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Exploring Strategies to Improve Cardiac Arrest Survival: Proceedings of a Workshop
by National Academies of Sciences Engineering MedicineCardiac arrest often strikes seemingly healthy individuals without warning and without regard to age, gender, race, or health status. Representing the third leading cause of death in the United States, cardiac arrest is defined as “a severe malfunction or cessation of the electrical and mechanical activity of the heart ... [which] results in almost instantaneous loss of consciousness and collapse†. Although the exact number of cardiac arrests is unknown, conservative estimates suggest that approximately 600,000 individuals experience a cardiac arrest in the United States each year. In June 2015, the Institute of Medicine (IOM) released its consensus report Strategies to Improve Cardiac Arrest Survival: A Time to Act, which evaluated the factors affecting resuscitation research and outcomes in the United States. Following the release of this report, the National Academies of Sciences, Engineering, and Medicine was asked to hold a workshop to explore the barriers and opportunities for advancing the IOM recommendations. This publication summarizes the presentations and discussions from the workshop.
Preparing for Future Products of Biotechnology
by National Academies of Sciences Engineering MedicineBetween 1973 and 2016, the ways to manipulate DNA to endow new characteristics in an organism (that is, biotechnology) have advanced, enabling the development of products that were not previously possible. What will the likely future products of biotechnology be over the next 5–10 years? What scientific capabilities, tools, and/or expertise may be needed by the regulatory agencies to ensure they make efficient and sound evaluations of the likely future products of biotechnology? Preparing for Future Products of Biotechnology analyzes the future landscape of biotechnology products and seeks to inform forthcoming policy making. This report identifies potential new risks and frameworks for risk assessment and areas in which the risks or lack of risks relating to the products of biotechnology are well understood.
The Role of Science, Technology, Innovation, and Partnerships in the Future of USAID
by National Academies of Sciences Engineering MedicineThe United States has long recognized that the nation’s prosperity and security depend on how we address challenges of disasters, poverty, famine, and disease around the world. The U.S. Agency for International Development (USAID) has played a vital role in promoting U.S. national and international interests by advancing strategies for employing science, technology, and innovation to respond to global challenges. The focus by USAID on science, technology, and innovation is critical to improve development outcomes. At the core of this progress is the engagement of science institutions and other innovative enterprises and their commitment to work in partnership with USAID to research, test, and scale solutions. The Role of Science, Technology, Innovation, and Partnerships in the Future of USAID provides an assessment and advice on the current and future role for science, technology, and innovation in assistance programs at USAID and on the role of partnerships in the public and private sectors to expand impact. This report examines challenges and opportunities for USAID in expanding the utilization of science, technology, and innovation in development assistance; assesses how USAID has deployed science, technology, and innovation; and recommends priority areas for improvement going forward in partnership with others.
Controlled Human Inhalation-Exposure Studies at EPA
by Engineering Medicine National Academies of SciencesThe U.S. Environmental Protection Agency (EPA) has a mission and regulatory responsibility to protect human health and the environment. EPA’s pursuit of that goal includes a variety of research activities involving human subjects, such as epidemiologic studies and surveys. Those research activities also involve studies of individuals who volunteer to be exposed to air pollutants intentionally in controlled laboratory settings so that measurements can be made of transient and reversible biomarker or physiologic responses to those exposures that can indicate pathways of toxicity and mechanisms of air-pollution responses. The results of those controlled human inhalation exposure (CHIE) studies, also referred to as human clinical studies or human challenge studies, are used to inform policy decisions and help establish or revise standards to protect public health and improve air quality. Controlled Human Inhalation-Exposure Studies at EPA addresses scientific issues and provides guidance on the conduct of CHIE studies. This report assesses the utility of CHIE studies to inform and reduce uncertainties in setting air-pollution standards to protect public health and assess whether continuation of such studies is warranted. It also evaluates the potential health risks to test subjects who participated in recent studies of air pollutants at EPA’s clinical research facility.
Assessment of Solid-State Lighting, Phase Two
by National Academies of Sciences Engineering MedicineThe standard incandescent light bulb, which still works mainly as Thomas Edison invented it, converts more than 90% of the consumed electricity into heat. Given the availability of newer lighting technologies that convert a greater percentage of electricity into useful light, there is potential to decrease the amount of energy used for lighting in both commercial and residential applications. Although technologies such as compact fluorescent lamps (CFLs) have emerged in the past few decades and will help achieve the goal of increased energy efficiency, solid-state lighting (SSL) stands to play a large role in dramatically decreasing U.S. energy consumption for lighting. Since the publication of the 2013 National Research Council report Assessment of Advanced Solid-State Lighting, the penetration of SSL has increased dramatically, with a resulting savings in energy and costs that were foreshadowed by that study. What was not anticipated then is the dramatic dislocation and restructuring of the SSL marketplace, as cost reductions for light-emitting diode (LED) components reduced profitability for LED manufacturers. At the same time, there has been the emergence of new applications for SSL, which have the potential to create new markets and commercial opportunities for the SSL industry. Assessment of Solid-State Lighting, Phase Two discusses these aspects of change—highlighting the progress of commercialization and acceptance of SSL and reviewing the technical advances and challenges in achieving higher efficacy for LEDs and organic light-emitting diodes. This report will also discuss the recent trends in SSL manufacturing and opportunities for new applications and describe the role played by the Department of Energy (DOE) Lighting Program in the development of SSL.
Flowback and Produced Waters: Proceedings of a Workshop
by National Academies of Sciences Engineering MedicineProduced water—water from underground formations that is brought to the surface during oil and gas production—is the greatest volume byproduct associated with oil and gas production. It is managed by some combination of underground injection, treatment and subsequent use, treatment and discharge, or evaporation, subject to compliance with state and federal regulations. Management of these waters is challenging not only for industry and regulators, but also for landowners and the public because of differences in the quality and quantity of produced water, varying infrastructure needs, costs, and environmental considerations associated with produced water disposal, storage, and transport. Unconventional oil and gas development involves technologies that combine horizontal drilling with the practice of hydraulic fracturing. Hydraulic fracturing is a controlled, high-pressure injection of fluid and proppant into a well to generate fractures in the rock formation containing the oil or gas. After the hydraulic fracture procedure is completed, the injected fluid is allowed to flow back into the well, leaving the proppant in the newly created fractures. As a result, a portion of the injected water returns to the surface and this water is called “flowback water” which initially may mix with the naturally occurring produced water from the formation. The chemistry and volume of water returning to the surface from unconventional oil and gas operations thus changes during the lifetime of the well due to the amount of fluid used in the initial stage of well development, the amount of water naturally occurring in the geologic formation, the original water and rock chemistry, the type of hydrocarbon being produced, and the way in which production is conducted. The volume and composition of flowback and produced waters vary with geography, time, and site-specific factors. A workshop was conducted by the National Academies of Sciences, Engineering, and Medicine to highlight the challenges and opportunities associated in managing produced water from unconventional hydrocarbon development, and particularly in the area of potential beneficial uses for these waters. This publication summarizes the presentations and discussions from the workshop.
Service-Learning in Undergraduate Geosciences: Proceedings of a Workshop
by National Academies of Sciences Engineering MedicineThe term “service-learning” generally refers to projects planned as components of academic coursework in which students use knowledge and skills taught in the course to address real needs in their communities. This kind of learning experience, which allows students to focus on critical, reflective thinking and civic responsibility, has become an increasingly popular component of undergraduate science education. In April 2016, the National Academies of Sciences, Engineering, and Medicine planned a workshop to explore the current and potential role of service-learning in undergraduate geosciences education. Participants explored how service learning is being used in geoscience education, its potential benefits, and the strength of the evidence base regarding the nature and benefits of these experiences. This publication summarizes the presentations and discussions from the workshop.
Undergraduate Research Experiences for STEM Students: Successes, Challenges, and Opportunities
by National Academies of Sciences Engineering MedicineUndergraduate research has a rich history, and many practicing researchers point to undergraduate research experiences (UREs) as crucial to their own career success. There are many ongoing efforts to improve undergraduate science, technology, engineering, and mathematics (STEM) education that focus on increasing the active engagement of students and decreasing traditional lecture-based teaching, and UREs have been proposed as a solution to these efforts and may be a key strategy for broadening participation in STEM. In light of the proposals questions have been asked about what is known about student participation in UREs, best practices in UREs design, and evidence of beneficial outcomes from UREs. Undergraduate Research Experiences for STEM Students provides a comprehensive overview of and insights about the current and rapidly evolving types of UREs, in an effort to improve understanding of the complexity of UREs in terms of their content, their surrounding context, the diversity of the student participants, and the opportunities for learning provided by a research experience. This study analyzes UREs by considering them as part of a learning system that is shaped by forces related to national policy, institutional leadership, and departmental culture, as well as by the interactions among faculty, other mentors, and students. The report provides a set of questions to be considered by those implementing UREs as well as an agenda for future research that can help answer questions about how UREs work and which aspects of the experiences are most powerful.
Human Genome Editing: Science, Ethics, and Governance
by National Academies of Sciences Engineering MedicineGenome editing is a powerful new tool for making precise alterations to an organism’s genetic material. Recent scientific advances have made genome editing more efficient, precise, and flexible than ever before. These advances have spurred an explosion of interest from around the globe in the possible ways in which genome editing can improve human health. The speed at which these technologies are being developed and applied has led many policymakers and stakeholders to express concern about whether appropriate systems are in place to govern these technologies and how and when the public should be engaged in these decisions. Human Genome Editing considers important questions about the human application of genome editing including: balancing potential benefits with unintended risks, governing the use of genome editing, incorporating societal values into clinical applications and policy decisions, and respecting the inevitable differences across nations and cultures that will shape how and whether to use these new technologies. This report proposes criteria for heritable germline editing, provides conclusions on the crucial need for public education and engagement, and presents 7 general principles for the governance of human genome editing.
Communities in Action: Pathways to Health Equity
by National Academies of Sciences Engineering MedicineIn the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual’s health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.
The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research
by National Academies of Sciences Engineering MedicineSignificant changes have taken place in the policy landscape surrounding cannabis legalization, production, and use. During the past 20 years, 25 states and the District of Columbia have legalized cannabis and/or cannabidiol (a component of cannabis) for medical conditions or retail sales at the state level and 4 states have legalized both the medical and recreational use of cannabis. These landmark changes in policy have impacted cannabis use patterns and perceived levels of risk. However, despite this changing landscape, evidence regarding the short- and long-term health effects of cannabis use remains elusive. While a myriad of studies have examined cannabis use in all its various forms, often these research conclusions are not appropriately synthesized, translated for, or communicated to policy makers, health care providers, state health officials, or other stakeholders who have been charged with influencing and enacting policies, procedures, and laws related to cannabis use. Unlike other controlled substances such as alcohol or tobacco, no accepted standards for safe use or appropriate dose are available to help guide individuals as they make choices regarding the issues of if, when, where, and how to use cannabis safely and, in regard to therapeutic uses, effectively. Shifting public sentiment, conflicting and impeded scientific research, and legislative battles have fueled the debate about what, if any, harms or benefits can be attributed to the use of cannabis or its derivatives, and this lack of aggregated knowledge has broad public health implications. The Health Effects of Cannabis and Cannabinoids provides a comprehensive review of scientific evidence related to the health effects and potential therapeutic benefits of cannabis. This report provides a research agenda—outlining gaps in current knowledge and opportunities for providing additional insight into these issues—that summarizes and prioritizes pressing research needs.
An Assessment of the National Institute of Standards and Technology Center for Nanoscale Science and Technology: Fiscal Year 2016
by National Academies of Sciences Engineering MedicineAt the request of the National Institute of Standards and Technology (NIST), the National Academies of Sciences, Engineering, and Medicine has, since 1959, annually assembled panels of experts from academia, industry, medicine, and other scientific and engineering communities to assess the quality and effectiveness of the NIST measurements and standards laboratories, of which there are now seven, as well as the adequacy of the laboratories’ resources. An Assessment of the National Institute of Standards and Technology Center for Nanoscale Science and Technology: Fiscal Year 2016 assesses the scientific and technical work performed by the NIST Center for Nanoscale Science and Technology and the accomplisments, challenges, and opportunities for improvement.
An Evidence Framework for Genetic Testing
by National Academies of Sciences Engineering MedicineAdvances in genetics and genomics are transforming medical practice, resulting in a dramatic growth of genetic testing in the health care system. The rapid development of new technologies, however, has also brought challenges, including the need for rigorous evaluation of the validity and utility of genetic tests, questions regarding the best ways to incorporate them into medical practice, and how to weigh their cost against potential short- and long-term benefits. As the availability of genetic tests increases so do concerns about the achievement of meaningful improvements in clinical outcomes, costs of testing, and the potential for accentuating medical care inequality. Given the rapid pace in the development of genetic tests and new testing technologies, An Evidence Framework for Genetic Testing seeks to advance the development of an adequate evidence base for genetic tests to improve patient care and treatment. Additionally, this report recommends a framework for decision-making regarding the use of genetic tests in clinical care.
Improving Collection of Indicators of Criminal Justice System Involvement in Population Health Data Programs: Proceedings of a Workshop
by National Academies of Sciences Engineering MedicineIn the U.S. criminal justice system in 2014, an estimated 2.2 million people were in incarcerated or under correctional supervision on any given day, and another 4.7 million were under community supervision, such as probation or parole. Among all U.S. adults, 1 in 31 is involved with the criminal justice system, many of them having had recurring encounters. The ability to measure the effects of criminal justice involvement and incarceration on health and health disparities has been a challenge, due largely to limited and inconsistent measures on criminal justice involvement and any data on incarceration in health data collections. The presence of a myriad of confounding factors, such as socioeconomic status and childhood disadvantage, also makes it hard to isolate and identify a causal relationship between criminal justice involvement and health. The Bureau of Justice Statistics collects periodic health data on the people who are incarcerated at any given time, but few national-level surveys have captured criminal justice system involvement for people previously involved in the system or those under community supervision—nor have they collected systematic data on the effects that go beyond the incarcerated individuals themselves. In March 2016 the National Academies of Sciences, Engineering, and Medicine held a workshop meant to assist the Office of the Assistant Secretary for Planning and Evaluation (ASPE) and Office of the Minority Health (OMH) in the U.S. Department of Health and Human Services in identifying measures of criminal justice involvement that will further their understanding of the socioeconomic determinants of health. Participants investigated the feasibility of collecting criminal justice experience data with national household-based health surveys. This publication summarizes the presentations and discussions from the workshop.
Using 21st Century Science to Improve Risk-Related Evaluations
by National Academies of Sciences Engineering MedicineOver the last decade, several large-scale United States and international programs have been initiated to incorporate advances in molecular and cellular biology, -omics technologies, analytical methods, bioinformatics, and computational tools and methods into the field of toxicology. Similar efforts are being pursued in the field of exposure science with the goals of obtaining more accurate and complete exposure data on individuals and populations for thousands of chemicals over the lifespan; predicting exposures from use data and chemical-property information; and translating exposures between test systems and humans. Using 21st Century Science to Improve Risk-Related Evaluations makes recommendations for integrating new scientific approaches into risk-based evaluations. This study considers the scientific advances that have occurred following the publication of the NRC reports Toxicity Testing in the 21st Century: A Vision and a Strategy and Exposure Science in the 21st Century: A Vision and a Strategy. Given the various ongoing lines of investigation and new data streams that have emerged, this publication proposes how best to integrate and use the emerging results in evaluating chemical risk. Using 21st Century Science to Improve Risk-Related Evaluations considers whether a new paradigm is needed for data validation, how to integrate the divergent data streams, how uncertainty might need to be characterized, and how best to communicate the new approaches so that they are understandable to various stakeholders.
Cryptographic Agility and Interoperability: Proceedings of a Workshop
by Engineering Medicine National Academies of SciencesIn May 2016, the National Academies of Sciences, Engineering, and Medicine hosted a workshop on Cryptographic Agility and Interoperability. Speakers at the workshop discussed the history and practice of cryptography, its current challenges, and its future possibilities. This publication summarizes the presentations and discussions from the workshop.
Optimizing the Process for Establishing the Dietary Guidelines for Americans: The Selection Process
by National Academies of Sciences Engineering MedicineFederal guidance on nutrition and diet is intended to reflect the state of the science and deliver the most reliable recommendations possible according to the best available evidence. This guidance, updated and presented every 5 years in the Dietary Guidelines for Americans (DGA), serves as the basis for all federal nutrition policies and nutrition assistance programs, as well as nutrition education programs. Despite the use of the guidelines over the past 30 years, recent challenges prompted Congress to question the process by which food and nutrition guidance is developed. This report assesses the process used to develop the guidelines; it does not evaluate the substance or use of the guidelines. As part of an overall, comprehensive review of the process to update the DGA, this first report seeks to discover how the advisory committee selection process can be improved to provide more transparency, eliminate bias, and include committee members with a range of viewpoints for the purpose of informing the 2020 cycle.
Countering Violent Extremism Through Public Health Practice: Proceedings of a Workshop
by Engineering Medicine National Academies of SciencesCountering violent extremism consists of various prevention and intervention approaches to increase the resilience of communities and individuals to radicalization toward violent extremism, to provide nonviolent avenues for expressing grievances, and to educate communities about the threat of recruitment and radicalization to violence. To explore the application of health approaches in community-level strategies to countering violent extremism and radicalization, the National Academies of Sciences, Engineering, and Medicine held a public workshop in September 2016. Participants explored the evolving threat of violent extremism and radicalization within communities across America, traditional versus health-centered approaches to countering violent extremism and radicalization, and opportunities for cross-sector and interdisciplinary collaboration and learning among domestic and international stakeholders and organizations. This publication summarizes the presentations and discussions from the workshop.
Review of the Marine Recreational Information Program
by National Academies of Sciences Engineering MedicineThe National Marine Fisheries Service (NMFS) of the National Oceanic and Atmospheric Administration (NOAA) is responsible for collecting information on marine recreational angling. It does so principally through the Marine Recreational Information Program (MRIP), a survey program that consists of an in-person survey at fishing access sites and a mail survey, in addition to other complementary or alternative surveys. Data collected from anglers through MRIP supply fisheries managers with essential information for assessing fish stocks. In 2006, the National Research Council provided an evaluation of MRIP’s predecessor, the Marine Recreational Fisheries Statistics Survey (MRFSS). That review, Review of Recreational Fisheries Survey Methods, presented conclusions and recommendations in six categories: sampling issues; statistical estimation issues; human dimensions; program management and support; communication and outreach; and general recommendations. After spending nearly a decade addressing the recommendations, NMFS requested another evaluation of its modified survey program (MRIP). This report, the result of that evaluation, serves as a 10-year progress report. It recognizes the progress that NMFS has made, including major improvements in the statistical soundness of its survey designs, and also highlights some remaining challenges and provides recommendations for addressing them.
Adopting the International System of Units for Radiation Measurements in the United States: Proceedings of a Workshop
by National Academies of Sciences Engineering MedicineMost countries in the world use the SI (Système International, also known as the metric system) units for radiation measurements in commercial and technical activities. The United States, in contrast, uses a mix of SI and conventional units for radiation measurements, despite 30-year-old national and international recommendations to exclusively use SI. Radiation professionals in the United States are faced with the need to understand both systems and make conversions between the two. In September 2016, the National Academies of Sciences, Engineering, and Medicine organized a workshop to explore potential communication improvements associated with adopting the international system of units (SI units) for radiation measurements in the United States. Participants discussed potential improvements in the effectiveness of responding to national and international radiation emergencies, international experiences in adopting the exclusive use of SI units of radiation measurements, and steps needed to adopt the exclusive use of SI units in the US in terms of timing, implementation, and ways to overcome or manage technical, economic, and policy barriers. This publication summarizes the presentations and discussions from the workshop.
Information Technology and the U.S. Workforce: Where Are We and Where Do We Go from Here?
by National Academies of Sciences Engineering MedicineRecent years have yielded significant advances in computing and communication technologies, with profound impacts on society. Technology is transforming the way we work, play, and interact with others. From these technological capabilities, new industries, organizational forms, and business models are emerging. Technological advances can create enormous economic and other benefits, but can also lead to significant changes for workers. IT and automation can change the way work is conducted, by augmenting or replacing workers in specific tasks. This can shift the demand for some types of human labor, eliminating some jobs and creating new ones. Information Technology and the U.S. Workforce explores the interactions between technological, economic, and societal trends and identifies possible near-term developments for work. This report emphasizes the need to understand and track these trends and develop strategies to inform, prepare for, and respond to changes in the labor market. It offers evaluations of what is known, notes open questions to be addressed, and identifies promising research pathways moving forward.
Volcanic Eruptions and Their Repose, Unrest, Precursors, and Timing
by National Academies of Sciences Engineering MedicineVolcanic eruptions are common, with more than 50 volcanic eruptions in the United States alone in the past 31 years. These eruptions can have devastating economic and social consequences, even at great distances from the volcano. Fortunately many eruptions are preceded by unrest that can be detected using ground, airborne, and spaceborne instruments. Data from these instruments, combined with basic understanding of how volcanoes work, form the basis for forecasting eruptions—where, when, how big, how long, and the consequences. Accurate forecasts of the likelihood and magnitude of an eruption in a specified timeframe are rooted in a scientific understanding of the processes that govern the storage, ascent, and eruption of magma. Yet our understanding of volcanic systems is incomplete and biased by the limited number of volcanoes and eruption styles observed with advanced instrumentation. Volcanic Eruptions and Their Repose, Unrest, Precursors, and Timing identifies key science questions, research and observation priorities, and approaches for building a volcano science community capable of tackling them. This report presents goals for making major advances in volcano science.
Valuing Climate Damages: Updating Estimation of the Social Cost of Carbon Dioxide
by Engineering Medicine National Academies of SciencesThe social cost of carbon (SC-CO2) is an economic metric intended to provide a comprehensive estimate of the net damages - that is, the monetized value of the net impacts, both negative and positive - from the global climate change that results from a small (1-metric ton) increase in carbon-dioxide (CO2) emissions. Under Executive Orders regarding regulatory impact analysis and as required by a court ruling, the U.S. government has since 2008 used estimates of the SC-CO2 in federal rulemakings to value the costs and benefits associated with changes in CO2 emissions. In 2010, the Interagency Working Group on the Social Cost of Greenhouse Gases (IWG) developed a methodology for estimating the SC-CO2 across a range of assumptions about future socioeconomic and physical earth systems. Valuing Climate Changes examines potential approaches, along with their relative merits and challenges, for a comprehensive update to the current methodology. This publication also recommends near- and longer-term research priorities to ensure that the SC- CO2 estimates reflect the best available science.
Innovations in Federal Statistics: Combining Data Sources While Protecting Privacy
by National Academies of Sciences Engineering MedicineFederal government statistics provide critical information to the country and serve a key role in a democracy. For decades, sample surveys with instruments carefully designed for particular data needs have been one of the primary methods for collecting data for federal statistics. However, the costs of conducting such surveys have been increasing while response rates have been declining, and many surveys are not able to fulfill growing demands for more timely information and for more detailed information at state and local levels. Innovations in Federal Statistics examines the opportunities and risks of using government administrative and private sector data sources to foster a paradigm shift in federal statistical programs that would combine diverse data sources in a secure manner to enhance federal statistics. This first publication of a two-part series discusses the challenges faced by the federal statistical system and the foundational elements needed for a new paradigm.
2015-2016 Assessment of the Army Research Laboratory
by National Academies of Sciences Engineering MedicineThe National Academies of Sciences, Engineering, and Medicine’s Army Research Laboratory Technical Assessment Board (ARLTAB) provides biennial assessments of the scientific and technical quality of the research, development, and analysis programs at the Army Research Laboratory (ARL), focusing on ballistics sciences, human sciences, information sciences, materials sciences, and mechanical sciences. This biennial report summarizes the findings of the ARLTAB from the reviews conducted by the panels in 2015 and 2016 and subsumes the 2015-2016 interim report.