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The quaint Midwestern town of Serenity is about to hit the small screen. Brandy Borne and her dramatically ditzy mother, Vivian, will be starring in Antique Sleuths, a reality TV show based on the duos antiquarian adventures--and their troubling talent for solving deadly crimes. What better shooting set than a creepy old house, the site of a 60-year-old unsolved axe murder?The location is perfect until Bruce Spring, the shows producer, meets a fatal axe-ident, mortally mauled just like the homes previous owner. The first suspect on the chopping block seems typecast for the role of killer--he was found at the scene of the attack, clutching a stained axe. But as Brandy and Vivian chop around for clues, plenty of other suspects stick out their necks. . . It seems the shows cameraman clashed with Bruce--could he be the culprit? What about the acrimony between Andrew, the harried homeowner, and Bruce, whose dirt-digging documentary all but accused Andrew of the original unsolved crime? And whos driving that blood-red Toyota that keeps making unscripted cameo appearances? If Brandy and Vivian are going to get to the bottom of this mystery, theyll have to be extra careful not to wind up on the cutting room floor--in pieces Dont miss Brandy Bornes tips on antiques "One of the funniest cozy series going. " --"Ellery Queen Mystery Magazine"
An innocent Beauty. A fearsome Beast. A dangerous passion. Mystery and speculation surround "the Dark Prince," a sorcerer who dwells in a kingdom cursed by endless winter. Though shunned by all, Prince Stellan secretly crusades against a zombie plague unleashed by his tyrannical father against the Five Lands. But only an alliance with Aldebaran will provide the support he needs to eradicate the plague once and for all Clarysa, daughter of the Aldebaran king, struggles under the weight of her role as princess. She yearns for adventure, but her father prefers to keep his youngest daughter safe within the palace walls. During one of her rare sanctioned trips beyond the walls of the castle, Clarysa comes face to face with the answer to her prayers. She's heard the tales of Stellan's dangerous nature. She knows a romance with him is forbidden. But one smoldering glance draws her deep into a world of dark magic and sensuous rapture. CONTENT WARNING: Magic, mayhem, and epic snowfall. A Lyrical Press Fantasy Romance | Once Upon
What happens undercover, stays under covers. Jessica Hartley is looking for answers surrounding the mysterious car accident that nearly claimed the life of her best friend. She's willing to risk it all, even her fledgling business, to find the person responsible and bring them to justice. Nate Steele is more than willing to help Jessica, but for reasons all his own. He's been watching the infamous Maxwell Office Solutions for some time now, convinced there's more going on than meets the eye. When his chief issues a cease and desist order yet again, Nate has no choice but to accept inexperienced Jessica as an undercover partner outside the letter of the law. Will Jessica and Nate be able to flush out Maxwell's elusive villain, or will their growing attraction for each other sabotage their undercover ploy? Motives aren't always what they seem when Jessica finds herself armed with Steele. CONTENT WARNING: Beware drool-worthy men in uniform, touchy-feely coworkers, and vindictive ex-girlfriends.
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.
The National Institute of Standards and Technology (NIST)--recognizing that information and insights gained through continual examination of practices for organizational assessment are useful for decision makers at organizations across the deferral, industrial, academic, and national laboratory sectors-recently requested that the National Research Council (NRC) organize a panel to review best practices in assessment of research and development (R&D) organizations. In response, the NRC established the Panel for Review of Best Practices in Assessment of Research and Development Organizations. The panel was charged to consider means of assessing the following in a manner that satisfies the requirements of NIST to perform effective assessments but also identifies assessment methods that can be applied selectively to other R&D organizations. These methods include: technical merit and quality of the science and engineering work, the adequacy of the resources available to support high-quality work, the effectiveness of the agency's delivery of the services and products required to fulfill its goals, the degree to which the agency's current and planned R&D portfolio supports its mission, as well as the agency's flexibility to respond to changing economic, political, social and technological contexts. As one means of data gathering, among others that the panel is performing toward development of a final report of its findings, the panel organized a planning committee for a workshop on best practices in assessment of R&D organizations. Best Practices in Assessment of Research and Development Organizations: Summary of a Workshop reviews the workshop conducted at the Keck Center of the National Academies in Washington, D.C., on March 19, 2012.
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.
Developing and Strengthening the Global Supply Chain for Second-Line Drugs for Multidrug-Resistant Tuberculosisby Institute of Medicine Forum on Drug Discovery, Development, and Translation Anne B. Claiborne Board on Health Sciences Policy Rebecca A. English Rita S. Guenther Anna Nicholson
To effectively treat patients diagnosed with drug-resistant (DR) tuberculosis (TB) and protect the population from further transmission of this infectious disease, an uninterrupted supply of quality-assured (QA), second-line anti-TB drugs (SLDs) is necessary. Patients diagnosed with multidrug-resistant tuberculosis (MDR TB)--a disease caused by strains of Mycobacterium tuberculosis (M.tb.) resistant to two primary TB drugs (isoniazid and rifampicin)--face lengthy treatment regimens of 2 years or more with daily, directly observed treatment (DOT) with SLDs that are less potent, more toxic, and more expensive than those used to treat drug-susceptible TB. From 2000 to 2009, only 0.2-0.5 percent of the estimated 5 million MDR TB cases globally were treated with drugs of known quality and in programs capable of delivering appropriate care (Keshavjee, 2012). The vast majority of MDR TB patients either died from lack of treatment or contributed to the spread of MDR TB in their communities. A strengthened global supply chain for SLDs could save lives by consistently delivering high quality medicines to more of the people who need them. This public workshop explored innovative solutions to the problem of how to get the right SLDs for MDR TB to people who critically need them. More specifically, the workshop examined current problems and potential opportunities for coordinated international efforts to ensure that a reliable and affordable supply of high-quality SLDs is available. Developing and Strengthening the Global Supply Chain for Second-Line Drugs for Multidrug-Resistant Tuberculosis: Workshop Summary covers the objectives of the workshop, which were to review: -To what extent and in what ways current mechanisms are or are not effectively accomplishing what is needed, including consideration of bottlenecks. -The advantages and disadvantages of centralization in the management of the global drug supply chain, and potential decentralized approaches to improve operations of the supply chain. -What can be learned from case studies and examples from other diseases (e.g., the Affordable Medicines Facility-malaria (AMFm) and the U.S. President's Emergency Plan for AIDS Relief [PEPFAR]) - The current allocation of responsibilities and roles of the private (including industry and nonprofit public health organizations) and public sectors, and examination of opportunities for enhancing and optimizing collaboration -Identification of potential innovative solutions to the problem
The Food Forum convened a public workshop on February 22-23, 2012, to explore current and emerging knowledge of the human microbiome, its role in human health, its interaction with the diet, and the translation of new research findings into tools and products that improve the nutritional quality of the food supply. The Human Microbiome, Diet, and Health: Workshop Summary summarizes the presentations and discussions that took place during the workshop. Over the two day workshop, several themes covered included: The microbiome is integral to human physiology, health, and disease. The microbiome is arguably the most intimate connection that humans have with their external environment, mostly through diet. Given the emerging nature of research on the microbiome, some important methodology issues might still have to be resolved with respect to undersampling and a lack of causal and mechanistic studies. Dietary interventions intended to have an impact on host biology via their impact on the microbiome are being developed, and the market for these products is seeing tremendous success. However, the current regulatory framework poses challenges to industry interest and investment.
In communities all around the world, water supplies are coming under increasing pressure as population growth, climate change, pollution, and changes in land use affect water quantity and quality. To address existing and anticipated water shortages, many communities are working to increase water conservation and are seeking alternative sources of water. Water reuse- the sue of treated wastewater, or "reclaimed" water, for beneficial purposes such as drinking, irrigation, or industrial uses- is one option that has helped some communities significantly expand their water supplies. Understanding Water Reuse summarizes the main findings of the National Research Council report Water Reuse: Expanding the Nation's Water Supply Through Reuse of Municipal Wastewater. The report provides an overview of the options and outlook for water reuse in the United States, discusses water treatment technologies and potential uses of reclaimed water, and presents a new analysis that compares the risks of drinking reclaimed water to those of drinking water from traditional sources.
Using Science to Improve the BLM Wild Horse and Burro Program: A Way Forward reviews the science that underpins the Bureau of Land Management's oversight of free-ranging horses and burros on federal public lands in the western United States, concluding that constructive changes could be implemented. The Wild Horse and Burro Program has not used scientifically rigorous methods to estimate the population sizes of horses and burros, to model the effects of management actions on the animals, or to assess the availability and use of forage on rangelands. Evidence suggests that horse populations are growing by 15 to 20 percent each year, a level that is unsustainable for maintaining healthy horse populations as well as healthy ecosystems. Promising fertility-control methods are available to help limit this population growth, however. In addition, science-based methods exist for improving population estimates, predicting the effects of management practices in order to maintain genetically diverse, healthy populations, and estimating the productivity of rangelands. Greater transparency in how science-based methods are used to inform management decisions may help increase public confidence in the Wild Horse and Burro Program.
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.
Over the past century, the U.S. Army Corps of Engineers has built a vast network of water management infrastructure that includes approximately 700 dams, 14,000 miles of levees, 12,000 miles of river navigation channels and control structures, harbors and ports, and other facilities. Historically, the construction of new infrastructure dominated the Corps' water resources budget and activities. Today, national water needs and priorities increasingly are shifting to operations, maintenance, and rehabilitation of existing infrastructure, much of which has exceeded its design life. However, since the mid-1980s federal funding for new project construction and major rehabilitation has declined steadily. As a result, much of the Corps' water resources infrastructure is deteriorating and wearing out faster than it is being replaced. Corps of Engineers Water Resources Infrastrucutre: Deterioration, Investment, or Divestment? explores the status of operations, maintenance, and rehabilitation of Corps water resources infrastructure, and identifies options for the Corps and the nation in setting maintenance and rehabilitation priorities.
From the use of personal products to our consumption of food, water, and air, people are exposed to a wide array of agents each day--many with the potential to affect health. Exposure Science in the 21st Century: A Vision and A Strategy investigates the contact of humans or other organisms with those agents (that is, chemical, physical, and biologic stressors) and their fate in living systems. The concept of exposure science has been instrumental in helping us understand how stressors affect human and ecosystem health, and in efforts to prevent or reduce contact with harmful stressors. In this way exposure science has played an integral role in many areas of environmental health, and can help meet growing needs in environmental regulation, urban and ecosystem planning, and disaster management. Exposure Science in the 21st Century: A Vision and A Strategy explains that there are increasing demands for exposure science information, for example to meet needs for data on the thousands of chemicals introduced into the market each year, and to better understand the health effects of prolonged low-level exposure to stressors. Recent advances in tools and technologies--including sensor systems, analytic methods, molecular technologies, computational tools, and bioinformatics--have provided the potential for more accurate and comprehensive exposure science data than ever before. This report also provides a roadmap to take advantage of the technologic innovations and strategic collaborations to move exposure science into the future.
She once lost his heart on a bluff. Will she risk everything to win it back? Beautician Tracy Quinn spends her days making the women of Colton, Texas beautiful, while living down the nickname of Olive Oyl, given to her by the only man she has ever loved--Zack Cartwright. She spends her nights alone, despite what her ex husband wants their friends and neighbors to think. Ex-rodeo cowboy. Ex-bad-boy. Ex-Marine. Widower and single dad Sheriff Zack Cartwright can describe his life in exes. One ex in particular reminds him of what's missing in his workaholic life: Tracy Quinn. For years since she broke his heart, he's practically made avoiding her a second job. He still wants her, but can never go after her. When cattle rustlers target her brother's ranch, Tracy and Zack are stuck working together. Her son could use a positive male role model, and his daughter is wild for a chance at a "substitute" mom. But Tracy's ex threatens to sue if she lets Zack near her son, and the Colton grapevine is abuzz with rumors about their past relationship. Is it worth the gamble to see if what they have is more than lust? CONTENT WARNING: Spicy sex. A Lyrical Press Contemporary Romance
She left home to find herself. . . and found love along the way. Maggie isn't looking for love on her backpacking trip through Australia. She's got enough man troubles back in Ireland. Australia is her escape, a place of adventure where she can create memories to last a lifetime. But some memories won't be left behind. Gray is ready to quit hiring backpackers to help with the work on his remote Queensland cattle station when Maggie turns up. She's just passing through, but the connection they forge during the long nights herding cattle won't be so easily cast aside. CONTENT WARNING: A strong-willed Irish heroine, a stubborn Australian hero, and oceans of difference to bridge for love. A Lyrical Press Contemporary Romance
They're headed for disaster in a race against love. Racecar driver Stone Adams likes fast women and faster cars, but his playboy lifestyle isn't making his sponsor happy. In an attempt to please the money man, Stone marries a woman in Vegas. But when he shows up at his new bride's house, he discovers she has a fiance she neglected to mention before their quickie wedding--and a younger sister who finds the whole situation hilarious. Grace Cromwell has always been the one to bail her big sister out of scrapes and jams. This time she doesn't want to be the scapegoat. But a photo of Grace and Stone ends up splashed across the front page of the newspaper and she's mistaken for his wife, so she doesn't have much choice. When Grace agrees to play the part of Stone's wife in public, they both have a hard time remembering it's all a charade. A Lyrical Press Contemporary Romance
Gossip says he is hot between the sheets. Has Mr. Insatiable finally met his match? Enya's been curious about Kit's bedroom exploits ever since his ex-girlfriend spilled the beans about his...skill. But he's not for her. Enya can't provide what he wants from life, especially not between the sheets. After Enya admits she's not good at sex, Kit persuades her to trust in him. Together, they can create fireworks in the bedroom. A few drinks followed by a discussion about kinky sex, and Enya succumbs to his charm. Thrilled he's been proven correct, Kit can't keep his hands off Enya, and she's unable, and unwilling, to resist him. But is it just great sex...or something more? CONTENT WARNING: Sexy, sizzling hot romance. Please read with air conditioning on. A Lyrical Press Contemporary Romance
Copyright 2011, Stephanie HaefnerAll rights reserved, Lyrical Press, Inc. "Meet me for a drink?" I called Rich at the office after leaving the dress shop. My mother had added three dresses to her file, with appointments at two other boutiques the following week. "Sure. I can leave in like fifteen minutes. I'll meet you there. "We didn't even have to specify the place. Happy Hour was always at Cosmos, the same place I'd been going to for years. Before Preston, and all the drama before that, it was where Marcus, Brenda, Rachel and I had gone every Friday. I walked in and miraculously found an unoccupied table. Clearly it was Friday and six in the evening--the place was crawling with people ready to start their weekend. Rich walked in before the waitress even made it over to me. He didn't see me at first, and I loved watching him scan the crowd. Unlike most of the male clientele in business suits and power ties, Rich's job required no dress code. He stood there in a pair of semi-faded jeans and a t-shirt from one of the bands he promoted--its tightness in all the right places. When his blue eyes found mine, a smile bowed his lips. I loved the way my heart still sped a bit when he walked toward me, the eyes of most of the female patrons on him. But his were only on mine. He leaned down and kissed me square on the mouth. "Everything okay? You sounded stressed on the phone. ""Little bit. I went dress shopping with my mom and Abby today. ""I can see how that would be stressful. ""It wasn't too bad, but I told her I want the bridesmaids to wear black cocktail dresses. ""Ouch. How'd she take it?""She didn't say what was on her mind, then anyway. But she's not happy. ""I know your parents are paying for a lot of stuff, but when it comes to dresses, shouldn't your opinion be the one that matters most?"God, I loved him so much. "Oh, I wanted to tell you. Marcus picked up a ton of honeymoon brochures. He's pretty sure they're going somewhere European. Paris would be so romantic, don't you think?""Yeah, of course. But I don't think we can take a honeymoon. ""Why not?""We can't expect your parents to pay thousands of dollars for the wedding and then drop another ten grand on a honeymoon. ""Yeah, probably not. " They'd paid for Abby and Daniel's wedding, but the honeymoon to Antigua was a gift from Daniel's parents. "But I'm sure we can save up and at least do something, even if we stay stateside. ""I don't know. Wouldn't you rather save our money so we have a down payment on an apartment?""Why?""Don't you want to get our own place someday?""Not really. I love our weird family, don't you?""Yeah, but it gets. . . cramped sometimes. "I laughed. "Cramped? Are you losing your mind? Our place is huge!" I laughed again and stood. "I'm ready for a drink. What do you want?""I'll get it," he barked as he stood and walked toward the bar. What a crab. He needed to do a few shots and wipe out that mood.
Science is increasingly driven by data, and spatial data underpin the science directions laid out in the 2007 U. S. Geological Survey (USGS) Science Strategy. A robust framework of spatial data, metadata, tools, and a user community that is interactively connected to use spatial data in an efficient and flexible way--known as a spatial data infrastructure (SDI)--must be available for scientists and managers to find, use, and share spatial data both within and beyond the USGS. Over the last decade, the USGS has conducted breakthrough research that has overcome some of the challenges associated with implementing a large SDI. Advancing Strategic Science: A Spatial Data Infrastructure Roadmap for the U. S. Geological Survey is intended to ground those efforts by providing a practical roadmap to full implementation of an SDI to enable the USGS to conduct strategic science.
Manufacturing is in a period of dramatic transformation. But in the United States, public and political dialogue is simplistically focused almost entirely on the movement of certain manufacturing jobs overseas to low-wage countries. The true picture is much more complicated, and also more positive, than this dialogue implies. After years of despair, many observers of US manufacturing are now more optimistic. A recent uptick in manufacturing employment and output in the United States is one factor they cite, but the main reasons for optimism are much more fundamental. Manufacturing is changing in ways that may favor American ingenuity. Rapidly advancing technologies in areas such as biomanufacturing, robotics, smart sensors, cloud-based computing, and nanotechnology have transformed not only the factory floor but also the way products are invented and designed, putting a premium on continual innovation and highly skilled workers. A shift in manufacturing toward smaller runs and custom-designed products is favoring agile and adaptable workplaces, business models, and employees, all of which have become a specialty in the United States. Future manufacturing will involve a global supply web, but the United States has a potentially great advantage because of our tight connections among innovations, design, and manufacturing and also our ability to integrate products and services. The National Academy of Engineering has been concerned about the issues surrounding manufacturing and is excited by the prospect of dramatic change. On June 11-12, 2012, it hosted a workshop in Washington, DC, to discuss the new world of manufacturing and how to position the United States to thrive in this world. The workshop steering committee focused on two particular goals. First, presenters and participants were to examine not just manufacturing but the broad array of activities that are inherently associated with manufacturing, including innovation and design. Second, the committee wanted to focus not just on making things but on making value, since value is the quality that will underlie high-paying jobs in America's future. Making Value: Integrating Manufacturing, Design, and Innovation to Thrive in the Changing Global Economy summarizes the workshop and the topics discussed by participants.
Tobacco use is the leading cause of preventable death in United States, causing more than 440,000 deaths annually and resulting in $193 billion in health-related economic losses each year--$96 billion in direct medical costs and $97 billion in lost productivity. Since the first U.S. Surgeon General's report on smoking in 1964, more than 29 Surgeon General's reports, drawing on data from thousands of studies, have documented the overwhelming and conclusive biologic, epidemiologic, behavioral, and pharmacologic evidence that tobacco use is deadly. This evidence base links tobacco use to the development of multiple types of cancer and other life-threatening conditions, including cardiovascular and respiratory diseases. Smoking accounts for at least 30 percent of all cancer deaths, and 80 percent of lung cancer deaths. Despite the widespread agreement on the dangers of tobacco use and considerable success in reducing tobacco use prevalence from over 40 percent at the time of the 1964 Surgeon General's report to less than 20 percent today, recent progress in reducing tobacco use has slowed. An estimated 18.9 percent of U.S. adults smoke cigarettes, nearly one in four high school seniors smoke, and 13 percent of high school males use smokeless tobacco products. In recognition that progress in combating cancer will not be fully achieved without addressing the tobacco problem, the National Cancer Policy Forum of the Institute of Medicine (IOM) convened a public workshop, Reducing Tobacco-Related Cancer Incidence and Mortality, June 11-12, 2012 in Washington, DC. In opening remarks to the workshop participants, planning committee chair Roy Herbst, professor of medicine and of pharmacology and chief of medical oncology at Yale Cancer Center and Smilow Cancer Hospital, described the goals of the workshop, which were to examine the current obstacles to tobacco control and to discuss potential policy, outreach, and treatment strategies that could overcome these obstacles and reduce tobacco-related cancer incidence and mortality. Experts explored a number of topics, including: the changing demographics of tobacco users and the changing patterns of tobacco product use; the influence of tobacco use on cancer incidence and cancer treatment outcomes; tobacco dependence and cessation programs; federal and state level laws and regulations to curtail tobacco use; tobacco control education, messaging, and advocacy; financial and legal challenges to tobacco control efforts; and research and infrastructure needs to support tobacco control strategies, reduce tobacco related cancer incidence, and improve cancer patient outcomes. Reducing Tobacco-Related Cancer Incidence and Mortality summarizes the workshop.
Review of Biotreatment, Water Recovery, and Brine Reduction Systems for the Pueblo Chemical Agent Destruction Pilot Plantby Committee on Review of Biotreatment Water Recovery Brine Reduction Systems for the Pueblo Chemical Agent Destruction Pilot Plant
The Pueblo Chemical Depot (PCD) in Colorado is one of two sites that features U. S. stockpile of chemical weapons that need to be destroyed. The PCD features about 2,600 tons of mustard-including agent. The PCD also features a pilot plant, the Pueblo Chemical Agent Destruction Pilot Plant (PCAPP), which has been set up to destroy the agent and munition bodies using novel processes. The chemical neutralization or hydrolysis of the mustard agent produces a Schedule 2 compound called thiodiglycol (TDG) that must be destroyed. The PCAPP uses a combined water recovery system (WRS) and brine reduction system (BRS) to destroy TDG and make the water used in the chemical neutralization well water again. Since the PCAPP is using a novel process, the program executive officer for the Assembled Chemical Weapons Alternatives (ACWA) program asked the National Research Council (NRC) to initiate a study to review the PCAPP WRS-BRS that was already installed at PCAPP. 5 months into the study in October, 2012, the NRC was asked to also review the Biotreatment area (BTA). The Committee on Review of Biotreatment, Water Recovery, and Brine Reduction Systems for the Pueblo Chemical Agent Destruction Pilot Plant was thus tasked with evaluating the operability, life-expectancy, working quality, results of Biotreatment studies carried out prior to 1999 and 1999-2004, and the current design, systemization approached, and planned operation conditions for the Biotreatment process. Review of Biotreatment, Water Recovery, and Brine Reduction Systems for the Pueblo Chemical Agent Destruction Pilot Plant is the result of the committee's investigation. The report includes diagrams of the Biotreatment area, the BRS, and WRS; a table of materials of construction, the various recommendations made by the committee; and more.
During the past century the major causes of morbidity and mortality in the United States have shifted from those related to communicable diseases to those due to chronic diseases. Just as the major causes of morbidity and mortality have changed, so too has the understanding of health and what makes people healthy or ill. Research has documented the importance of the social determinants of health (for example, socioeconomic status and education) that affect health directly as well as through their impact on other health determinants such as risk factors. Targeting interventions toward the conditions associated with today's challenges to living a healthy life requires an increased emphasis on the factors that affect the current cause of morbidity and mortality, factors such as the social determinants of health. Many community-based prevention interventions target such conditions. Community-based prevention interventions offer three distinct strengths. First, because the intervention is implemented population-wide it is inclusive and not dependent on access to a health care system. Second, by directing strategies at an entire population an intervention can reach individuals at all levels of risk. And finally, some lifestyle and behavioral risk factors are shaped by conditions not under an individual's control. For example, encouraging an individual to eat healthy food when none is accessible undermines the potential for successful behavioral change. Community-based prevention interventions can be designed to affect environmental and social conditions that are out of the reach of clinical services. Four foundations - the California Endowment, the de Beaumont Foundation, the W.K. Kellogg Foundation, and the Robert Wood Johnson Foundation - asked the Institute of Medicine to convene an expert committee to develop a framework for assessing the value of community-based, non-clinical prevention policies and wellness strategies, especially those targeting the prevention of long-term, chronic diseases. The charge to the committee was to define community-based, non-clinical prevention policy and wellness strategies; define the value for community-based, non-clinical prevention policies and wellness strategies; and analyze current frameworks used to assess the value of community-based, non-clinical prevention policies and wellness strategies, including the methodologies and measures used and the short- and long-term impacts of such prevention policy and wellness strategies on health care spending and public health. An Integrated Framework for Assessing the Value of Community-Based Prevention summarizes the committee's findings.
Every year, the Global Forum undertakes two workshops whose topics are selected by the more than 55 members of the Forum. It was decided in this first year of the Forum's existence that the workshops should lay the foundation for future work of the Forum and the topic that could best provide this base of understanding was "interprofessional education." The first workshop took place August 29-30, 2012, and the second was on November 29-30, 2012. Both workshops focused on linkages between interprofessional education (IPE) and collaborative practice. The difference between them was that Workshop 1 set the stage for defining and understanding IPE while Workshop 2 brought in speakers from around the world to provide living histories of their experience working in and between interprofessional education and interprofessional or collaborative practice. A committee of health professional education experts planned, organized, and conducted a 2-day, interactive public workshop exploring issues related to innovations in health professions education (HPE). The committee involved educators and other innovators of curriculum development and pedagogy and will be drawn from at least four health disciplines. The workshop followed a high-level framework and established an orientation for the future work of the Global Forum on Innovations in Health Professional Education. Interprofessional Education for Collaboration: Learning How to Improve Health from Interprofessional Models Across the Continuum of Education to Practice summarizes the presentations and small group discussions that focused on innovations in five areas of HPE: 1. Curricular innovations - Concentrates on what is being taught to health professions' learners to meet evolving domestic and international needs; 2. Pedagogic innovations - Looks at how the information can be better taught to students and WHERE education can takes place; 3. Cultural elements - Addresses who is being taught by whom as a means of enhancing the effectiveness of the design, development and implementation of interprofessional HPE; 4. Human resources for health - Focuses on how capacity can be innovatively expanded to better ensure an adequate supply and mix of educated health workers based on local needs; and 5. Metrics - Addresses how one measures whether learner assessment and evaluation of educational impact and care delivery systems influence individual and population health.
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.
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