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Health literacy has been shown to affect health outcomes. The use of preventive services improves health and prevents costly health care expenditures. Several studies have found that health literacy makes a difference in the extent to which populations use preventive services. On September 15, 2009, the Institute of Medicine Roundtable on Health Literacy held a workshop to explore approaches to integrate health literacy into primary and secondary prevention. Promoting Health Literacy to Encourage Prevention and Wellnessserves as a factual account of the discussion that took place at the workshop. The report describes the inclusion of health literacy into public health prevention programs at the national, state and local levels, reviews how insurance companies factor health literacy into their prevention programs, and discusses industry contributions to providing health literate primary and secondary prevention.
Health literacy is the degree to which individuals can obtain, process, and understand the basic health information and services they need to make appropriate health decisions. According to Health Literacy: A Prescription to End Confusion(IOM, 2004), nearly half of all American adults--90 million people--have inadequate health literacy to navigate the healthcare system. To address issues raised in that report, the Institute of Medicine convened the Roundtable on Health Literacy, which brings together leaders from the federal government, foundations, health plans, associations, and private companies to discuss challenges facing health literacy practice and research and to identify approaches to promote health literacy in both the public and private sectors. On November 30, 2010, the roundtable cosponsored a workshop with the University of California, Los Angeles (UCLA), Anderson School of Management in Los Angeles. Improving Health Literacy Within a Stateserves as a summary of what occurred at the workshop. The workshop focused on understanding what works to improve health literacy across a state, including how various stakeholders have a role in improving health literacy. The focus of the workshop was on presentations and discussions that address (1) the clinical impacts of health literacy improvement approaches; (2) economic outcomes of health literacy implementation; and (3) how various stakeholders can affect health literacy.
The human-mediated introduction of species to regions of the world they could never reach by natural means has had great impacts on the environment, the economy, and society. In the ocean, these invasions have long been mediated by the uptake and subsequent release of ballast water in ocean-going vessels. Increasing world trade and a concomitantly growing global shipping fleet composed of larger and faster vessels, combined with a series of prominent ballast-mediated invasions over the past two decades, have prompted active national and international interest in ballast water management. Assessing the Relationship Between Propagule Pressure and Invasion Risk in Ballast Waterinforms the regulation of ballast water by helping the Environnmental Protection Agency (EPA) and the U. S. Coast Guard (USCG) better understand the relationship between the concentration of living organisms in ballast water discharges and the probability of nonindigenous organisms successfully establishing populations in U. S. waters. The report evaluates the risk-release relationship in the context of differing environmental and ecological conditions,including estuarine and freshwater systems as well as the waters of the three-mile territorial sea. It recommends how various approaches can be used by regulatory agencies to best inform risk management decisions on the allowable concentrations of living organisms in discharged ballast water in order to safeguard against the establishment of new aquatic nonindigenous species, and to protect and preserve existing indigenous populations of fish, shellfish, and wildlife and other beneficial uses of the nation's waters. Assessing the Relationship Between Propagule Pressure and Invasion Risk in Ballast Waterprovides valuable information that can be used by federal agencies, such as the EPA, policy makers, environmental scientists, and researchers.
Increasing National Resilience to Hazards and Disasters: The Perspective from the Gulf Coast of Louisiana and Mississippi: Summary of a Workshopby The National Academy of Sciences
Natural disasters are having an increasing effect on the lives of people in the United States and throughout the world. Every decade, property damage caused by natural disasters and hazards doubles or triples in the United States. More than half of the U. S. population lives within 50 miles of a coast, and all Americans are at risk from such hazards as fires, earthquakes, floods, and wind. The year 2010 saw 950 natural catastrophes around the world--the second highest annual total ever--with overall losses estimated at $130 billion. The increasing impact of natural disasters and hazards points to increasing importance of resilience, the ability to prepare and plan for, absorb, recover from, or more successfully adapt to actual or potential adverse events, at the individual , local, state, national, and global levels. Assessing National Resilience to Hazards and Disastersreviews the effects of Hurricane Katrina and other natural and human-induced disasters on the Gulf Coast of Louisiana and Mississippi and to learn more about the resilience of those areas to future disasters. Topics explored in the workshop range from insurance, building codes, and critical infrastructure to private-sector issues, public health, nongovernmental organizations and governance. This workshop summary provides a rich foundation of information to help increase the nation's resilience through actionable recommendations and guidance on the best approaches to reduce adverse impacts from hazards and disasters.
Examination of the U.S. Air Force's Aircraft Sustainment Needs in the Future and Its Strategy to Meet Those Needsby The National Academy of Sciences
The ability of the United States Air Force (USAF) to keep its aircraft operating at an acceptable operational tempo, in wartime and in peacetime, has been important to the Air Force since its inception. This is a much larger issue for the Air Force today, having effectively been at war for 20 years, with its aircraft becoming increasingly more expensive to operate and maintain and with military budgets certain to further decrease. The enormously complex Air Force weapon system sustainment enterprise is currently constrained on many sides by laws, policies, regulations and procedures, relationships, and organizational issues emanating from Congress, the Department of Defense (DoD), and the Air Force itself. Against the back-drop of these stark realities, the Air Force requested the National Research Council (NRC) of the National Academies, under the auspices of the Air Force Studies Board to conduct and in-depth assessment of current and future Air Force weapon system sustainment initiatives and recommended future courses of action for consideration by the Air Force. Examination of the U. S. Air Force's Aircraft Sustainment Needs in the Future and Its Strategy to Meet Those Needsaddresses the following topics: Assess current sustainment investments, infrastructure, and processes for adequacy in sustaining aging legacy systems and their support equipment. Determine if any modifications in policy are required and, if so, identify them and make recommendations for changes in Air Force regulations, policies, and strategies to accomplish the sustainment goals of the Air Force. Determine if any modifications in technology efforts are required and, if so, identify them and make recommendations regarding the technology efforts that should be pursued because they could make positive impacts on the sustainment of the current and future systems and equipment of the Air Force. Determine if the Air Logistics Centers have the necessary resources (funding, manpower, skill sets, and technologies) and are equipped and organized to sustain legacy systems and equipment and the Air Force of tomorrow. Identify and make recommendations regarding incorporating sustainability into future aircraft designs.
Animal Research in a Global Environment: Meeting the Challenges: Proceedings of the November 2008 International Workshopby The National Academy of Sciences
Animal research will play an essential role in efforts to meet increasing demands for global health care. Yet the animal research community faces the challenge of overcoming negative impressions that industry and academia engage in international collaborations in order to conduct work in parts of the world where animal welfare standards are less stringent. Thus, the importance of ensuring the international harmonization of the principles and standards of animal care and use cannot be overstated. A number of national and international groups are actively working toward this goal. The Institute for Laboratory Animal Research (ILAR), a program unit of the US National Research Council, is committed to promoting both the welfare of animals used in research and the quality of the resulting science. In 2008, to follow up on the 2003 event, ILAR convened a workshop which brought together 200 participants from 17 countries. Their mission was to identify and promote better understanding of important challenges in the conduct of animal research across country boundaries. These challenges include: the sourcing of animals; the quality of veterinary care; competent staff; the provision of a suitable environment (including nutritious food and potable water) for animals; and ongoing oversight of the animal program; among others. Animal Research in a Global Environmentsummarizes the proceedings of the 2008 workshop. The impact of this 2008 workshop has extended beyond the oral presentations conveyed in these proceedings. It has been a vital bridge for diverse colleagues and organizations around the world to advance initiatives designed to fill gaps in standards, professional qualifications, and coordination of animal use.
Increasing cost and declining response rates are two of the problems facing US federal government household surveys that led the Census Bureau to call for the workshop. It was held in November 2010, and though no consensus was reached, there was much sharing of views and ideas among statisticians in a number of agencies. Among the areas summarized here are sampling frames, the collection of household data, small-area estimation, survey content, and next steps. There is no index. Annotation Â©2012 Book News, Inc. , Portland, OR (booknews. com)
Whether or not the United States has safe and effective medical countermeasures--such as vaccines, drugs, and diagnostic tools--available for use during a disaster can mean the difference between life and death for many Americans. The Food and Drug Administration (FDA) and the scientific community at large could benefit from improved scientific tools and analytic techniques to undertake the complex scientific evaluation and decision making needed to make essential medical countermeasures available. At the request of FDA, the Institute of Medicine (IOM) held a workshop to examine methods to improve the development, evaluation, approval, and regulation of medical countermeasures. During public health emergencies such as influenza or chemical, biological, radiological/nuclear (CBRN) attacks, safe and effective vaccines, treatments, and other medical countermeasures are essential to protecting national security and the well being of the public. Advancing Regulatory Science for Medical Countermeasure Developmentexamines current medical countermeasures, and investigates the future of research and development in this area. Convened on March 29-30, 2011, this workshop identified regulatory science tools and methods that are available or under development, as well as major gaps in currently available regulatory science tools. Advancing Regulatory Science for Medical Countermeasure Developmentis a valuable resource for federal agencies including the Food and Drug Administration (FDA), the Department of Health and Human Services (HHS), the Department of Defense (DoD), as well as health professionals, and public and private health organizations.
This report was undertaken by the Committee on Advancing Pain Research, Care, and Education, sponsored by the Institute of Medicine of the National Academies. Initial chapters describe the purposes and scope of the study and introduce discussion of types of pain, its impact and causes, and the need for a cultural transformation. Subsequent chapters focus on pain as a public health challenge, treatment, and education and research challenges. The final chapter is indeed a blueprint, as announced in the subtitle. Completing the volume are a glossary and appendixes that include a summary of written public testimony, and economic costs of pain in the US. Annotation ©2012 Book News, Inc. , Portland, OR (booknews. com)
In 2008, the Computer and Information Science and Engineering Directorate of the National Science Foundation asked the National Research Council (NRC) to conduct two workshops to explore the nature of computational thinking and its cognitive and educational implications. The first workshop focused on the scope and nature of computational thinking and on articulating what "computational thinking for everyone" might mean. A report of that workshop was released in January 2010. Drawing in part on the proceedings of that workshop, Report of a Workshop of Pedagogical Aspects of Computational Thinking, summarizes the second workshop, which was held February 4-5, 2010, in Washington, D. C. , and focuses on pedagogical considerations for computational thinking. This workshop was structured to gather pedagogical inputs and insights from educators who have addressed computational thinking in their work with K-12 teachers and students. It illuminates different approaches to computational thinking and explores lessons learned and best practices. Individuals with a broad range of perspectives contributed to this report. Since the workshop was not intended to result in a consensus regarding the scope and nature of computational thinking, Report of a Workshop of Pedagogical Aspects of Computational Thinking does not contain findings or recommendations.
The workshop had been planned for a long time, but convened three days after the March 2011 Tohoku earthquake and tsunami in Japan, lending a sense of urgency to establishing a research agency to help communities become earthquake resilient. After setting out the research challenges, participants identified experimental and cyberinfrastructure networked facilities needed to address the challenges. Among these are a community resilience observatory, a rapid monitoring facility, a large-scale shaking table, and a mobile facility for in-situ structural testing. Annotation Â©2012 Book News, Inc. , Portland, OR (booknews. com)
This manual from the National Research Council and a committee of judges, scientists, and engineers assists judges in cases involving complex scientific and technical evidence by detailing the basic principles of specific scientific fields from which legal evidence is often taken and by providing examples of cases. After introductory chapters on the admissibility of expert testimony and how science works, reference guides for DNA identification evidence, statistics, multiple regression, survey research, estimation of economic damages, epidemiology, toxicology, medical testimony, engineering, and other sciences are provided. Each contains an overview of the topic in lay terms and its principles and methods, citations and glossaries, and issues and key questions that are useful to judges and others in the legal profession. This edition has updated and new chapters on neuroscience, exposure science, mental health, and forensic science. Annotation ©2011 Book News, Inc. , Portland, OR (booknews. com)
This is the fifteenth volume in the series of Memorial Tributes compiled by the National Academy of Engineering as a personal remembrance of the lives and outstanding achievements of its members and foreign associates. These volumes are intended to stand as an enduring record of the many contributions of engineers and engineering to the benefit of humankind. In most cases, the authors of the tributes are contemporaries or colleagues who had personal knowledge of the interests and the engineering accomplishments of the deceased.
Science, technology, engineering, and mathematics (STEM) are cultural achievements that reflect our humanity, power our economy, and constitute fundamental aspects of our lives as citizens, consumers, parents, and members of the workforce. Providing all students with access to quality education in the STEM disciplines is important to our nation's competitiveness. However, it is challenging to identify the most successful schools and approaches in the STEM disciplines because success is defined in many ways and can occur in many different types of schools and settings. In addition, it is difficult to determine whether the success of a school's students is caused by actions the school takes or simply related to the population of students in the school. Successful K-12 STEM Educationdefines a framework for understanding "success" in K-12 STEM education. The book focuses its analysis on the science and mathematics parts of STEM and outlines criteria for identifying effective STEM schools and programs. Because a school's success should be defined by and measured relative to its goals, the book identifies three important goals that share certain elements, including learning STEM content and practices, developing positive dispositions toward STEM, and preparing students to be lifelong learners. A successful STEM program would increase the number of students who ultimately pursue advanced degrees and careers in STEM fields, enhance the STEM-capable workforce, and boost STEM literacy for all students. It is also critical to broaden the participation of women and minorities in STEM fields. Successful K-12 STEM Education examines the vast landscape of K-12 STEM education by considering different school models, highlighting research on effective STEM education practices, and identifying some conditions that promote and limit school- and student-level success in STEM. The book also looks at where further work is needed to develop appropriate data sources. The book will serve as a guide to policy makers; decision makers at the school and district levels; local, state, and federal government agencies; curriculum developers; educators; and parent and education advocacy groups.
Armor plays a significant role in the protection of warriors. During the course of history, the introduction of new materials and improvements in the materials already used to construct armor has led to better protection and a reduction in the weight of the armor. But even with such advances in materials, the weight of the armor required to manage threats of ever-increasing destructive capability presents a huge challenge. Opportunities in Protection Materials Science and Technology for Future Army Applicationsexplores the current theoretical and experimental understanding of the key issues surrounding protection materials, identifies the major challenges and technical gaps for developing the future generation of lightweight protection materials, and recommends a path forward for their development. It examines multiscale shockwave energy transfer mechanisms and experimental approaches for their characterization over short timescales, as well as multiscale modeling techniques to predict mechanisms for dissipating energy. The report also considers exemplary threats and design philosophy for the three key applications of armor systems: (1) personnel protection, including body armor and helmets, (2) vehicle armor, and (3) transparent armor. Opportunities in Protection Materials Science and Technology for Future Army Applications recommends that the Department of Defense (DoD) establish a defense initiative for protection materials by design (PMD), with associated funding lines for basic and applied research. The PMD initiative should include a combination of computational, experimental, and materials testing, characterization, and processing research conducted by government, industry, and academia.
With the responsibility to ensure the safety of food, drugs, and other products, the U.S. Food and Drug Administration (FDA) faces decisions that may have public-health consequences every day. Often the decisions must be made quickly and on the basis of incomplete information. FDA recognized that collecting and evaluating information on the risks posed by the regulated products in a systematic manner would aid in its decision-making process. Consequently, FDA and the Department of Health and Human Services (DHHS) asked the National Research Council (NRC) to develop a conceptual model that could evaluate products or product categories that FDA regulates and provide information on the potential health consequences associated with them. A Risk-Characterization Framework for Decision-Making at the Food and Drug Administration describes the proposed risk-characterization framework that can be used to evaluate, compare, and communicate the public-health consequences of decisions concerning a wide variety of products. The framework presented in this report is intended to complement other risk-based approaches that are in use and under development at FDA, not replace them. It provides a common language for describing potential public-health consequences of decisions, is designed to have wide applicability among all FDA centers, and draws extensively on the well-vetted risk literature to define the relevant health dimensions for decision-making at the FDA. The report illustrates the use of that framework with several case studies, and provides conclusions and recommendations.
Each year approximately 1. 5 million people are diagnosed with cancer in the United States, most of whom inevitably face difficult decisions concerning their course of care. Recognizing challenges associated with cancer treatment, the National Coalition for Cancer Survivorship (NCCS) and the National Cancer Policy Forum (NCPF) of the Institute of Medicine (IOM) hosted a public workshop in Washington, DC on February 28 and March 1, 2011, entitled Patient-Centered Cancer Treatment Planning: Improving the Quality of Oncology Care. This workshop summary includes an overview of patient-centered care and cancer treatment planning, as well as subject areas on shared decision making, communication in the cancer care setting, and patient experiences with cancer treatment. Best practices, models of treatment planning, and tools to facilitate their use are also discussed, along with policy changes that may promote patient-centeredness by enhancing patient's understanding of and commitment to the goals of treatment through shared decision-making process with their healthcare team from the moment of diagnosis onward. Moreover, Patient-Centered Cancer Treatment Planningemphasizes treatment planning for patients with cancer at the time diagnosis.
Clinical trials enable scientific discoveries to advance patient care, in addition to informing and guiding subsequent research. The National Cancer Institute's (NCI's) Clinical Trials Cooperative Group Program works to advance patient care and research. The Cooperative Group Program has been instrumental in establishing the standards for cancer patient care and clinical research methods. Despite broad participation in the program, financial strain and procedural burdens limit the ability of the Cooperative Group Program to undertake medical practice-changing clinical research. Thus, the Institute of Medicine's (IOM's) National Cancer Policy Forum and the American Society of Clinical Oncology held a workshop on March 21, 2011 to follow up on the 2010 IOM report, A National Clinical Trials System for the 21st Century: Reinvigorating the NCI Cooperative Group Program, which made recommendations to strengthen the NCI Cooperative Group Program. In keeping with the established commitment to excellence Implementing a National Cancer Clinical Trials System for the 21st Centuryoutlines how to improve the current system by incorporating innovative science and trial design into cancer clinical trials. It also examines the impact of increasing quality in regards to speed, efficiency, design, launch, and conduct, as well as improving prioritization, and incentivized participation.
Obesity is a major public health challenge. More than one-third of the U. S. adult population is considered obese, a figure that has more than doubled since the mid-1970s. Among children, obesity rates have more than tripled over the same period. Not only is obesity associated with numerous medical complications, but it incurs significant economic cost. At its simplest, obesity is a result of an energy imbalance, with obese (and overweight) people consuming more energy (calories) than they are expending. During the last 10-20 years, behavioral scientists have made significant progress toward building an evidence base for understanding what drives energy imbalance in overweight and obese individuals. Meanwhile, food scientists have been tapping into this growing evidence base to improve existing technologies and create new technologies that can be applied to alter the food supply in ways that reduce the obesity burden on the American population. Leveraging Food Technology for Obesity Prevention and Reduction Effort examines the complexity of human eating behavior and explores ways in which the food industry can continue to leverage modern food processing technologies to influence energy intake. The report also examines the opportunities and challenges of altering the food supply--both at home and outside the home--and outlines lessons learned, best practices, and next steps.
The National Research Council convened a Committee on Incorporating Sustainability in the US Environmental Protection Agency, to provide an operational framework for this integration as one of the drivers within the EPA's regulatory responsibility, as well as to address how the existing framework rooted in risk assessment/risk management can be integrated and identify the scientific and analytical tools and expertise needed to support it. Following a brief history of sustainability in the US and internationally, the proposed framework is presented, as are the processes and tools and discussion of how the EPA decision-making process can be integrated, cultural change management at the agency, and the relevance and utility of sustainability considerations in the EPA's accomplishment of its mission, as well as examples of successful sustainability initiatives. There is no index. Annotation ©2011 Book News, Inc. , Portland, OR (booknews. com)
Medical devices that are deemed to have a moderate risk to patients generally cannot go on the market until they are cleared through the FDA 510(k) process. In recent years, individuals and organizations have expressed concern that the 510(k) process is neither making safe and effective devices available to patients nor promoting innovation in the medical-device industry. Several high-profile mass-media reports and consumer-protection groups have profiled recognized or potential problems with medical devices cleared through the 510(k) clearance process. The medical-device industry and some patients have asserted that the process has become too burdensome and is delaying or stalling the entry of important new medical devices to the market. At the request of the FDA, the Institute of Medicine (IOM) examined the 510(k) process. Medical Devices and the Public's Healthexamines the current 510(k) clearance process and whether it optimally protects patients and promotes innovation in support of public health. It also identifies legislative, regulatory, or administrative changes that will achieve the goals of the 510(k) clearance process. Medical Devices and the Public's Healthrecommends that the U. S. Food and Drug Administration gather the information needed to develop a new regulatory framework to replace the 35-year-old 510(k) clearance process for medical devices. According to the report, the FDA's finite resources are best invested in developing an integrated premarket and postmarket regulatory framework.
The National Research Council's Committee on the Role of Human Factors in Home Health Care was formed to investigate the role of human factors in home health care and the range of issues resulting from the increased use of medical devices, technologies, and practices in the home. It conducted a workshop on the topic held in October 2009 in Washington, DC, and reports on its conclusions and recommendations here. The report details the relevant people, tasks, technologies, and environments to highlight the most prevalent and serious threats to safety, quality of care, and care recipient and provider well-being. It documents the characteristics of people who give and receive care; human factors tools and methods and their application; tasks and their demands and analysis; technologies used; care factors in physical, social/cultural, community, and policy environments; and 11 recommendations on technologies, residential environments, research and development needs, and other areas, including regulation, adverse event reporting, safety and modification of housing, accessibility and universal design, teamwork and coordination, and assessment. There is no index. Annotation ©2011 Book News, Inc. , Portland, OR (booknews. com)
The San Francisco Bay Delta Estuary is a large, complex estuarine ecosystem in California. It has been substantially altered by dikes, levees, channelization, pumps, human development, introduced species, dams on its tributary streams and contaminants. The Delta supplies water from the state's wetter northern regions to the drier southern regions and also serves as habitat for many species, some of which are threatened and endangered. The restoration of water exacerbated tensions over water allocation in recent years, and have led to various attempts to develop comprehensive plans to provide reliable water supplies and to protect the ecosystem. One of these plans is the Bay Delta Conservation Plan (BDCP). The report, A Review of the Use of Science and Adaptive Management in California's Draft Bay Delta Conservation Plan,determines that the plan is incomplete in a number of important areas and takes this opportunity to identify key scientific and structural gaps that, if addressed, could lead to a more successful and comprehensive final BDCP. The plan is missing the type of structure usually associated with current planning methods in which the goals and objectives are specified, alternative measure for achieving the objectives are introduced and analyzed, and a course of action in identified based on analytical optimization of economic, social, and environmental factors. Yet the panel underscores the importance of a credible and a robust BDCP in addressing the various water management problems that beset the Delta. A stronger, more complete, and more scientifically credible BDCP that effectively integrates and utilizes science could indeed pave the way toward the next generation of solutions to California's chronic water problems.
Scientists from biological, medical, and environmental fields look both at specific pathogens and hosts and at the role fungus plays in the world and the economy generally. The 80-page workshop overview is followed by 21 contributed papers on such topics as the emergence of Cryptococcus gattii in British Columbia and the Pacific Northwest, surveillance for emerging diseases in wildlife, putting yellow rust into the perspective of the increased risk of global wheat rust pandemics, similarities and differences in fungal pathogenesis in plants and animals, the effect of the trade-mediated spread of amphibian chytrid on amphibian conservation, and the pan-European distribution of the bat white-nose syndrome fungus. The workshop was held in December 2010, in Washington, DC. Annotation Â©2012 Book News, Inc. , Portland, OR (booknews. com)
Glutamate-Related Biomarkers in Drug Development for Disorders of the Nervous System: Workshop Summaryby The National Academy of Sciences
Glutamate is the most pervasive neurotransmitter in the central nervous system (CNS). Despite this fact, no validated biological markers, or biomarkers, currently exist for measuring glutamate pathology in CNS disorders or injuries. Glutamate dysfunction has been associated with an extensive range of nervous system diseases and disorders. Problems with how the neurotransmitter glutamate functions in the brain have been linked to a wide variety of disorders, including schizophrenia, Alzheimer's, substance abuse, and traumatic brain injury. These conditions are widespread, affecting a large portion of the United States population, and remain difficult to treat. Efforts to understand, treat, and prevent glutamate-related disorders can be aided by the identification of valid biomarkers. The Institute of Medicine's Forum on Neuroscience and Nervous System Disorders held a workshop on June 21-22, 2010, to explore ways to accelerate the development, validation, and implementation of such biomarkers. Glutamate-Related Biomarkers in Drug Development for Disorders of the Nervous System: Workshop Summaryinvestigates promising current and emerging technologies, and outlines strategies to procure resources and tools to advance drug development for associated nervous system disorders. Moreover, this report highlights presentations by expert panelists, and the open panel discussions that occurred during the workshop.
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