-- 4 PART I: BACKGROUND-- 5 2 The Trucking and Bus Industries-- 6 3 Consequences of Fatigue from Insufficient Sleep-- 7 4 Hours-of-Service Regulations-- 8 PART II: CURRENT RESEARCH DATA AND METHODS-- 9 5 Data Sources-- 10 6 Research Methodology and Principles: Assessing Causality-- 11 PART III: CURRENT RESEARCH FINDINGS-- 12 7 Fatigue, Hours of Service, and Highway Safety-- 13 8 Fatigue and Health and Wellness-- 14 9 Technological Countermeasures for and Corporate Management of Fatigue-- 15 PART IV: RESEARCH DIRECTIONS-- 16 10 Research Directions for Fatigue and Highway Safety-- 17 11 Research Directions for Studying the Impact of Fatigue on Commercial Motor Vehicle Drivers' Health and Wellness-- 18 Glossary-- 19 References-- 20 Appendix: Biographical Sketches of Panel Members and Staff-- 21 Committee on National Statistics.
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There are approximately 4,000 fatalities in crashes involving trucks and buses in the United States each year. Though estimates are wide-ranging, possibly 10 to 20 percent of these crashes might have involved fatigued drivers. The stresses associated with their particular jobs (irregular schedules, etc.) and the lifestyle that many truck and bus drivers lead, puts them at substantial risk for insufficient sleep and for developing short- and long-term health problems. Commercial Motor Vehicle Driver Fatigue, Long-Term Health and Highway Safety assesses the state of knowledge about the relationship of such factors as hours of driving, hours on duty, and periods of rest to the fatigue experienced by truck and bus drivers while driving and the implications for the safe operation of their vehicles. This report evaluates the relationship of these factors to driversa (TM) health over the longer term, and identifies improvements in data and research methods that can lead to better understanding in both areas.
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• 1 Front Matter-- 2 Summary-- 3 1 Introduction-- 4 2 Understanding Stigma of Mental and Substance Use Disorders-- 5 3 The Science of Communication-- 6 4 Approaches to Reducing Stigma-- 7 5 Research Strategies-- 8 6 Conclusions and Recommendations-- 9 References-- 10 Appendix A: Agendas: Public Workshops-- 11 Appendix B: Biographical Sketches of Committee Members and Staff.
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Estimates indicate that as many as 1 in 4 Americans will experience a mental health problem or will misuse alcohol or drugs in their lifetimes. These disorders are among the most highly stigmatized health conditions in the United States, and they remain barriers to full participation in society in areas as basic as education, housing, and employment. Improving the lives of people with mental health and substance abuse disorders has been a priority in the United States for more than 50 years. The Community Mental Health Act of 1963 is considered a major turning point in America's efforts to improve behavioral healthcare. It ushered in an era of optimism and hope and laid the groundwork for the consumer movement and new models of recovery. The consumer movement gave voice to people with mental and substance use disorders and brought their perspectives and experience into national discussions about mental health. However over the same 50-year period, positive change in American public attitudes and beliefs about mental and substance use disorders has lagged behind these advances. Stigma is a complex social phenomenon based on a relationship between an attribute and a stereotype that assigns undesirable labels, qualities, and behaviors to a person with that attribute. Labeled individuals are then socially devalued, which leads to inequality and discrimination. This report contributes to national efforts to understand and change attitudes, beliefs and behaviors that can lead to stigma and discrimination. Changing stigma in a lasting way will require coordinated efforts, which are based on the best possible evidence, supported at the national level with multiyear funding, and planned and implemented by an effective coalition of representative stakeholders. Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma Change explores stigma and discrimination faced by individuals with mental or substance use disorders and recommends effective strategies for reducing stigma and encouraging people to seek treatment and other supportive services. It offers a set of conclusions and recommendations about successful stigma change strategies and the research needed to inform and evaluate these efforts in the United States.
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• 1 Front Matter-- 2 Summary-- 3 1 Introduction-- 4 2 Tobacco Control Landscape-- 5 3 Building Effective Models to Guide Policy Decision Making-- 6 4 An Evaluation Framework for Policy-Relevant Agent-Based Models-- 7 5 Review of the Social Network Analysis for Policy on Directed Graph Networks Model-- 8 6 Data and Implementation Needs for Computational Modeling for Tobacco Control-- 9 Appendix A: Considerations and Best Practices in Agent-Based Modeling to Inform Policy--Ross A. Hammond-- 10 Appendix B: Agent-Based Models for Policy Analysis--Lawrence Blume-- 11 Appendix C: Assessing Agent-Based Models for Regulatory Applications: Lessons from Energy Analysis--Alan H. Sanstad-- 12 Appendix D: Committee Meeting Agendas-- 13 Appendix E: Committee Biographical Sketches-- 14 Index.
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Tobacco consumption continues to be the leading cause of preventable disease and death in the United States. The Food and Drug Administration (FDA) regulates the manufacture, distribution, and marketing of tobacco products - specifically cigarettes, cigarette tobacco, roll-your-own tobacco, and smokeless tobacco - to protect public health and reduce tobacco use in the United States. Given the strong social component inherent to tobacco use onset, cessation, and relapse, and given the heterogeneity of those social interactions, agent-based models have the potential to be an essential tool in assessing the effects of policies to control tobacco. Assessing the Use of Agent-Based Models for Tobacco Regulation describes the complex tobacco environment; discusses the usefulness of agent-based models to inform tobacco policy and regulation; presents an evaluation framework for policy-relevant agent-based models; examines the role and type of data needed to develop agent-based models for tobacco regulation; provides an assessment of the agent-based model developed for FDA; and offers strategies for using agent-based models to inform decision making in the future.
(source: Nielsen Book Data)

• 1 Front Matter-- 2 Summary-- 3 1 Introduction-- 4 2 Carbon Dioxide Removal-- 5 3 Assessment of Possible Carbon Dioxide Removal and Long-Term Sequestration Systems-- 6 4 Social Context-- 7 5 Way Forward-- 8 References-- 9 Appendix A: Statement of Task for the Committee-- 10 Appendix B: Committee Biographies-- 11 Appendix C: Acronyms and Abbreviations.
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The signals are everywhere that our planet is experiencing significant climate change. It is clear that we need to reduce the emissions of carbon dioxide and other greenhouse gases from our atmosphere if we want to avoid greatly increased risk of damage from climate change. Aggressively pursuing a program of emissions abatement or mitigation will show results over a timescale of many decades. How do we actively remove carbon dioxide from the atmosphere to make a bigger difference more quickly? As one of a two-book report, this volume of Climate Intervention discusses CDR, the carbon dioxide removal of greenhouse gas emissions from the atmosphere and sequestration of it in perpetuity. Climate Intervention: Carbon Dioxide Removal and Reliable Sequestration introduces possible CDR approaches and then discusses them in depth. Land management practices, such as low-till agriculture, reforestation and afforestation, ocean iron fertilization, and land-and-ocean-based accelerated weathering, could amplify the rates of processes that are already occurring as part of the natural carbon cycle. Other CDR approaches, such as bioenergy with carbon capture and sequestration, direct air capture and sequestration, and traditional carbon capture and sequestration, seek to capture CO2 from the atmosphere and dispose of it by pumping it underground at high pressure. This book looks at the pros and cons of these options and estimates possible rates of removal and total amounts that might be removed via these methods. With whatever portfolio of technologies the transition is achieved, eliminating the carbon dioxide emissions from the global energy and transportation systems will pose an enormous technical, economic, and social challenge that will likely take decades of concerted effort to achieve. Climate Intervention: Carbon Dioxide Removal and Reliable Sequestration will help to better understand the potential cost and performance of CDR strategies to inform debate and decision making as we work to stabilize and reduce atmospheric concentrations of carbon dioxide.
(source: Nielsen Book Data)

• Introduction: Overview of the Challenges Facing the Animal Agriculture Enterprise
• Global Food Security Challenge: Sustainability Considerations
• Animal Agriculture Research Needs: U.S. Perspective
• Global Considerations for Animal Agriculture Research
• Capacity Building and Infrastructure for Research in Food Security and Animal Sciences
• Recommendations
• Appendix A: Committee on Considerations for the Future of Animal Science Research: Biographical Information
• Appendix B: Statement of Task
• Appendix C: Glossary
• Appendix D: Key Strategies Involving Animal Agriculture Being Focused on by USDA Research, Education, and Economics (REE)
• Appendix E: USDA ARS Proposed FY 2015 Priorities
• Appendix F: Animal Health Priorities from a 2011 USDA NIFA Workshop
• Appendix G: Results of a USDA ARS- and NIFA-Sponsored Workshop on Animal Health
• Appendix H: Summary of NOAA/USDA Findings on Alternative Feeds for Aquaculture
• Appendix I: Goals for Priorities Identified by the EU Animal Task Force
• Appendix J: USDA NIFA Investment in Animal Science by Species
• Appendix K: Animal Science Investment by Knowledge Area
• Appendix L: USDA ARS Animal Agriculture Research FY 2010FY 2014.

By 2050 the world's population is projected to grow by one-third, reaching between 9 and 10 billion. With globalization and expected growth in global affluence, a substantial increase in per capita meat, dairy, and fish consumption is also anticipated. The demand for calories from animal products will nearly double, highlighting the critical importance of the world's animal agriculture system. Meeting the nutritional needs of this population and its demand for animal products will require a significant investment of resources as well as policy changes that are supportive of agricultural production. Ensuring sustainable agricultural growth will be essential to addressing this global challenge to food security. Critical Role of Animal Science Research in Food Security and Sustainability identifies areas of research and development, technology, and resource needs for research in the field of animal agriculture, both nationally and internationally. This report assesses the global demand for products of animal origin in 2050 within the framework of ensuring global food security; evaluates how climate change and natural resource constraints may impact the ability to meet future global demand for animal products in sustainable production systems; and identifies factors that may impact the ability of the United States to meet demand for animal products, including the need for trained human capital, product safety and quality, and effective communication and adoption of new knowledge, information, and technologies. The agricultural sector worldwide faces numerous daunting challenges that will require innovations, new technologies, and new ways of approaching agriculture if the food, feed, and fiber needs of the global population are to be met. The recommendations of Critical Role of Animal Science Research in Food Security and Sustainability will inform a new roadmap for animal science research to meet the challenges of sustainable animal production in the 21st century.

• 1 Front Matter-- 2 Summary-- 3 Part I: Setting the Stage-- 4 1 Introduction-- 5 2 Science to Inform Team Science-- 6 Part II: The Individual and Team Levels-- 7 3 Overview of the Research on Team Effectiveness-- 8 4 Team Composition and Assembly-- 9 5 Professional Development and Education for Team Science-- 10 6 Team Science Leadership-- 11 Part III: The Institutional and Organizational Level-- 12 7 Supporting Virtual Collaboration-- 13 8 Institutional and Organizational Support for Team Science-- 14 9 Funding and Evaluation of Team Science-- 15 Part IV: A Path Forward-- 16 10 Advancing Research on the Effectiveness of Team Science-- 17 References-- 18 Appendix: Biographical Sketches of Committee Members.
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The past half-century has witnessed a dramatic increase in the scale and complexity of scientific research. The growing scale of science has been accompanied by a shift toward collaborative research, referred to as "team science." Scientific research is increasingly conducted by small teams and larger groups rather than individual investigators, but the challenges of collaboration can slow these teams' progress in achieving their scientific goals. How does a team-based approach work, and how can universities and research institutions support teams? Enhancing the Effectiveness of Team Science synthesizes and integrates the available research to provide guidance on assembling the science team; leadership, education and professional development for science teams and groups. It also examines institutional and organizational structures and policies to support science teams and identifies areas where further research is needed to help science teams and groups achieve their scientific and translational goals. This report offers major public policy recommendations for science research agencies and policymakers, as well as recommendations for individual scientists, disciplinary associations, and research universities. Enhancing the Effectiveness of Team Science will be of interest to university research administrators, team science leaders, science faculty, and graduate and postdoctoral students.
(source: Nielsen Book Data)

• 1 Front Matter-- 2 Summary-- 3 1 Introduction and Context-- 4 2 Industrial Biotechnology: Past and Present-- 5 3 Vision of the Future: What New Chemicals Could Be Made?-- 6 4 How Do We Get There?-- 7 5 What Is Success and How to Get There: Recommendations-- 8 References-- 9 Appendix A: Glossary-- 10 Appendix B: The Current Regulatory Framework-- 11 Appendix C: Committee Member and Staff Biographies-- 12 Appendix D: Workshop Agenda and Attendees-- 13 FIgures S-1 and 5-1 (foldout).
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The tremendous progress in biology over the last half century - from Watson and Crick's elucidation of the structure of DNA to today's astonishing, rapid progress in the field of synthetic biology - has positioned us for significant innovation in chemical production. New bio-based chemicals, improved public health through improved drugs and diagnostics, and biofuels that reduce our dependency on oil are all results of research and innovation in the biological sciences. In the past decade, we have witnessed major advances made possible by biotechnology in areas such as rapid, low-cost DNA sequencing, metabolic engineering, and high-throughput screening. The manufacturing of chemicals using biological synthesis and engineering could expand even faster. A proactive strategy - implemented through the development of a technical roadmap similar to those that enabled sustained growth in the semiconductor industry and our explorations of space - is needed if we are to realize the widespread benefits of accelerating the industrialization of biology. Industrialization of Biology presents such a roadmap to achieve key technical milestones for chemical manufacturing through biological routes. This report examines the technical, economic, and societal factors that limit the adoption of bioprocessing in the chemical industry today and which, if surmounted, would markedly accelerate the advanced manufacturing of chemicals via industrial biotechnology. Working at the interface of synthetic chemistry, metabolic engineering, molecular biology, and synthetic biology, Industrialization of Biology identifies key technical goals for next-generation chemical manufacturing, then identifies the gaps in knowledge, tools, techniques, and systems required to meet those goals, and targets and timelines for achieving them. This report also considers the skills necessary to accomplish the roadmap goals, and what training opportunities are required to produce the cadre of skilled scientists and engineers needed.
(source: Nielsen Book Data)

In the last few decades great strides have been made in chemistry at the nanoscale, where the atomic granularity of matter and the exact positions of individual atoms are key determinants of structure and dynamics. Less attention, however, has been paid to the mesoscale--it is at this scale, in the range extending from large molecules (10 nm) through viruses to eukaryotic cells (10 microns), where interesting ensemble effects and the functionality that is critical to macroscopic phenomenon begins to manifest itself and cannot be described by laws on the scale of atoms and molecules alone. To further explore how knowledge about mesoscale phenomena can impact chemical research and development activities and vice versa, the Chemical Sciences Roundtable of the National Research Council convened a workshop on mesoscale chemistry in November 2014. With a focus on the research on chemical phenomena at the mesoscale, participants examined the opportunities that utilizing those behaviors can have for developing new catalysts, adding new functionality to materials, and increasing our understanding of biological and interfacial systems. The workshop also highlighted some of the challenges for analysis and description of mesoscale structures. This report summarizes the presentations and discussion of the workshop.

• 1 Front Matter-- 2 Summary-- 3 1 Introduction-- 4 2 TCDD: Physicochemical Properties and Health Guidelines-- 5 3 Air Force Use of the C-123 Provider: Background and Sampling Data-- 6 4 Evaluation of Assessments of Possible Exposure of Air Force Reservists from Service in Operation Ranch Hand C-123s-- 7 5 Summary of Findings-- 8 References-- 9 Appendix A: Public Agendas from Committee Meetings-- 10 Appendix B: History and Sampling of C-123s in the United States After Spraying Herbicides in Vietnam-- 11 Appendix C: Committee Biographies.
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From 1972 to 1982, approximately 1,500-2,100 US Air Force Reserve personnel trained and worked on C-123 aircraft that had formerly been used to spray herbicides in Vietnam as part of Operation Ranch Hand. After becoming aware that some of the aircraft on which they had worked had previously served this purpose, some of these AF Reservists applied to the US Department of Veterans Affairs (VA) for compensatory coverage under the Agent Orange Act of 1991. The Act provides health care and disability coverage for health conditions that have been deemed presumptively service-related for herbicide exposure during the Vietnam War. The VA denied the applications on the basis that these veterans were ineligible because as non-Vietnam-era veterans or as Vietnam-era veterans without "boots on the ground" service in Vietnam, they were not covered. However, with the knowledge that some air and wipe samples taken between 1979 and 2009 from some of the C-123s used in Operation Ranch Hand showed the presence of agent orange residues, representatives of the C-123 Veterans Association began a concerted effort to reverse VA's position and obtain coverage. At the request of the VA, Post-Vietnam Dioxin Exposure in Agent Orange-Contaminated C-123 Aircraft evaluates whether or not service in these C-123s could have plausibly resulted in exposures detrimental to the health of these Air Force Reservists. The Institute of Medicine assembled an expert committee to address this question qualitatively, but in a scientific and evidence-based fashion. This report evaluates the reliability of the available information for establishing exposure and addresses and places in context whether any documented residues represent potentially harmful exposure by characterizing the amounts available and the degree to which absorption might be expected. Post-Vietnam Dioxin Exposure rejects the idea that the dioxin residues detected on interior surfaces of the C-123s were immobile and effectively inaccessible to the Reservists as a source of exposure. Accordingly, this report states with confidence that the Air Force Reservists were exposed when working in the Operation Ranch Hand C-123s and so experienced some increase in their risk of a variety of adverse responses.
(source: Nielsen Book Data)

• 1 Front Matter-- 2 1 Introduction-- 3 2 Evacuation, Patient Tracking, and Information Sharing in a Regional Response-- 4 3 Public Health Surge Capacity and Community Resilience-- 5 4 Coordination of a Community Response-- 6 5 Final Remarks-- 7 A-- References-- 8 B-- Acronyms-- 9 C-- Statement of Task-- 10 D--Agendas-- 11 E-- Biographical Sketches of Invited Speakers and Panelists-- 12 F-- Speakers and Registered Attendees.
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When disaster strikes, it rarely impacts just one jurisdiction. Many catastrophic disaster plans include support from neighboring jurisdictions that likely will not be available in a regional disaster. Bringing multiple stakeholders together from sectors that do not routinely work with each other can augment a response to a disaster, but can also be extremely difficult because of the multi-disciplinary communication and coordination needed to ensure effective medical and public health response. As many communities within a region will have similar vulnerabilities, a logical step in planning is to establish responsibilities and capacities, and be able to work toward common goals to address all-hazards when the entire region is affected. To explore these considerations, the Institute of Medicine's Forum on Medical and Public Health Preparedness for Catastrophic Events organized a series of three regional workshops in 2014 to explore opportunities to strengthen the regional coordination required in response to a large scale multijurisdictional disaster. The purpose of each regional workshop was to discuss ways to strengthen coordination among multiple jurisdictions in various regions to ensure fair and equitable treatment of communities from all impacted areas. Regional Disaster Response Coordination to Support Health Outcomes summarizes the presentation and discussion of these workshops.
(source: Nielsen Book Data)

• 1 Front Matter-- 2 1 Introduction-- 3 2 Interaction Between the Brain and the Digestive System-- 4 3 Assessing the Science Behind Methodologies Being Used to Characterize Food as Addictive-- 5 4 Future Directions: Is the Addiction Model for Drugs and Alcohol Appropriate for Food?-- 6 5 Integrating the Evidence-- 7 References-- 8 Appendix A: Abbreviations and Acronyms-- 9 Appendix B: Workshop Agenda-- 10 Appendix C: Speaker Biographical Sketches.
• (source: Nielsen Book Data)

On July 9-10, 2014, the Institute of Medicine's Food Forum hosted a public workshop to explore emerging and rapidly developing research on relationships among the brain, the digestive system, and eating behavior. Drawing on expertise from the fields of nutrition and food science, animal and human physiology and behavior, and psychology and psychiatry as well as related fields, the purpose of the workshop was to (1) review current knowledge on the relationship between the brain and eating behavior, explore the interaction between the brain and the digestive system, and consider what is known about the brain's role in eating patterns and consumer choice; (2) evaluate current methods used to determine the impact of food on brain activity and eating behavior; and (3) identify gaps in knowledge and articulate a theoretical framework for future research. Relationships among the Brain, the Digestive System, and Eating Behavior summarizes the presentations and discussion of the workshop.
(source: Nielsen Book Data)

• 1 Front Matter-- 2 Summary-- 3 1 Introduction-- 4 2 Hydrologic Modeling-- 5 3 Ecological Modeling-- 6 4 Monitoring-- 7 5 Applied Research Program-- 8 6 Overarching Issues-- 9 Acronyms.
• (source: Nielsen Book Data)

The Edwards Aquifer in south-central Texas is the primary source of water for one of the fastest growing cities in the United States, San Antonio, and it also supplies irrigation water to thousands of farmers and livestock operators. It is also is the source water for several springs and rivers, including the two largest freshwater springs in Texas that form the San Marcos and Comal Rivers. The unique habitat afforded by these spring-fed rivers has led to the development of species that are found in no other locations on Earth. Due to the potential for variations in spring flow caused by both human and natural causes, these species are continuously at risk and have been recognized as endangered under the federal Endangered Species Act (ESA). In an effort to manage the river systems and the aquifer that controls them, the Edwards Aquifer Authority and stakeholders have developed a Habitat Conservation Plan (HCP). The HCP seeks to effectively manage the river-aquifer system to ensure the viability of the ESA-listed species in the face of drought, population growth, and other threats to the aquifer. The National Research Council was asked to assist in this process by reviewing the activities around implementing the HCP. Review of the Edwards Aquifer Habitat Conservation Plan: Report 1 is the first stage of a three-stage study. This report reviews the scientific efforts that are being conducted to help build a better understanding of the river-aquifer system and its relationship to the ESA-listed species. These efforts, which include monitoring and modeling as well as research on key uncertainties in the system, are designed to build a better understanding of how best to manage and protect the system and the endangered species. Thus, the current report is focused specifically on a review of the hydrologic modeling, the ecological modeling, the water quality and biological monitoring, and the Applied Research Program. The fundamental question that Review of the Edwards Aquifer Habitat Conservation Plan: Report 1 addresses is whether the scientific initiatives appropriately address uncertainties and fill knowledge gaps in the river-aquifer system and the species of concern. It is hoped that the successful completion of these scientific initiatives will ultimately lead the Edwards Aquifer Authority to an improved understanding of how to manage the system and protect these species.
(source: Nielsen Book Data)

• 1 Front Matter-- 2 Summary-- 3 1 Introduction-- 4 2 Characterization of Renal Toxicity-- 5 3 Characterization of Neurobehavioral Effects-- 6 4 Other Health Outcomes-- 7 5 Use of the Guidance-- 8 Appendix A: Committee Biographies-- 9 Appendix B: Guidance for VHA Staff Honoring America's Veterans and Caring for Camp Lejeune Families Act of 2012, Section 102, Covered Clinical Conditions-- 10 Appendix C: Excerpt from the Honoring America's Veterans and Caring for Camp Lejeune Families Act of 2012 (P.L. 112-154).
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U.S. Marine Corps Base Camp Lejeune, located in eastern North Carolina, is a large installation that covers 156,000 acres and is home at any given time to a population of about 170,000 active-duty personnel, family members, retirees, and civilian employees living on base or in the surrounding community. Between 1957 and 1987, the ground water at Camp Lejeune was inadvertently contaminated with chemicals, primarily industrial solvents that are now known to cause cancer and other health problems. In 1980, drinking water contaminants, primarily trichloroethylene (TCE) and perchloroethylene (PCE), as well as other solvents, were first detected at Camp Lejeune in treated drinking water. The contaminated wells were closed in 1987. In 1989, the U.S. Environmental Protection Agency placed Camp Lejeune on the National Priorities List, also known as Superfund. It is estimated that between 500,000 and 1,000,000 people may have used the contaminated water and many of them continue to have concerns about the long-term effects that might result from that exposure. In 2012 Congress passed the Honoring America's Veterans and Caring for Camp Lejeune Families Act. The law provides health benefits to veterans and family members who have any of 15 health outcomes associated with exposure to TCE, PCE, or solvent mixtures. At the request of the Veteran's Administration, Review of the VA Guidance for the Health Conditions Identified by the Camp Lejeune Legislation reviews the latest scientific literature to ensure that the clinical guidance provided for the 15 covered medical conditions is scientifically sound. This report also describes the medical conditions that result from renal toxicity due to solvent exposures and characterizes neurobehavioral effects as mandated for coverage in the law.
(source: Nielsen Book Data)

• 1 Front Matter-- 2 Summary-- 3 1 Introduction-- 4 2 Guiding Principles for Sharing Clinical Trial Data-- 5 3 The Roles and Responsibilities of Stakeholders in the Sharing of Clinical Trial Data-- 6 4 The Clinical Trial Life Cycle and When to Share Data-- 7 5 Access to Clinical Trial Data: Governance-- 8 6 The Future of Data Sharing in a Changing Landscape-- 9 Appendix A: Study Approach-- 10 Appendix B: Concepts and Methods for De-identifying Clinical Trial Data-- 11 Appendix C: Legal Discussion of Risks to Industry Sponsors-- 12 Appendix D: Clinical Trial Data Sharing Policies: Top 1-12 Pharmaceutical Companies Ranked by 2013 Market Capitalization-- 13 Appendix E: Biosketches of Committee Members.
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Data sharing can accelerate new discoveries by avoiding duplicative trials, stimulating new ideas for research, and enabling the maximal scientific knowledge and benefits to be gained from the efforts of clinical trial participants and investigators. At the same time, sharing clinical trial data presents risks, burdens, and challenges. These include the need to protect the privacy and honor the consent of clinical trial participants; safeguard the legitimate economic interests of sponsors; and guard against invalid secondary analyses, which could undermine trust in clinical trials or otherwise harm public health. Sharing Clinical Trial Data presents activities and strategies for the responsible sharing of clinical trial data. With the goal of increasing scientific knowledge to lead to better therapies for patients, this book identifies guiding principles and makes recommendations to maximize the benefits and minimize risks. This report offers guidance on the types of clinical trial data available at different points in the process, the points in the process at which each type of data should be shared, methods for sharing data, what groups should have access to data, and future knowledge and infrastructure needs. Responsible sharing of clinical trial data will allow other investigators to replicate published findings and carry out additional analyses, strengthen the evidence base for regulatory and clinical decisions, and increase the scientific knowledge gained from investments by the funders of clinical trials. The recommendations of Sharing Clinical Trial Data will be useful both now and well into the future as improved sharing of data leads to a stronger evidence base for treatment. This book will be of interest to stakeholders across the spectrum of research--from funders, to researchers, to journals, to physicians, and ultimately, to patients.
(source: Nielsen Book Data)

• 1 Front Matter-- 2 1 Introduction-- 3 2 Defining PAPRs and Current Standards-- 4 3 Why, Where, and How PAPRs Are Being Used in Health Care-- 5 4 Research and Design Perspectives-- 6 5 Priorities and Opportunities for Improving PAPRs for Use in Health Care-- 7 References-- 8 Appendix A: Agenda-- 9 Appendix B: Registered Attendees.
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Protecting 18 million United States health care workers from infectious agents - known and unknown - involves a range of occupational safety and health measures that include identifying and using appropriate protective equipment. The 2009 H1N1 influenza pandemic and the 2014 Ebola virus outbreak in West Africa have called raised questions about how best to ensure appropriate and effective use of different kinds of personal protective equipment such as respirators, not only to promote occupational safety but also to reduce disease transmission. The Use and Effectiveness of Powered Air Purifying Respirators in Health Care is the summary of a workshop convened by the Institute of Medicine Standing Committee on Personal Protective Equipment for Workplace Safety and Health to explore the current state of practices and research related to powered air purifying respirator (PAPRs) and potential updates to performance requirements. Presentations and discussions highlighted current health care practices using PAPRs and outlined the research to date on the use and effectiveness of PAPRs in health care settings with a focus on the performance requirements. The Use and Effectiveness of Powered Air Purifying Respirators in Health Care focuses on efficacy, current training, maintenance, supplies, and possible enhancements and barriers to use in inpatient, clinic, nursing home, and community (home) settings. This report also explores the strengths and weaknesses of using various approaches to health care PAPR standards.
(source: Nielsen Book Data)

• Introduction and overview
• Health care and health care measurement in America
• Improving the impact of measurement
• The core measure set
• Implementation : putting the core measures to use
• Action agenda
• Appendixes: Glossary ; Existing reporting requirements ; Existing data sources ; Existing infrastructure ; Biosketches of committee members and staff.

Thousands of measures are in use today to assess health and health care in the United States. Although many of these measures provide useful information, their usefulness in either gauging or guiding performance improvement in health and health care is seriously limited by their sheer number, as well as their lack of consistency, compatibility, reliability, focus, and organization. To achieve better health at lower cost, all stakeholders-including health professionals, payers, policy makers, and members of the public-must be alert to what matters most. What are the core measures that will yield the clearest understanding and focus on better health and well-being for Americans? Vital Signs explores the most important issues-healthier people, better quality care, affordable care, and engaged individuals and communities-and specifies a streamlined set of 15 core measures. These measures, if standardized and applied at national, state, local, and institutional levels across the country, will transform the effectiveness, efficiency, and burden of health measurement and help accelerate focus and progress on our highest health priorities. Vital Signs also describes the leadership and activities necessary to refine, apply, maintain, and revise the measures over time, as well as how they can improve the focus and utility of measures outside the core set. If health care is to become more effective and more efficient, sharper attention is required on the elements most important to health and health care. Vital Signs lays the groundwork for the adoption of core measures that, if systematically applied, will yield better health at a lower cost for all Americans.

• 1 Front Matter-- 2 1 Introduction-- 3 2 Intake and Exposure to Caffeine-- 4 3 Safety Signals and Surveillance-- 5 4 Exploring Safe Caffeine Exposure Levels for Vulnerable Populations-- 6 5 Caffeine Effects on the Cardiovascular System-- 7 6 Caffeine Effects on the Central Nervous System and Behavioral Effects Associated with Caffeine Consumption-- 8 7 Other Compounds Impacting Caffeine Effects-- 9 8 Public Comments-- 10 9 Moving Forward: Filling the Data Gaps-- 11 Appendix A: Workshop Agenda-- 12 Appendix B: Workshop Attendees-- 13 Appendix C: Biographical Sketches of Workshop Speakers and Moderators-- 14 Appendix D: Workshop Statement of Task.
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Caffeine in Food and Dietary Supplements is the summary of a workshop convened by the Institute of Medicine in August 2013 to review the available science on safe levels of caffeine consumption in foods, beverages, and dietary supplements and to identify data gaps. Scientists with expertise in food safety, nutrition, pharmacology, psychology, toxicology, and related disciplines; medical professionals with pediatric and adult patient experience in cardiology, neurology, and psychiatry; public health professionals; food industry representatives; regulatory experts; and consumer advocates discussed the safety of caffeine in food and dietary supplements, including, but not limited to, caffeinated beverage products, and identified data gaps. Caffeine, a central nervous stimulant, is arguably the most frequently ingested pharmacologically active substance in the world. Occurring naturally in more than 60 plants, including coffee beans, tea leaves, cola nuts and cocoa pods, caffeine has been part of innumerable cultures for centuries. But the caffeine-in-food landscape is changing. There are an array of new caffeine-containing energy products, from waffles to sunflower seeds, jelly beans to syrup, even bottled water, entering the marketplace. Years of scientific research have shown that moderate consumption by healthy adults of products containing naturally-occurring caffeine is not associated with adverse health effects. The changing caffeine landscape raises concerns about safety and whether any of these new products might be targeting populations not normally associated with caffeine consumption, namely children and adolescents, and whether caffeine poses a greater health risk to those populations than it does for healthy adults. This report delineates vulnerable populations who may be at risk from caffeine exposure; describes caffeine exposure and risk of cardiovascular and other health effects on vulnerable populations, including additive effects with other ingredients and effects related to pre-existing conditions; explores safe caffeine exposure levels for general and vulnerable populations; and identifies data gaps on caffeine stimulant effects.
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• 1 Front Matter-- 2 Summary-- 3 1 Introduction-- 4 2 Selection of Domains for Consideration-- 5 3 Identified Candidate Domains-- 6 A Agendas of Public Meetings-- 7 B Committee Biographies.
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Substantial empirical evidence of the contribution of social and behavioral factors to functional status and the onset and progression of disease has accumulated over the past few decades. Electronic health records (EHRs) provide crucial information to providers treating individual patients, to health systems, including public health officials, about the health of populations, and to researchers about the determinants of health and the effectiveness of treatment. Inclusion of social and behavioral health domains in EHRs is vital to all three uses. The Health Information Technology for Economic and Clinical Health Act and the Patient Protection and Affordable Care Act place new importance on the widespread adoption and meaningful use of EHRs. "Meaningful use" in a health information technology context refers to the use of EHRs and related technology within a health care organization to achieve specified objectives. Achieving meaningful use also helps determine whether an organization can receive payments from the Medicare EHR Incentive Program or the Medicaid EHR Incentive Program. Capturing Social and Behavioral Domains in Electronic Health Records is the first phase of a two-phase study to identify domains and measures that capture the social determinants of health to inform the development of recommendations for meaningful use of EHRs. This report identifies specific domains to be considered by the Office of the National Coordinator, specifies criteria that should be used in deciding which domains should be included, identifies core social and behavioral domains to be included in all EHRs, and identifies any domains that should be included for specific populations or settings defined by age, socioeconomic status, race/ethnicity, disease, or other characteristics.
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• 1 Front Matter-- 2 1 Introduction-- 3 2 Identifying and Characterizing Uncertainty-- 4 3 The Regulators' Challenge-- 5 4 Basic Methodologies and Applications for Understanding and Evaluating Uncertainty-- 6 5 Communicating Uncertainty-- 7 6 Final Reflections on Ways to Characterize and Communicate Uncertainty-- 8 References-- 9 Appendix A: Workshop Agenda-- 10 Appendix B: FDA Case Studies-- 11 Appendix C: Bibliography-- 12 Appendix D: Participant Biographies.
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Despite the extensive body of evidence that informs regulatory decisions on pharmaceutical products, significant uncertainties persist, including the underlying variability in human biology, factors associated with the chemistry of a drug, and limitations in the research and clinical trial process itself that might limit the generalizability of results. As a result, regulatory reviewers are consistently required to draw conclusions about a drug's safety and efficacy from imperfect data. Efforts are underway within the drug development community to enhance the evaluation and communication of the benefits and risks associated with pharmaceutical products, aimed at increasing the predictability, transparency, and efficiency of pharmaceutical regulatory decision making. Effectively communicating regulatory decisions necessarily includes explanation of the impact of uncertainty on decision making. On February 12 and May 12, 2014, the Institute of Medicine's Forum on Drug Discovery, Development, and Translation held public workshops to advance the development of more systematic and structured approaches to characterize and communicate the sources of uncertainty in the assessment of benefits and risks, and to consider their implications for pharmaceutical regulatory decisions. Workshop presentations and discussions on February 12 were convened to explore the science of identifying and characterizing uncertainty in scientific evidence and approaches to translate uncertainties into decisions that reflect the values of stakeholders. The May 12 workshop presentations and discussions explored tools and approaches to communicating about scientific uncertainties to a range of stakeholders in the drug development process. Characterizing and Communicating Uncertainty in the Assessment of Benefits and Risks of Pharmaceutical Products summarizes the presentation and discussion of both events. This report explores potential analytical and communication approaches and identifies key considerations on their development, evaluation, and incorporation into pharmaceutical benefit- risk assessment throughout the entire drug development lifecycle.
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• Introduction
• The current logistics picture
• Reducing the major logistics demands
• Logistics mobility
• Maintenance, retrograde, and waste
• Logistics enterprise information systems and decision support
• Use of contractors and the Army Reserve
• Optimizing the logistics effort
• Logistics-centric science and technology and research and development investment strategy
• Future operations : how it might be
• Findings and recommendations.

"Force Multiplying Technologies for Logistics Support to Military Operations explores Army logistics in a global, complex environment that includes the increasing use of antiaccess and area-denial tactics and technologies by potential adversaries. This report describes new technologies and systems that would reduce the demand for logistics and meet the demand at the point of need, make maintenance more efficient, improve inter- and intratheater mobility, and improve near-real-time, in-transit visibility. Force Multiplying Technologies also explores options for the Army to operate with the other services and improve its support of Special Operations Forces. This report provides a logistics-centric research and development investment strategy and illustrative examples of how improved logistics could look in the future."--Publisher description.

• 1 Front Matter-- 2 Summary-- 3 1 Introduction-- 4 2 Evolution of the U.S. Research Enterprise-- 5 3 Understanding the Pathways from Research to Innovation-- 6 4 The Usefulness and Limitations of Metrics in Measuring the Returns on Publicly Funded Research-- 7 5 Measuring Research Impacts and Quality-- 8 6 Understanding the Research Enterprise as a Complex System-- 9 7 Conclusion-- 10 References-- 11 Appendix A: An Evaluation of STAR METRICS-- 12 Appendix B: U.S. Universities and Industrial Innovation: An Interactive Relationship Producing Economic Value from Research-- 13 Appendix C-- Annotated Bibliography of Selected Studies-- 14 Appendix D: The Study Process-- 15 Appendix E: Biographical Sketches of Committee Members and Staff.
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Scientific research has enabled America to remain at the forefront of global competition for commercially viable technologies and other innovations. For more than 65 years, the United States has led the world in science and technology. Discoveries from scientific research have extended our understanding of the physical and natural world, the cosmos, society, and of humans - their minds, bodies, and economic and other social interactions. Through these discoveries, science has enabled longer and healthier lives, provided for a better-educated citizenry, enhanced the national economy, and strengthened America\'s position in the global economy. At a time of budget stringency, how can we foster scientific innovation to ensure America\'s unprecedented prosperity, security, and quality of life? Although many studies have investigated the impacts of research on society, Furthering America's Research Enterprise brings to bear a fresh approach informed by a more holistic understanding of the research enterprise as a complex, dynamic system. This understanding illuminates why America's research enterprise has historically been so successful; where attention should be focused to increase the societal benefits of research investments; and how those who make decisions on the allocation of funds for scientific research can best carry out their task. This report will be of special interest to policy makers who support or manage the research enterprise, to others in public and private institutions who fund research, to scholars of the research enterprise, and to scientists and engineers who seek to better understand the many pathways through which their research benefits society.
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• 1 Front Matter-- 2 1 Introduction-- 3 2 Opening Session-- 4 3 Geographic Footprint of Shale Gas Extraction-- 5 4 Occupational Health and Community Impacts-- 6 5 Air Quality-- 7 6 Water Quality-- 8 7 Sustainable Energy-- 9 8 Research Opportunities: Research Community-- 10 9 Research Opportunities: Federal Representatives-- 11 Appendix A: Agenda-- 12 Appendix B: Speaker Biosketches-- 13 Appendix C: Acronyms.
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Natural gas extraction from shale formations, which includes hydraulic fracturing, is increasingly in the news as the use of extraction technologies has expanded, rural communities have been transformed seemingly overnight, public awareness has increased, and regulations have been developed. The governmental public health system, which retains primary responsibility for health, was not an early participant in discussions about shale gas extraction; thus public health is lacking critical information about environmental health impacts of these technologies and is limited in its ability to address concerns raised by regulators at the federal and state levels, communities, and workers employed in the shale gas extraction industry. Health Impact Assessment of Shale Gas Extraction is the summary of a workshop convened in 2012 by the Institute of Medicine (IOM) Roundtable on Environmental Health Sciences, Research, and Medicine to discuss the human health impact of shale gas extraction through the lens of a health impact assessment. Eminent scientists, physicians, public health experts, and representatives from government agencies at federal and state levels, from nongovernment organizations, from the business sector, and from interest groups representing the interests of the citizens met to exchange ideas and to inform on hydraulic fracturing as a means of extraction of natural gas. This report examines the state of the science regarding shale gas extraction, the direct and indirect environmental health impacts of shale gas extraction, and the use of health impact assessment as a tool that can help decision makers identify the public health consequences of shale gas extraction.
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• 1 Front Matter-- 2 Summary-- 3 1 Introduction-- 4 2 Describing the Problem-- 5 3 Causality-- 6 4 Consequences of Child Abuse and Neglect-- 7 5 The Child Welfare System-- 8 6 Interventions and Service Delivery Systems-- 9 7 Research Challenges and Infrastructure-- 10 8 Child Abuse and Neglect Policy-- 11 9 Recommendations-- 12 Appendix A: Workshop Open Session Agendas-- 13 Appendix B: Research Recommendations and Priorities from the 1993 National Research Council Report "Understanding Child Abuse and Neglect"-- 14 Appendix C: Biosketches of Committee Members.
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Each year, child protective services receive reports of child abuse and neglect involving six million children, and many more go unreported. The long-term human and fiscal consequences of child abuse and neglect are not relegated to the victims themselves -- they also impact their families, future relationships, and society. In 1993, the National Research Council (NRC) issued the report, Under-standing Child Abuse and Neglect, which provided an overview of the research on child abuse and neglect. New Directions in Child Abuse and Neglect Research updates the 1993 report and provides new recommendations to respond to this public health challenge. According to this report, while there has been great progress in child abuse and neglect research, a coordinated, national research infrastructure with high-level federal support needs to be established and implemented immediately. New Directions in Child Abuse and Neglect Research recommends an actionable framework to guide and support future child abuse and neglect research. This report calls for a comprehensive, multidisciplinary approach to child abuse and neglect research that examines factors related to both children and adults across physical, mental, and behavioral health domains--including those in child welfare, economic support, criminal justice, education, and health care systems--and assesses the needs of a variety of subpopulations. It should also clarify the causal pathways related to child abuse and neglect and, more importantly, assess efforts to interrupt these pathways. New Directions in Child Abuse and Neglect Research identifies four areas to look to in developing a coordinated research enterprise: a national strategic plan, a national surveillance system, a new generation of researchers, and changes in the federal and state programmatic and policy response.
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• 1 Front Matter-- 2 SUMMARY-- 3 1 INTRODUCTION-- 4 2 CONCEPTUAL FRAMEWORKS FOR REVIEWING EVIDENCE-BASED PREVENTION IN PSYCHOLOGICAL HEALTH-- 5 3 UNDERSTANDING PSYCHOLOGICAL HEALTH IN THE MILITARY-- 6 4 EVIDENCE FOR DEPARTMENT OF DEFENSE INTERVENTIONS FOR PREVENTING PSYCHOLOGICAL DISORDERS-- 7 5 MEASUREMENT OF DEPARTMENT OF DEFENSE PREVENTION INTERVENTIONS RELATED TO PSYCHOLOGICAL HEALTH-- 8 6 FINDINGS AND RECOMMENDATIONS-- 9 Appendix A: SUMMARY FROM *RETURNING HOME FROM IRAQ AND AFGHANISTAN: ASSESSMENT OF READJUSTMENT NEEDS OF SERVICE MEMBERS AND THEIR FAMILIES*-- 10 Appendix B: INFORMATION-GATHERING MEETING AGENDA-- 11 Appendix C: SUPPLEMENTAL HEALTH SCREENING QUESTIONNAIRE-- 12 Appendix D: PRE-DEPLOYMENT HEALTH ASSESSMENT QUESTIONNAIRE-- 13 Appendix E: POST-DEPLOYMENT HEALTH ASSESSMENT QUESTIONNAIRE-- 14 Appendix F: POST-DEPLOYMENT HEALTH RE-ASSESSMENT QUESTIONNAIRE-- 15 Appendix G: PROGRAM REVIEWS FROM *SUBSTANCE USE DISORDERS IN THE U.S. ARMED FORCES*-- 16 Appendix H: TABLE OF DOD PROGRAMS TO INCREASE RESILIENCE OR PREVENT PSYCHOLOGICAL HEALTH DISORDERS, AS IDENTIFIED BY RAND.
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Being deployed to a war zone can result in numerous adverse psychological health conditions. It is well documented in the literature that there are high rates of psychological disorders among military personnel serving in Operation Enduring Freedom in Afghanistan and Operation Iraqi Freedom in Iraq as well as among the service members' families. For service members' families, the degree of hardship and negative consequences rises with the amount of the service members' exposure to traumatic or life-altering experiences. Adult and child members of the families of service members who experience wartime deployments have been found to be at increased risk for symptoms of psychological disorders and to be more likely to use mental health services. In an effort to provide early recognition and early intervention that meet the psychological health needs of service members and their families, DOD currently screens for many of these conditions at numerous points during the military life cycle, and it is implementing structural interventions that support the improved integration of military line personnel, non-medical caregivers, and clinicians, such as RESPECT-Mil (Re-engineering Systems of Primary Care Treatment in the Military), embedded mental health providers, and the Patient-Centered Medical Home. Preventing Psychological Disorders in Service Members and Their Families evaluates risk and protective factors in military and family populations and suggests that prevention strategies are needed at multiple levels - individual, interpersonal, institutional, community, and societal - in order to address the influence that these factors have on psychological health. This report reviews and critiques reintegration programs and prevention strategies for PTSD, depression, recovery support, and prevention of substance abuse, suicide, and interpersonal violence.
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• 1 Front Matter-- 2 Summary-- 3 1 Introduction-- 4 2 Evolution of Combat Helmets-- 5 3 Threats, Head Injuries, and Test Methodologies-- 6 4 Combat Helmet Testing-- 7 5 Helmet Performance Measures and Trends in Test Data-- 8 6 First Article Testing Protocols for Resistance to Penetration: Statistical Considerations and Evaluation of DoD Test Plans-- 9 7 Test Protocols for Backface Deformation: Statistical Considerations and Assessment-- 10 8 Lot Acceptance Testing-- 11 9 Characterization Tests for the Advanced Combat Helmet and Future Helmets-- 12 10 Linking Helmet Protection to Brain Injury-- 13 Appendix A: Study Origination Documents-- 14 Appendix B: Protocols for First Article and Lot Acceptance Testing-- 15 Appendix C: Committee Meetings and Data-Gathering Activities-- 16 Appendix D: Test Range Description and the Ballistic Testing Process-- 17 Appendix E: Synopsis of Brain Injury Detection Methods-- 18 Appendix F: Biographical Sketches of Committee Members.
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Combat helmets have evolved considerably over the years from those used in World War I to today's Advanced Combat Helmet. One of the key advances was the development of aramid fibers in the 1960s, which led to today's Kevlar-based helmets. The Department of Defense is continuing to invest in research to improve helmet performance, through better design and materials as well as better manufacturing processes. Review of the Department of Defense Test Protocols for Combat Helmets considers the technical issues relating to test protocols for military combat helmets. At the request of the DOD Director of Operational Test and Evaluation, this report evaluates the adequacy of the Advanced Combat Helmet test protocol for both first article testing and lot acceptance testing, including its use of the metrics of probability of no penetration and the upper tolerance limit (used to evaluate backface deformation). The report evaluates appropriate use of statistical techniques in gathering data; adequacy of current helmet testing procedures; procedures for the conduct of additional analysis of penetration and backface deformation data; and scope of characterization testing relative to the benefit of the information obtained.
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• 1 Front Matter-- 2 Summary-- 3 1 Introduction-- 4 2 Neuroscience, Biomechanics, and Risks of Concussion in the Developing Brain-- 5 3 Concussion Recognition, Diagnosis, and Acute Management-- 6 4 Treatment and Management of Prolonged Symptoms and Post-Concussion Syndrome-- 7 5 Consequences of Repetitive Head Impacts and Multiple Concussions-- 8 6 Protection and Prevention Strategies-- 9 7 Conclusions and Recommendations-- 10 Appendix A: Public Workshop Agendas-- 11 Appendix B: Biographical Sketches of Committee Members-- 12 Appendix C: Clinical Evaluation Tools.
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In the past decade, few subjects at the intersection of medicine and sports have generated as much public interest as sports-related concussions - especially among youth. Despite growing awareness of sports-related concussions and campaigns to educate athletes, coaches, physicians, and parents of young athletes about concussion recognition and management, confusion and controversy persist in many areas. Currently, diagnosis is based primarily on the symptoms reported by the individual rather than on objective diagnostic markers, and there is little empirical evidence for the optimal degree and duration of physical rest needed to promote recovery or the best timing and approach for returning to full physical activity. Sports-Related Concussions in Youth: Improving the Science, Changing the Culture reviews the science of sports-related concussions in youth from elementary school through young adulthood, as well as in military personnel and their dependents. This report recommends actions that can be taken by a range of audiences - including research funding agencies, legislatures, state and school superintendents and athletic directors, military organizations, and equipment manufacturers, as well as youth who participate in sports and their parents - to improve what is known about concussions and to reduce their occurrence. Sports-Related Concussions in Youth finds that while some studies provide useful information, much remains unknown about the extent of concussions in youth; how to diagnose, manage, and prevent concussions; and the short- and long-term consequences of concussions as well as repetitive head impacts that do not result in concussion symptoms. The culture of sports negatively influences athletes' self-reporting of concussion symptoms and their adherence to return-to-play guidance. Athletes, their teammates, and, in some cases, coaches and parents may not fully appreciate the health threats posed by concussions. Similarly, military recruits are immersed in a culture that includes devotion to duty and service before self, and the critical nature of concussions may often go unheeded. According to Sports-Related Concussions in Youth, if the youth sports community can adopt the belief that concussions are serious injuries and emphasize care for players with concussions until they are fully recovered, then the culture in which these athletes perform and compete will become much safer. Improving understanding of the extent, causes, effects, and prevention of sports-related concussions is vitally important for the health and well-being of youth athletes. The findings and recommendations in this report set a direction for research to reach this goal.
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• 1 Front Matter-- 2 1 Introduction and Overview-- 3 2 Life Scientists Engaged: Personal Experiences from the Frontier-- 4 3 Trends in Public Engagement Mechanisms and Attitudes-- 5 4 Models for a Sustainable Infrastructure-- 6 5 Toward a Sustainable Infrastructure:Friction and Momentum-- 7 6 Pathways and Destinations-- 8 References-- 9 Appendix A--Statement of Task-- 10 Appendix B--Workshop Agenda-- 11 Appendix C--Biographies of Workshop Speakers, Panelists, Moderators, and Planning Committee Members-- 12 Appendix D--Workshop Attendees-- 13 Appendix E--Ideas from the Audience Engagement Exercise Community Ideas as Building Blocks-- 14 Appendix F--Networks, Hubs, and Resources for Science Communication.
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Advances in the life sciences - from the human genome to biotechnology to personalized medicine and sustainable communities - have profound implications for the well-being of society and the natural world. Improved public understanding of such scientific advances has the potential to benefit both individuals and society through enhanced quality of life and environmental protection, improved K-12 and undergraduate science education, greater understanding of human connections to the natural world, and more sustainable policies and regulations. Yet few systems of support exist to help life scientist communicators share their research with a broad range of public audiences, or engage the public in discussions about their work. Sustainable Infrastructures for Life Science Communication is the summary of a two-part workshop convened in December 2013 and January 2014 by the National Research Council Roundtable on Public Interfaces of the Life Sciences to identify infrastructure-related barriers that inhibit or prohibit life scientists from communicating about their work and characteristics of infrastructure that facilitate or encourage scientists to engage with public audiences. The workshop featured both formal presentations and panel discussions among participants from academia, industry, journalism, the federal government, and nonprofit organizations. The presentations highlighted the motivations of and challenges to life scientist communicators, theoretical approaches to science communication, examples of different types of infrastructure to support science communication, and the need for building more sustainable science communication infrastructures. This report considers communication infrastructure across a range of life science institutions, including federal agencies, academia, industry, and nonprofit organizations and explores novel approaches to facilitate effective science communication.
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• 1 Front Matter-- 2 Summary-- 3 1 Introduction-- 4 2 Evaluating the Evidence-- 5 3 Exposure to the Herbicides Used in Vietnam-- 6 4 Information Related to Biologic Plausibility-- 7 5 Epidemiologic Studies: Compendium of New Publications-- 8 6 Epidemiologic Studies: Background on Multiply Referenced Populations-- 9 7 Immune-System Disorders-- 10 8 Cancer-- 11 9 Fertility and Gestational Outcomes-- 12 10 Effects on Future Generations-- 13 11 Neurologic Disorders-- 14 12 Cardiovascular and Metabolic Outcomes-- 15 13 Other Chronic Health Outcomes-- 16 14 Conclusions and Recommendations-- 17 Appendix A: Issues Raised by the Public and Agendas of Public Meetings Held by the Committee to Review the Health Effects in Vietnam Veterans of Exposure to Herbicides (Ninth Biennial Update) and Other Written Submissions to the Committee-- 18 Appendix B: Short-Term Adverse Health Responses-- 19 Appendix C: Clarification of Cancer Groupings Used in Reporting Results, with Correspondence to National Institute for Occupational Safety and Health Cause-of-Death Codes and International Classification of Diseases Codes for Cancers-- 20 Appendix D: Biographies of Committee to Review the Health Effects in Vietnam Veterans of Exposure to Herbicides (Ninth Biennial Update) and Staff.
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From 1962 to 1971, the US military sprayed herbicides over Vietnam to strip the thick jungle canopy that could conceal opposition forces, to destroy crops that those forces might depend on, and to clear tall grasses and bushes from the perimeters of US base camps and outlying fire-support bases. Mixtures of 2,4-dichlorophenoxyacetic acid (2,4-D), 2,4,5-trichlorophenoxyacetic acid (2,4,5-T), picloram, and cacodylic acid made up the bulk of the herbicides sprayed. The main chemical mixture sprayed was Agent Orange, a 50:50 mixture of 2,4-D and 2,4,5-T. At the time of the spraying, 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), the most toxic form of dioxin, was an unintended contaminant generated during the production of 2,4,5-T and so was present in Agent Orange and some other formulations sprayed in Vietnam. Because of complaints from returning Vietnam veterans about their own health and that of their children combined with emerging toxicologic evidence of adverse effects of phenoxy herbicides and TCDD, the National Academy of Sciences (NAS) was asked to perform a comprehensive evaluation of scientific and medical information regarding the health effects of exposure to Agent Orange, other herbicides used in Vietnam, and the various components of those herbicides, including TCDD. Updated evaluations are conducted every two years to review newly available literature and draw conclusions from the overall evidence.Veterans and Agent Orange: Update 2012 reviews peer-reviewed scientific reports concerning associations between health outcomes and exposure to TCDD and other chemicals in the herbicides used in Vietnam that were published in October 2010--September 2012 and integrates this information with the previously established evidence database. This report considers whether a statistical association with herbicide exposure exists, taking into account the strength of the scientific evidence and the appropriateness of the statistical and epidemiological methods used to detect the association; the increased risk of disease among those exposed to herbicides during service in the Republic of Vietnam during the Vietnam era; and whether there exists a plausible biological mechanism or other evidence of a causal relationship between herbicide exposure and the disease.
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• 1 Front Matter-- 2 Executive Summary-- 3 I: INNOVATION AND PLACE-BASED ECONOMIC DEVELOPMENT-- 4 1 Innovation in the States-- 5 2 State and Regional Development and Clustering-- 6 II: THE CATALYTIC ROLE OF PUBLIC PURPOSE ORGANIZATIONS-- 7 3 Universities as Innovation Drivers-- 8 4 State Strategies for Innovation-- 9 5 The Federal Dimension-- 10 III: REVIEW OF SELECTED STATE AND REGIONAL PRACTICES-- 11 6 Rebuilding Ohio's Innovation Economy-- 12 7 The New York Nanotechnology Initiative-- 13 8 New Initiatives in Illinois and Arkansas-- 14 IV: BIBLIOGRAPHY-- 15 Bibliography-- 16 V: ANNEX A: STANFORD AND SILICON VALLEY-- 17 Annex A--Stanford and Silicon Valley-- 18 VI: ANNEX B: NORTH CAROLINA'S RESEARCH TRIANGLE PARK-- 19 Annex B--North Carolina's Research Triangle Park.
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Most of the policy discussion about stimulating innovation has focused on the federal level. This study focuses on the significant activity at the state level, with the goal of improving the public's understanding of key policy strategies and exemplary practices. Based on a series of workshops and conferences that brought together policymakers along with leaders of industry and academia in a select number of states, the study highlights a rich variety of policy initiatives underway at the state and regional level to foster knowledge based growth and employment. Perhaps what distinguishes this effort at the state level is most of all the high degree of pragmatism. Operating out of necessity, innovation policies at the state level often involve taking advantage of existing resources and recombining them in new ways, forging innovative partnerships among universities, industry and government organizations, growing the skill base, and investing in the infrastructure to develop new technologies and new industries. Many of these initiatives are being guided by leaders from the private sector and universities. The objective of Best Practices in State and Regional Innovation Initiatives: Competing in the 21st Century is not to do an empirical review of the inputs and outputs of various state programs. Nor is it to evaluate which programs are superior. Indeed, some of the notable successes, such as the Albany nanotechnology cluster, represent a leap of leadership, investment, and sustained commitment that has had remarkable results in an industry that is actively pursued by many countries. The study's goal is to illustrate the approaches taken by a variety of highly diverse states as they confront the increasing challenges of global competition for the industries and jobs of today and tomorrow.
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• 1 Front Matter-- 2 I: OVERVIEW-- 3 Overview-- 4 II: PROCEEDINGS-- 5 DAY 1 Welcome and Introduction-- 6 Keynote Address-- 7 Panel I: The Ohio Innovation Economy in the Global Context-- 8 Panel II: Stimulating Manufacturing in Ohio-- 9 Panel III: Innovation Clusters and Economic Development-- 10 Keynote Address: Investing in Ohio-- 11 Panel IV: State and Regional Innovation Programs-- 12 Panel V: The New Energy Economy in Ohio-- 13 DAY
• 2: Welcome and Introduction-- 14 Panel VI: 21st Century Universities: Drivers of Regional Growth & Employment-- 15 Panel VII: Biomedical Growth Opportunities-- 16 Panel VIII: Growing the Ohio Flexible Electronics Industry-- 17 Panel IX: Early-Stage Finance and Entrepreneurship in Ohio-- 18 III: APPENDIXES-- 19 Appendix A: Agenda-- 20 Appendix B: Biographies of Speakers-- 21 Appendix C: Participants List-- 22 Appendix D: Bibliography.
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Since 1991, the National Research Council, under the auspices of the Board on Science, Technology, and Economic Policy, has undertaken a program of activities to improve policymakers' understandings of the interconnections of science, technology, and economic policy and their importance for the American economy and its international competitive position. The Board's activities have corresponded with increased policy recognition of the importance of knowledge and technology to economic growth. One important element of STEP's analysis concerns the growth and impact of foreign technology programs. U.S. competitors have launched substantial programs to support new technologies, small firm development, and consortia among large and small firms to strengthen national and regional positions in strategic sectors. Some governments overseas have chosen to provide public support to innovation to overcome the market imperfections apparent in their national innovation systems. They believe that the rising costs and risks associated with new potentially high-payoff technologies, and the growing global dispersal of technical expertise, underscore the need for national R&D programs to support new and existing high-technology firms within their borders. Similarly, many state and local governments and regional entities in the United States are undertaking a variety of initiatives to enhance local economic development and employment through investment programs designed to attract knowledge-based industries and grow innovation clusters. These state and regional programs and associated policy measures are of great interest for their potential contributions to growth and U.S. competitiveness and for the "best practice" lessons that they offer for other state and regional programs. STEP's project on State and Regional Innovation Initiatives is intended to generate a better understanding of the challenges associated with the transition of research into products, the practices associated with successful state and regional programs, and their interaction with federal programs and private initiatives. The study seeks to achieve this goal through a series of complementary assessments of state, regional, and federal initiatives; analyses of specific industries and technologies from the perspective of crafting supportive public policy at all three levels; and outreach to multiple stakeholders. Building the Ohio Innovation Economy: Summary of a Symposium explains the of the study, which is to improve the operation of state and regional programs and, collectively, enhance their impact.
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• 1 Front Matter-- 2 Summary-- 3 1 Introduction-- 4 2 The Effects of Falsified and Substandard Drugs-- 5 3 The Magnitude of the Problem-- 6 4 Causes of Falsified and Substandard Drugs-- 7 5 Weaknesses in the Drug Distribution Chain-- 8 6 Detection Technology-- 9 7 An International Code of Practice for Falsified and Substandard Medicines-- 10 Appendix A: Glossary-- 11 Appendix B: Committee Biographies-- 12 Appendix C: Meeting Agendas.
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The adulteration and fraudulent manufacture of medicines is an old problem, vastly aggravated by modern manufacturing and trade. In the last decade, impotent antimicrobial drugs have compromised the treatment of many deadly diseases in poor countries. More recently, negligent production at a Massachusetts compounding pharmacy sickened hundreds of Americans. While the national drugs regulatory authority (hereafter, the regulatory authority) is responsible for the safety of a country's drug supply, no single country can entirely guarantee this today. The once common use of the term counterfeit to describe any drug that is not what it claims to be is at the heart of the argument. In a narrow, legal sense a counterfeit drug is one that infringes on a registered trademark. The lay meaning is much broader, including any drug made with intentional deceit. Some generic drug companies and civil society groups object to calling bad medicines counterfeit, seeing it as the deliberate conflation of public health and intellectual property concerns. Countering the Problem of Falsified and Substandard Drugs accepts the narrow meaning of counterfeit, and, because the nuances of trademark infringement must be dealt with by courts, case by case, the report does not discuss the problem of counterfeit medicines.
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• 1 Front Matter-- 2 Summary-- 3 1 Introduction-- 4 2 A Vision for the CTSA Program in a Changing Landscape-- 5 3 Leadership-- 6 4 Crosscutting Topics-- 7 5 Conclusion: Opportunities for Action-- 8 Appendix A: Data Sources and Methods-- 9 Appendix B: Committee Biographical Sketches.
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In 2006 the National Institutes of Health (NIH) established the Clinical and Translational Science Awards (CTSA) Program, recognizing the need for a new impetus to encourage clinical and translational research. At the time it was very difficult to translate basic and clinical research into clinical and community practice; making it difficult for individual patients and communities to receive its benefits. Since its creation the CTSA Program has expanded, with 61 sites spread across the nation's academic health centers and other institutions, hoping to provide catalysts and test beds for policies and practices that can benefit clinical and translation research organizations throughout the country. The NIH contracted with the Institute of Medicine (IOM) in 2012 to conduct a study to assess and provide recommendations on appropriateness of the CTSA Program's mission and strategic goals and whether changes were needed. The study was also address the implementation of the program by the National Center for Advancing Translational Sciences (NCATS) while exploring the CTSA's contributions in the acceleration of the development of new therapeutics. A 13-member committee was established to head this task; the committee had collective expertise in community outreach and engagement, public health and health policy, bioethics, education and training, pharmaceutical research and development, program evaluation, clinical and biomedical research, and child health research. The CTSA Program at NIH: Opportunities for Advancing Clinical and Translational Research is the result of investigations into previous program evaluations and assessments, open-session meetings and conference class, and the review of scientific literature. Overall, the committee believes that the CTSA Program is significant to the advancement of clinical and translational research through its contributions. The Program would benefit from a variety of revisions, however, to make it more efficient and effective.
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• 1 Front Matter-- 2 Summary-- 3 1 Introduction-- 4 2 The Ecosystem Services Approach-- 5 3 Resilience and Ecosystem Services-- 6 4 Oil Spill Response Technologies-- 7 5 Ecosystem Services in the Gulf of Mexico-- 8 6 Research Needs in Support of Understanding Ecosystem Services in the Gulf of Mexico-- 9 References-- 10 Appendix A: Biographical Sketches of Committee Members and Staff.
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As the Gulf of Mexico recovers from the Deepwater Horizon oil spill, natural resource managers face the challenge of understanding the impacts of the spill and setting priorities for restoration work. The full value of losses resulting from the spill cannot be captured, however, without consideration of changes in ecosystem services--the benefits delivered to society through natural processes. An Ecosystem Services Approach to Assessing the Impacts of the Deepwater Horizon Oil Spill in the Gulf of Mexico discusses the benefits and challenges associated with using an ecosystem services approach to damage assessment, describing potential impacts of response technologies, exploring the role of resilience, and offering suggestions for areas of future research. This report illustrates how this approach might be applied to coastal wetlands, fisheries, marine mammals, and the deep sea -- each of which provide key ecosystem services in the Gulf -- and identifies substantial differences among these case studies. The report also discusses the suite of technologies used in the spill response, including burning, skimming, and chemical dispersants, and their possible long-term impacts on ecosystem services.
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• 1 Front Matter-- 2 Summary-- 3 1 Introduction-- 4 2 Status and Trends of Physical Activity Behaviors and Related School Policies-- 5 3 Physical Activity and Physical Education: Relationship to Growth, Development, and Health-- 6 4 Physical Activity, Fitness, and Physical Education: Effects on Academic Performance-- 7 5 Approaches to Physical Education in Schools-- 8 6 Approaches to Physical Activity in Schools-- 9 7 The Effectiveness of Physical Activity and Physical Education Policies and Programs: Summary of the Evidence-- 10 8 Recommendations-- 11 Appendix A: Acronyms and Glossary-- 12 Appendix B: Methodology-- 13 Appendix C: State Legislative Policies on Physical Education and Physical Activity-- 14 Appendix D: Workshop and Panel Public Sessions-- 15 Appendix E: Committee Member Biographical Sketches.
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Physical inactivity is a key determinant of health across the lifespan. A lack of activity increases the risk of heart disease, colon and breast cancer, diabetes mellitus, hypertension, osteoporosis, anxiety and depression and others diseases. Emerging literature has suggested that in terms of mortality, the global population health burden of physical inactivity approaches that of cigarette smoking. The prevalence and substantial disease risk associated with physical inactivity has been described as a pandemic. The prevalence, health impact, and evidence of changeability all have resulted in calls for action to increase physical activity across the lifespan. In response to the need to find ways to make physical activity a health priority for youth, the Institute of Medicine's Committee on Physical Activity and Physical Education in the School Environment was formed. Its purpose was to review the current status of physical activity and physical education in the school environment, including before, during, and after school, and examine the influences of physical activity and physical education on the short and long term physical, cognitive and brain, and psychosocial health and development of children and adolescents. Educating the Student Body makes recommendations about approaches for strengthening and improving programs and policies for physical activity and physical education in the school environment. This report lays out a set of guiding principles to guide its work on these tasks. These included: recognizing the benefits of instilling life-long physical activity habits in children; the value of using systems thinking in improving physical activity and physical education in the school environment; the recognition of current disparities in opportunities and the need to achieve equity in physical activity and physical education; the importance of considering all types of school environments; the need to take into consideration the diversity of students as recommendations are developed. This report will be of interest to local and national policymakers, school officials, teachers, and the education community, researchers, professional organizations, and parents interested in physical activity, physical education, and health for school-aged children and adolescents.
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• 1 Front Matter-- 2 Engaging the Public in Critical Disaster Planning and Decision Making-- 3 Appendix A: References-- 4 Appendix B: Statement of Task-- 5 Appendix C: Workshop Agenda-- 6 Appendix D: Biographical Sketches of Speakers and Panelists.
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Engaging the Public in Critical Disaster Planning and Decision Making is the summary of a workshop held in March 2013 to discuss the key principles of public engagement during the development of disaster plans, the response phase, and during the dissemination phase when interested community partners and the general public are informed of the policies that have been adopted. Presenters provided specific examples of resources to assist jurisdictions in planning public engagement activities as well as challenges experienced and potential solutions. This report introduces key principles of public engagement, provides practical guidance on how to plan and implement a public engagement activity, and presents tools to facilitate planning.
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• 1 Front Matter-- 2 Summary-- 3 1 Introduction-- 4 2 Risk Assessment and Uncertainty-- 5 3 Uncertainty in Technological and Economic Factors in EPA's Decision Making-- 6 4 Uncertainty and Decision Making: Lessons from Other Public Health Contexts-- 7 5 Incorporating Uncertainty into Decision Making-- 8 6 Communication of Uncertainty-- 9 7 Synthesis and Recommendations-- 10 Appendix A: Approaches to Accounting for Uncertainty-- 11 Appendix B: Committee Member Biographical Sketches-- 12 Appendix C: Meeting Agendas.
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The U.S. Environmental Protection Agency (EPA) is one of several federal agencies responsible for protecting Americans against significant risks to human health and the environment. As part of that mission, EPA estimates the nature, magnitude, and likelihood of risks to human health and the environment; identifies the potential regulatory actions that will mitigate those risks and protect public health1 and the environment; and uses that information to decide on appropriate regulatory action. Uncertainties, both qualitative and quantitative, in the data and analyses on which these decisions are based enter into the process at each step. As a result, the informed identification and use of the uncertainties inherent in the process is an essential feature of environmental decision making. EPA requested that the Institute of Medicine (IOM) convene a committee to provide guidance to its decision makers and their partners in states and localities on approaches to managing risk in different contexts when uncertainty is present. It also sought guidance on how information on uncertainty should be presented to help risk managers make sound decisions and to increase transparency in its communications with the public about those decisions. Given that its charge is not limited to human health risk assessment and includes broad questions about managing risks and decision making, in this report the committee examines the analysis of uncertainty in those other areas in addition to human health risks. Environmental Decisions in the Face of Uncertainty explains the statement of task and summarizes the findings of the committee.
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• 1 Front Matter-- 2 Summary-- 3 1 Mission, Evolution, and Context-- 4 2 Program Structure and Operation-- 5 3 Assessments and Outcomes-- 6 4 Findings and Recommendations-- 7 References-- 8 Appendixes-- 9 Appendix A: Agency Profiles-- 10 Appendix B: State Profiles-- 11 Appendix C: Statement of Task and Congressional Mandate-- 12 Appendix D: Biographical Sketches of Committee Members.
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The primary federal program designed to ensure that all states are capable of participating the nation's research enterprise fall under the general rubric of the Experimental Program to Stimulate Competitive Research (EPSCOR). The National Science Foundation (NSF), Department of Energy, Department of Agriculture, and National Aeronautics and Space Administration have active EPSCOR programs. Since its inaugural year in 1979, the EPSCOR program has grown from funding programs in five states to awarding funding to 31 states in 2012. The Experimental Program to Stimulate Competitive Research assesses the effectiveness of EPSCOR and similar federal agency programs in improving national research capabilities, promoting an equitable distribution of research funding, and integrating their efforts with other initiatives designed to strengthen the nation's research capacity. This report also looks at the effectiveness of EPSCOR states in using awards to develop science engineering research and education, as well a science and engineering infrastructure within their state. The Experimental Program to Stimulate Competitive Research makes recommendations for improvement for each agency to create a more focused program with greater impact.
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• 1 Front Matter-- 2 1 Introduction and Overview-- 3 2 Evaluation of Current Animal Models-- 4 3 Translation from Animal Models to the Clinic: Case Examples from Neuroscience Research-- 5 4 Perspectives on Standardization-- 6 5 Perspectives on Corresponding Animal and Clinical Endpoints-- 7 6 Addressing the Translational Disconnect-- 8 7 Summary of Workshop Topics-- 9 Appendix A: References-- 10 Appendix B: Workshop Agenda-- 11 Appendix C: Registered Attendees.
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Nervous system diseases and disorders are highly prevalent and substantially contribute to the overall disease burden. Despite significant information provided by the use of animal models in the understanding of the biology of nervous system disorders and the development of therapeutics; limitations have also been identified. Treatment options that are high in efficacy and low in side effects are still lacking for many diseases and, in some cases are nonexistent. A particular problem in drug development is the high rate of attrition in Phase II and III clinical trials. Why do many therapeutics show promise in preclinical animal models but then fail to elicit predicted effects when tested in humans? On March 28 and 29, 2012, the Institute of Medicine Forum on Neuroscience and Nervous System Disorders convened the workshop "Improving Translation of Animal Models for Nervous System Disorders" to discuss potential opportunities for maximizing the translation of new therapies from animal models to clinical practice. The primary focus of the workshop was to examine mechanisms for increasing the efficiency of translational neuroscience research through discussions about how and when to use animal models most effectively and then best approaches for the interpretation of the data collected. Specifically, the workshop objectives were to: discuss key issues that contribute to poor translation of animal models in nervous system disorders, examine case studies that highlight successes and failures in the development and application of animal models, consider strategies to increase the scientific rigor of preclinical efficacy testing, explore the benefits and challenges to developing standardized animal and behavioral models. Improving the Utility and Translation of Animal Models for Nervous System Disorders: Workshop Summary also identifies methods to facilitate development of corresponding animal and clinical endpoints, indentifies methods that would maximize bidirectional translation between basic and clinical research and determines the next steps that will be critical for improvement of the development and testing of animal models of disorders of the nervous system.
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• 1 Front Matter-- 2 PART I: FINAL REPORT-- 3 Summary-- 4 1 Introduction and Approach-- 5 2 A Conceptual Model of Aging for the Next Generation of Research-- 6 3 Data Needs and Opportunities-- 7 4 Roadblocks and Bridges to Transdisciplinary Research-- 8 References-- 9 Appendix: Biographical Sketches of Panel Members-- 10 PART II: PAPERS-- 11 5 Introduction and Overview--Linda J. Waite-- 12 6 The New Realities of Aging: Social and Economic Contexts--Jacqueline L. Angel and Richard A. Settersten, Jr-- 13 7 Research Opportunities in the Demography of Aging--Melissa Hardy and Vegard Skirbekk-- 14 8 Networks, Neighborhoods, and Institutions: An Integrated "Activity Space" Approach for Research on Aging--Kathleen A. Cagney, Christopher R. Browning, Aubrey L. Jackson, and Brian Soller-- 15 9 Constrained Choices: The Shifting Institutional Contexts of Aging and the Life Course--Phyllis Moen-- 16 10 Opportunities and Challenges in the Study of Biosocial Dynamics in Healthy Aging--Tara L. Gruenewald-- 17 11 The Loyal Opposition: A Commentary on "Opportunities and Challenges in the Study of Biosocial Dynamics in Healthy Aging"--Maxine Weinstein, Dana A. Glei, and Noreen Goldman-- 18 12 Social Genomics and the Life Course: Opportunities and Challenges for Multilevel Population Research--Michael J. Shanahan-- 19 13 The Challenge of Social Genomics: A Commentary on "Social Genomics and the Life Course: Opportunities and Challenges for Multilevel Population Research"--Jason Schnittker-- 20 14 Interventions to Promote Health and Prevent Disease: Perspectives on Clinical Trials Past, Present, and Future--S. Leonard Syme and Abby C. King-- 21 Committee on Population.
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The aging of the population of the United States is occurring at a time of major economic and social changes. These economic changes include consideration of increases in the age of eligibility for Social Security and Medicare and possible changes in benefit levels. Furthermore, changes in the social context in which older individuals and families function may well affect the nature of key social relationships and institutions that define the environment for older persons. Sociology offers a knowledge base, a number of useful analytic approaches and tools, and unique theoretical perspectives that can facilitate understanding of these demographic, economic, and social changes and, to the extent possible, their causes, consequences and implications. New Directions in the Sociology of Aging evaluates the recent contributions of social demography, social epidemiology and sociology to the study of aging and identifies promising new research directions in these sub-fields. Included in this study are nine papers prepared by experts in sociology, demography, social genomics, public health, and other fields, that highlight the broad array of tools and perspectives that can provide the basis for further advancing the understanding of aging processes in ways that can inform policy. This report discusses the role of sociology in what is a wide-ranging and diverse field of study; a proposed three-dimensional conceptual model for studying social processes in aging over the life cycle; a review of existing databases, data needs and opportunities, primarily in the area of measurement of interhousehold and intergenerational transmission of resources, biomarkers and biosocial interactions; and a summary of roadblocks and bridges to transdisciplinary research that will affect the future directions of the field of sociology of aging.
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• 1 Front Matter-- 2 Summary-- 3 1 Introduction and Background-- 4 2 A Vision and Goals for Workforce Readiness and Resilience-- 5 3 Leadership, Communication, and Culture in the Department of Homeland Security-- 6 4 Measurement, Evaluation, and Reporting for Improved Readiness and Resilience-- 7 5 Elements of the Department of Homeland Security Workforce Readiness and Resilience Strategic Plan-- 8 Appendix A--Department of Homeland Security Organizational Charts-- 9 Appendix B--Committee Meeting Agendas-- 10 Appendix C--Public Comments from Department of Homeland Security Staff-- 11 Appendix D--Inventory of Programs and Services of the Department of Homeland Security-- 12 Appendix E--Organizational Self-Assessment Tool - NIOSH Essential Elements-- 13 Appendix F--Committee Biosketches.
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The responsibilities of the Department of Homeland Security (DHS) range from preventing foreign and domestic terrorist attacks; securing the nation's borders; safeguarding transportation systems; responding to natural disasters; nuclear detection; and more. Created in 2002 from a merger that rapidly incorporated parts of eight cabinet departments and 22 government agencies, DHS has struggled to integrate its numerous components and their unique cultures. While DHS is very accomplished at performing its many missions, the nature of the DHS work environment is inherently stressful, and employees suffer from low morale. A Ready and Resilient Workforce for the Department of Homeland Security: Protecting America's Front Line reviews current workforce resilience efforts, identifies gaps, and provides recommendations for a 5-year strategy to improve DHSTogether, the current DHS workforce resilience program. This report stresses the importance of strong leadership, communication, measurement, and evaluation in the organization and recommends content for a 5-year plan that will promote centralized strategic direction and resource investment to improve readiness and resilience at the department. While all DHS component agencies share a common mission, each have distinct roles with different stressors attached, making implementation of an organization-wide resilience or wellness program difficult. The recommendations of A Ready and Resilient Workforce for the Department of Homeland Security outline how DHS can focus its efforts on creating a common culture of workforce readiness and resilience, while recognizing the distinct, proud, celebrated cultures of its component agencies.
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• 1 Front Matter-- 2 Summary-- 3 1 Introduction-- 4 2 Haz-Map Database-- 5 3 Site Exposure Matrix Dat-- 6 4 Findings and Recommendations-- 7 Appendix A: Biosketches of Committee Members-- 8 Appendix B: Substances Evaluated by the Committee to Identify Toxic Substance-Occupational Disease Links Not Found in SEM-- 9 Appendix C: Individuals Who Made Presentations to the Committee.
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Beginning with the development of the atomic bomb during World War II, the United States continued to build nuclear weapons throughout the Cold War. Thousands of people mined and milled uranium, conducted research on nuclear warfare, or worked in nuclear munitions factories around the country from the 1940s through the 1980s. Such work continues today, albeit to a smaller extent. The Department of Energy (DOE) is now responsible for overseeing those sites and facilities, many of which were, and continue to be, run by government contractors. The materials used at those sites were varied and ranged from the benign to the toxic and highly radioactive. Workers at DOE facilities often did not know the identity of the materials with which they worked and often were unaware of health risks related to their use. In many instances, the work was considered top secret, and employees were cautioned not to reveal any work-related information to family or others. Workers could be exposed to both radioactive and nonradioactive toxic substances for weeks or even years. Consequently, some of the workers have developed health problems and continue to have concerns about potential health effects of their exposures to occupational hazards during their employment in the nuclear weapons industry. In response to the concerns expressed by workers and their representatives, DOL asked the Institute of Medicine (IOM) to review the SEM database and its use of a particular database, Haz-Map, as the source of its toxic substance-occupational disease links. Accordingly, this IOM consensus report reflects careful consideration of its charge by the committee, and describes the strengths and shortcomings of both. To complete its task, IOM formed an ad hoc committee of experts in occupational medicine, toxicology, epidemiology, industrial hygiene, public health, and biostatistics to conduct an 18-month study to review the scientific rigor of the SEM database. The committee held two public meetings at which it heard from DOL Division of Energy Employee Occupational Illness Compensation (DEEOIC) representatives, the DOL contractor that developed the SEM database, the developer of the Haz-Map database, DOE worker advocacy groups, and several individual workers. The committee also submitted written questions to DOL to seek clarification of specific issues and received written responses from DEEOIC. The committee's report considers both the strengths and weaknesses of the SEM and the Haz-Map databases, recognizing that the latter was developed first and for a different purpose. The committee then discusses its findings and recommends improvements that could be made in both databases with a focus on enhancing the usability of SEM for both DOL claims examiners and for former DOE workers and their representatives. Review of the Department of Labor's Site Exposure Matrix Database summarizes the committee's findings.
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• 1 Front Matter-- 2 Workshop Overview-- 3 Appendix A-- 4 Appendix B--Agenda-- 5 Appendix C--Acronyms-- 6 Appendix D--Glossary-- 7 Appendix E--Speaker Biographies.
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Over the past several decades, new scientific tools and approaches for detecting microbial species have dramatically enhanced our appreciation of the diversity and abundance of the microbiota and its dynamic interactions with the environments within which these microorganisms reside. The first bacterial genome was sequenced in 1995 and took more than 13 months of work to complete. Today, a microorganism's entire genome can be sequenced in a few days. Much as our view of the cosmos was forever altered in the 17th century with the invention of the telescope, these genomic technologies, and the observations derived from them, have fundamentally transformed our appreciation of the microbial world around us. On June 12 and 13, 2012, the Institute of Medicine's (IOM's) Forum on Microbial Threats convened a public workshop in Washington, DC, to discuss the scientific tools and approaches being used for detecting and characterizing microbial species, and the roles of microbial genomics and metagenomics to better understand the culturable and unculturable microbial world around us. Through invited presentations and discussions, participants examined the use of microbial genomics to explore the diversity, evolution, and adaptation of microorganisms in a wide variety of environments; the molecular mechanisms of disease emergence and epidemiology; and the ways that genomic technologies are being applied to disease outbreak trace back and microbial surveillance. Points that were emphasized by many participants included the need to develop robust standardized sampling protocols, the importance of having the appropriate metadata, data analysis and data management challenges, and information sharing in real time. The Science and Applications of Microbial Genomics summarizes this workshop.
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• 1 Front Matter-- 2 1 Introduction and Themes of the Workshop-- 3 2 The Benefits of Data Sharing-- 4 3 Barriers to Data Sharing-- 5 4 Models of Data Sharing-- 6 5 Standardization to Enhance Data Sharing-- 7 6 Changing the Culture of Research-- 8 7 Final Reflections on Sharing Clinical Research Data-- 9 References-- 10 Appendix A: Workshop Agenda-- 11 Appendix B: List of Data-Sharing Initiatives-- 12 Appendix C: Participant Biographies.
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Pharmaceutical companies, academic researchers, and government agencies such as the Food and Drug Administration and the National Institutes of Health all possess large quantities of clinical research data. If these data were shared more widely within and across sectors, the resulting research advances derived from data pooling and analysis could improve public health, enhance patient safety, and spur drug development. Data sharing can also increase public trust in clinical trials and conclusions derived from them by lending transparency to the clinical research process. Much of this information, however, is never shared. Retention of clinical research data by investigators and within organizations may represent lost opportunities in biomedical research. Despite the potential benefits that could be accrued from pooling and analysis of shared data, barriers to data sharing faced by researchers in industry include concerns about data mining, erroneous secondary analyses of data, and unwarranted litigation, as well as a desire to protect confidential commercial information. Academic partners face significant cultural barriers to sharing data and participating in longer term collaborative efforts that stem from a desire to protect intellectual autonomy and a career advancement system built on priority of publication and citation requirements. Some barriers, like the need to protect patient privacy, pre- sent challenges for both sectors. Looking ahead, there are also a number of technical challenges to be faced in analyzing potentially large and heterogeneous datasets. This public workshop focused on strategies to facilitate sharing of clinical research data in order to advance scientific knowledge and public health. While the workshop focused on sharing of data from preplanned interventional studies of human subjects, models and projects involving sharing of other clinical data types were considered to the extent that they provided lessons learned and best practices. The workshop objectives were to examine the benefits of sharing of clinical research data from all sectors and among these sectors, including, for example: benefits to the research and development enterprise and benefits to the analysis of safety and efficacy. Sharing Clinical Research Data: Workshop Summary identifies barriers and challenges to sharing clinical research data, explores strategies to address these barriers and challenges, including identifying priority actions and "low-hanging fruit" opportunities, and discusses strategies for using these potentially large datasets to facilitate scientific and public health advances.
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• 1 Front Matter-- 2 Summary-- 3 1 Introduction-- 4 2 Approach to Evidence Review-- 5 3 Sodium Intake and Intermediate Markers for Health Outcomes-- 6 4 Sodium Intake and Health Outcomes-- 7 5 Findings and Conclusions-- 8 Appendix A: Acronyms and Abbreviations-- 9 Appendix B: Committee Member Biographical Sketches-- 10 Appendix C: Open Session Agendas-- 11 Appendix D: Biomarkers Figure-- 12 Appendix E: Literature Search Strategy-- 13 Appendix F: Presentation of Results - Evidence Tables.
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Despite efforts over the past several decades to reduce sodium intake in the United States, adults still consume an average of 3,400 mg of sodium every day. A number of scientific bodies and professional health organizations, including the American Heart Association, the American Medical Association, and the American Public Health Association, support reducing dietary sodium intake. These organizations support a common goal to reduce daily sodium intake to less than 2,300 milligrams and further reduce intake to 1,500 mg among persons who are 51 years of age and older and those of any age who are African-American or have hypertension, diabetes, or chronic kidney disease. A substantial body of evidence supports these efforts to reduce sodium intake. This evidence links excessive dietary sodium to high blood pressure, a surrogate marker for cardiovascular disease (CVD), stroke, and cardiac-related mortality. However, concerns have been raised that a low sodium intake may adversely affect certain risk factors, including blood lipids and insulin resistance, and thus potentially increase risk of heart disease and stroke. In fact, several recent reports have challenged sodium reduction in the population as a strategy to reduce this risk. Sodium Intake in Populations recognizes the limitations of the available evidence, and explains that there is no consistent evidence to support an association between sodium intake and either a beneficial or adverse effect on most direct health outcomes other than some CVD outcomes (including stroke and CVD mortality) and all-cause mortality. Some evidence suggested that decreasing sodium intake could possibly reduce the risk of gastric cancer. However, the evidence was too limited to conclude the converse-that higher sodium intake could possibly increase the risk of gastric cancer. Interpreting these findings was particularly challenging because most studies were conducted outside the United States in populations consuming much higher levels of sodium than those consumed in this country. Sodium Intake in Populations is a summary of the findings and conclusions on evidence for associations between sodium intake and risk of CVD-related events and mortality.
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• 1 Front Matter-- 2 Summary-- 3 1 Introduction-- 4 2 Conceptualizing Experienced (or Hedonic) Well-Being-- 5 3 Measuring Experienced Well-Being-- 6 4 Additional Conceptual and Measurement Issues-- 7 5 Subjective Well-Being and Policy-- 8 6 Data Collection Strategies-- 9 References-- 10 Appendix A: Experienced Well-Being Questions and Modules from Existing Surveys-- 11 Appendix B: The Subjective Well-Being Moduleof the American Time Use Survey:Assessment for Its Continuation-- 12 Appendix C: Biographical Sketches of Panel Members-- 13 Committee on National Statistics.
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Subjective well-being refers to how people experience and evaluate their lives and specific domains and activities in their lives. This information has already proven valuable to researchers, who have produced insights about the emotional states and experiences of people belonging to different groups, engaged in different activities, at different points in the life course, and involved in different family and community structures. Research has also revealed relationships between people's self-reported, subjectively assessed states and their behavior and decisions. Research on subjective well-being has been ongoing for decades, providing new information about the human condition. During the past decade, interest in the topic among policy makers, national statistical offices, academic researchers, the media, and the public has increased markedly because of its potential for shedding light on the economic, social, and health conditions of populations and for informing policy decisions across these domains. Subjective Well-Being: Measuring Happiness, Suffering, and Other Dimensions of Experience explores the use of this measure in population surveys. This report reviews the current state of research and evaluates methods for the measurement. In this report, a range of potential experienced well-being data applications are cited, from cost-benefit studies of health care delivery to commuting and transportation planning, environmental valuation, and outdoor recreation resource monitoring, and even to assessment of end-of-life treatment options. Subjective Well-Being finds that, whether used to assess the consequence of people's situations and policies that might affect them or to explore determinants of outcomes, contextual and covariate data are needed alongside the subjective well-being measures. This report offers guidance about adopting subjective well-being measures in official government surveys to inform social and economic policies and considers whether research has advanced to a point which warrants the federal government collecting data that allow aspects of the population's subjective well-being to be tracked and associated with changing conditions.
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• 1 Front Matter-- 2 Summary-- 3 1 Introduction-- 4 2 The Evolution of and Factors Affecting Underground Development-- 5 3 Contributions of Underground Engineering to Sustainable and Resilient Urban Development-- 6 4 Health and Safety Underground-- 7 5 Lifecycle Sustainability, Costs, and Benefits of Underground Infrastructure Development-- 8 6 Innovative Underground Technology and Engineering for Sustainable Development-- 9 7 Institutional, Educational, Research, and Workforce Capacity-- 10 Appendixes-- 11 Appendix A: Committee and Staff Biographies-- 12 Appendix B: Open Session Meeting Agendas-- 13 Appendix C: Interdisciplinary Underground Engineering Practice.
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For thousands of years, the underground has provided humans refuge, useful resources, physical support for surface structures, and a place for spiritual or artistic expression. More recently, many urban services have been placed underground. Over this time, humans have rarely considered how underground space can contribute to or be engineered to maximize its contribution to the sustainability of society. As human activities begin to change the planet and population struggle to maintain satisfactory standards of living, placing new infrastructure and related facilities underground may be the most successful way to encourage or support the redirection of urban development into sustainable patterns. Well maintained, resilient, and adequately performing underground infrastructure, therefore, becomes an essential part of sustainability, but much remains to be learned about improving the sustainability of underground infrastructure itself. At the request of the National Science Foundation (NSF), the National Research Council (NRC) conducted a study to consider sustainable underground development in the urban environment, to identify research needed to maximize opportunities for using underground space, and to enhance understanding among the public and technical communities of the role of underground engineering in urban sustainability. Underground Engineering for Sustainable Urban Development explains the findings of researchers and practitioners with expertise in geotechnical engineering, underground design and construction, trenchless technologies, risk assessment, visualization techniques for geotechnical applications, sustainable infrastructure development, life cycle assessment, infrastructure policy and planning, and fire prevention, safety and ventilation in the underground. This report is intended to inform a future research track and will be of interest to a broad audience including those in the private and public sectors engaged in urban and facility planning and design, underground construction, and safety and security.
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• 1 Front Matter-- 2 Summary-- 3 1 Introduction-- 4 2 Approach-- 5 3 Evaluating Biological Mechanisms of Adverse Events-- 6 4 Measles, Mumps, and Rubella Vaccine-- 7 5 Varicella Virus Vaccine-- 8 6 Influenza Vaccine-- 9 7 Hepatitis A Vaccine-- 10 8 Hepatitis B Vaccine-- 11 9 Human Papillomavirus Vaccine-- 12 10 Diphtheria Toxoid, Tetanus Toxoid, and Acellular PertussisContaining Vaccines-- 13 11 Meningococcal Vaccine-- 14 12 Injection-Related Adverse Events-- 15 13 Concluding Comments-- 16 Appendix A: Glossary-- 17 Appendix B: List of Adverse Events-- 18 Appendix C: Literature Search Strategy-- 19 Appendix D: Causality Conclusion Tables-- 20 Appendix E: References-- 21 Appendix F: Committee Biosketches-- 22 Appendix G: Meeting Agendas-- 23 Index.
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In 1900, for every 1,000 babies born in the United States, 100 would die before their first birthday, often due to infectious diseases. Today, vaccines exist for many viral and bacterial diseases. The National Childhood Vaccine Injury Act, passed in 1986, was intended to bolster vaccine research and development through the federal coordination of vaccine initiatives and to provide relief to vaccine manufacturers facing financial burdens. The legislation also intended to address concerns about the safety of vaccines by instituting a compensation program, setting up a passive surveillance system for vaccine adverse events, and by providing information to consumers. A key component of the legislation required the U.S. Department of Health and Human Services to collaborate with the Institute of Medicine to assess concerns about the safety of vaccines and potential adverse events, especially in children. Adverse Effects of Vaccines reviews the epidemiological, clinical, and biological evidence regarding adverse health events associated with specific vaccines covered by the National Vaccine Injury Compensation Program (VICP), including the varicella zoster vaccine, influenza vaccines, the hepatitis B vaccine, and the human papillomavirus vaccine, among others. For each possible adverse event, the report reviews peer-reviewed primary studies, summarizes their findings, and evaluates the epidemiological, clinical, and biological evidence. It finds that while no vaccine is 100 percent safe, very few adverse events are shown to be caused by vaccines. In addition, the evidence shows that vaccines do not cause several conditions. For example, the MMR vaccine is not associated with autism or childhood diabetes. Also, the DTaP vaccine is not associated with diabetes and the influenza vaccine given as a shot does not exacerbate asthma. Adverse Effects of Vaccines will be of special interest to the National Vaccine Program Office, the VICP, the Centers for Disease Control and Prevention, vaccine safety researchers and manufacturers, parents, caregivers, and health professionals in the private and public sectors.
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