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The Context of Military Environments: An Agenda for Basic Research on Social and Organizational Factors Relevant to Small Units
by Committee on the Context of Military Environments: Social Organization FactorsThe United States Army faces a variety of challenges to maintain a ready and capable force into the future. Missions are increasingly diverse, ranging from combat and counterinsurgency to negotiation, reconstruction, and stability operations, and require a variety of personnel and skill sets to execute. Missions often demand rapid decision-making and coordination with others in novel ways, so that personnel are not simply following a specific set of tactical orders but rather need to understand broader strategic goals and choose among courses of action. Like any workforce, the Army is diverse in terms of demographic characteristics such as gender and race, with increasing pressure to ensure equal opportunities across all demographic parties. With these challenges comes the urgent need to better understand how contextual factors influence soldier and small unit behavior and mission performance. Recognizing the need to develop a portfolio of research to better understand the influence of social and organizational factors on the behavior of individuals and small units, the U. S. Army Research Institute (ARI) requested the National Research Council's Board on Behavioral, Cognitive, and Sensory Sciences to outline a productive and innovative collection of future basic science research projects to improve Amy mission performance for immediate implementation and lasting over the next 10-20 years. This report presents recommendations for a program of basic scientific research on the roles of social and organizational contextual factors, such as organizational institutions, culture, and norms, as determinants and moderators of the performance of individual soldiers and small units. "The Context of Military Environments: Basic Research Opportunities on Social and Organizational Factors" synthesizes and assesses basic research opportunities in the behavioral and social sciences related to social and organizational factors that comprise the context of individual and small unit behavior in military environments. This report focuses on tactical operations of small units and their leaders, to include the full spectrum of unique military environments including: major combat operations, stability/support operations, peacekeeping, and military observer missions, as well as headquarters support units. This report identifies key contextual factors that shape individual and small unit behavior and assesses the state of the science regarding these factors. "The Context of Military Environments" recommends an agenda for ARI's future research in order to maximize the effectiveness of U. S. Army personnel policies and practices of selection, recruitment, and assignment as well as career development in training and leadership. The report also specifies the basic research funding level needed to implement the recommended agenda for future ARI research.
The National Children's Study 2014: An Assessment
by Greg J. DuncanThe National Children's Study (NCS) was authorized by the Children's Health Act of 2000 and is being implemented by a dedicated Program Office in the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). The NCS is planned to be a longitudinal observational birth cohort study to evaluate the effects of chronic and intermittent exposures on child health and development in the U. S. . The NCS would be the first study to collect a broad range of environmental exposure measures for a national probability sample of about 100,000 children, followed from birth or before birth to age 21. Detailed plans for the NCS were developed by 2007 and reviewed by a National Research Council / Institute of Medicine panel. At that time, sample recruitment for the NCS Main Study was scheduled to begin in 2009 and to be completed within about 5 years. However, results from the initial seven pilot locations, which recruited sample cases in 2009-2010, indicated that the proposed household-based recruitment approach would be more costly and time consuming than planned. In response, the Program Office implemented a number of pilot tests in 2011 to evaluate alternative recruitment methods and pilot testing continues to date. At the request of Congress, The National Children's Study 2014 reviews the revised study design and proposed methodologies for the NCS Main Study. This report assesses the study's plan to determine whether it is likely to produce scientifically sound results that are generalizable to the United States population and appropriate subpopulations. The report makes recommendations about the overall study framework, sample design, timing, content and need for scientific expertise and oversight. The National Children's Study has the potential to add immeasurably to scientific knowledge about the impact of environmental exposures, broadly defined, on children\'s health and development in the United States. The recommendations of this report will help the NCS will achieve its intended objective to examine the effects of environmental influences on the health and development of American children.
Issues in Returning Individual Results from Genome Research Using Population-Based Banked Specimens, with a Focus on the National Health and Nutrition Examination Survey: A Workshop Summary
by Kevin KinsellaPopulation surveys traditionally collect information from respondents about their circumstances, behaviors, attitudes, and other characteristics. In recent years, many surveys have been collecting not only questionnaire answers, but also biologic specimens such as blood samples, saliva, and buccal swabs, from which a respondent's DNA can be ascertained along with other biomarkers (e. g. , the level of a certain protein in the blood). The National Health and Nutrition Examination Survey (NHANES), sponsored by the National Center for Health Statistics (NCHS), has been collecting and storing genetic specimens since 1991, and other surveys, such as the Health and Retirement Study (HRS) funded by the National Institute on Aging, have followed suit. In order to give their informed consent to participate in a survey, respondents need to know the disposition and use of their data. Will their data be used for one research project and then destroyed, or will they be archived for secondary use? Sponsors of repeated cross-sectional surveys, such as NHANES, and of longitudinal surveys that follow panels of individuals over time, such as HRS, generally want to retain data for a wide range of secondary uses, many of which are not explicitly foreseen at the time of data collection. They typically inform respondents that their data will be stored in a secure manner and may be provided to researchers with suitable protections against individual identification. The addition of biologic specimens to a survey adds complications for storing, protecting, and providing access to such data and measurements made from them. There are also questions of whether, when, and for which biologic measurements the results should be reported back to individual respondents. Recently, the cost of full genomic sequencing has plummeted, and research findings are beginning to accumulate that bear up under replication and that potentially have clinical implications for a respondent. For example, knowing that one possesses a certain gene or gene sequence might suggest that one should seek a certain kind of treatment or genetic counseling or inform one's blood relatives. Biomedical research studies, in which participants are asked to donate tissues for genetic studies and are usually told that they will not be contacted with any results, are increasingly confronting the issue of when and which DNA results to return to participants. Issues in Returning Individual Results from Genome Research Using Population-Based Banked Specimens, with a Focus on the National Health and Nutrition Examination Survey is the summary of a workshop convened in February 2013 by the Committee on National Statistics in the Division of Behavioral and Social Sciences and Education of the National Research Council. This report considers how population surveys, in particular NHANES, should implement the reporting of results from genomic research using stored specimens and address informed consent for future data collection as well as for the use of banked specimens covered by prior informed consent agreements. The report will be of interest to survey organizations that include or contemplate including the collection of biologic specimens in population surveys for storing for genetic research. The issues involved are important for advancing social, behavioral, and biomedical knowledge while appropriately respecting and protecting individual survey respondents.
Civic Engagement and Social Cohesion: Measuring Dimensions of Social Capital to Inform Policy
by Kenneth PrewittPeople's bonds, associations and networks - as well as the civil, political, and institutional characteristics of the society in which they live - can be powerful drivers affecting the quality of life among a community's, a city's, or a nation's inhabitants and their ability to achieve both individual and societal goals. Civic engagement, social cohesion, and other dimensions of social capital affect social, economic and health outcomes for individuals and communities. Can these be measured, and can federal surveys contribute toward this end? Can this information be collected elsewhere, and if so, how should it be collected? "Civic Engagement and Social Cohesion" identifies measurement approaches that can lead to improved understanding of civic engagement, social cohesion, and social capital - and their potential role in explaining the functioning of society. With the needs of data users in mind, this report examines conceptual frameworks developed in the literature to determine promising measures and measurement methods for informing public policy discourse. The report identifies working definitions of key terms; advises on the feasibility and specifications of indicators relevant to analyses of social, economic, and health domains; and assesses the strength of the evidence regarding the relationship between these indicators and observed trends in crime, employment, and resilience to shocks such as natural disasters. "Civic Engagement and Social Cohesion" weighs the relative merits of surveys, administrative records, and non-government data sources, and considers the appropriate role of the federal statistical system. This report makes recommendations to improve the measurement of civic health through population surveys conducted by the government and identifies priority areas for research, development, and implementation.
Views of the U.S. National Academies of Sciences, Engineering, and Medicine on Agenda Items at Issue at the World Radiocommunication Conference 2023
by National Academies of Sciences, Engineering, and Medicine Division on Engineering and Physical Sciences Board on Physics and Astronomy Committee on the Views on the World Radiocommunication Conference 2023The radio frequency spectrum is a limited resource for which there is an ever-increasing demand from an expansive range of applications - all the way from commercial, such as mobile phones, to scientific, such as hurricane monitoring from space. Since radio waves do not stop at national borders, international regulation is necessary to ensure effective use of the radio spectrum for all parties. Use of the radio spectrum is regulated internationally by the Radio Regulations (RR), an international treaty. The International Telecommunication Union (ITU) has as its mission the facilitation of the efficient and interference-free use of the radio spectrum. Every 2 to 5 years, the ITU convenes a World Radiocommunication Conference (WRC) to review and revise the international RR. Changes to the RR are formulated through proposals to the conference according to Agenda Items, which are agreed on at the previous WRC. At the request of the National Science Foundation and the National Aeronautics and Space Administration, this report provides guidance to U.S. spectrum managers and policymakers as they prepare for the 2023 WRC to protect the scientific exploration of Earth and the universe using the radio spectrum. This report identifies the 2023 agenda items of relevance to U.S. radio astronomers and Earth remote sensing researchers, along with proposed agenda items for the 2027 WRC.
Force Multiplying Technologies for Logistics Support to Military Operations
by Committee on Force Multiplying Technologies for Logistics Support to Military OperationsThe mission of the United States Army is to fight and win our nation's wars by providing prompt, sustained land dominance across the full range of military operations and spectrum of conflict in support of combatant commanders. Accomplishing this mission rests on the ability of the Army to equip and move its forces to the battle and sustain them while they are engaged. Logistics provides the backbone for Army combat operations. Without fuel, ammunition, rations, and other supplies, the Army would grind to a halt. The U. S. military must be prepared to fight anywhere on the globe and, in an era of coalition warfare, to logistically support its allies. While aircraft can move large amounts of supplies, the vast majority must be carried on ocean going vessels and unloaded at ports that may be at a great distance from the battlefield. As the wars in Afghanistan and Iraq have shown, the costs of convoying vast quantities of supplies is tallied not only in economic terms but also in terms of lives lost in the movement of the materiel. As the ability of potential enemies to interdict movement to the battlefield and interdict movements in the battlespace increases, the challenge of logistics grows even larger. No matter how the nature of battle develops, logistics will remain a key factor. "Force Multiplying Technologies for Logistics Support to Military Operations" explores Army logistics in a global, complex environment that includes the increasing use of antiaccess and area-denial tactics and technologies by potential adversaries. This report describes new technologies and systems that would reduce the demand for logistics and meet the demand at the point of need, make maintenance more efficient, improve inter- and intratheater mobility, and improve near-real-time, in-transit visibility. "Force Multiplying Technologies" also explores options for the Army to operate with the other services and improve its support of Special Operations Forces. This report provides a logistics-centric research and development investment strategy and illustrative examples of how improved logistics could look in the future.
Facilitating Patient Understanding of Discharge Instructions: Workshop Summary
by Joe AlperThe Roundtable on Health Literacy brings together leaders from academia, industry, government, foundations, and associations and representatives of patient and consumer interests who work to improve health literacy. To achieve its mission, the roundtable discusses challenges facing health literacy practice and research and identifies approaches to promote health literacy through mechanisms and partnerships in both the public and private sectors. To explore the aspects of health literacy that impact the ability of patients to understand and follow discharge instructions and to learn from examples of how discharge instructions can be written to improve patient understanding of-and hence compliance with-discharge instructions, the Roundtable on Health Literacy held a public workshop. The workshop featured presentations and discussions that examined the implications of health literacy for discharge instructions for both ambulatory and inpatient facilities. Facilitating Patient Understanding of Discharge Instructions summarizes the presentations and discussions of the workshop. This report gives an overview of the impact of discharge instructions on outcomes, and discusses the specifics of inpatient discharge summaries and outpatient after-visit summaries. The report also contains case studies illustrating different approaches to improving discharge instructions.
Financing Population Health Improvement: Workshop Summary
by Joe AlperDespite spending far more on medical care than any other nation and despite having seen a century of unparalleled improvement in population health and longevity, the United States has fallen behind many of its global counterparts and competitors in such health outcomes as overall life expectancy and rates of preventable diseases and injuries. A fundamental but often overlooked driver of the imbalance between spending and outcomes is the nation\'s inadequate investment in non-clinical strategies that promote health and prevent disease and injury population-wide, strategies that fall under the rubric of "population health. " Given that it is unlikely that government funding for governmental public health agencies, whether at the local, state, or federal levels, will see significant and sustained increases, there is interest in finding creative sources of funding for initiatives to improve population health, both through the work of public health agencies and through the contributions of other sectors, including nonhealth entities. Financing Population Health Improvement is the summary of a workshop convened by the Institute of Medicine Roundtable on Population Health Improvement in February 2014 to explore the range of resources that might be available to provide a secure funding stream for non-clinical actions to enhance health. Presenters and participants discussed the range of potential resources (e. g. , financial, human, and community) explored topics related to financial resources. This report discusses return on investment, the value of investing in population-based interventions, and possible sources of funding to improve population health.
Complex Operational Decision Making in Networked Systems of Humans and Machines: A Multidisciplinary Approach
by Committee on Integrating Humans Machines Networks: A Global Review of Data-to-Decision TechnologiesOver the last two decades, computers have become omnipresent in daily life. Their increased power and accessibility have enabled the accumulation, organization, and analysis of massive amounts of data. These data, in turn, have been transformed into practical knowledge that can be applied to simple and complex decision making alike. In many of today's activities, decision making is no longer an exclusively human endeavor. In both virtual and real ways, technology has vastly extended people's range of movement, speed and access to massive amounts of data. Consequently, the scope of complex decisions that human beings are capable of making has greatly expanded. At the same time, some of these technologies have also complicated the decision making process. The potential for changes to complex decision making is particularly significant now, as advances in software, memory storage and access to large amounts of multimodal data have dramatically increased. Increasingly, our decision making process integrates input from human judgment, computing results and assistance, and networks. Human beings do not have the ability to analyze the vast quantities of computer-generated or -mediated data that are now available. How might humans and computers team up to turn data into reliable (and when necessary, speedy) decisions? Complex Operational Decision Making in Networked Systems of Humans and Machines explores the possibilities for better decision making through collaboration between humans and computers. This study is situated around the essence of decision making; the vast amounts of data that have become available as the basis for complex decision making; and the nature of collaboration that is possible between humans and machines in the process of making complex decisions. This report discusses the research goals and relevant milestones in several enabling subfields as they relate to enhanced human-machine collaboration for complex decision making; the relevant impediments and systems-integration challenges that are preventing technological breakthroughs in these subfields; and a sense of the research that is occurring in university, government and industrial labs outside of the United States, and the implications of this research for U. S. policy. The development of human-machine collaboration for complex decision making is still in its infancy relative to where cross-disciplinary research could take it over the next generation. Complex Operational Decision Making explores challenges to progress, impediments to achieving technological breakthroughs, opportunities, and key research goals.
The Cost of Inaction for Young Children Globally: Workshop Summary
by Kimber Bogard"The Cost of Inaction for Young Children Globally" is the summary of a workshop hosted by the Institute of Medicine Forum on Investing in Young Children Globally in April 2014 to focus on investments in young children and the cost of inaction. Participants explored existing, new, and innovative science and research from around the world to translate this evidence into sound and strategic investments in policies and practices that will make a difference in the lives of children and their caregivers. This report discusses intersections across health, education, nutrition, living conditions, and social protection and how investments of economic, natural, social, and other resources can sustain or promote early childhood development and well-being.
A Framework for Assessing Effects of the Food System
by Malden C. NesheimHow we produce and consume food has a bigger impact on Americans' well-being than any other human activity. The food industry is the largest sector of our economy; food touches everything from our health to the environment, climate change, economic inequality, and the federal budget. From the earliest developments of agriculture, a major goal has been to attain sufficient foods that provide the energy and the nutrients needed for a healthy, active life. Over time, food production, processing, marketing, and consumption have evolved and become highly complex. The challenges of improving the food system in the 21st century will require systemic approaches that take full account of social, economic, ecological, and evolutionary factors. Policy or business interventions involving a segment of the food system often have consequences beyond the original issue the intervention was meant to address. "A Framework for Assessing Effects of the Food System" develops an analytical framework for assessing effects associated with the ways in which food is grown, processed, distributed, marketed, retailed, and consumed in the United States. The framework will allow users to recognize effects across the full food system, consider all domains and dimensions of effects, account for systems dynamics and complexities, and choose appropriate methods for analysis. This report provides example applications of the framework based on complex questions that are currently under debate: consumption of a healthy and safe diet, food security, animal welfare, and preserving the environment and its resources. "A Framework for Assessing Effects of the Food System" describes the U. S. food system and provides a brief history of its evolution into the current system. This report identifies some of the real and potential implications of the current system in terms of its health, environmental, and socioeconomic effects along with a sense for the complexities of the system, potential metrics, and some of the data needs that are required to assess the effects. The overview of the food system and the framework described in this report will be an essential resource for decision makers, researchers, and others to examine the possible impacts of alternative policies or agricultural or food processing practices.
Surmounting the Barriers: Summary of a Workshop
by National Academy of Engineering"Surmounting the Barriers: Ethnic Diversity in Engineering Education" is the summary of a workshop held in September 2013 to take a fresh look at the impediments to greater diversification in engineering education. The workshop brought together educators in engineering from two- and four-year colleges and staff members from the three sponsoring organizations: the National Science Foundation, the National Academy of Engineering and the American Society for Engineering Education. While the goal of diversifying engineering education has long been recognized, studied, and subjected to attempted interventions, progress has been fitful and slow. This report discusses reasons why past recommendations to improve diversity had not been adopted in full or in part. "Surmounting the Barriers" identifies a series of key impediments, including a lack of incentives for faculty and institutions; inadequate or only short-term financial support; an unsupportive institutional and faculty culture and environment; a lack of institutional and constituent engagement; and inadequate assessments, metrics, and data tracking. The report also shares success stories about instances where barriers to diversity have been identified and surmounted, and the resources that could enable real solutions to implement steps toward progress.
Post-Vietnam Dioxin Exposure in Agent Orange-Contaminated C-123 Aircraft
by Committee to Evaluate the Potential Exposure of Agent Orange/TCDD Residue Level of Risk of Adverse Health Effects for Aircrew of Post-Vietnam C-123 AircraftFrom 1972 to 1982, approximately 1,500-2,100 US Air Force Reserve personnel trained and worked on C-123 aircraft that had formerly been used to spray herbicides in Vietnam as part of Operation Ranch Hand. After becoming aware that some of the aircraft on which they had worked had previously served this purpose, some of these AF Reservists applied to the US Department of Veterans Affairs (VA) for compensatory coverage under the Agent Orange Act of 1991. The Act provides health care and disability coverage for health conditions that have been deemed presumptively service-related for herbicide exposure during the Vietnam War. The VA denied the applications on the basis that these veterans were ineligible because as non-Vietnam-era veterans or as Vietnam-era veterans without "boots on the ground" service in Vietnam, they were not covered. However, with the knowledge that some air and wipe samples taken between 1979 and 2009 from some of the C-123s used in Operation Ranch Hand showed the presence of agent orange residues, representatives of the C-123 Veterans Association began a concerted effort to reverse VA's position and obtain coverage. At the request of the VA, "Post-Vietnam Dioxin Exposure in Agent Orange-Contaminated C-123 Aircraft" evaluates whether or not service in these C-123s could have plausibly resulted in exposures detrimental to the health of these Air Force Reservists. The Institute of Medicine assembled an expert committee to address this question qualitatively, but in a scientific and evidence-based fashion. This report evaluates the reliability of the available information for establishing exposure and addresses and places in context whether any documented residues represent potentially harmful exposure by characterizing the amounts available and the degree to which absorption might be expected. "Post-Vietnam Dioxin Exposure" rejects the idea that the dioxin residues detected on interior surfaces of the C-123s were immobile and effectively inaccessible to the Reservists as a source of exposure. Accordingly, this report states with confidence that the Air Force Reservists were exposed when working in the Operation Ranch Hand C-123s and so experienced some increase in their risk of a variety of adverse responses.
Culture Matters: International Research Collaboration in a Changing World--Summary of a Workshop
by Susan Sauer SloanIn an increasingly interconnected world, science and technology research often transects international boundaries and involves researchers from multiple nations. This paradigm provides both new opportunities and new challenges. As science and technology capabilities grow around the world, United States-based organizations are finding that international collaborations and partnerships provide unique opportunities to enhance research and training. At the same time, enhancing international collaboration requires recognition of differences in culture, legitimate national security needs, and critical needs in education and training. Culture Matters is the summary of a workshop convened by the Government-University-Industry Research Roundtable (GUIRR) in July 2013 to address how culture and cultural perception influence and impact the process by which research agreements are made and negotiated across international boundaries. In this workshop, "Culture Matters: An Approach to International Research Agreements", representatives from around the world and from GUIRR's three constituent sectors - government, university, and industry - gathered to provide input into four specific meeting tracks or domains. The tracks focused on research and agreements affecting or involving people/human subjects; environmental and natural resources; science, engineering, and manufacturing; and agriculture and animal issues. This report examines each of these domains and the role that culture and cultural expectations may have in the forging and implementation of international research agreements.
Investing in the Health and Well-Being of Young Adults
by Richard J. BonnieYoung adulthood - ages approximately 18 to 26 - is a critical period of development with long-lasting implications for a person's economic security, health and well-being. Young adults are key contributors to the nation's workforce and military services and, since many are parents, to the healthy development of the next generation. Although 'millennials' have received attention in the popular media in recent years, young adults are too rarely treated as a distinct population in policy, programs, and research. Instead, they are often grouped with adolescents or, more often, with all adults. Currently, the nation is experiencing economic restructuring, widening inequality, a rapidly rising ratio of older adults, and an increasingly diverse population. The possible transformative effects of these features make focus on young adults especially important. A systematic approach to understanding and responding to the unique circumstances and needs of today's young adults can help to pave the way to a more productive and equitable tomorrow for young adults in particular and our society at large. "Investing in The Health and Well-Being of Young Adults "describes what is meant by the term young adulthood, who young adults are, what they are doing, and what they need. This study recommends actions that nonprofit programs and federal, state, and local agencies can take to help young adults make a successful transition from adolescence to adulthood. According to this report, young adults should be considered as a separate group from adolescents and older adults. "Investing in The Health and Well-Being of Young Adults" makes the case that increased efforts to improve high school and college graduate rates and education and workforce development systems that are more closely tied to high-demand economic sectors will help this age group achieve greater opportunity and success. The report also discusses the health status of young adults and makes recommendations to develop evidence-based practices for young adults for medical and behavioral health, including preventions. What happens during the young adult years has profound implications for the rest of the life course, and the stability and progress of society at large depends on how any cohort of young adults fares as a whole. "Investing in The Health and Well-Being of Young Adults" will provide a roadmap to improving outcomes for this age group as they transition from adolescence to adulthood.
Characterizing and Communicating Uncertainty in the Assessment of Benefits and Risks of Pharmaceutical Products: Workshop Summary
by Denise CarusoDespite the extensive body of evidence that informs regulatory decisions on pharmaceutical products, significant uncertainties persist, including the underlying variability in human biology, factors associated with the chemistry of a drug, and limitations in the research and clinical trial process itself that might limit the generalizability of results. As a result, regulatory reviewers are consistently required to draw conclusions about a drug's safety and efficacy from imperfect data. Efforts are underway within the drug development community to enhance the evaluation and communication of the benefits and risks associated with pharmaceutical products, aimed at increasing the predictability, transparency, and efficiency of pharmaceutical regulatory decision making. Effectively communicating regulatory decisions necessarily includes explanation of the impact of uncertainty on decision making. On February 12 and May 12, 2014, the Institute of Medicine's Forum on Drug Discovery, Development, and Translation held public workshops to advance the development of more systematic and structured approaches to characterize and communicate the sources of uncertainty in the assessment of benefits and risks, and to consider their implications for pharmaceutical regulatory decisions. Workshop presentations and discussions on February 12 were convened to explore the science of identifying and characterizing uncertainty in scientific evidence and approaches to translate uncertainties into decisions that reflect the values of stakeholders. The May 12 workshop presentations and discussions explored tools and approaches to communicating about scientific uncertainties to a range of stakeholders in the drug development process. "Characterizing and Communicating Uncertainty in the Assessment of Benefits and Risks of Pharmaceutical Products" summarizes the presentation and discussion of both events. This report explores potential analytical and communication approaches and identifies key considerations on their development, evaluation, and incorporation into pharmaceutical benefit- risk assessment throughout the entire drug development lifecycle.
3D Printing in Space
by Committee on Space-Based Additive ManufacturingAdditive manufacturing has the potential to positively affect human spaceflight operations by enabling the in-orbit manufacture of replacement parts and tools, which could reduce existing logistics requirements for the International Space Station and future long-duration human space missions. The benefits of in-space additive manufacturing for robotic spacecraft are far less clear, although this rapidly advancing technology can also potentially enable space-based construction of large structures and, perhaps someday, substantially in the future, entire spacecraft. Additive manufacturing can also help to reimagine a new space architecture that is not constrained by the design and manufacturing confines of gravity, current manufacturing processes, and launch-related structural stresses. The specific benefits and potential scope of additive manufacturing remain undetermined. The realities of what can be accomplished today, using this technology on the ground, demonstrate the substantial gaps between the vision for additive manufacturing in space and the limitations of the technology and the progress that has to be made to develop it for space use. "3D Printing in Space" evaluates the prospects of in-space additive manufacturing. This report examines the various technologies available and currently in development, and considers the possible impacts for crewed space operations and robotic spacecraft operations. Ground-based additive manufacturing is being rapidly developed by industry, and "3D Printing in Space" discusses government-industry investments in technology development. According to this report, the International Space Station provides an excellent opportunity for both civilian and military research on additive manufacturing technology. Additive manufacturing presents potential opportunities, both as a tool in a broad toolkit of options for space-based activities and as a potential paradigm-changing approach to designing hardware for in-space activities. This report makes recommendations for future research, suggests objectives for an additive manufacturing roadmap, and envisions opportunities for cooperation and joint development.
A Framework to Guide Selection of Chemical Alternatives
by Committee on the Design Evaluation of Safer Chemical Substitutions: A Framework to Inform Government Industry DecisionHistorically, regulations governing chemical use have often focused on widely used chemicals and acute human health effects of exposure to them, as well as their potential to cause cancer and other adverse health effects. As scientific knowledge has expanded there has been an increased awareness of the mechanisms through which chemicals may exert harmful effects on human health, as well as their effects on other species and ecosystems. Identification of high-priority chemicals and other chemicals of concern has prompted a growing number of state and local governments, as well as major companies, to take steps beyond existing hazardous chemical federal legislation. Interest in approaches and policies that ensure that any new substances substituted for chemicals of concern are assessed as carefully and thoroughly as possible has also burgeoned. The overarching goal of these approaches is to avoid regrettable substitutions, which occur when a toxic chemical is replaced by another chemical that later proved unsuitable because of persistence, bioaccumulation, toxicity, or other concerns. Chemical alternative assessments are tools designed to facilitate consideration of these factors to assist stakeholders in identifying chemicals that may have the greatest likelihood of harm to human and ecological health, and to provide guidance on how the industry may develop and adopt safer alternatives. A Framework to Guide Selection of Chemical Alternatives develops and demonstrates a decision framework for evaluating potentially safer substitute chemicals as primarily determined by human health and ecological risks. This new framework is informed by previous efforts by regulatory agencies, academic institutions, and others to develop alternative assessment frameworks that could be operationalized. In addition to hazard assessments, the framework incorporates steps for life-cycle thinking - which considers possible impacts of a chemical at all stages including production, use, and disposal - as well as steps for performance and economic assessments. The report also highlights how modern information sources such as computational modeling can supplement traditional toxicology data in the assessment process. This new framework allows the evaluation of the full range of benefits and shortcomings of substitutes, and examination of tradeoffs between these risks and factors such as product functionality, product efficacy, process safety, and resource use. Through case studies, this report demonstrates how different users in contrasting decision contexts with diverse priorities can apply the framework. This report will be an essential resource to the chemical industry, environmentalists, ecologists, and state and local governments.
Identifying the Culprit: Assessing Eyewitness Identification
by Committee on Scientific Approaches to Understanding Maximizing The Validity Reliability of Eyewitness Identification in Law Enforcement the CourtsEyewitnesses play an important role in criminal cases when they can identify culprits. Estimates suggest that tens of thousands of eyewitnesses make identifications in criminal investigations each year. Research on factors that affect the accuracy of eyewitness identification procedures has given us an increasingly clear picture of how identifications are made, and more importantly, an improved understanding of the principled limits on vision and memory that can lead to failure of identification. Factors such as viewing conditions, duress, elevated emotions, and biases influence the visual perception experience. Perceptual experiences are stored by a system of memory that is highly malleable and continuously evolving, neither retaining nor divulging content in an informational vacuum. As such, the fidelity of our memories to actual events may be compromised by many factors at all stages of processing, from encoding to storage and retrieval. Unknown to the individual, memories are forgotten, reconstructed, updated, and distorted. Complicating the process further, policies governing law enforcement procedures for conducting and recording identifications are not standard, and policies and practices to address the issue of misidentification vary widely. These limitations can produce mistaken identifications with significant consequences. What can we do to make certain that eyewitness identification convicts the guilty and exonerates the innocent? "Identifying the Culprit" makes the case that better data collection and research on eyewitness identification, new law enforcement training protocols, standardized procedures for administering line-ups, and improvements in the handling of eyewitness identification in court can increase the chances that accurate identifications are made. This report explains the science that has emerged during the past 30 years on eyewitness identifications and identifies best practices in eyewitness procedures for the law enforcement community and in the presentation of eyewitness evidence in the courtroom. In order to continue the advancement of eyewitness identification research, the report recommends a focused research agenda. "Identifying the Culprit" will be an essential resource to assist the law enforcement and legal communities as they seek to understand the value and the limitations of eyewitness identification and make improvements to procedures.
Investing in Global Health Systems: Sustaining Gains, Transforming Lives
by Gillian J. BuckleyThe United States has been a generous sponsor of global health programs for the past 25 years or more. This investment has contributed to meaningful changes, especially for women and children, who suffer the brunt of the world's disease and disability. Development experts have long debated the relative merits of vertical health programming, targeted to a specific service or patient group, and horizontal programming, supporting more comprehensive care. The U. S. government has invested heavily in vertical programs, most notably through the President's Emergency Plan for AIDS Relief (PEPFAR), its flagship initiative for HIV and AIDS. PEPFAR and programs like it have met with good success. Protecting these successes and continuing progress in the future depends on the judicious integration of vertical programs with local health systems. A strong health system is the best insurance developing countries can have against a disease burden that is shifting rapidly and in ways that history has not prepared us for. Reaching the poor with development assistance is an increasingly complicated task. The majority of the roughly 1 billion people living in dire poverty are in middle-income countries, where foreign assistance is not necessarily needed or welcome. Many of the rest live in fragile states, where political volatility and weak infrastructure make it difficult to use aid effectively. The poorest people in the world are also the sickest; they are most exposed to disease vectors and infection. Nevertheless, they are less likely to access health services. Improving their lot means removing the systemic barriers that keep the most vulnerable people from gaining such access. "Investing in Global Health Systems" discusses the past and future of global health. First, the report gives context by laying out broad trends in global health. Next, it discusses the timeliness of American investment in health systems abroad and explains how functional health systems support health, encourage prosperity, and advance global security. Lastly, it lays out, in broad terms, an effective donor strategy for health, suggesting directions for both the manner and substance of foreign aid given. The challenge of the future of aid programming is to sustain the successes of the past 25 years, while reducing dependence on foreign aid. "Investing in Global Health Systems" aims to help government decision makers assess the rapidly changing social and economic situation in developing countries and its implications for effective development assistance. This report explains how health systems improvements can lead to better health, reduce poverty, and make donor investment in health sustainable.
SBIR at the National Science Foundation
by Committee on Capitalizing on Science Technology Innovation An Assessment Of The Small Busin Program-Phase IIThe Small Business Innovation Research (SBIR) program is one of the largest examples of U. S. public-private partnerships, and was established in 1982 to encourage small businesses to develop new processes and products and to provide quality research in support of the U. S. government’s many missions. The U. S. Congress tasked the National Research Council with undertaking a comprehensive study of how the SBIR program has stimulated technological innovation and used small businesses to meet federal research and development needs, and with recommending further improvements to the program. In the first round of this study, an ad hoc committee prepared a series of reports from 2004 to 2009 on the SBIR program at the five agencies responsible for 96 percent of the program’s operations -- including the National Science Foundation (NSF). Building on the outcomes from the first round, this second round presents the committee’s second review of the NSF SBIR program’s operations. Public-private partnerships like SBIR are particularly important since today's knowledge economy is driven in large part by the nation's capacity to innovate. One of the defining features of the U. S. economy is a high level of entrepreneurial activity. Entrepreneurs in the United States see opportunities and are willing and able to assume risk to bring new welfare-enhancing, wealth-generating technologies to the market. Yet, although discoveries in areas such as genomics, bioinformatics, and nanotechnology present new opportunities, converting these discoveries into innovations for the market involves substantial challenges. The American capacity for innovation can be strengthened by addressing the challenges faced by entrepreneurs.
Integrating Research and Practice: Workshop Summary
by Joe AlperHealth care has been called one of the most complex sectors of the U. S. economy. Driven largely by robust innovation in treatments and interventions, this complexity has created an increased need for evidence about what works best for whom in order to inform decisions that lead to safe, efficient, effective, and affordable care. As health care becomes more digital, clinical datasets are becoming larger and more numerous. By realizing the potential of knowledge generation that is more closely integrated with the practice of care, it should be possible not only to produce more usable evidence to inform decisions, but also to increase the efficiency and decrease the costs of doing clinical research. Patient-Centered Clinical Research Network, or PCORnet, is a nation-wide patient-centered clinical research network intended to form a resource of clinical, administrative, and patient data that can be used to carry out observational and interventional research studies and enhance the use of clinical data to advance the learning health care system. The primary goal of the first phase of PCORnet will be to establish the data infrastructure necessary to do such research. In April and June 2014 the Institute of Medicine's Roundtable on Value and Science-Driven Health Care convened two workshops aimed at accelerating progress toward real-time knowledge generation through the seamless integration of clinical practice and research, one of the fundamental concepts of a continuously learning health system, centered on the development of the PCORnet. The first workshop brought together health care system leaders, both administrative and clinical, and researchers to consider issues and strategic priorities for building a successful and durable clinical research network and facilitate progress toward a continuously learning health care system more broadly, including issues related to science, technology, ethics, business, regulatory oversight, sustainability, and governance. The second workshop focused on implementation approaches. Health system CEOs convened to consider strategic priorities and explore approaches to implementation. These workshops will inform the decisions of field leaders moving forward, including PCORI, the PCORnet steering committee, and PCORnet grantees. Integrating Research and Practice is the summary of the presentations and discussions of the workshops.
The Role and Potential of Communities in Population Health Improvement: Workshop Summary
by Theresa Wizemann"The Role and Potential of Communuties in Population Health Improvement" is the summary of a workshop held by the Institute of Medicine Roundtable on Population Health Improvement in April 2014 that featured invited speakers from community groups that have taken steps to improve the health of their communities. Speakers from communities across the United States discussed the potential roles of communities for improving population health. The workshop focused on youth organizing, community organizing or other types of community participation, and partnerships between community and institutional actors. This report explores the roles and potential of the community as leaders, partners, and facilitators in transforming the social and environmental conditions that shape health and well-being at the local level.
Promising and Best Practices in Total Worker Health: Workshop Summary
by Victoria WeisfeldCombined with the more traditional employer occupational safety and health protection activities are newer employment-based programs to promote better health through helping workers quit smoking, lose weight, reduce stress, or exercise more regularly. In support of these efforts, some employers have made changes in their policies and facilities to support physical activity and healthier eating, and some employers connect with community resources for health education, health fairs, and other services. This diverse array of activities most typically has been planned, managed, and assessed - to the extent they exist in the workplace at all - by different, often uncoordinated departments within the business entity. Some employers have reconceptualized their safety, prevention, and promotion initiatives and attempted to bring them together into a coherent whole. The National Institute for Occupational Safety and Health (NIOSH) has supported this integration, defining Total Worker Health as "a strategy integrating occupational safety and health protection with health promotion to prevent worker injury and illness and to advance health and well-being. " In May 2014, with support from NIOSH, the Institute of Medicine organized a workshop on Total Worker Health. Rather than a review of published literature, this workshop sought input from a wide variety of on-the-ground stakeholders regarding their experiences with integrating occupational safety and health protection with health promotion in the workplace. Promising and Best Practices in Total Worker Health is the summary of the discussions and presentations of the event. This report identifies prevalent and best practices in programs that integrate occupational safety and health protection with health promotion in small, medium, and large workplaces; employer and employee associations; academia; government agencies; and other stakeholder groups.
Space Studies Board Annual Report 2019
by National Academies of Sciences, Engineering, and Medicine Division on Engineering and Physical Sciences Space Studies BoardThe Space Studies Board (SSB) is a unit of the Division on Engineering and Physical Sciences of the National Academies of Sciences, Engineering, and Medicine. SSB provides an independent, authoritative forum for information and advice on all aspects of space science and applications and serves as the focal point within the National Academies for activities on space research. Space Studies Board Annual Report 2019 describes the projects and activities of SSB; explains the SSB's collaboration with other National Academies of Sciences, Engineering, and Medicine units; and assures the quality of the SSB reports.