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Improving Care to Prevent Suicide Among People with Serious Mental Illness: Proceedings Of A Workshop
by National Academies of Sciences Engineering MedicineSuicide prevention initiatives are part of much broader systems connected to activities such as the diagnosis of mental illness, the recognition of clinical risk, improving access to care, and coordinating with a broad range of outside agencies and entities around both prevention and public health efforts. Yet suicide is also an intensely personal issue that continues to be surrounded by stigma. On September 11-12, 2018, the National Academies of Sciences, Engineering, and Medicine held a workshop in Washington, DC, to discuss preventing suicide among people with serious mental illness. The workshop was designed to illustrate and discuss what is known, what is currently being done, and what needs to be done to identify and reduce suicide risk. Improving Care to Prevent Suicide Among People with Serious Mental Illness summarizes presentations and discussions of the workshop.
Making Climate Assessments Work: Learning From California And Other Subnational Climate Assessments: Proceedings Of A Workshop
by Engineering Medicine National Academies of SciencesClimate assessment activities are increasingly driven by subnational organizations—city, county, and state governments; utilities and private companies; and stakeholder groups and engaged publics—trying to better serve their constituents, customers, and members by understanding and preparing for how climate change will impact them locally. Whether the threats are drought and wildfires, storm surge and sea level rise, or heat waves and urban heat islands, the warming climate is affecting people and communities across the country. To explore the growing role of subnational climate assessments and action, the National Academies of Sciences, Engineering, and Medicine hosted the 2-day workshop on August 14-15, 2018. This publication summarizes the presentations and discussions from the workshop.
Considerations for the Design of a Systematic Review of Care Interventions for Individuals with Dementia and Their Caregivers: Letter Report
by Medicine Engineering National Academies of SciencesConsiderations for the Design of a Systematic Review of Care Interventions for Individuals with Dementia and Their Caregivers: Letter Report provides input into the design of an Agency for Healthcare Research and Quality (AHRQ) systematic review of evidence on effective care-related interventions for people with dementia and their caregivers. This letter report describes potential changes and considerations for the key questions and study design that would result in the most informative and timely evidence review on this topic.
Final Report of the Committee on a Strategic Plan for U.S. Burning Plasma Research
by National Academies of Sciences Engineering MedicineFusion offers the prospect of virtually unlimited energy. The United States and many nations around the world have made enormous progress toward achieving fusion energy. With ITER scheduled to go online within a decade and demonstrate controlled fusion ten years later, now is the right time for the United States to develop plans to benefit from its investment in burning plasma research and take steps to develop fusion electricity for the nation’s future energy needs. At the request of the Department of Energy, the National Academies of Sciences, Engineering, and Medicine organized a committee to develop a strategic plan for U.S. fusion research. The final report’s two main recommendations are: (1) The United States should remain an ITER partner as the most cost-effective way to gain experience with a burning plasma at the scale of a power plant. (2) The United States should start a national program of accompanying research and technology leading to the construction of a compact pilot plant that produces electricity from fusion at the lowest possible capital cost.
Frontiers of Engineering: Reports On Leading-edge Engineering From The 2018 Symposium
by National Academy of EngineeringThis volume presents papers on the topics covered at the National Academy of Engineering's 2018 US Frontiers of Engineering Symposium. Every year the symposium brings together 100 outstanding young leaders in engineering to share their cutting-edge research and innovations in selected areas. The 2018 symposium was held September 5-7 and hosted by MIT Lincoln Laboratory in Lexington, Massachusetts. The intent of this book is to convey the excitement of this unique meeting and to highlight innovative developments in engineering research and technical work.
A Decadal Survey of the Social and Behavioral Sciences: A Research Agenda For Advancing Intelligence Analysis
by National Academies of Sciences Engineering MedicineThe primary function of the intelligence analyst is to make sense of information about the world, but the way analysts do that work will look profoundly different a decade from now. Technological changes will bring both new advances in conducting analysis and new risks related to technologically based activities and communications around the world. Because these changes are virtually inevitable, the Intelligence Community will need to make sustained collaboration with researchers in the social and behavioral sciences (SBS) a key priority if it is to adapt to these changes in the most productive ways. A Decadal Survey Of The Social and Behavioral Sciences provides guidance for a 10-year research agenda. This report identifies key opportunities in SBS research for strengthening intelligence analysis and offers ideas for integrating the knowledge and perspectives of researchers from these fields into the planning and design of efforts to support intelligence analysis.
Acquisition Strategies for Future Space-Based Optics: Unclassified Summary
by National Academies of Sciences Engineering MedicineThis study originated with congressionally directed language from the House Permanent Select Committee for Intelligence (HPSCI) in 2016 and titled “Acquisition Strategies for Future Space Based Optics”. This publication is an unclassified summary of the classified report.
Independent Assessment of Science and Technology for the Department of Energy’s Defense Environmental Cleanup Program
by National Academies of Sciences Engineering MedicineThe National Defense Authorization Act for fiscal year 2017 contained a request for a National Academies of Sciences, Engineering, and Medicine review and assessment of science and technology development efforts within the Department of Energy’s Office of Environmental Management (DOE-EM). This technical report is the result of the review and presents findings and recommendations.
Continuous Manufacturing for the Modernization of Pharmaceutical Production: Proceedings Of A Workshop
by National Academies of Sciences Engineering MedicineOn July 30-31, 2018, the National Academies of Sciences, Engineering, and Medicine held a workshop titled Continuous Manufacturing for the Modernization of Pharmaceutical Production. This workshop discussed the business and regulatory concerns associated with adopting continuous manufacturing techniques to produce biologics such as enzymes, monoclonal antibodies, and vaccines. The participants also discussed specific challenges for integration across the manufacturing system, including upstream and downstream processes, analytical techniques, and drug product development. The workshop addressed these challenges broadly across the biologics domain but focused particularly on drug categories of greatest FDA and industrial interest such as monoclonal antibodies and vaccines. This publication summarizes the presentations and discussions from the workshop.
Achieving Behavioral Health Equity for Children, Families, and Communities: Proceedings Of A Workshop
by National Academies of Sciences Engineering MedicineIn November 2017, the The Forum on Promoting Children's Cognitive, Affective, and Behavioral Health, in collaboration with the Roundtable on the Promotion of Health Equity, convened a workshop on promoting children's behavioral health equity. The workshop used a socio-ecological developmental model to explore health equity of children and families, including those with complex needs and chronic conditions. Particular attention was paid to challenges experienced by children and families in both rural and urban contexts, to include but not limited to poverty, individual and institutional racism, low-resourced communities, and hindered access to educational and health care services. Workshop participants also engaged in solution-oriented discussions of initiatives, policies, and programs that aim to improve social determinants of health, opportunities for behavioral health promotion, and access to quality services that address the behavioral health of all children and families. This publication summarizes the presentations and discussion of the event.
Integrating Health Care and Social Services for People with Serious Illness: Proceedings Of A Workshop
by National Academies of Sciences Engineering MedicineA growing body of research indicates that social determinants of health have a significant impact on health care utilization and outcomes. Researchers and policymakers in the United States have spent decades exploring and discussing approaches to integrating health care and social services. While no nation has a truly integrated system, many other industrialized nations invest more heavily in social services than the United States, and are more effective in integrating these services with health care. Integrating health care and social services, such as accessible housing, meals and nutrition services, transportation, and caregiver training, is particularly important for those facing serious illness who typically encounter multiple chronic conditions, pain and other symptoms, functional dependency, frailty, and significant family caregiver needs. In an effort to better understand and facilitate discussions about the challenges and opportunities related to integrating health care and social services for people with serious illness, the National Academies of Sciences, Engineering, and Medicine held a full-day public workshop on July 19, 2018 in Washington, DC. The workshop featured a broad range of experts and stakeholders including researchers, policy analysts, patient and family caregiving advocates, and representatives of federal agencies. This publication summarizes the presentations and discussions from the workshop.
Evaluating the Taxonomic Status of the Mexican Gray Wolf and the Red Wolf
by National Academies of Sciences Engineering MedicineScientists strive to develop clear rules for naming and grouping living organisms. But taxonomy, the scientific study of biological classification and evolution, is often highly debated. Members of a species, the fundamental unit of taxonomy and evolution, share a common evolutionary history and a common evolutionary path to the future. Yet, it can be difficult to determine whether the evolutionary history or future of a population is sufficiently distinct to designate it as a unique species. A species is not a fixed entity – the relationship among the members of the same species is only a snapshot of a moment in time. Different populations of the same species can be in different stages in the process of species formation or dissolution. In some cases hybridization and introgression can create enormous challenges in interpreting data on genetic distinctions between groups. Hybridization is far more common in the evolutionary history of many species than previously recognized. As a result, the precise taxonomic status of an organism may be highly debated. This is the current case with the Mexican gray wolf (Canis lupus baileyi) and the red wolf (Canis rufus), and this report assesses the taxonomic status for each.
Examining the Impact of Real-World Evidence on Medical Product Development: Proceedings Of A Workshop Series
by National Academies of Sciences Engineering MedicineRandomized controlled trials (RCTs) have traditionally served as the gold standard for generating evidence about medical interventions. However, RCTs have inherent limitations and may not reflect the use of medical products in the real world. Additionally, RCTs are expensive, time consuming, and cannot answer all questions about a product or intervention. Evidence generated from real-world use, such as real-world evidence (RWE) may provide valuable information, alongside RCTs, to inform medical product decision making. To explore the potential for using RWE in medical product decision making, the National Academies of Sciences, Engineering, and Medicine planned a three-part workshop series. The series was designed to examine the current system of evidence generation and its limitations, to identify when and why RWE may be an appropriate type of evidence on which to base decisions, to learn from successful initiatives that have incorporated RWE, and to describe barriers that prevent RWE from being used to its full potential. This publication summarizes the discussions from the entire workshop series.
Dietary Reference Intakes for Sodium and Potassium (Dietary Reference Intakes Ser.)
by National Academies of Sciences Engineering MedicineAs essential nutrients, sodium and potassium contribute to the fundamentals of physiology and pathology of human health and disease. In clinical settings, these are two important blood electrolytes, are frequently measured and influence care decisions. Yet, blood electrolyte concentrations are usually not influenced by dietary intake, as kidney and hormone systems carefully regulate blood values. Over the years, increasing evidence suggests that sodium and potassium intake patterns of children and adults influence long-term population health mostly through complex relationships among dietary intake, blood pressure and cardiovascular health. The public health importance of understanding these relationships, based upon the best available evidence and establishing recommendations to support the development of population clinical practice guidelines and medical care of patients is clear. This report reviews evidence on the relationship between sodium and potassium intakes and indicators of adequacy, toxicity, and chronic disease. It updates the Dietary Reference Intakes (DRIs) using an expanded DRI model that includes consideration of chronic disease endpoints, and outlines research gaps to address the uncertainties identified in the process of deriving the reference values and evaluating public health implications.
Health Systems Interventions to Prevent Firearm Injuries and Death: Proceedings of a Workshop
by National Academies of Sciences Engineering MedicineFirearm injuries and death are a serious public health concern in the United States. Firearm-related injuries account for tens of thousands of premature deaths of adults and children each year and significantly increase the burden of injury and disability. Firearm injuries are also costly to the health system, accounting for nearly $3 billion in emergency department and inpatient care each year. The National Academies of Sciences, Engineering, and Medicine convened a workshop to examine the roles that health systems can play in addressing the epidemic of firearm violence in the United States. This publication summarizes the presentations and discussions from the workshop.
Improving the EPA Multi-Sector General Permit for Industrial Stormwater Discharges
by National Academies of Sciences Engineering MedicineIndustrial stormwater is derived from precipitation and/or runoff that comes in contact with industrial manufacturing, processing, storage, or material overburden and then runs offsite and enters drainage systems or receiving waters. In 1987, Congress significantly expanded the National Pollutant Discharge Elimination System (NPDES) program through amendments to the Clean Water Act to include industrial stormwater runoff conveyed through outfalls directly to receiving waters or indirectly through municipal separate storm sewer systems. The added regulation of stormwater in the NPDES program has been challenging. Stormwater is produced throughout a developed landscape, and its production and delivery are episodic. In 2009, the National Research Council released a comprehensive report on the Environmental Protection Agency’s Stormwater Program that covered all sectors of the program. This study builds on that report, with a focus on industrial stormwater monitoring and management.
Care, Use, and Welfare of Marmosets as Animal Models for Gene Editing-Based Biomedical Research: Proceedings Of A Workshop
by National Academies of Sciences Engineering MedicineThe marmoset, a type of small monkey native to South America, is a research model of increasing importance for biomedical research in the United States and globally. Marmosets offer a range of advantages as animal models in neuroscience, aging, infectious diseases, and other fields of study. They may be particularly useful for the development of new disease models using genetic engineering and assisted reproductive technologies. However, concerns have been voiced with respect to the development of new marmoset-based models of disease, ethical considerations for their use, the supply of marmosets available for research, and gaps in guidance for their care and management. To explore and address these concerns, the Roundtable on Science and Welfare in Laboratory Animal Use hosted a public workshop on October 22-23, 2018, in Washington, DC. The workshop focused on the availability of marmosets in the United States and abroad; animal welfare and ethical considerations stemming from the use of wildtype and genetically modified marmosets; and standards of housing and care, dietary needs, and feeding requirements for marmosets in captivity. This publication summarizes the presentations and discussions from the workshop.
Planetary Protection Classification of Sample Return Missions from the Martian Moons
by National Academies of Sciences Engineering MedicineAn international consensus policy to prevent the biological cross-contamination of planetary bodies exists and is maintained by the Committee on Space Research (COSPAR) of the International Council for Science, which is consultative to the United Nations Committee on the Peaceful Uses of Outer Space. Currently, COSPAR’s planetary protection policy does not specify the status of sample-return missions from Phobos or Deimos, the moons of Mars. Although the moons themselves are not considered potential habitats for life or of intrinsic relevance to prebiotic chemical evolution, recent studies indicate that a significant amount of material recently ejected from Mars could be present on the surface of Phobos and, to a lesser extent, Deimos. This report reviews recent theoretical, experimental, and modeling research on the environments and physical conditions encountered by Mars ejecta during certain processes. It recommends whether missions returning samples from Phobos and/or Deimos should be classified as “restricted” or “unrestricted” Earth return in the framework of the planetary protection policy maintained by COSPAR. This report also considers the specific ways the classification of sample return from Deimos is a different case than sample return from Phobos.
Transgenic Neuroscience Research: Exploring The Scientific Opportunities Afforded By New Nonhuman Primate Models: Proceedings Of A Workshop
by National Academies of Sciences Engineering MedicineTo examine the promise, concerns, and challenges related to neuroscience research using genetically modified nonhuman primates, the National Academies of Sciences, Engineering, and Medicine hosted a public workshop on October 4, 2018, bringing together an international group of experts and stakeholders representing academia, industry, laboratory animal management, disease-focused foundations, and federal agencies. The workshop was designed to explore the current state and future promise of research using genetically modified nonhuman primate models of disease to understand the complex functions of the brain that control behavior, movement, and cognition in both health and disease states. This publication summarizes the presentations and discussions from the workshop.
Nutrient Requirements of Dogs and Cats (Nutrient Requirements Of Domestic Animals Ser.)
by National Research Council; Division on Earth and Life Studies Board on Agriculture and Natural Resources Committee on Animal Nutrition Subcommittee on Dog and Cat NutritionUpdating recommendations last made by the National Research Council in the mid-1980s, this report provides nutrient recommendations based on physical activity and stage in life, major factors that influence nutrient needs. It looks at how nutrients are metabolized in the bodies of dogs and cats, indications of nutrient deficiency, and diseases related to poor nutrition. The report provides a valuable resource for industry professionals formulating diets, scientists setting research agendas, government officials developing regulations for pet food labeling, and as a university textbook for dog and cat nutrition. It can also guide pet owners feeding decisions for their pets with information on specific nutrient needs, characteristics of different types of pet foods, and factors to consider when feeding cats and dogs.
Nutrient Requirements of Horses: Sixth Revised Edition
by National Research Council Division on Earth and Life Studies Board on Agriculture and Natural Resources Committee on Nutrient Requirements of HorsesProper formulation of diets for horses depends on adequate knowledge of their nutrient requirements. These requirements depend on the breed and age of the horse and whether it is exercising, pregnant, or lactating. A great deal of new information has been accumulated since the publication 17 years ago of the last edition of Nutrient Requirements of Horses. This new edition features a detailed review of scientific literature, summarizing all the latest information, and provides a new set of requirements based on revised data. Also included is updated information on the composition of feeds, feed additives, and other compounds routinely fed to horses. The effects of physiological factors, such as exercise, and environmental factors, such as temperature and humidity, are covered, as well. Nutrient Requirements of Horses also contains information on several nutritional and metabolic diseases that horses often have. Designed primarily as a reference, both practical and technical, Nutrient Requirements of Horses is intended to ensure that the diets of horses and other equids contain adequate amounts of nutrients and that the intakes of certain nutrients are not so excessive that they inhibit performance or impair health. This book is primarily intended for animal nutritionists, veterinarians, and other scientists; however, individual horse owners and managers will also find some of this material useful. Professors who teach graduate courses in animal nutrition will find Nutrient Requirements of Horses beneficial as a textbook.
Exploring Sources of Variability Related to the Clinical Translation of Regenerative Engineering Products: Proceedings Of A Workshop
by National Academies of Sciences Engineering MedicineThe emerging multidisciplinary field of regenerative engineering is devoted to the repair, regeneration, and replacement of damaged tissues or organs in the body. To accomplish this it uses a combination of principles and technologies from disciplines such as advanced materials science, developmental and stem cell biology, immunology, physics, and clinical translation. The term "regenerative engineering" reflects a new understanding of the use of tissue engineering for regeneration and also the growing number of research and product development efforts that incorporate elements from a variety of fields. Because regenerative engineered therapies rely on live cells and scaffolds, there are inherent challenges in quality control arising from variability in source and final products. Furthermore, each patient recipient, tissue donor, and product application is unique, meaning that the field faces complexities in the development of safe and effective new products and therapies which are not faced by developers of more conventional therapies. Understanding the many sources of variability can help reduce this variability and ensure consistent results. The Forum on Regenerative Medicine hosted a public workshop on October 18, 2018, in Washington, DC, to explore the various factors that must be taken into account in order to develop successful regenerative engineering products. Invited speakers and participants discussed factors and sources of variability in the development and clinical application of regenerative engineering products, characteristics of high-quality products, and how different clinical needs, models, and contexts can inform the development of a product to improve patient outcomes. This publication summarizes the presentation and discussion of the workshop.
Exploring Medical and Public Health Preparedness for a Nuclear Incident: Proceedings Of A Workshop
by National Academies of Sciences Engineering MedicineThe National Academies of Sciences, Engineering, and Medicine held a workshop on August 22–23, 2018, in Washington, DC, to explore medical and public health preparedness for a nuclear incident. The event brought together experts from government, nongovernmental organizations, academia, and the private sector to explore current assumptions behind the status of medical and public health preparedness for a nuclear incident, examine potential changes in these assumptions in light of increasing concerns about the use of nuclear warfare, and discuss challenges and opportunities for capacity building in the current threat environment. This publication summarizes the presentations and discussions from the workshop.
Report Series: Committee on Astrobiology and Planetary Science: Review of the Planetary Science Aspects of NASA SMD's Lunar Science and Exploration Initiative
by National Academies of Sciences Engineering MedicineOn December 11, 2017, President Donald Trump signed Space Policy Directive-1 (SPD-1). The new directive replaced original text in the National Space Policy of the United States of America and instructed the Administrator of the National Aeronautics and Space Administration (NASA) to “lead the return of humans to the Moon for long-term exploration and utilization, followed by human missions to Mars and other destinations”. In response to and in support of the vision expressed in SPD-1, this report reviews decadal and other community-guided lunar science priorities as context for NASA’s current lunar plans and then presents and evaluates the actions being taken by NASA’s Planetary Science Division to support lunar science.
Report Series: Committee on Astrobiology and Planetary Science: Review of the Commercial Aspects of NASA SMD’s Lunar Science and Exploration Initiative
by National Academies of Sciences Engineering MedicineOn December 11, 2017, President Donald Trump signed Space Policy Directive-1 (SPD-1). The new directive replaced original text in the National Space Policy of the United States of America and instructed the Administrator of the National Aeronautics and Space Administration (NASA) to "lead the return of humans to the Moon for long-term exploration and utilization, followed by human missions to Mars and other destinations". In response to and in support of the vision expressed in SPD-1, the first report reviewed decadal and other community-guided lunar science priorities as context for NASA’s current lunar plans and then presented and evaluated the actions being taken by NASA’s Planetary Science Division (PSD) to support lunar science. At the request of NASA PSD, this second report explores plans for commercial partnerships, lunar infrastructure development, and related aspects of NASA’s lunar science and exploration initiative.