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Ten years after the sequencing of the human genome, scientists have developed genetic tests that can predict a person's response to certain drugs, estimate the risk of developing Alzheimer's disease, and make other predictions based on known links between genes and diseases. However, genetic tests have yet to become a routine part of medical care, in part because there is not enough evidence to show they help improve patients' health. The Institute of Medicine (IOM) held a workshop to explore how researchers can gather better evidence more efficiently on the clinical utility of genetic tests. Generating Evidence for Genomic Diagnostic Test Development compares the evidence that is required for decisions regarding clearance, use, and reimbursement, to the evidence that is currently generated. The report also addresses innovative and efficient ways to generate high-quality evidence, as well as barriers to generating this evidence. Generating Evidence for Genomic Diagnostic Test Development contains information that will be of great value to regulators and policymakers, payers, health-care providers, researchers, funders, and evidence-based review groups.
How Communities Can Use Risk Assessment Results: Making Ends Meet: A Summary of the June 3, 2010 Workshop of the Disasters Roundtableby National Research Council of the National Academies
The polar regions are experiencing rapid changes in climate. These changes are causing observable ecological impacts of various types and degrees of severity at all ecosystem levels, including society. Even larger changes and more significant impacts are anticipated. As species respond to changing environments over time, their interactions with the physical world and other organisms can also change. This chain of interactions can trigger cascades of impacts throughout entire ecosystems. Evaluating the interrelated physical, chemical, biological, and societal components of polar ecosystems is essential to understanding their vulnerability and resilience to climate forcing. The Polar Research Board (PRB) organized a workshop to address these issues. Experts gathered from a variety of disciplines with knowledge of both the Arctic and Antarctic regions. Participants were challenged to consider what is currently known about climate change and polar ecosystems and to identify the next big questions in the field. A set of interdisciplinary "frontier questions" emerged from the workshop discussions as important topics to be addressed in the coming decades. To begin to address these questions, workshop participants discussed the need for holistic, interdisciplinary systems approach to understanding polar ecosystem responses to climate change. As an outcome of the workshop, participants brainstormed methods and technologies that are crucial to advance the understanding of polar ecosystems and to promote the next generation of polar research. These include new and emerging technologies, sustained long-term observations, data synthesis and management, and data dissemination and outreach.
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.
Trends in Science and Technology Relevant to the Biological and Toxin Weapons Convention: Summary of an International Workshopby National Research Council of the National Academies
This report offers a summary of the substantive presentations during an international workshop, Trends in Science and Technology Relevant to the Biological and Toxin Weapons Convention, held 31 October - 3 November, 2010 at the Institute of Biophysics of the Chinese Academy of Sciences. It is meant to provide scientists and other technical experts with factual information about the range and variety of topics discussed at the workshop, which may be of interest to national governments and non-governmental organizations as they begin to prepare for the 7th Review Conference of the Biological and Toxin Weapons Convention (BWC) in 2011. The Beijing workshop reflected the continuing engagement by national academies international scientific organizations, and individual scientists and engineers in considering the biosecurity implications of developments in the life sciences and assessing trends in science and technology (S&T) relevant to nonproliferation. The workshop provided an opportunity for the scientific community to discuss the implications of relevant developments in S&T for multiple aspects of the BWC. Trends in Science and Technology Relevant to the Biological and Toxin Weapons Convention follows the structure of the plenary sessions at the workshop. It begins with introductory material about the BWC and current examples of the types and modes of science advice available to the BWC and other international nonproliferation and disarmament agreements, in particular the Chemical Weapons Convention (CWC). This report includes only a very brief description of the some of the post-presentation discussions held during the plenary sessions - and does not include an account of the small breakout groups - since these were intended to inform the committee's finding and conclusions and will be reflected in the final report.
The two hundredth anniversary of the birth of Charles Darwin, February 12, 2009, occurred at a critical time for the United States and the world. In honor of Darwin's birthday, the National Research Council appointed a committee under the auspices of the U.S. National Committee (USNC) for DIVERSITAS to plan a Symposium on Twenty-first Century Ecosystems. The purpose of the symposium was to capture some of the current excitement and recent progress in scientific understanding of ecosystems, from the microbial to the global level, while also highlighting how improved understanding can be applied to important policy issues that have broad biodiversity and ecosystem effects. The aim was to help inform new policy approaches that could satisfy human needs while also maintaining the integrity of the goods and services provided by biodiversity and ecosystems over both the short and the long terms. This report summarizes the views expressed by symposium participants; however, it does not provide a session-by-session summary of the presentations at the symposium. Instead, the symposium steering committee identified eight key themes that emerged from the lectures, which were addressed in different contexts by different speakers. The focus here is on general principles rather than specifics. These eight themes provide a sharp focus on a few concepts that enable scientists, environmental NGOs, and policy makers to engage more effectively around issues of central importance for biodiversity and ecosystem management.
Many ongoing changes are likely to have an impact on cancer research and care. For example, technological advances are rapidly changing the way cancer research is conducted, and the recently passed healthcare reform legislation has many implications for cancer care. Technological advances are altering the way cancer research is conducted and cancer care is delivered, and the recently passed healthcare reform legislation has many implications for cancer care. There is a growing emphasis on molecularly targeted therapies, information technology (IT), and patient-centered care, and clinical cancer research has become a global endeavor. At the same time, there are concerns about shrinking research budgets and escalating costs of cancer care. Considering such changes, the National Cancer Policy Forum (NCPF) of the Institute of Medicine held a National Cancer Policy Summit on October 25, 2010. The Summit convened key leaders in the cancer community to identify and discuss the most pressing policy issues in cancer research and cancer care. The National Cancer Policy Summit: Opportunities and Challenges in Cancer Research and Care is a summary of the summit. The report explores policy issues related to cancer research, the implementation of healthcare reform, delivery of cancer care, and cancer control and public health needs. Expert participants suggested many potential actions to provide patient-centered cancer care, to foster more collaboration, and to achieve other goals to improve research and care.
From the interior of the Sun, to the upper atmosphere and near-space environment of Earth, and outward to a region far beyond Pluto where the Sun's influence wanes, advances during the past decade in space physics and solar physics--the disciplines NASA refers to as heliophysics--have yielded spectacular insights into the phenomena that affect our home in space. Solar and Space Physics, from the National Research Council's (NRC's) Committee for a Decadal Strategy in Solar and Space Physics, is the second NRC decadal survey in heliophysics. Building on the research accomplishments realized during the past decade, the report presents a program of basic and applied research for the period 2013-2022 that will improve scientific understanding of the mechanisms that drive the Sun's activity and the fundamental physical processes underlying near-Earth plasma dynamics, determine the physical interactions of Earth's atmospheric layers in the context of the connected Sun-Earth system, and enhance greatly the capability to provide realistic and specific forecasts of Earth's space environment that will better serve the needs of society. Although the recommended program is directed primarily at NASA and the National Science Foundation for action, the report also recommends actions by other federal agencies, especially the parts of the National Oceanic and Atmospheric Administration charged with the day-to-day (operational) forecast of space weather. In addition to the recommendations included in this summary, related recommendations are presented in this report.
It is as yet uncertain how the Gulf of Mexico oil spill will affect the health of clean-up workers and volunteers, residents, and visitors in the Gulf. The IOM recommends that the U.S. Department of Health and Human Services focus on researching psychological and behavioral health, exposure information to oil and dispersants, seafood safety, communication methods for health studies, and methods for conducting research in order to better understand and mitigate the effects on human health for this oil spill and for future disasters.
The Importance of Common Metrics for Advancing Social Science Theory and Research: A Workshop Summaryby National Research Council of the National Academies
In February 2010, the National Research Council convened a workshop to investigate the feasibility of developing well-grounded common metrics to advance behavioral and social science research, both in terms of advancing the development of theory and increasing the utility of research for policy and practice. The Workshop on Advancing Social Science Theory: The Importance of Common Metrics had three goals: To examine the benefits and costs involved in moving from metric diversity to greater standardization, both in terms of advancing the development of theory and increasing the utility of research for policy and practice. To consider whether a set of criteria can be developed for understanding when the measurement of a particular construct is ready to be standardized. To explore how the research community can foster a move toward standardization when it appears warranted. This book is a summary of the two days of presentations and discussions that took place during the workshop.
Natural disasters--including hurricanes, earthquakes, volcanic eruptions, and floods--caused over 220,000 deaths worldwide in the first half of 2010 and wreaked havoc on homes, buildings, and the environment. To withstand and recover from natural and human-caused disasters, it is essential that citizens and communities work together to anticipate threats, limit their effects, and rapidly restore functionality after a crisis. Increasing evidence indicates that collaboration between the private and public sectors could improve the ability of a community to prepare for, respond to, and recover from disasters. Several previous National Research Council reports have identified specific examples of the private and public sectors working cooperatively to reduce the effects of a disaster by implementing building codes, retrofitting buildings, improving community education, or issuing extreme-weather warnings. State and federal governments have acknowledged the importance of collaboration between private and public organizations to develop planning for disaster preparedness and response. Despite growing ad hoc experience across the country, there is currently no comprehensive framework to guide private-public collaboration focused on disaster preparedness, response, and recovery. Building Community Disaster Resilience through Private-Public Collaboration assesses the current state of private-public sector collaboration dedicated to strengthening community resilience, identifies gaps in knowledge and practice, and recommends research that could be targeted for investment. Specifically, the book finds that local-level private-public collaboration is essential to the development of community resilience. Sustainable and effective resilience-focused private-public collaboration is dependent on several basic principles that increase communication among all sectors of the community, incorporate flexibility into collaborative networks, and encourage regular reassessment of collaborative missions, goals, and practices.
Today, scores of companies, primarily in the United States and Europe, are offering whole genome scanning services directly to the public. The proliferation of these companies and the services they offer demonstrate a public appetite for this information and where the future of genetics may be headed; they also demonstrate the need for serious discussion about the regulatory environment, patient privacy, and other policy implications of direct-to-consumer (DTC) genetic testing. Rapid advances in genetic research already have begun to transform clinical practice and our understanding of disease progression. Existing research has revealed a genetic basis or component for numerous diseases, including Parkinson's disease, Alzheimer's disease, diabetes, heart disease, and several forms of cancer. The availability of the human genome sequence and the HapMap, plummeting costs of high-throughput screening, and increasingly sophisticated computational analyses have led to an explosion of discoveries of linkages between patterns of genetic variation and disease susceptibility. While this research is by no means a straight path toward better public health, improved knowledge of the genetic linkages has the potential to change fundamentally the way health professionals and public health practitioners approach the prevention and treatment of disease. Realizing this potential will require greater sophistication in the interpretation of genetic tests, new training for physicians and other diagnosticians, and new approaches to communicating findings to the public. As this rapidly growing field matures, all of these questions require attention from a variety of perspectives. To discuss some of the foregoing issues, several units of the National Academies held a workshop on August 31 and September 1, 2009, to bring together a still-developing community of professionals from a variety of relevant disciplines, to educate the public and policy-makers about this emerging field, and to identify issues for future study. The meeting featured several invited presentations and discussions on the many technical, legal, policy, and ethical questions that such DTC testing raises, including: (1) overview of the current state of knowledge and the future research trajectory; (2) shared genes and emerging issues in privacy; (3) the regulatory framework; and (4) education of the public and the medical community.
Nearly 5.3 million Americans are living with Alzheimer's disease, and 26.6 million people are affected worldwide. The Alzheimer's Disease Neuroimaging Initiative (ADNI), a public-private partnership, provides a publicly available, international database of clinical and imaging data to foster research and collaboration on Alzheimer's research worldwide. The Institute of Medicine held a workshop on July 12, 2010, to explore opportunities to use information from and partnerships formed because of ADNI to continue to improve the understanding and treatment of Alzheimer's disease.
An Assessment of the National Institute of Standards and Technology Center for Neutron Research: Fiscal Year 2010by National Research Council of the National Academies
The National Institute of Standards and Technology (NIST) Center for Neutron Research (NCNR) is a national user facility whose mission is to ensure the availability of neutron measurement capabilities in order to meet the needs of U.S. researchers from industry, academia, and government agencies. This mission is aligned with the mission of NIST, which is to promote U.S. innovation and industrial competitiveness by advancing measurement science, standards, and technology in ways that enhance economic security and improve the quality of life. As requested by the Deputy Director of NIST, this book assesses NCNR, based on the following criteria: (1) the technical merit of the current laboratory programs relative to current state-of-the-art programs worldwide; (2) the adequacy of the laboratory budget, facilities, equipment, and human resources, as they affect the quality of the laboratory technical programs; and (3) the degree to which the laboratory programs in measurement science and standards achieve their stated objectives and desired impact.
An Assessment of the National Institute of Standards and Technology Building and Fire Research Laboratory: Fiscal Year 2010by National Research Council of the National Academies
A panel of experts appointed by the National Research Council assessed the scientific and technical work of the Building and Fire Research Laboratory (BFRL) of the National Institute of Standards and Technology (NIST). The scope of the assessment included the following criteria: (1) the technical merit of the current laboratory programs relative to the current state of the art worldwide; (2) the adequacy of the laboratory facilities, equipment, and human resources, as they affect the quality of the laboratory technical programs; and (3) the degree to which the laboratory programs in measurement science and standards achieve their stated objectives and desired impact.
An Assessment of the National Institute of Standards and Technology Materials Science and Engineering Laboratory: Fiscal Year 2010by National Research Council of the National Academies
The Materials Science and Engineering Laboratory (MSEL) of the National Institute of Standards and Technology (NIST) works with industry, standards bodies, universities, and other government laboratories to improve the nation's measurements and standards infrastructure for materials. A panel of experts appointed by the National Research Council (NRC) assessed the four divisions of MSEL, by visiting these divisions and reviewing their activities.
An Assessment of the National Institute of Standards and Technology Manufacturing Engineering Laboratory: Fiscal Year 2010by National Research Council of the National Academies
The mission of the Manufacturing Engineering Laboratory (MEL) of the National Institute of Standards and Technology (NIST) is to promote innovation and the competitiveness of U.S. manufacturing through measurement science, measurement services, and critical technical contributions to standards. The MEL is organized in five divisions: Intelligent Systems, Manufacturing Metrology, Manufacturing Systems Integration, Precision Engineering, and Fabrication Technology. A panel of experts appointed by the National Research Council (NRC) assessed the first four divisions.
An Assessment of the National Institute of Standards and Technology Physics Laboratory: Fiscal Year 2010by National Research Council of the National Academies
The mission of the National Institute of Standards and Technology (NIST) Physics Laboratory is to support U.S. industry, government, and the scientific community by providing measurement services and research for electronic, optical, and radiation technology. In this respect, the laboratory provides the foundation for the metrology of optical and ionizing radiations, time and frequency, and fundamental quantum processes, historically major areas of standards and technology. The Panel on Physics visited the six divisions of the laboratory and reviewed a selected sample of their programs and projects.
The implications of climate change for the environment and society depend on the rate and magnitude of climate change, but also on changes in technology, economics, lifestyles, and policy that will affect the capacity both for limiting and adapting to climate change. Describing Socioeconomic Futures for Climate Change Research and Assessment reviews the state of science for considering socioeconomic changes over long time frames and clarifies definitions and concepts to facilitate communication across research communities. The book also explores driving forces and key uncertainties that will affect impacts, adaptation, vulnerability and mitigation in the future. Furthermore, it considers research needs and the elements of a strategy for describing socioeconomic and environmental futures for climate change research and assessment. Describing Socioeconomic Futures for Climate Change Research and Assessment explores the current state of science in scenario development and application, asserting that while little attention has been given to preparing quantitative and narrative socioeconomic information, advances in computing capacity are making development of such probabilistic scenarios a reality. It also addresses a number of specific methodological challenges and opportunities and discusses opportunities for a next round of assessments.
The passive, receive-only Radio Astronomy Service (RAS) and the Earth Exploration-Satellite Service (EESS) provide otherwise impossible scientific observations of the Universe and Earth through the use of advanced receiver technology with extreme sensitivity and the employment of complex noise reduction algorithms. Even with such technology, RAS and EESS are quite adversely affected by what most active services would consider low noise levels. To ensure their ability to use the radio spectrum for scientific purposes, scientists must be party to the discussion in the lead-up to the World Radiocommunication Conference (WRC), which will next be held in January and February 2012 in Geneva, Switzerland. By request of the National Science Foundation and the National Aeronautics and Space Administration, the National Research Council was convened to provide guidance to the U.S. spectrum managers and policymakers as they prepare for the WRC in order to protect the scientific exploration of the Earth and Universe using the radio spectrum. While the resulting document is targeted at U.S. agencies, representatives of foreign governments and foreign scientific users will find its contents useful as they plan their own WRC positions.
In the face of so many daunting near-term challenges,U.S. government and industry are letting the crucial strategic issues of U.S. competitiveness slip below the surface. Five years ago,the National Academies prepared Rising Above the Gathering Storm,a book that cautioned: "Without a renewed effort to bolster the foundations of our competitiveness,we can expect to lose our privileged position." Since that time we find ourselves in a country where much has changed--and a great deal has not changed. So where does America stand relative to its position of five years ago when the Gathering Storm book was prepared? The unanimous view of the authors is that our nation's outlook has worsened. The present volume,Rising Above the Gathering Storm,Revisited,explores the tipping point America now faces. Addressing America's competitiveness challenge will require many years if not decades; however,the requisite federal funding of much of that effort is about to terminate. Rising Above the Gathering Storm,Revisited provides a snapshot of the work of the government and the private sector in the past five years,analyzing how the original recommendations have or have not been acted upon,what consequences this may have on future competitiveness,and priorities going forward. In addition,readers will find a series of thought- and discussion-provoking factoids--many of them alarming--about the state of science and innovation in America. Rising Above the Gathering Storm,Revisited is a wake-up call. To reverse the foreboding outlook will require a sustained commitment by both individual citizens and government officials--at all levels. This book,together with the original Gathering Storm volume,provides the roadmap to meet that goal. While this book is essential for policy makers,anyone concerned with the future of innovation,competitiveness,and the standard of living in the United States will find this book an ideal tool for engaging their government representatives,peers,and community about this momentous issue.
Despite many advances, security and privacy often remain too complex for individuals or enterprises to manage effectively or to use conveniently. Security is hard for users, administrators, and developers to understand, making it all too easy to use, configure, or operate systems in ways that are inadvertently insecure. Moreover, security and privacy technologies originally were developed in a context in which system administrators had primary responsibility for security and privacy protections and in which the users tended to be sophisticated. Today, the user base is much wider--including the vast majority of employees in many organizations and a large fraction of households--but the basic models for security and privacy are essentially unchanged.Security features can be clumsy and awkward to use and can present significant obstacles to getting work done. As a result, cybersecurity measures are all too often disabled or bypassed by the users they are intended to protect. Similarly, when security gets in the way of functionality, designers and administrators deemphasize it. The result is that end users often engage in actions, knowingly or unknowingly, that compromise the security of computer systems or contribute to the unwanted release of personal or other confidential information. <i>Toward Better Usability, Security, and Privacy of Information Technology</i> discusses computer system security and privacy, their relationship to usability, and research at their intersection.
The Emerging Threat of Drug-Resistant Tuberculosis in Southern Africa: Global and Local Challenges and Solutions - Summary of a Joint Workshop by the Institute of Medicine and the Academy of Science of South Africaby Institute of Medicine of the National Academies
Tuberculosis (TB) kills approximately 4,500 people worldwide every day. While most cases of TB can be treated with antibiotics, some strains have developed drug resistance that makes their treatment more expensive, more toxic and less effective for the patient. The IOM Forum on Drug Discovery, Development, and Translation and the Academy of Science of South Africa held a workshop to discuss ways to fight the growing threat of drug-resistant TB.
The 2009 H1N1 vaccination campaign was one of the largest public health campaigns in U.S. history, vaccinating one-quarter of the population in the first three months. The IOM held three workshops in Raleigh, NC; Austin, TX; and Seattle, WA to learn from participants' experiences during the campaign and improve future emergency vaccination programs.
The goal of this study was to assess the value and feasibility of developing and implementing content standards for engineering education at the K-12 level. Content standards have been developed for three disciplines in STEM education--science,technology,and mathematic--but not for engineering. To date,a small but growing number of K-12 students are being exposed to engineering-related materials,and limited but intriguing evidence suggests that engineering education can stimulate interest and improve learning in mathematics and science as well as improve understanding of engineering and technology. Given this background,a reasonable question is whether standards would improve the quality and increase the amount of teaching and learning of engineering in K-12 education.The book concludes that,although it is theoretically possible to develop standards for K-12 engineering education,it would be extremely difficult to ensure their usefulness and effective implementation. This conclusion is supported by the following findings: (1) there is relatively limited experience with K-12 engineering education in U.S. elementary and secondary schools,(2) there is not at present a critical mass of teachers qualified to deliver engineering instruction,(3) evidence regarding the impact of standards-based educational reforms on student learning in other subjects,such as mathematics and science,is inconclusive,and (4) there are significant barriers to introducing stand-alone standards for an entirely new content area in a curriculum already burdened with learning goals in more established domains of study.
Developing credible short-term and long-term projections of Medicare health care costs is critical for public- and private-sector policy planning, but faces challenges and uncertainties. There is uncertainty not only in the underlying economic and demographic assumptions used in projection models, but also in what a policy modeler assumes about future changes in the health status of the population and the factors affecting health status , the extent and pace of scientific and technological breakthroughs in medical care, the preferences of the population for particular kinds of care, the likelihood that policy makers will alter current law and regulations, and how each of these factors relates to health care costs for the elderly population. Given the substantial growth in the Medicare population and the continued increases in Medicare, Medicaid, and private health insurance spending, the availability of well-specified models and analyses that can provide useful information on the likely cost implications of health care policy alternatives is essential. It is therefore timely to review the capabilities and limitations of extant health care cost models and to identify areas for research that offer the most promise to improve modeling, not only of current U.S. health care programs, but also of policy alternatives that may be considered in the coming years. The National Research Council conducted a public workshop focusing on areas of research needed to improve health care cost projections for the Medicare population, and on the strengths and weaknesses of competing frameworks for projecting health care expenditures for the elderly. The workshop considered major classes of projection and simulation models that are currently used and the underlying data sources and research inputs for these models. It also explored areas in which additional research and data are needed to inform model development and health care policy analysis more broadly. The workshop, summarized in this volume, drew people from a wide variety of disciplines and perspectives, including federal agencies, academia, and nongovernmental organizations.
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