- Table View
- List View
Emerging Technology Intersections and Partnerships for Counterproliferation: Proceedings of a Workshop
by National Academies of Sciences, Engineering, and Medicine Division on Engineering and Physical Sciences Intelligence Community Studies BoardThe Intelligence Community Studies Board of the National Academies of Sciences, Engineering, and Medicine convened a workshop on February 27, 2020 to explore insights from world-class experts and technologists familiar with the extensive range of issues associated with the counterproliferation mission, which is countering the spread of weapons of mass destruction, their delivery systems, related technologies, and expertise as a result of indigenous developments and/or transfers between entities. The workshop was designed to explore emerging technology intersections of interest and areas of convergence with relevance to the mission of the National Counterproliferation Center (NCPC) within the Office of the Director of National Intelligence. This publication summarizes the presentation and discussion of the workshop.
Flourishing in Adolescence: A Virtual Workshop: Proceedings Of A Workshop
by National Academies of Sciences, Engineering, and Medicine Division of Behavioral and Social Sciences and Education Board on Children, Youth, and Families Forum for Children’s Well-Being: Promoting Cognitive, Affective, and Behavioral Health for Children and YouthAdolescence is a dynamic time for both brain development and social pressures, making it a critical period to understand mental, emotional, and behavioral health, yet it is often overlooked in terms of policies and service interventions, which makes many young people feel unheard when communicating their own challenges. To explore best practices in providing and supporting adolescent health services and key messaging and communication strategies related to the mental, emotional, and behavioral health of adolescents, the National Academies of Sciences, Engineering, and Medicine's Forum for Children's Well-Being held a workshop on May 5, 2020. The workshop featured a panel of youth representatives who shared their own experiences related to mental, emotional, and behavioral health. This publication summarizes the presentation and discussion of the workshop.
Children’s Mental Health and the Life Course Model: Proceedings Of A Workshop
by National Academies of Sciences, Engineering, and Medicine Division of Behavioral and Social Sciences and Education Board on Children, Youth, and Families Forum for Children's Well-Being: Promoting Cognitive, Affective, and Behavioral Health for Children and YouthWith rapidly rising rates of mental health disorders, changing patterns of occurrence, and increasing levels of morbidity, the need for a better understanding of the developmental origins and influence of mental health on children’s behavioral health outcomes has become critical. This need for better understanding extends to both the growing prevalence of mental health disorders as well as the role and impact of neurodevelopmental pathways in their onset and expression. Addressing these changes in disease patterns and effects on children and families will require a multifaceted approach that goes beyond simply making changes to clinical care or adding personnel to the health services system. New policies, financing, and implementation can put established best practices and numerous research findings from around the country into action. The Maternal and Child Health Life Course Intervention Research Network and the Forum for Children's Well-Being at the National Academies of Sciences, Engineering, and Medicine jointly organized a webinar series to explore how mental health disorders develop over the life course, with a special emphasis on prenatal, early, middle, and later childhood development. This series centered on identifying gaps in our knowledge, exploring possible new strategies for using existing data to enhance understanding of the developmental origins of mental disorders, reviewing potential approaches to prevention and optimization, and proposing new ways of framing how to understand, address, and prevent these disorders from a life course development perspective. This publication summarizes the presentations and discussions from the series.
Scanning for New Evidence on the Nutrient Content of Human Milk: A Process Model For Determining Age-specific Nutrient Requirements
by National Academies of Sciences, Engineering, and Medicine Health and Medicine Division Food and Nutrition Board Committee on Scanning for New Evidence on the Nutrient Content of Human MilkHuman milk is considered the biologic norm for feeding the human infant during the first 6 months of life, and it is a preferred food from 6 to 12 months. It is a complex food and exerts its biologic effects well beyond its known nutritional value; however, human milk composition and the complexity of its composition is not wholly known or understood. Thus, defining the composition of milk, as well as both the individual and combined effects of milk components and the volume consumed on infant growth and development, is central to optimizing infant health. Furthermore, defining human milk composition, volume, and the myriad factors that influence milk components is needed for developing future Dietary Reference Intake (DRI) standards for nutrient intakes during the first 12 months of life. Scanning for New Evidence on the Nutrient Content of Human Milk examines the new and emerging evidence describing the nutrient content of human milk as well as the volume of milk consumed, both of which are needed to understand nutrient consumption by healthy breastfed infants. An evidence scan approach was used to summarize the status of the published literature on the nutrient content of human milk and to identify new evidence on nutrients in human milk that could inform the need for a systematic review as a component of the DRI process.
Childhood Cancer and Functional Impacts Across the Care Continuum
by National Academies of Sciences, Engineering, and Medicine Health and Medicine Division Board on Health Care Services Committee on Childhood Cancers and DisabilitySince the late 1960s, the survival rate in children and adolescents diagnosed with cancer has steadily improved, with a corresponding decline in the cancer-specific death rate. Although the improvements in survival are encouraging, they have come at the cost of acute, chronic, and late adverse effects precipitated by the toxicities associated with the individual or combined use of different types of treatment (e.g., surgery, radiation, chemotherapy). In some cases, the impairments resulting from cancer and its treatment are severe enough to qualify a child for U.S. Social Security Administration disability benefits. At the request of Social Security Administration, Childhood Cancer and Functional Impacts Across the Care Continuum provides current information and findings and conclusions regarding the diagnosis, treatment, and prognosis of selected childhood cancers, including different types of malignant solid tumors, and the effect of those cancers on children’s health and functional capacity, including the relative levels of functional limitation typically associated with the cancers and their treatment. This report also provides a summary of selected treatments currently being studied in clinical trials and identifies any limitations on the availability of these treatments, such as whether treatments are available only in certain geographic areas.
Exploring the State of the Science of Solid Organ Transplantation and Disability: Proceedings Of A Workshop
by National Academies of Sciences, Engineering, and Medicine Health and Medicine Division Board on Health Care ServicesTransplantation of a solid organ, such as a kidney, heart, or liver, is a lifesaving procedure and is sometimes the only viable treatment for patients experiencing end-stage organ failure as a result of illness or injury. A growing prevalence of solid organ diseases in the United States is contributing to more people needing a transplant and longer wait times on the national transplant waiting list. While transplantation can lengthen a person’s life, the road to recovery is difficult and complex. Transplant recipients commonly experience considerable impairments related to health factors, medication side effects, organ rejection, or other setbacks that can cause functional limitations. A spectrum of services and supports can be beneficial to patient functioning and quality of life, but patient access is variable due to individual, system, and social factors. To gain an understanding of current scientific findings in the field of solid organ transplantation, the U.S. Social Security Administration asked the National Academies of Sciences, Engineering, and Medicine’s Board on Health Care Services to organize a virtual public workshop to examine disability associated with organ transplantation. The workshop, held March 22-23, 2021, focused on kidney, heart, liver, and lung transplantation, and to a lesser extent intestine transplantation. Subject-matter experts presented on clinical aspects of post-transplantation recovery and described the implications for physical, cognitive, and psychosocial functioning in adults and children. This publication summarizes the presentations and panel discussions from the workshop.
Decarcerating Correctional Facilities during COVID-19: Advancing Health, Equity, And Safety
by Division of Behavioral and Social Sciences and Education Committee on Law and Justice National Academies of Sciences, Engineering, and Medicine Committee on the Best Practices for Implementing Decarceration as a Strategy to Mitigate the Spread of COVID-19 in Correctional FacilitiesThe conditions and characteristics of correctional facilities - overcrowded with rapid population turnover, often in old and poorly ventilated structures, a spatially concentrated pattern of releases and admissions in low-income communities of color, and a health care system that is siloed from community public health - accelerates transmission of the novel coronavirus (SARS-CoV-2) responsible for COVID-19. Such conditions increase the risk of coming into contact with the virus for incarcerated people, correctional staff, and their families and communities. Relative to the general public, moreover, incarcerated individuals have a higher prevalence of chronic health conditions such as asthma, hypertension, and cardiovascular disease, making them susceptible to complications should they become infected. Indeed, cumulative COVID-19 case rates among incarcerated people and correctional staff have grown steadily higher than case rates in the general population. Decarcerating Correctional Facilities during COVID-19 offers guidance on efforts to decarcerate, or reduce the incarcerated population, as a response to COIVD-19 pandemic. This report examines best practices for implementing decarceration as a response to the pandemic and the conditions that support safe and successful reentry of those decarcerated.
A Review of Methods for Detecting Soreness in Horses
by National Academies of Sciences, Engineering, and Medicine Division on Earth and Life Studies Board on Agriculture and Natural Resources Committee on a Review of Methods for Detecting Soreness in HorsesDuring the last century and today, the Tennessee walking horse has been used primarily for pleasure and show competition. Unique and natural to the breed is a smooth four-beat "running walk" gait. In the 1950s the accentuated or exaggerated running walk, known as the "big lick" became popular at high-level competitions. The combination of exaggerated high-action step in front and long stride behind is still considered desirable in today's horse show competitions, and it is often achieved through soring. Soring is the practice of applying a substance or mechanical device to the lower limb of a horse that will create enough pain that the horse will exaggerate its gait to relieve the discomfort. In 1970 Congress put into law the Horse Protection Act (HPA) to specifically address the practice of soring by prohibiting the showing, exhibition, or sale of Tennessee walking horses that are found to be sore. Sadly, soring is still being done even after 50 years of HPA enforcement. This report reviews the methods for detecting soreness in horses, in hopes of advancing the goal of ultimately eliminating the act of soring in horses and improving the welfare of Tennessee walking horses. A Review of Methods for Detecting Soreness in Horses examines what is known about the quality and consistency of available methods to identify soreness in horses; identifies potential new and emerging methods, approaches, and technologies for detecting hoof and pastern pain and its causes; and identifies research and technology needs to improve the reliability of methods to detect soreness. This independent study will help ensure that HPA inspection protocols are based on sound scientific principles that can be applied with consistency and objectivity.
Current Issues in the Assessment of Respiratory Protective Devices for Occupational and Non-Occupational Uses: Proceedings Of A Workshop
by National Academies of Sciences, Engineering, and Medicine Health and Medicine Division Board on Health Sciences PolicyTo address approaches to the respirator approval process in the current landscape for both occupational and non-occupational use of respirators, the National Academies of Sciences, Engineering, and Medicine̱s Standing Committee on Personal Protective Equipment for Workplace Safety and Health convened a virtual workshop, Current Issues in the Assessment of Respiratory Protective Devices: Nontraditional Workers and Public Use on August 4–5, 2020. Additionally, the workshop considered gaps in respiratory protection for outdoor workers and the general public. This publication summarizes the presentation and discussion of the workshop.
The Use of Systematic Review in EPA’s Toxic Substances Control Act Risk Evaluations
by National Academies of Sciences, Engineering, and Medicine Division on Earth and Life Studies Board on Environmental Studies and Toxicology Committee to Review EPA’s TSCA Systematic Review Guidance DocumentSystematic review - a scientific investigation that focuses on a specific question and uses explicit, prespecified scientific methods to identify, select, assess, and summarize the findings of similar but separate studies - has become the foundation for assessing evidence to be used for decision making in a variety of health contexts, including health care and public health. At the request of the Environmental Protection Agency (EPA), this publication reviews EPA's 2018 guidance document Application of Systematic Review in TSCA (Toxic Substances and Control Act) Risk Evaluations and associated materials to determine whether the process is comprehensive, workable, objective, and transparent.
Sexually Transmitted Infections: Adopting a Sexual Health Paradigm
by National Academies of Sciences, Engineering, and Medicine Health and Medicine Division Board on Population Health and Public Health Practice Committee on Prevention and Control of Sexually Transmitted Infections in the United StatesOne in five people in the United States had a sexually transmitted infection (STI) on any given day in 2018, totaling nearly 68 million estimated infections. STIs are often asymptomatic (especially in women) and are therefore often undiagnosed and unreported. Untreated STIs can have severe health consequences, including chronic pelvic pain, infertility, miscarriage or newborn death, and increased risk of HIV infection, genital and oral cancers, neurological and rheumatological effects. In light of this, the Centers for Disease Control and Prevention, through the National Association of County and City Health Officials, commissioned the National Academies of Sciences, Engineering, and Medicine to convene a committee to examine the prevention and control of sexually transmitted infections in the United States and provide recommendations for action. In 1997, the Institute of Medicine released a report, The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Although significant scientific advances have been made since that time, many of the problems and barriers described in that report persist today; STIs remain an underfunded and comparatively neglected field of public health practice and research. The committee reviewed the current state of STIs in the United States, and the resulting report, Sexually Transmitted Infections: Advancing a Sexual Health Paradigm, provides advice on future public health programs, policy, and research.
Diagnosing and Treating Adult Cancers and Associated Impairments
by National Academies of Sciences, Engineering, and Medicine Health and Medicine Division Board on Health Care Services Committee on Diagnosing and Treating Adult CancersCancer is the second leading cause of death among adults in the United States after heart disease. However, improvements in cancer treatment and earlier detection are leading to growing numbers of cancer survivors. As the number of cancer survivors grows, there is increased interest in how cancer and its treatments may affect a person's ability to work, whether the person has maintained employment throughout the treatment or is returning to work at a previous, current, or new place of employment. Cancer-related impairments and resulting functional limitations may or may not lead to disability as defined by the U.S. Social Security Administration (SSA), however, adults surviving cancer who are unable to work because of cancer-related impairments and functional limitations may apply for disability benefits from SSA. At the request of SSA, Diagnosing and Treating Adult Cancers and Associated Impairments provides background information on breast cancer, lung cancer, and selected other cancers to assist SSA in its review of the listing of impairments for disability assessments. This report addresses several specific topics, including determining the latest standards of care as well as new technologies for understanding disease processes, treatment modalities, and the effect of cancer on a person's health and functioning, in order to inform SSA's evaluation of disability claims for adults with cancer.
Gulf Research Program Annual Report 2019
by National Academies of Sciences, Engineering, and Medicine Gulf Research ProgramEach year, the Gulf Research Program (GRP) produces an annual report to summarize how funds were used. These reports review accomplishments, highlight activities, and, over time, will assess metrics to determine how the program is progressing in accomplishing its goals. The 2019 annual report is the sixth report in this series. The GRP is an independent, science-based program founded in 2013. Through grants, fellowships, and other activities, it seeks to enhance oil system safety and the protection of human health and the environment in the Gulf of Mexico region and other areas along the U.S. outer continental shelf with offshore oil and gas operations.
Information Technology Innovation: Resurgence, Confluence, And Continuing Impact
by National Academies of Sciences, Engineering, and Medicine Division on Engineering and Physical Sciences Computer Science and Telecommunications Board Panel on Artificial Intelligence Committee on Depicting Innovation in Information TechnologyInformation technology (IT) is widely understood to be the enabling technology of the 21st century. IT has transformed, and continues to transform, all aspects of our lives: commerce and finance, education, energy, health care, manufacturing, government, national security, transportation, communications, entertainment, science, and engineering. IT and its impact on the U.S. economy—both directly (the IT sector itself) and indirectly (other sectors that are powered by advances in IT)—continue to grow in size and importance. IT’s impacts on the U.S. economy—both directly (the IT sector itself) and indirectly (other sectors that are powered by advances in IT)—continue to grow. IT enabled innovation and advances in IT products and services draw on a deep tradition of research and rely on sustained investment and a uniquely strong partnership in the United States among government, industry, and universities. Past returns on federal investments in IT research have been extraordinary for both U.S. society and the U.S. economy. This IT innovation ecosystem fuels a virtuous cycle of innovation with growing economic impact. Building on previous National Academies work, this report describes key features of the IT research ecosystem that fuel IT innovation and foster widespread and longstanding impact across the U.S. economy. In addition to presenting established computing research areas and industry sectors, it also considers emerging candidates in both categories.
Science and Engineering in Preschool Through Elementary Grades: The Brilliance Of Children And The Strengths Of Educators
by National Academies of Sciences, Engineering, and Medicine Division of Behavioral and Social Sciences and Education Board on Science Education Committee on Enhancing Science and Engineering in Prekindergarten Through Fifth GradesStarting in early childhood, children are capable of learning sophisticated science and engineering concepts and engage in disciplinary practices. They are deeply curious about the world around them and eager to investigate the many questions they have about their environment. Educators can develop learning environments that support the development and demonstration of proficiencies in science and engineering, including making connections across the contexts of learning, which can help children see their ideas, interests, and practices as meaningful not just for school, but also in their lives. Unfortunately, in many preschool and elementary schools science gets relatively little attention compared to English language arts and mathematics. In addition, many early childhood and elementary teachers do not have extensive grounding in science and engineering content. Science and Engineering in Preschool through Elementary Grades provides evidence-based guidance on effective approaches to preschool through elementary science and engineering instruction that supports the success of all students. This report evaluates the state of the evidence on learning experiences prior to school; promising instructional approaches and what is needed for implementation to include teacher professional development, curriculum, and instructional materials; and the policies and practices at all levels that constrain or facilitate efforts to enhance preschool through elementary science and engineering. Building a solid foundation in science and engineering in the elementary grades sets the stage for later success, both by sustaining and enhancing students' natural enthusiasm for science and engineering and by establishing the knowledge and skills they need to approach the more challenging topics introduced in later grades. Through evidence-based guidance on effective approaches to preschool through elementary science and engineering instruction, this report will help teachers to support the success of all students.
Peer Review of a Report Commissioned by the Social Security Administration on Selected Occupational Requirements
by National Academies of Sciences, Engineering, and Medicine Health and Medicine Division Board on Health Care Services Committee for a Peer Review of a Report Commissioned by the Social Security Administration on Required Mental Health Requirements for Selected OccupationsAt the request of the Social Security Administration (SSA), this publication reviews a commissioned report by Abt Associates on selected occupational requirements. SSA asked Abt to assemble information on the levels of social interaction and adaption required to perform tasks in these occupations for a given specific vocational preparation range. This review examines the suitability of the databases used, the soundness of the methodology used to connect occupational tasks to social interactive and adaptive functional capacities, and the appropriateness of the expertise gathered to perform the analysis.
The Future of Electric Power in the United States: Proceedings Of A Workshop
by National Academies of Sciences, Engineering, and Medicine Division on Engineering and Physical Sciences Board on Energy and Environmental Systems Committee on the Future of Electric Power in the U.S.Electric power is essential for the lives and livelihoods of all Americans, and the need for electricity that is safe, clean, affordable, and reliable will only grow in the decades to come. At the request of Congress and the Department of Energy, the National Academies convened a committee of experts to undertake a comprehensive evaluation of the U.S. grid and how it might evolve in response to advances in new energy technologies, changes in demand, and future innovation. The Future of Electric Power in the United States presents an extensive set of policy and funding recommendations aimed at modernizing the U.S. electric system. The report addresses technology development, operations, grid architectures, and business practices, as well as ways to make the electricity system safe, secure, sustainable, equitable, and resilient.
Enhancing Federal Clean Energy Innovation: Proceedings Of A Workshop
by National Academies of Sciences, Engineering, and Medicine Division on Engineering and Physical Sciences Board on Energy and Environmental SystemsA widespread and rapid transition to a low-carbon energy system by 2050 is essential to keep pace with ambitious policy goals and avoid the worst consequences of climate change. Innovation is necessary to lower costs and improve performance of existing technologies and to develop new clean energy options that address challenges in harder-to-decarbonize sectors. To examine means by which the U.S. federal government can rise to this challenge, the National Academies of Sciences, Engineering, and Medicine hosted a virtual workshop series "Enhancing Federal Clean Energy Innovation" on July 27 to August 7, 2020. The workshop featured timely, action-orientated assessments of how to strengthen development and penetration of new clean energy technologies. This publication summarizes the presentations and discussions that occurred over the course of the workshop.
High and Rising Mortality Rates Among Working-Age Adults
by National Academies of Sciences, Engineering, and Medicine Division of Behavioral and Social Sciences and Education Committee on National Statistics Committee on Population Committee on Rising Midlife Mortality Rates and Socioeconomic DisparitiesThe past century has witnessed remarkable advances in life expectancy in the United States and throughout the world. In 2010, however, progress in life expectancy in the United States began to stall, despite continuing to increase in other high-income countries. Alarmingly, U.S. life expectancy fell between 2014 and 2015 and continued to decline through 2017, the longest sustained decline in life expectancy in a century (since the influenza pandemic of 1918-1919). The recent decline in U.S. life expectancy appears to have been the product of two trends: (1) an increase in mortality among middle-aged and younger adults, defined as those aged 25-64 years (i.e., "working age"), which began in the 1990s for several specific causes of death (e.g., drug- and alcohol-related causes and suicide); and (2) a slowing of declines in working-age mortality due to other causes of death (mainly cardiovascular diseases) after 2010.High and Rising Mortality Rates among Working Age Adults highlights the crisis of rising premature mortality that threatens the future of the nation’s families, communities, and national wellbeing. This report identifies the key drivers of increasing death rates and disparities in working-age mortality over the period 1990 to 2017; elucidates modifiable risk factors that could alleviate poor health in the working-age population, as well as widening health inequalities; identifies key knowledge gaps and make recommendations for future research and data collection to fill those gaps; and explores potential policy implications. After a comprehensive analysis of the trends in working-age mortality by age, sex, race/ethnicity, and geography using the most up-to-date data, this report then looks upstream to the macrostructural factors (e.g., public policies, macroeconomic trends, social and economic inequality, technology) and social determinants (e.g., socioeconomic status, environment, social networks) that may affect the health of working-age Americans in multiple ways and through multiple pathways.
Space Nuclear Propulsion for Human Mars Exploration
by National Academies of Sciences, Engineering, and Medicine Division on Engineering and Physical Sciences Aeronautics and Space Engineering Board Space Nuclear Propulsion Technologies CommitteeSpace Nuclear Propulsion for Human Mars Exploration identifies primary technical and programmatic challenges, merits, and risks for developing and demonstrating space nuclear propulsion technologies of interest to future exploration missions. This report presents key milestones and a top-level development and demonstration roadmap for performance nuclear thermal propulsion and nuclear electric propulsion systems and identifies missions that could be enabled by successful development of each technology.
2020 Census Data Products: Proceedings Of A Workshop
by National Academies of Sciences, Engineering, and Medicine Division of Behavioral and Social Sciences and Education Committee on National StatisticsThe Committee on National Statistics of the National Academies of Sciences, Engineering, and Medicine convened a 2-day public workshop from December 11-12, 2019, to discuss the suite of data products the Census Bureau will generate from the 2020 Census. The workshop featured presentations by users of decennial census data products to help the Census Bureau better understand the uses of the data products and the importance of these uses and help inform the Census Bureau's decisions on the final specification of 2020 data products. This publication summarizes the presentation and discussion of the workshop.
Empowering the Defense Acquisition Workforce to Improve Mission Outcomes Using Data Science
by Division of Behavioral and Social Sciences and Education Policy and Global Affairs Division on Engineering and Physical Sciences Committee on National Statistics Board on Higher Education and Workforce Computer Science and Telecommunications Board Air Force Studies Board Committee on Applied and Theoretical Statistics Board on Mathematical Sciences and Analytics Committee on Improving Defense Acquisition Workforce Capability in Data UseThe effective use of data science - the science and technology of extracting value from data - improves, enhances, and strengthens acquisition decision-making and outcomes. Using data science to support decision making is not new to the defense acquisition community; its use by the acquisition workforce has enabled acquisition and thus defense successes for decades. Still, more consistent and expanded application of data science will continue improving acquisition outcomes, and doing so requires coordinated efforts across the defense acquisition system and its related communities and stakeholders. Central to that effort is the development, growth, and sustainment of data science capabilities across the acquisition workforce. At the request of the Under Secretary of Defense for Acquisition and Sustainment, Empowering the Defense Acquisition Workforce to Improve Mission Outcomes Using Data Science assesses how data science can improve acquisition processes and develops a framework for training and educating the defense acquisition workforce to better exploit the application of data science. This report identifies opportunities where data science can improve acquisition processes, the relevant data science skills and capabilities necessary for the acquisition workforce, and relevant models of data science training and education.
Harmonizing the Process for Establishing Nutrient Reference Values: A Tool Kit
by National Academies of Sciences, Engineering, and Medicine Health and Medicine Division Food and Nutrition Board Lindsay Allen Janet King Ann YaktineHarmonized approaches to setting recommendations for safe and appropriate dietary intakes and nutritional interventions are critical to support the resolution of differences across countries in setting national and international nutrition standards; promote consistency in public and clinical health objectives; provide a mechanism for designing national and international food and nutrition policies; and enhance the transparency of national standards for trade and other regulatory actions that have economic, health, and safety implications. Consistent dietary intake recommendations cannot be made without first establishing a consistent approach to derive reference values for population-level nutrient intakes. This tool kit is designed to help global stakeholders, including those in low- and middle-income countries, participate more easily in the process of implementing, disseminating, and evaluating a consistent and homogeneous methodological approach to the nutrient reference value process.
The Future of Nursing 2020-2030: Charting A Path To Achieve Health Equity
by National Academies of Sciences, Engineering, and Medicine National Academy of Medicine Committee on the Future of Nursing 2020–2030The decade ahead will test the nation’s nearly 4 million nurses in new and complex ways. Nurses live and work at the intersection of health, education, and communities. Nurses work in a wide array of settings and practice at a range of professional levels. They are often the first and most frequent line of contact with people of all backgrounds and experiences seeking care and they represent the largest of the health care professions. A nation cannot fully thrive until everyone - no matter who they are, where they live, or how much money they make - can live their healthiest possible life, and helping people live their healthiest life is and has always been the essential role of nurses. Nurses have a critical role to play in achieving the goal of health equity, but they need robust education, supportive work environments, and autonomy. Accordingly, at the request of the Robert Wood Johnson Foundation, on behalf of the National Academy of Medicine, an ad hoc committee under the auspices of the National Academies of Sciences, Engineering, and Medicine conducted a study aimed at envisioning and charting a path forward for the nursing profession to help reduce inequities in people’s ability to achieve their full health potential. The ultimate goal is the achievement of health equity in the United States built on strengthened nursing capacity and expertise. By leveraging these attributes, nursing will help to create and contribute comprehensively to equitable public health and health care systems that are designed to work for everyone. The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity explores how nurses can work to reduce health disparities and promote equity, while keeping costs at bay, utilizing technology, and maintaining patient and family-focused care into 2030. This work builds on the foundation set out by The Future of Nursing: Leading Change, Advancing Health (2011) report.
Implementing High-Quality Primary Care: Rebuilding the Foundation of Health Care
by National Academies of Sciences, Engineering, and Medicine Health and Medicine Division Board on Health Care Services Committee on Implementing High-Quality Primary CareHigh-quality primary care is the foundation of the health care system. It provides continuous, person-centered, relationship-based care that considers the needs and preferences of individuals, families, and communities. Without access to high-quality primary care, minor health problems can spiral into chronic disease, chronic disease management becomes difficult and uncoordinated, visits to emergency departments increase, preventive care lags, and health care spending soars to unsustainable levels. Unequal access to primary care remains a concern, and the COVID-19 pandemic amplified pervasive economic, mental health, and social health disparities that ubiquitous, high-quality primary care might have reduced. Primary care is the only health care component where an increased supply is associated with better population health and more equitable outcomes. For this reason, primary care is a common good, which makes the strength and quality of the country's primary care services a public concern. Implementing High-Quality Primary Care: Rebuilding the Foundation of Health Care puts forth an evidence-based plan with actionable objectives and recommendations for implementing high-quality primary care in the United States. The implementation plan of this report balances national needs for scalable solutions while allowing for adaptations to meet local needs.