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Aging and the Macroeconomy

by National Research Council Committee on Population Division on Engineering and Physical Sciences Division of Behavioral and Social Sciences and Education Board on Mathematical Sciences And Their Applications Committee on the Long-Run Macro-Economic Effects of the Aging U.S. Population

The United States is in the midst of a major demographic shift. In the coming decades, people aged 65 and over will make up an increasingly large percentage of the population: The ratio of people aged 65+ to people aged 20-64 will rise by 80%. This shift is happening for two reasons: people are living longer, and many couples are choosing to have fewer children and to have those children somewhat later in life. The resulting demographic shift will present the nation with economic challenges, both to absorb the costs and to leverage the benefits of an aging population. Aging and the Macroeconomy: Long-Term Implications of an Older Population presents the fundamental factors driving the aging of the U.S. population, as well as its societal implications and likely long-term macroeconomic effects in a global context. The report finds that, while population aging does not pose an insurmountable challenge to the nation, it is imperative that sensible policies are implemented soon to allow companies and households to respond. It offers four practical approaches for preparing resources to support the future consumption of households and for adapting to the new economic landscape.

Budgeting for Immigration Enforcement

by National Research Council Peter Reuter Division of Behavioral and Social Sciences and Education Malay Majmundar Committee on Law and Justice Steve Redburn Committee on Estimating Costs of Immigration Enforcement in the Department of Justice

Immigration enforcement is carried out by a complex legal and administrative system, operating under frequently changing legislative mandates and policy guidance, with authority and funding spread across several agencies in two executive departments and the courts. The U.S. Department of Homeland Security (DHS) is responsible for conducting immigration enforcement both at the border and in the United States; the U.S. Department of Justice (DOJ) is responsible for conducting immigration removal procedures and criminal trials and for prosecuting people charged with immigration-related crimes. DOJ confronts at least five technical challenges to modeling its resource needs for immigration enforcement that are specific to the immigration enforcement system. Despite the inherent limitations, budgeting for immigration enforcement can be improved by changing the method for budgeting. Budgeting for Immigration Enforcement addresses how to improve budgeting for the federal immigration enforcement system, specifically focusing on the parts of that system that are operated and funded by the U.S. Department of Justice (DOJ). The report recommends that DOJ establish policy-level procedures to plan and coordinate policy planning and implementation to improve performance of the immigration enforcement system. The report also recommends that DOJ and DHS accelerate their design of an integrated capacity to track cases and project immigration enforcement activity. Policy makers and others who are interested in how the nation's immigration enforcement system is organized and operates also will find it useful.

Climate and Social Stress

by National Research Council Paul C. Stern Division of Behavioral and Social Sciences and Education Board on Environmental Change and Society John D. Steinbruner Jo L. Husbands Committee on Assessing the Impact of Climate Change on Social and Political Stresses

Climate change can reasonably be expected to increase the frequency and intensity of a variety of potentially disruptive environmental events--slowly at first, but then more quickly. It is prudent to expect to be surprised by the way in which these events may cascade, or have far-reaching effects. During the coming decade, certain climate-related events will produce consequences that exceed the capacity of the affected societies or global systems to manage; these may have global security implications. Although focused on events outside the United States, Climate and Social Stress: Implications for Security Analysis recommends a range of research and policy actions to create a whole-of-government approach to increasing understanding of complex and contingent connections between climate and security, and to inform choices about adapting to and reducing vulnerability to climate change.

Climate Change Education

by National Research Council Division of Behavioral and Social Sciences and Education Board on Environmental Change and Society Board on Science Education Michael A. Feder Sherrie Forest

The global scientific and policy community now unequivocally accepts that human activities cause global climate change. Although information on climate change is readily available, the nation still seems unprepared or unwilling to respond effectively to climate change, due partly to a general lack of public understanding of climate change issues and opportunities for effective responses. The reality of global climate change lends increasing urgency to the need for effective education on earth system science, as well as on the human and behavioral dimensions of climate change, from broad societal action to smart energy choices at the household level. The public's limited understanding of climate change is partly the result of four critical challenges that have slowed development and delivery of effective climate change education. As one response to these challenges, Congress, in its 2009 and 2010 appropriation process, requested that the National Science Foundation (NSF) create a program in climate change education to provide funding to external grantees to improve climate change education in the United States. To support and strengthen these education initiatives, the Board on Science Education of the National Research Council (NRC) created the Climate Change Education Roundtable. The Roundtable convened two workshops. Climate Change Education Goals, Audiences, and Strategies is a summary of the discussions and presentations from the first workshop, held October 21 and 22, 2010. This report focuses on two primary topics: public understanding and decision maker support. It should be viewed as an initial step in examining the research on climate change and applying it in specific policy circumstances.

The Continuing Epidemiological Transition in Sub-Saharan Africa

by National Research Council Committee on Population Division of Behavioral and Social Sciences and Education Kevin Kinsella Thomas J. Plewes

Among the poorest and least developed regions in the world, sub-Saharan Africa has long faced a heavy burden of disease, with malaria, tuberculosis, and, more recently, HIV being among the most prominent contributors to that burden. Yet in most parts of Africa-and especially in those areas with the greatest health care needs-the data available to health planners to better understand and address these problems are extremely limited. The vast majority of Africans are born and will die without being recorded in any document or spearing in official statistics. With few exceptions, African countries have no civil registration systems in place and hence are unable to continuously generate vital statistics or to provide systematic information on patterns of cause of death, relying instead on periodic household-level surveys or intense and continuous monitoring of small demographic surveillance sites to provide a partial epidemiological and demographic profile of the population. In 1991 the Committee on Population of the National Academy of Sciences organized a workshop on the epidemiological transition in developing countries. The workshop brought together medical experts, epidemiologists, demographers, and other social scientists involved in research on the epidemiological transition in developing countries to discuss the nature of the ongoing transition, identify the most important contributors to the overall burden of disease, and discuss how such information could be used to assist policy makers in those countries to establish priorities with respect to the prevention and management of the main causes of ill health. This report summarizes the presentations and discussions from a workshop convened in October 2011 that featured invited speakers on the topic of epidemiological transition in sub-Saharan Africa. The workshop was organized by a National Research Council panel of experts in various aspects of the study of epidemiological transition and of sub-Saharan data sources. The Continuing Epidemiological Transition in Sub-Saharan Africa serves as a factual summary of what occurred at the workshop in October 2011.

Design of the National Children's Study

by Institute of Medicine National Research Council Committee on National Statistics Board on Children, Youth, and Families Division of Behavioral and Social Sciences and Education Nancy Kirkendall

The Children's Health Act mandated the National Children's Study (NCS) in 2000 with one of its purposes being to authorize the National Institute of Child Health and Human Development (NICHD) to study the environmental influences (including physical, chemical, biological, and psychosocial) on children's health and development. The NCS examines all aspects of the environment including air, water, diet, noise, family dynamics, and genetics, on the growth, development, and health of children across the United States, for a period of 21 years. The purpose of NCS is to improve the health and well-being of children and to contribute to understanding the role of these factors on health and disease. The research plan for the NCS was developed from 2005 to 2007 in collaboration among the Interagency Coordinating Committee, the NCS Advisory Committee, the NCS Program Office, Westat, the Vanguard Center principal investigators, and federal scientists. The current design of the study, however, uses a separate pilot to assess quality of scientific output, logistics, and operations and a "Main Study" to examine exposure-outcome relationships. The NCS proposed the use of a multilayered cohort approach for the Main Study, which was one of the topics for discussion at the workshop that is the subject of this publication. In the fall of 2012, NICHD requested that the Committee on National Statistics (CNSTAT) of the NRC and the IOM convene a joint workshop, to be led by CNSTAT. The workshop was to focus on issues related to the overall design (including the framework for implementation) of the NCS. The committee was provided a background paper which it used to select the challenges that were discussed at the workshop. Design of the National Children's Study: A Workshop Summary presents an overview of the workshop held on January 11, 2013. The publication includes summaries of the four sessions of the workshop, a list of participants, and the agenda.

Deterrence and the Death Penalty

by National Research Council John V. Pepper Division of Behavioral and Social Sciences and Education Committee on Law and Justice Daniel S. Nagin Committee on Deterrence and the Death Penalty

Many studies during the past few decades have sought to determine whether the death penalty has any deterrent effect on homicide rates. Researchers have reached widely varying, even contradictory, conclusions. Some studies have concluded that the threat of capital punishment deters murders, saving large numbers of lives; other studies have concluded that executions actually increase homicides; still others, that executions have no effect on murder rates. Commentary among researchers, advocates, and policymakers on the scientific validity of the findings has sometimes been acrimonious. Against this backdrop, the National Research Council report Deterrence and the Death Penalty assesses whether the available evidence provides a scientific basis for answering questions of if and how the death penalty affects homicide rates. This new report from the Committee on Law and Justice concludes that research to date on the effect of capital punishment on homicide rates is not useful in determining whether the death penalty increases, decreases, or has no effect on these rates. The key question is whether capital punishment is less or more effective as a deterrent than alternative punishments, such as a life sentence without the possibility of parole. Yet none of the research that has been done accounted for the possible effect of noncapital punishments on homicide rates. The report recommends new avenues of research that may provide broader insight into any deterrent effects from both capital and noncapital punishments.

The Early Childhood Care and Education Workforce

by Institute of Medicine National Research Council Division of Behavioral and Social Sciences and Education Board on Children, Youth and Families Committee on Early Childhood Care and Education Workforce: A Workshop

Early childhood care and education (ECCE) settings offer an opportunity to provide children with a solid beginning in all areas of their development. The quality and efficacy of these settings depend largely on the individuals within the ECCE workforce. Policy makers need a complete picture of ECCE teachers and caregivers in order to tackle the persistent challenges facing this workforce. The IOM and the National Research Council hosted a workshop to describe the ECCE workforce and outline its parameters. Speakers explored issues in defining and describing the workforce, the marketplace of ECCE, the effects of the workforce on children, the contextual factors that shape the workforce, and opportunities for strengthening ECCE as a profession.

Effective Tracking of Building Energy Use

by National Research Council Committee on National Statistics Division on Engineering and Physical Sciences Division of Behavioral and Social Sciences and Education William F. Eddy Krisztina Marton Board on Energy and Environmental Systems Panel on Redesigning the Commercial Buildings and Residential Energy Consumption Surveys of the Energy Information Administration

The United States is responsible for nearly one-fifth of the world's energy consumption. Population growth, and the associated growth in housing, commercial floor space, transportation, goods, and services is expected to cause a 0.7 percent annual increase in energy demand for the foreseeable future. The energy used by the commercial and residential sectors represents approximately 40 percent of the nation's total energy consumption, and the share of these two sectors is expected to increase in the future. The Commercial Buildings Energy Consumption Survey (CBECS) and Residential Energy Consumption Survey (RECS) are two major surveys conducted by the Energy Information Administration. The surveys are the most relevant sources of data available to researchers and policy makers on energy consumption in the commercial and residential sectors. Many of the design decisions and operational procedures for the CBECS and RECS were developed in the 1970s and 1980s, and resource limitations during much of the time since then have prevented EIA from making significant changes to the data collections. Effective Tracking of Building Energy Use makes recommendations for redesigning the surveys based on a review of evolving data user needs and an assessment of new developments in relevant survey methods.

Evaluation of PEPFAR

by Institute of Medicine Board on Children, Youth, and Families Division of Behavioral and Social Sciences and Education Board on Global Health Committee on the Outcome and Impact Evaluation of Global HIV/AIDS Programs Implemented Under the Lantos-Hyde Act of 2008

The U.S. government supports programs to combat global HIV/AIDS through an initiative that is known as the President's Emergency Plan for AIDS Relief (PEPFAR). This initiative was originally authorized in the U.S. Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 and focused on an emergency response to the HIV/AIDS pandemic to deliver lifesaving care and treatment in low- and middle-income countries (LMICs) with the highest burdens of disease. It was subsequently reauthorized in the Tom Lantos and Henry J. Hyde U.S. Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008 (the Lantos-Hyde Act). Evaluation of PEPFAR makes recommendations for improving the U.S. government's bilateral programs as part of the U.S. response to global HIV/AIDS. The overall aim of this evaluation is a forward-looking approach to track and anticipate the evolution of the U.S. response to global HIV to be positioned to inform the ability of the U.S. government to address key issues under consideration at the time of the report release.

Fostering Independence, Participation, and Healthy Aging Through Technology

by Institute of Medicine National Research Council Steve Olson Division of Behavioral and Social Sciences and Education Board on Health Sciences Policy Tracy A. Lustig Forum on Aging, Disability, and Independence

The Institute of Medicine (IOM) and the National Research Council (NRC) have had prominent roles in discussions of aging, disability, and technology for decades. In 1978, Aging and Medical Education (IOM, 1978) raised national awareness of the challenges to physicians posed by the aging of the U.S. population. Thirty years later, Retooling for an Aging America highlighted concerns for the entire health care workforce in view of the aging of the population, including the role of technology in caring for older populations. The 1988 report The Aging Population in the 21st Century examined social, economic, and demographic changes among older adults, as well as many health-related topics: health promotion and disease prevention; quality of life; health care system financing and use; and the quality of care-- especially long-term care. In 1991, the landmark report Disability in America laid out a national agenda to prevent disability and improve the lives of people with disabling conditions. The 1997 report Enabling America: Assessing the Role of Rehabilitation Science and Engineering examined the knowledge base of rehabilitation science and engineering and proposed ways to translate scientific findings into interventions that produce better health. And the 2007 report The Future of Disability in America examined progress made since the earlier reports and looked at continuing barriers that limit the independence, productivity, and participation in community life of people with disabilities. All these reports were produced by committees appointed in accordance with guidelines of the National Academies and met multiples times to compile and review evidence, reach consensus on conclusions and recommendations, draft a report of the committee, and then modify that draft report in response to comments from outside reviewers. The IOM and NRC have also held several workshops related to aging, disability, and technology and published summary reports, such as Technology for Adaptive Aging and Grand Challenges of Our Aging Society. The IOM and NRC also convene groups that take a different approach to issues of pressing national and international importance. Often known as forums or roundtables, these groups meet regularly to foster dialogue and confront issues of mutual interest and concern among a broad range of stakeholders. They can convene workshops, initiate cooperative projects among members, commission independently authored articles, and generate ideas for independent consensus studies. In 2012 the IOM and NRC joined together to establish the Forum on Aging, Disability, and Independence to provide a neutral venue for broad-ranging discussions among the many stakeholders involved with aging and disability. The goals of the forum are to highlight areas in which the coordination of the aging and disability networks is strong, examine the challenges involved in aligning the aging and disability networks, explore new approaches for resolving problem areas, elevate the visibility and broaden the perspectives of stakeholders, and set the stage for future policy actions. Forum sponsors and members include federal agencies, health professional associations, private sector businesses, academics, and consumers. Fostering Independence, Participation, and Healthy Aging Through Technology summarizes this workshop.

From Neurons to Neighborhoods

by Institute of Medicine National Research Council Steve Olson Board on Children, Youth, and Families Division of Behavioral and Social Sciences and Education

From Neurons to Neighborhoods: An Update: Workshop Summary is based on the original study From Neurons to Neighborhoods: Early Childhood Development, which released in October of 2000. From the time of the original publication's release, much has occurred to cause a fundamental reexamination of the nation's response to the needs of young children and families, drawing upon a wealth of scientific knowledge that has emerged in recent decades. The study shaped policy agendas and intervention efforts at national, state, and local levels. It captured a gratifying level of attention in the United States and around the world and has helped to foster a highly dynamic and increasingly visible science of early childhood development. It contributed to a growing public understanding of the foundational importance of the early childhood years and has stimulated a global conversation about the unmet needs of millions of young children. Ten years later, the Board on Children, Youth, and Families of the Institute of Medicine (IOM) and the National Research Council (NRC) held a 2-day workshop in Washington, D.C., to review and commemorate a decade of advances related to the mission of the report. The workshop began with a series of highly interactive breakout sessions in which experts in early childhood development examined the four organizing themes of the original report and identified both measurable progress and remaining challenges. The second day of the workshop, speakers chosen for their diverse perspectives on early childhood research and policy issues discussed how to build on the accomplishments of the past decade and to launch the next era in early childhood science, policy, and practice. From Neurons to Neighborhoods: An Update: Workshop Summary emphasizes that there is a single, integrated science of early childhood development despite the extent to which it is carved up and divided among a diversity of professional disciplines, policy sectors, and service delivery systems. While much work still remains to be done to reach this goal, the 2010 workshop demonstrated both the promise of this integrated science and the rich diversity of contributions to that science.

Health and Incarceration

by Institute of Medicine National Research Council Division of Behavioral and Social Sciences and Education Committee on Law and Justice Board on the Health of Select Populations Amy Smith Committee on Causes and Consequences of High Rates of Incarceration

Over the past four decades, the rate of incarceration in the United States has skyrocketed to unprecedented heights, both historically and in comparison to that of other developed nations. At far higher rates than the general population, those in or entering U.S. jails and prisons are prone to many health problems. This is a problem not just for them, but also for the communities from which they come and to which, in nearly all cases, they will return. Health and Incarceration is the summary of a workshop jointly sponsored by the National Academy of Sciences(NAS) Committee on Law and Justice and the Institute of Medicine(IOM) Board on Health and Select Populations in December 2012. Academics, practitioners, state officials, and nongovernmental organization representatives from the fields of healthcare, prisoner advocacy, and corrections reviewed what is known about these health issues and what appear to be the best opportunities to improve healthcare for those who are now or will be incarcerated. The workshop was designed as a roundtable with brief presentations from 16 experts and time for group discussion. Health and Incarceration reviews what is known about the health of incarcerated individuals, the healthcare they receive, and effects of incarceration on public health. This report identifies opportunities to improve healthcare for these populations and provides a platform for visions of how the world of incarceration health can be a better place.

Human Performance Modification

by National Research Council Division on Engineering and Physical Sciences Division of Behavioral and Social Sciences and Education Board on Behavioral, Cognitive, and Sensory Sciences Committee on Assessing Foreign Technology Development in Human Performance Modification

The development of technologies to modify natural human physical and cognitive performance is one of increasing interest and concern, especially among military services that may be called on to defeat foreign powers with enhanced warfighter capabilities. Human performance modification (HPM) is a general term that can encompass actions ranging from the use of "natural" materials, such as caffeine or khat as a stimulant, to the application of nanotechnology as a drug delivery mechanism or in an invasive brain implant. Although the literature on HPM typically addresses methods that enhance performance, another possible focus is methods that degrade performance or negatively affect a military force's ability to fight. Advances in medicine, biology, electronics, and computation have enabled an increasingly sophisticated ability to modify the human body, and such innovations will undoubtedly be adopted by military forces, with potential consequences for both sides of the battle lines. Although some innovations may be developed for purely military applications, they are increasingly unlikely to remain exclusively in that sphere because of the globalization and internationalization of the commercial research base. Based on its review of the literature, the presentations it received and on its own expertise, the Committee on Assessing Foreign Technology Development in Human Performance Modification chose to focus on three general areas of HPM: human cognitive modification as a computational problem, human performance modification as a biological problem, and human performance modification as a function of the brain-computer interface. Human Performance Modification: Review of Worldwide Research with a View to the Future summarizes these findings.

Improving Measures of Science, Technology, and Innovation

by National Research Council Kaye Husbands Fealing Committee on National Statistics Robert E. Litan Policy and Global Affairs Division of Behavioral and Social Sciences and Education Andrew W. Wyckoff Board on Science, Technology, and Economic Policy Panel on Developing Science, Technology, and Innovation Indicators for the Future

The National Center for Science and Engineering Statistics (NCSES), at the U.S. National Foundation, is 1 of 14 major statistical agencies in the federal government, of which at least 5 collect relevant information on science, technology, and innovation activities in the United States and abroad. The America COMPETES Reauthorization Act of 2010 expanded and codified NCSES's role as a U.S. federal statistical agency. Important aspects of the agency's mandate include collection, acquisition, analysis, and reporting and dissemination of data on research and development trends, on U.S. competitiveness in science, technology, and research and development, and on the condition and progress of U.S. science, technology, engineering, and mathematics (STEM) education. Improving Measures of Science, Technology and Innovation: Interim Report examines the status of the NCSES's science, technology, and innovation (STI) indicators. This report assesses and provides recommendations regarding the need for revised, refocused, and newly developed indicators designed to better reflect fundamental and rapid changes that are reshaping global science, technology and innovation systems. The book also determines the international scope of STI indicators and the need for developing new indicators that measure developments in innovative activities in the United States and abroad, and Offers foresight on the types of data, metrics and indicators that will be particularly influential in evidentiary policy decision-making for years to come. In carrying out its charge, the authoring panel undertook a broad and comprehensive review of STI indicators from different countries, including Japan, China, India and several countries in Europe, Latin America and Africa. Improving Measures of Science, Technology, and Innovation makes recommendations for near-term action by NCSES along two dimensions: (1) development of new policy-relevant indicators that are based on NCSES survey data or on data collections at other statistical agencies; and (2) exploration of new data extraction and management tools for generating statistics, using automated methods of harvesting unstructured or scientometric data and data derived from administrative records.

Improving Self-Escape from Underground Coal Mines

by National Research Council Division of Behavioral and Social Sciences and Education Committee on Mine Safety: Essential Components of Self-Escape Board on Human-Systems Integration

Coal mine disasters in the United States are relatively rare events; many of the roughly 50,000 miners underground will never have to evacuate a mine in an emergency during their careers. However, for those that do, the consequences have the potential to be devastating. U.S. mine safety practices have received increased attention in recent years because of the highly publicized coal mine disasters in 2006 and 2010. Investigations have centered on understanding both how to prevent or mitigate emergencies and what capabilities are needed by miners to self-escape to a place of safety successfully. This report focuses on the latter - the preparations for self-escape. In the wake of 2006 disasters, the U.S. Congress passed the Mine Improvement and New Emergency Response Act of 2006 (MINER Act), which was designed to strengthen existing mine safety regulations and set forth new measures aimed at improving accident preparedness and emergency response in underground coal mines. Since that time, the efforts of the National Institute of Occupational Safety and Health (NIOSH) and the Mine Safety and Health Administration (MSHA) have contributed to safety improvements in the mining industry. However, the Upper Big Branch mine explosion in 2010 served as a reminder to remain ever vigilant on improving the prevention of mine disasters and preparations to help miners survive in the event of emergencies. This study was set in the context of human-systems integration (HSI), a systems approach that examines the interaction of people, tasks, and equipment and technology in the pursuit of a goal. It recognizes this interaction occurs within, and is influenced by, the broader environmental context. A key premise of human-systems integration is that much important information is lost when the various tasks within a system are considered individually or in isolation rather than in interaction with the whole system. Improving Self-Escape from Underground Coal Mines, the task of self-escape is part of the mine safety system.

Industrial Methods for the Effective Development and Testing of Defense Systems

by National Research Council Committee on National Statistics Board on Army Science and Technology Division on Engineering and Physical Sciences Division of Behavioral and Social Sciences and Education Panel on Industrial Methods for the Effective Test and Development of Defense Systems

During the past decade and a half, the National Research Council, through its Committee on National Statistics, has carried out a number of studies on the application of statistical methods to improve the testing and development of defense systems. These studies were intended to provide advice to the Department of Defense (DOD), which sponsored these studies. The previous studies have been concerned with the role of statistical methods in testing and evaluation, reliability practices, software methods, combining information, and evolutionary acquisition. Industrial Methods for the Effective Testing and Development of Defense Systems is the latest in a series of studies, and unlike earlier studies, this report identifies current engineering practices that have proved successful in industrial applications for system development and testing. This report explores how developmental and operational testing, modeling and simulation, and related techniques can improve the development and performance of defense systems, particularly techniques that have been shown to be effective in industrial applications and are likely to be useful in defense system development. In addition to the broad issues, the report identifies three specific topics for its focus: finding failure modes earlier, technology maturity, and use of all relevant information for operational assessments.

Medical Care Economic Risk

by Institute of Medicine National Research Council Committee on National Statistics Board on Health Care Services Division of Behavioral and Social Sciences and Education Michael J. O'Grady Panel on Measuring Medical Care Risk in Conjunction with the New Supplemental Income Poverty Measure Gooloo S. Wunderlich

The United States has seen major advances in medical care during the past decades, but access to care at an affordable cost is not universal. Many Americans lack health care insurance of any kind, and many others with insurance are nonetheless exposed to financial risk because of high premiums, deductibles, co-pays, limits on insurance payments, and uncovered services. One might expect that the U.S. poverty measure would capture these financial effects and trends in them over time. Yet the current official poverty measure developed in the early 1960s does not take into account significant increases and variations in medical care costs, insurance coverage, out-of-pocket spending, and the financial burden imposed on families and individuals. Although medical costs consume a growing share of family and national income and studies regularly document high rates of medical financial stress and debt, the current poverty measure does not capture the consequences for families' economic security or their income available for other basic needs. In 1995, a panel of the National Research Council (NRC) recommended a new poverty measure, which compares families' disposable income to poverty thresholds based on current spending for food, clothing, shelter, utilities, and a little more. The panel's recommendations stimulated extensive collaborative research involving several government agencies on experimental poverty measures that led to a new research Supplemental Poverty Measure (SPM), which the U.S. Census Bureau first published in November 2011 and will update annually. Analyses of the effects of including and excluding certain factors from the new SPM showed that, were it not for the cost that families incurred for premiums and other medical expenses not covered by health insurance, 10 million fewer people would have been poor according to the SPM. The implementation of the patient Protection and Affordable Care Act (ACA) provides a strong impetus to think rigorously about ways to measure medical care economic burden and risk, which is the basis for Medical Care Economic Risk. As new policies - whether part of the ACA or other policies - are implemented that seek to expand and improve health insurance coverage and to protect against the high costs of medical care relative to income, such measures will be important to assess the effects of policy changes in both the short and long term on the extent of financial burden and risk for the population, which are explained in this report.

Monitoring Progress Toward Successful K-12 STEM Education

by Board on Testing and Assessment National Research Council Division of Behavioral and Social Sciences and Education Board on Science Education Committee on the Evaluation Framework for Successful K-12 STEM Education

Following a 2011 report by the National Research Council (NRC) on successful K-12 education in science, technology, engineering, and mathematics (STEM), Congress asked the National Science Foundation to identify methods for tracking progress toward the report's recommendations. In response, the NRC convened the Committee on an Evaluation Framework for Successful K-12 STEM Education to take on this assignment. The committee developed 14 indicators linked to the 2011 report's recommendations. By providing a focused set of key indicators related to students' access to quality learning, educator's capacity, and policy and funding initiatives in STEM, the committee addresses the need for research and data that can be used to monitor progress in K-12 STEM education and make informed decisions about improving it. The recommended indicators provide a framework for Congress and relevant deferral agencies to create and implement a national-level monitoring and reporting system that: assesses progress toward key improvements recommended by a previous National Research Council (2011) committee; measures student knowledge, interest, and participation in the STEM disciplines and STEM-related activities; tracks financial, human capital, and material investments in K-12 STEM education at the federal, state, and local levels; provides information about the capabilities of the STEM education workforce, including teachers and principals; and facilitates strategic planning for federal investments in STEM education and workforce development when used with labor force projections. All 14 indicators explained in this report are intended to form the core of this system. Monitoring Progress Toward Successful K-12 STEM Education: A Nation Advancing? summarizes the 14 indicators and tracks progress towards the initial report's recommendations.

New Directions in Assessing Performance Potential of Individuals and Groups

by National Research Council Robert Pool Division of Behavioral and Social Sciences and Education Board on Behavioral, Cognitive, and Sensory Sciences Committee on Measuring Human Capabilities: Performance Potential of Individuals and Collectives

As an all-volunteer service accepting applications from nearly 400,000 potential recruits annually from across the U.S. population, the U.S. military must accurately and efficiently assess the individual capability of each recruit for the purposes of selection, job classification, and unit assignment. New Directions for Assessing Performance Potential of Individuals and Groups is the summary of a workshop held April 3-4, 2013 to examine the future of military entrance assessments. This workshop was a part of the first phase of a larger study that will investigate cutting-edge research into the measurement of both individual capabilities and group composition in order to identify future research directions that may lead to improved assessment and selection of enlisted personnel for the U.S. Army. The workshop brought together scientists from a variety of relevant areas to focus on cognitive and noncognitive attributes that can be used in the initial testing and assignment of enlisted personnel. This report discusses the evolving goals of candidate testing, emerging constructs and theory, and ethical implications of testing methods.

Priorities for Research to Reduce the Threat of Firearm-Related Violence

by Institute of Medicine National Research Council Bruce M. Altevogt Division of Behavioral and Social Sciences and Education Committee on Law and Justice Arlene F. Lee Patrick W. Kelley Committee on Priorities for a Public Health Research Agenda to Reduce the Threat of Firearm-Related Violence Executive Office, Institute of Medicine Margaret A. Mccoy Alan I. Leshner

In 2010, more than 105,000 people were injured or killed in the United States as the result of a firearm-related incident. Recent, highly publicized, tragic mass shootings in Newtown, CT; Aurora, CO; Oak Creek, WI; and Tucson, AZ, have sharpened the American public's interest in protecting our children and communities from the harmful effects of firearm violence. While many Americans legally use firearms for a variety of activities, fatal and nonfatal firearm violence poses a serious threat to public safety and welfare. In January 2013, President Barack Obama issued 23 executive orders directing federal agencies to improve knowledge of the causes of firearm violence, what might help prevent it, and how to minimize its burden on public health. One of these orders directed the Centers for Disease Control and Prevention (CDC) to, along with other federal agencies, immediately begin identifying the most pressing problems in firearm violence research. The CDC and the CDC Foundation asked the IOM, in collaboration with the National Research Council, to convene a committee tasked with developing a potential research agenda that focuses on the causes of, possible interventions to, and strategies to minimize the burden of firearm-related violence. Priorities for Research to Reduce the Threat of Firearm-Related Violence focuses on the characteristics of firearm violence, risk and protective factors, interventions and strategies, the impact of gun safety technology, and the influence of video games and other media.

Proposed Revisions to the Common Rule

by National Research Council Robert Pool Division of Behavioral and Social Sciences and Education Board on Behavioral, Cognitive, and Sensory Sciences Committee on Revisions to the Common Rule for the Protection of Human Subjects in Research in the Behavioral and Social Sciences

On July 26, 2011, the U.S. Department of Health and Human Services issued an advance notice of proposed rulemaking (ANPRM) with the purpose of soliciting comments on how current regulations for protecting research participants could be modernized and revised. The rationale for revising the regulations was as follows: this ANPRM seeks comment on how to better protect human subjects who are involved in research, while facilitating valuable research and reducing burden, delay, and ambiguity for investigators. The current regulations governing human subjects research were developed years ago when research was predominantly conducted at universities, colleges, and medical institutions, and each study generally took place at only a single site. Although the regulations have been amended over the years, they have not kept pace with the evolving human research enterprise, the proliferation of multisite clinical trials and observational studies, the expansion of health services research, research in the social and behavioral sciences, and research involving databases, the Internet, and biological specimen repositories, and the use of advanced technologies, such as genomics. Proposed Revisions to the Common Rule: Perspectives of Social and Behavioral Scientists: Workshop Summary focuses on six broad topic areas: 1. Evidence on the functioning of the Common Rule and of institutional review boards (IRBs), to provide context for the proposed revisions. 2. The types and levels of risks and harms encountered in social and behavioral sciences, and issues related to the severity and probability of harm, because the ANPRM asks for input on calibration of levels of review to levels of risk. 3. The consent process and special populations, because new rules have been proposed to improve informed consent (e.g., standard consent form, consent for future uses of biospecimens, and re-consenting for further use of existing research data). 4. Issues related to the protection of research participants in studies that involve use of existing data and data sharing, because the ANPRM proposed applying standards for protecting the privacy of healthcare data to research data. 5. Multidisciplinary and multisite studies, because the ANPRM proposed a revision to the regulations that would allow multisite studies to be covered by a single IRB. 6. The purview and roles of IRBs, because the ANPRM included possible revisions to categories of research that could entail changes in IRB oversight.

Reforming Juvenile Justice

by Richard J. Bonnie Robert L. Johnson National Research Council Division of Behavioral and Social Sciences and Education Committee on Law and Justice Julie Schuck Committee on Assessing Juvenile Justice Reform Betty M. Chemers

Adolescence is a distinct, yet transient, period of development between childhood and adulthood characterized by increased experimentation and risk-taking, a tendency to discount long-term consequences, and heightened sensitivity to peers and other social influences. A key function of adolescence is developing an integrated sense of self, including individualization, separation from parents, and personal identity. Experimentation and novelty-seeking behavior, such as alcohol and drug use, unsafe sex, and reckless driving, are thought to serve a number of adaptive functions despite their risks. Research indicates that for most youth, the period of risky experimentation does not extend beyond adolescence, ceasing as identity becomes settled with maturity. Much adolescent involvement in criminal activity is part of the normal developmental process of identity formation and most adolescents will mature out of these tendencies. Evidence of significant changes in brain structure and function during adolescence strongly suggests that these cognitive tendencies characteristic of adolescents are associated with biological immaturity of the brain and with an imbalance among developing brain systems. This imbalance model implies dual systems: one involved in cognitive and behavioral control and one involved in socio-emotional processes. Accordingly adolescents lack mature capacity for self-regulations because the brain system that influences pleasure-seeking and emotional reactivity develops more rapidly than the brain system that supports self-control. This knowledge of adolescent development has underscored important differences between adults and adolescents with direct bearing on the design and operation of the justice system, raising doubts about the core assumptions driving the criminalization of juvenile justice policy in the late decades of the 20th century. It was in this context that the Office of Juvenile Justice and Delinquency Prevention (OJJDP) asked the National Research Council to convene a committee to conduct a study of juvenile justice reform. The goal of Reforming Juvenile Justice: A Developmental Approach was to review recent advances in behavioral and neuroscience research and draw out the implications of this knowledge for juvenile justice reform, to assess the new generation of reform activities occurring in the United States, and to assess the performance of OJJDP in carrying out its statutory mission as well as its potential role in supporting scientifically based reform efforts.

Research Opportunities Concerning the Causes and Consequences of Child Food Insecurity and Hunger

by Institute of Medicine National Research Council Committee on National Statistics Division of Behavioral and Social Sciences and Education Food and Nutrition Board Nancy Kirkendall Connie Citro Carol House

Section 141 of The Healthy, Hunger-Free Kids Act of 20101 provides funding for a research program on the causes and consequences of childhood hunger and food insecurity, and the characteristics of households with childhood hunger and food insecurity, with a particular focus on efforts to improve the knowledge base regarding contributing factors, geographic distribution, programmatic effectiveness, public health and medical costs, and consequences for child development, well-being, and educational attainment. The Economic Research Service and Food and Nutrition Service of the US Department of Agriculture conducted two outreach efforts to obtain input from the research community and other stakeholders to help focus on areas and methods with the greatest research potential. First, Food and Nutrition Service sought written comments to selected questions through publication of a Federal Register Notice. The second option was to convene a workshop under the auspices of the Committee on National Statistics of the National Research Council and the Food and Nutrition Board of the Institute of Medicine. Research Opportunities Concerning the Causes and Consequences of Child Food Insecurity and Hunger is the summary of that workshop, convened in Fall 2012 to examine research gaps and opportunities to advance understanding of the causes and consequences of child hunger in the United States. This report reviews the adequacy of current knowledge, identifies substantial research gaps, and considers data availability of economic, health, social, cultural, demographic, and other factors that contribute to childhood hunger or food insecurity. It also considers the geographic distribution of childhood hunger and food insecurity; the extent to which existing federal assistance programs reduce childhood hunger and food insecurity; childhood hunger and food insecurity persistence, and the extent to which it is due to gaps in program coverage; and the inability of potential participants to access programs, or the insufficiency of program benefits or services. Research Opportunities Concerning the Causes and Consequences of Child Food Insecurity and Hunger will be a resource to inform discussions about the public health and medical costs of childhood hunger and food insecurity through its focus on determinants of child food insecurity and hunger, individual, community, and policy responses to hunger, impacts of child food insecurity and hunger, and measurement and surveillance issues.

A Review of the U.S. Global Change Research Program's Strategic Plan

by National Research Council Division of Behavioral and Social Sciences and Education Board on Environmental Change and Society Division on Earth and Life Studies Committee to Advise the U.S. Global Change Research Program Board on Atmospheric Sciences and Climate

The U.S. government supports a large, diverse suite of activities that can be broadly characterized as "global change research." Such research offers a wide array of benefits to the nation, in terms of protecting public health and safety, enhancing economic strength and competitiveness, and protecting the natural systems upon which life depends. The U.S. Global Change Research Program (USGCRP), which coordinates the efforts of numerous agencies and departments across the federal government, was officially established in 1990 through the U.S. Global Change Research Act (GCRA). In the subsequent years, the scope, structure, and priorities of the Program have evolved, (for example, it was referred to as the Climate Change Science Program [CCSP] for the years 2002-2008), but throughout, the Program has played an important role in shaping and coordinating our nation's global change research enterprise. This research enterprise, in turn, has played a crucial role in advancing understanding of our changing global environment and the countless ways in which human society affects and is affected by such changes. In mid-2011, a new NRC Committee to Advise the USGCRP was formed and charged to provide a centralized source of ongoing whole-program advice to the USGCRP. The first major task of this committee was to provide a review of the USGCRP draft Strategic Plan 2012-2021 (referred to herein as "the Plan"), which was made available for public comment on September 30, 2011. A Review of the U.S. Global Change Research Program's Strategic Plan addresses an array of suggestions for improving the Plan, ranging from relatively small edits to large questions about the Program's scope, goals, and capacity to meet those goals. The draft Plan proposes a significant broadening of the Program's scope from the form it took as the CCSP. Outlined in this report, issues of key importance are the need to identify initial steps the Program will take to actually achieve the proposed broadening of its scope, to develop critical science capacity that is now lacking, and to link the production of knowledge to its use; and the need to establish an overall governance structure that will allow the Program to move in the planned new directions.

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