- Table View
- List View
Exploring Lessons Learned from a Century of Outbreaks: Readiness For 2030: Proceedings Of A Workshop
by National Academies of Sciences Engineering MedicineIn November 2018, an ad hoc planning committee at the National Academies of Sciences, Engineering, and Medicine planned two sister workshops held in Washington, DC, to examine the lessons from influenza pandemics and other major outbreaks, understand the extent to which the lessons have been learned, and discuss how they could be applied further to ensure that countries are sufficiently ready for future pandemics. This publication summarizes the presentations and discussions from both workshops.
Report 3 on Tracking and Assessing Governance and Management Reform in the Nuclear Security Enterprise
by National Academy of Public AdministrationThe congressionally mandated report A New Foundation for the Nuclear Enterprise (the "Augustine-Mies" report), released in November 2014, concluded that "the existing governance structures and many of the practices of the [nuclear security] enterprise are inefficient and ineffective, thereby putting the entire enterprise at risk over the long term." Following the release of the Augustine-Mies report, the National Defense Authorization Act for Fiscal Year 2016 called for DOE to develop an implementation plan for responding to the recommendations in that and similar reports. The NDAA also called for a 4 1⁄2-year study, joint between the National Academies of Sciences, Engineering, and Medicine and the National Academy of Public Administration, to evaluate the implementation plan, to track the actions proposed in that plan, and to assess progress. This report is the third in a series of reports to be issued over 2017–2020 as part of that study.
Traumatic Brain Injury: A Roadmap For Accelerating Progress
by National Academies of Sciences, Engineering, and Medicine Health and Medicine Division Board on Health Care Services Board on Health Sciences Policy Committee on Accelerating Progress in Traumatic Brain Injury Research and CareEvery community is affected by traumatic brain injury (TBI). Causes as diverse as falls, sports injuries, vehicle collisions, domestic violence, and military incidents can result in injuries across a spectrum of severity and age groups. Just as the many causes of TBI and the people who experience it are diverse, so too are the physiological, cognitive, and behavioral changes that can occur following injury. The overall TBI ecosystem is not limited to healthcare and research, but includes the related systems that administer and finance healthcare, accredit care facilities, and provide regulatory approval and oversight of products and therapies. TBI also intersects with the wide range of community organizations and institutions in which people return to learning, work, and play, including the education system, work environments, professional and amateur sports associations, the criminal justice system, and others. Traumatic Brain Injury: A Roadmap for Accelerating Progress examines the current landscape of basic, translational, and clinical TBI research and identifies gaps and opportunities to accelerate research progress and improve care with a focus on the biological, psychological, sociological, and ecological impacts. This report calls not merely for improvement, but for a transformation of attitudes, understanding, investments, and care systems for TBI.
Reducing Impacts of Food Loss and Waste: Proceedings Of A Workshop
by Engineering Medicine National Academies of SciencesEven as malnutrition in the form of hunger and obesity affect the health and well-being of millions of people worldwide, a significant amount of food is lost or wasted every day, in every country, and at every stage in the supply chain from the farm to the household. According to a 2011 estimate by the Food and Agriculture Organization of the United Nations (FAO), about one-third of food produced is lost or wasted globally. Beyond quantity estimates, however, less is known about the impacts on farmers, food prices, food availability, and environment of reducing food loss and waste. On October 17, 2018, the National Academies of Sciences, Engineering, and Medicine organized a workshop to examine key challenges that arise in reducing food loss and waste throughout the supply chain and discussed potential ways to address these challenges. This publication summarizes the presentations and discussions from the workshop.
School Success: An Opportunity For Population Health: Proceedings Of A Workshop
by National Academies of Sciences, Engineering, and Medicine Health and Medicine Division Board on Population Health and Public Health Practice Roundtable on Population Health ImprovementEducation and health care significantly influence well-being and health outcomes, especially throughout adolescence. In fact, doctors note that performance in school is highly reflective of a child's current and future health. Despite knowledge of this connection, pediatricians are rarely aware of their patients' school performance and have a limited understanding of the education system. Fostering collaboration and aligning efforts within the health and education sectors is a critical step towards building stronger and healthier communities. On June 14, 2018, the National Academies convened a workshop to discuss how efforts within the health sector can support children's education from pre-kindergarten through 12th grade and to explore the barriers between these sectors. The committee also examined case examples of health-education collaboration and opportunities in policy. This publication summarizes the presentations and discussions from the workshop.
Improving Cancer Diagnosis and Care: Clinical Application Of Computational Methods In Precision Oncology: Proceedings Of A Workshop
by National Academies of Sciences Engineering MedicineA hallmark of high-quality cancer care is the delivery of the right treatment to the right patient at the right time. Precision oncology therapies, which target specific genetic changes in a patient’s cancer, are changing the nature of cancer treatment by allowing clinicians to select therapies that are most likely to benefit individual patients. In current clinical practice, oncologists are increasingly formulating cancer treatment plans using results from complex laboratory and imaging tests that characterize the molecular underpinnings of an individual patient’s cancer. These molecular fingerprints can be quite complex and heterogeneous, even within a single patient. To enable these molecular tumor characterizations to effectively and safely inform cancer care, the cancer community is working to develop and validate multiparameter omics tests and imaging tests as well as software and computational methods for interpretation of the resulting datasets. To examine opportunities to improve cancer diagnosis and care in the new precision oncology era, the National Cancer Policy Forum developed a two-workshop series. The first workshop focused on patient access to expertise and technologies in oncologic imaging and pathology and was held in February 2018. The second workshop, conducted in collaboration with the Board on Mathematical Sciences and Analytics, was held in October 2018 to examine the use of multidimensional data derived from patients with cancer, and the computational methods that analyze these data to inform cancer treatment decisions. This publication summarizes the presentations and discussions from the second workshop.
Advancing Progress in the Development of Combination Cancer Therapies with Immune Checkpoint Inhibitors: Proceedings Of A Workshop
by National Academies of Sciences Engineering MedicineIn recent years, significant progress has been made in the clinical development and use of various types of cancer immunotherapy, all of which rely on the immune system to fight cancer. The majority of new cancer drug applications submitted to the Food and Drug Administration (FDA) are for immunotherapies or combinations involving immunotherapies. One type of immunotherapy is an immune checkpoint inhibitor. Cells in the human body have proteins that regulate the immune system response to foreign invaders (e.g., cancer cells, microorganisms). However, cancer cells can coopt these “checkpoint” proteins and thwart the immune system’s ability to recognize and attack cancer cells. To help promote an immune response to cancer, researchers have developed immune checkpoint inhibitors that enable T-cells to recognize cancer cells as foreign and to prevent deactivation of an immune system response. To examine the challenges and opportunities to develop combination cancer therapies that include immune checkpoint inhibitors, the National Cancer Policy Forum held a workshop on July 16–17, 2018, in Washington, DC. This workshop convened stakeholders with a broad range of expertise, including cancer researchers, clinicians, patient advocates, and representatives from industry, academia, and government. This publication summarizes the presentations and discussions from the workshop.
The Role of Nonpharmacological Approaches to Pain Management: Proceedings Of A Workshop
by National Academies of Sciences Engineering MedicinePain is a leading cause of disability globally. The dramatic increase in opioid prescriptions within the past decade in the United States has contributed to the opioid epidemic the country currently faces, magnifying the need for longer term solutions to treat pain. The substantial burden of pain and the ongoing opioid crisis have attracted increased attention in medical and public policy communities, resulting in a revolution in thinking about how pain is managed. This new thinking acknowledges the complexity and biopsychosocial nature of the pain experience and the need for multifaceted pain management approaches with both pharmacological and nonpharmacological therapies. The magnitude and urgency of the twin problems of chronic pain and opioid addiction, combined with the changing landscape of pain management, prompted the National Academies of Sciences, Engineering, and Medicine to convene a workshop on December 4–5, 2018, in Washington, DC. The workshop brought together a diverse group of stakeholders to discuss the current status of nonpharmacological approaches to pain management, gaps, and future directions. This publication summarizes the presentations and discussions from the workshop.
Strengthening the Connection Between Health Professions Education and Practice: Proceedings Of A Joint Workshop
by National Academies of Sciences Engineering MedicineOn November 13 and 14, 2018, members of the National Academies of Sciences, Engineering, and Medicine’s Global Forum on Innovation in Health Professional Education participated in a joint workshop with affiliates of the National Center for Interprofessional Practice and Education. The workshop participants explored the intersection of health professions education and practice. Both sectors are working toward the same goal of improving the health of patients and populations, without compromising the mental stability and wellbeing of the workforce or its learners. However, while education and practice have the same goal, there is a need for greater alignment between the sectors to more fully realize these desired outcomes. For example, educators, practitioners, and administrators must learn to adapt and respond to the growing role of technology within a wider context, in order to most effectively apply higher education within health systems. This publication summarizes the presentations and discussions from the workshop.
A Health Equity Approach to Obesity Efforts: Proceedings Of A Workshop
by National Academies of Sciences Engineering MedicineThe obesity crisis in the United States disproportionately affects some demographic groups more than others. Contextual influences on obesity are complex and include an individual's weight-related behaviors and outcomes, the intermediate variables that influence these behaviors and outcomes, and broader, upstream historical, social, economic, physical, and policy contexts. The National Academies convened a workshop on April 1, 2019 to explore the history of health equity issues in demographic groups that have above-average obesity risk and to consider principles and approaches to address these issues as part of obesity prevention and treatment efforts. This publication summarizes the presentations and discussions from the workshop.
A Class Approach to Hazard Assessment of Organohalogen Flame Retardants
by National Academies of Sciences Engineering MedicineIn the 1970s, flame retardants began to be added to synthetic materials to meet strict flammability standards. Over the years, diverse flame retardants have been manufactured and used in various products. Some flame retardants have migrated out of the products, and this has led to widespread human exposure and environmental contamination. There also is mounting evidence that many flame retardants are associated with adverse human health effects. As a result, some flame retardants have been banned, restricted, or voluntarily phased out of production and use. This publication develops a scientifically based scoping plan to assess additive, nonpolymeric organohalogen flame retardants as a class for potential chronic health hazards under the Federal Hazardous Substances Act, including cancer, birth defects, and gene mutations.
Strategic Long-Term Participation by DoD in Its Manufacturing USA Institutes: Proceedings Of A Workshop
by National Academies of Sciences Engineering MedicineTo effectively mature and transition DoD manufacturing science and technology advances into production, DoD must have access to a robust and responsive U.S. industrial base which is often driven by advanced manufacturing technologies. The Manufacturing USA institutes are considered crucial and game-changing catalysts that are bringing together innovative ecosystems in various technology and market sectors critical to DoD and the nation. Since 2012, DoD has invested $600 million directly in its Manufacturing USA institutes with the understanding that the initial federal investment included (1) core funding and (2) one-time, start-up funding to establish the institutes within a period of 5 to 7 years. As the institutes now begin to reach year five, DoD is evaluating the effectiveness of the institutes in fulfilling their goals and the best on-going roles for the federal government, including on-going funding options, to ensure optimal benefit to U.S. competitiveness. This report reviews the role of DoD’s investment to date in establishing its eight institutes as public–private partnerships and its engagement with each institute after it has matured beyond the start-up period.
Cryptography and the Intelligence Community: The Future Of Encryption
by National Academies of Sciences, Engineering, and Medicine Division on Engineering and Physical SciencesEncryption is a process for making information unreadable by an adversary who does not possess a specific key that is required to make the encrypted information readable. The inverse process, making information that has been encrypted readable, is referred to as decryption. Cryptography has become widespread and is used by private as well as governmental actors. It also enables authentication and underlies the safe use of the Internet and computer systems by individuals and organizations worldwide. Emerging cryptographic technologies offer capabilities such as the ability to process encrypted information without first decrypting it. At the request of the Office of the Director of National Intelligence, this report identifies potential scenarios that would describe the balance between encryption and decryption over the next 10 to 20 years and assesses the national security and intelligence implications of each scenario. For each of these scenarios, Cryptography and the Intelligence Community identifies risks, opportunities, and actions. Attention to the findings should enable the Intelligence Community to prepare for the future and to recognize emerging trends and developments and respond appropriately.
Beyond Spectre: Confronting New Technical and Policy Challenges: Proceedings of a Workshop
by National Academies of Sciences Engineering MedicineIn 2017, researchers discovered a vulnerability in microprocessors used in computers and devices all over the world. The vulnerability, named Spectre, combines side effects from caching and speculative execution, which are techniques that have been used for many years to increase the speed at which computers operate. The discovery upends a number of common assumptions about cybersecurity and draws attention to the complexities of the global supply chain and global customer base for the vast range of devices and cloud capabilities that all computer users rely on. In October 2018, the Forum on Cyber Resilience hosted a workshop to explore the implications of this development. This publication summarizes the presentations and discussions from the workshop.
2017-2018 Assessment of the Army Research Laboratory: Interim Report
by National Academies of Sciences Engineering MedicineThe Army Research Laboratory (ARL) is the corporate laboratory for the U.S. army, which bridges scientific and military communities. The ARL is critical in maintaining the United States’ dominant military power through its advanced research and analysis capabilities. The National Academies of Sciences, Engineering, and Medicine's Army Research Laboratory Technical Assessment Board (ARLTAB) conducts biennial assessments of the scientific and technical quality of the facilities. These assessments are necessary to ensure that the ARL’s resources and quality of programs are maximized. 2017-2018 Assessment of the Army Research Laboratory includes findings and recommendations regarding the quality of the ARL’s research, development, and analysis programs. The report of the assessment is subdivided by the ARL’s Science and Technology campaigns, including Materials Research, Sciences for Lethality and Protection, Information Sciences, Computational Sciences, Sciences for Maneuver, Human Sciences, and Analysis and Assessment. This biennial report summarizes the findings for the 2017-2018 period.
Revisiting the Manufacturing USA Institutes: Proceedings Of A Workshop
by National Academies of Sciences Engineering MedicineThe Manufacturing USA initiative seeks to reinforce U.S.-based advanced manufacturing through partnerships among industry, academia, and government. Started in 2012 and established with bipartisan support by the Revitalize American Manufacturing and Innovation Act of 2014, the initiative envisages a nationwide network of research centers for manufacturing innovation. Some 14 manufacturing innovation institutes have been established to facilitate the movement of early-stage research into proven capabilities ready for adoption by U.S. manufacturers. To better understand the role and experiences of the Manufacturing USA institutes, a committee of the National Academies of Sciences, Engineering, and Medicine convened a workshop on May 23, 2017 drawing together institute directors and manufacturing policy experts along with leaders from industry, academia, and government. Given the continued prominence of enhancing domestic manufacturing and international competitiveness in public policy discussions, the National Academies convened a second workshop on November 14, 2018, to monitor the progress of the Manufacturing USA institutes. This publication summarizes the presentations and discussions from this second workshop.
A Research Agenda for Transforming Separation Science
by National Academies of Sciences Engineering MedicineSeparation science plays a critical role in maintaining our standard of living and quality of life. Many industrial processes and general necessities such as chemicals, medicines, clean water, safe food, and energy sources rely on chemical separations. However, the process of chemical separations is often overlooked during product development and this has led to inefficiency, unnecessary waste, and lack of consensus among chemists and engineers. A reevaluation of system design, establishment of standards, and an increased focus on the advancement of separation science are imperative in supporting increased efficiency, continued U.S. manufacturing competitiveness, and public welfare. A Research Agenda for Transforming Separation Science explores developments in the industry since the 1987 National Academies report, Separation and Purification: Critical Needs and Opportunities. Many needs stated in the original report remain today, in addition to a variety of new challenges due to improved detection limits, advances in medicine, and a recent emphasis on sustainability and environmental stewardship. This report examines emerging chemical separation technologies, relevant developments in intersecting disciplines, and gaps in existing research, and provides recommendations for the application of improved separation science technologies and processes. This research serves as a foundation for transforming separation science, which could reduce global energy use, improve human and environmental health, and advance more efficient practices in various industries.
Understanding Northern Latitude Vegetation Greening and Browning: Proceedings of a Workshop
by National Academies of Sciences Engineering MedicineVegetation change has been observed across Arctic and boreal regions. Studies have often documented large-scale greening trends, but they have also identified areas of browning or shifts between greening and browning over varying spatial extents and time periods. At the same time, though, there are large portions of these ecosystems that have not exhibited measurable trends in greening or browning. These findings have fueled many questions about the drivers of vegetation dynamics, how trends are measured, and potential implications of vegetation change at local to global scales. In December 2018, the National Academies of Sciences, Engineering, and Medicine, convened a workshop to discuss opportunities to improve understanding of greening and browning trends and drivers and the implications of these vegetation changes. The discussions included a close look at many of the methodological approaches used to evaluate greening and browning, as well as exploration of newer technologies that may help advance the science. This publication summarizes the presentations and discussions from the workshop.
A Decision Framework for Interventions to Increase the Persistence and Resilience of Coral Reefs
by National Academies of Sciences Engineering MedicineCoral reefs are critical to ocean and human life because they provide food, living area, storm protection, tourism income, and more. However, human-induced stressors, such as overfishing, sediment, pollution, and habitat destruction have threatened ocean ecosystems globally for decades. In the face of climate change, these ecosystems now face an array of unfamiliar challenges due to destructive rises in ocean temperature, acidity and sea level. These factors lead to an increased frequency of bleaching events, hindered growth, and a decreasing rate of calcification. Research on interventions to combat these relatively new stressors and a reevaluation of longstanding interventions is necessary to understand and protect coral reefs in this changing climate. Previous research on these methods prompts further questions regarding the decision making process for site-specific interventions. A Decision Framework for Interventions to Increase the Persistence and Resilience of Coral Reefs builds upon a previous report that reviews the state of research on methods that have been used, tested, or proposed to increase the resilience of coral reefs. This new report aims to help coral managers evaluate the specific needs of their site and navigate the 23 different interventions described in the previous report. A case study of the Caribbean, a region with low coral population plagued by disease, serves as an example for coral intervention decision making. This report provides complex coral management decision making tools, identifies gaps in coral biology and conservation research, and provides examples to help individuals and communities tailor a decision strategy to a local area.
Assessment of the Information Sciences Directorate at the Army Research Office
by National Academies of Sciences Engineering MedicineThis report summarizes the 2018 findings of the Panel on Review of Extramural Basic Research at the Army Research Laboratory, which reviewed the programs at the Army Research Office’s Information Sciences Directorate.
Pain Management for People with Serious Illness in the Context of the Opioid Use Disorder Epidemic: Proceedings Of A Workshop
by National Academies of Sciences Engineering MedicineThe United States is facing an opioid use disorder epidemic with opioid overdoses killing 47,000 people in the U.S. in 2017. The past three decades have witnessed a significant increase in the prescribing of opioids for pain, based on the belief that patients were being undertreated for their pain, coupled with a widespread misunderstanding of the addictive properties of opioids. This increase in prescribing of opioids also saw a parallel increase in addiction and overdose. In an effort to address this ongoing epidemic of opioid misuse, policy and regulatory changes have been enacted that have served to limit the availability of prescription opioids for pain management. Overlooked amid the intense focus on efforts to end the opioid use disorder epidemic is the perspective of clinicians who are experiencing a significant amount of daily tension as opioid regulations and restrictions have limited their ability to treat the pain of their patients facing serious illness. Increased public and clinician scrutiny of opioid use has resulted in patients with serious illness facing stigma and other challenges when filling prescriptions for their pain medications or obtaining the prescription in the first place. Thus clinicians, patients, and their families are caught between the responses to the opioid use disorder epidemic and the need to manage pain related to serious illness. The National Academies of Sciences, Engineering, and Medicine sponsored a workshop on November 29, 2018, to examine these unintended consequences of the responses to the opioid use disorder epidemic for patients, families, communities, and clinicians, and to consider potential policy opportunities to address them. This publication summarizes the presentations and discussions from the workshop.
Guiding Cancer Control: A Path To Transformation
by National Academies of Sciences Engineering MedicineThroughout history, perhaps no other disease has generated the level of social, scientific, and political discourse or has had the degree of cultural significance as cancer. A collective in the truest sense of the word, “cancer” is a clustering of different diseases that afflict individuals in different ways. Its burdens are equally broad and diverse, from the physical, financial, and psychological tolls it imposes on individuals to the costs it inflicts upon the nation’s clinical care and public health systems, and despite decades of concerted efforts often referred to as the “war on cancer”, those costs have only continued to grow over time. The causes and effects of cancer are complex—in part preventable and treatable, but also in part unknown, and perhaps even unknowable. Guiding Cancer Control defines the key principles, attributes, methods, and tools needed to achieve the goal of implementing an effective national cancer control plan. This report describes the current structure of cancer control from a local to global scale, identifies necessary goals for the system, and formulates the path towards integrated disease control systems and a cancer-free future. This framework is a crucial step in establishing an effective, efficient, and accountable system for controlling cancer and other diseases.
Offshore Well Completion and Stimulation: Using Hydraulic Fracturing And Other Technologies: Proceedings Of A Workshop
by National Academies of Sciences Engineering MedicineWhile the public is generally aware of the use of hydraulic fracturing for unconventional resource development onshore, it is less familiar with the well completion and stimulation technologies used in offshore operations, including hydraulic fracturing, gravel packs, “fracpacks,” and acid stimulation. Just as onshore technologies have improved, these well completion and stimulation technologies for offshore hydrocarbon resource development have progressed over many decades. To increase public understanding of these technologies, the National Academies of Sciences, Engineering, and Medicine established a planning committee to organize and convene a workshop on Offshore Well Completion and Stimulation: Using Hydraulic Fracturing and Other Technologies on October 2-3, 2017, in Washington, DC. This workshop examined the unique features about operating in the U.S. offshore environment, including well completion and stimulation technologies, environmental considerations and concerns, and health and safety management. Participants from across government, industry, academia, and nonprofit sectors shared their perspectives on operational and regulatory approaches to mitigating risks to the environment and to humans in the development of offshore resources. This publication summarizes the presentations and discussions from the workshop.
Thriving on Our Changing Planet: A Decadal Strategy for Earth Observation from Space: An Overview for Decision Makers and the Public
by National Academies of Sciences Engineering MedicineWe live on a dynamic Earth shaped by both natural processes and the impacts of humans on their environment. It is in our collective interest to observe and understand our planet, and to predict future behavior to the extent possible, in order to effectively manage resources, successfully respond to threats from natural and human-induced environmental change, and capitalize on the opportunities – social, economic, security, and more – that such knowledge can bring. By continuously monitoring and exploring Earth, developing a deep understanding of its evolving behavior, and characterizing the processes that shape and reshape the environment in which we live, we not only advance knowledge and basic discovery about our planet, but we further develop the foundation upon which benefits to society are built. Thriving on Our Changing Planet: A Decadal Strategy for Earth Observation from Space (National Academies Press, 2018) provides detailed guidance on how relevant federal agencies can ensure that the United States receives the maximum benefit from its investments in Earth observations from space, while operating within realistic cost constraints. This short booklet, designed to be accessible to the general public, provides a summary of the key ideas and recommendations from the full decadal survey report.
Strategic Long-Term Participation by DoD in Its Manufacturing USA Institutes: Proceedings Of A Workshop
by National Academies of Sciences Engineering MedicineThe U.S. Department of Defense (DoD) Manufacturing USA Institutes aim to protect national security and increase U.S. competitiveness in manufacturing. The domestic industrial base is critical to supporting and sustaining both military advantage and economic competitiveness. Through these institutes, the DoD is committed to domestically designing and manufacturing the most innovative defense systems. Intended as intensely collaborative applied research and development endeavors among government, industry, and academia, the institutes are envisioned to become lasting, self-sustaining national assets. A long-term strategy is needed to achieve this goal. The National Academies of Sciences, Engineering, and Medicine recently convened a workshop to discuss the long-term sustainability of the Manufacturing USA Institutes. Participants explored different perspectives across multiple disciplines, discussed public-private partnership models, and considered international programs in advanced manufacturing to inform their recommendations regarding the future of the institutes. This publication summarizes the presentations and discussions from the workshop.