Despite their obvious importance, very little is actually known about the processes and factors that influence the assembly, function, and stability of microbial communities. Gaining this knowledge will require a seismic shift away from the study of individual microbes in isolation to inquiries into the nature of diverse and often complex microbial communities, the forces that shape them, and their relationships with other communities and organisms, including their multicellular hosts.
On March 6 and 7, 2012, the Institute of Medicine's (IOM's) Forum on Microbial Threats hosted a public workshop to explore the emerging science of the "social biology" of microbial communities. Workshop presentations and discussions embraced a wide spectrum of topics, experimental systems, and theoretical perspectives representative of the current, multifaceted exploration of the microbial frontier. Participants discussed ecological, evolutionary, and genetic factors contributing to the assembly, function, and stability of microbial communities; how microbial communities adapt and respond to environmental stimuli; theoretical and experimental approaches to advance this nascent field; and potential applications of knowledge gained from the study of microbial communities for the improvement of human, animal, plant, and ecosystem health and toward a deeper understanding of microbial diversity and evolution. The Social Biology of Microbial Communities: Workshop Summary further explains the happenings of the workshop.
Because of complaints from returning Vietnam veterans about their own health and that of their children combined with emerging toxicologic evidence of adverse effects of phenoxy herbicides and TCDD, the National Academy of Sciences (NAS) was asked to perform a comprehensive evaluation of scientific and medical information regarding the health effects of exposure to Agent Orange, other herbicides used in Vietnam, and the various components of those herbicides, including TCDD. Updated evaluations are conducted every two years to review newly available literature and draw conclusions from the overall evidence.Veterans and Agent Orange: Update 2012 reviews peer-reviewed scientific reports concerning associations between health outcomes and exposure to TCDD and other chemicals in the herbicides used in Vietnam that were published in October 2010--September 2012 and integrates this information with the previously established evidence database. This report considers whether a statistical association with herbicide exposure exists, taking into account the strength of the scientific evidence and the appropriateness of the statistical and epidemiological methods used to detect the association; the increased risk of disease among those exposed to herbicides during service in the Republic of Vietnam during the Vietnam era; and whether there exists a plausible biological mechanism or other evidence of a causal relationship between herbicide exposure and the disease.
The Infectious Etiology of Chronic Diseases: Defining the Relationship, Enhancing the Research, and Mitigating the Effects, summarizes a two-day workshop held by the Institute of Medicineâ€™s Forum on Microbial Threats to address this rapidly evolving field. Participants explored factors driving infectious etiologies of chronic diseases of prominence, identified difficulties in linking infectious agents with chronic outcomes, and discussed broad-based strategies and research programs to advance the field.
Today's health care providers have more research findings and more technology available to them than ever before. Yet recent reports have raised serious doubts about the quality of health care in America.
Crossing the Quality Chasm makes an urgent call for fundamental change to close the quality gap. This book recommends a sweeping redesign of the American health care system and provides overarching principles for specific direction for policymakers, health care leaders, clinicians, regulators, purchasers, and others. In this comprehensive volume the committee offers:
A set of performance expectations for the 21st century health care system. A set of 10 new rules to guide patient-clinician relationships. A suggested organizing framework to better align the incentives inherent in payment and accountability with improvements in quality. Key steps to promote evidence-based practice and strengthen clinical information systems.
Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change.
Successful K-12 STEM Education defines a framework for understanding "success" in K-12 STEM education. The book focuses its analysis on the science and mathematics parts of STEM and outlines criteria for identifying effective STEM schools and programs. Because a school's success should be defined by and measured relative to its goals, the book identifies three important goals that share certain elements, including learning STEM content and practices, developing positive dispositions toward STEM, and preparing students to be lifelong learners. A successful STEM program would increase the number of students who ultimately pursue advanced degrees and careers in STEM fields, enhance the STEM-capable workforce, and boost STEM literacy for all students. It is also critical to broaden the participation of women and minorities in STEM fields.
Successful K-12 STEM Education examines the vast landscape of K-12 STEM education by considering different school models, highlighting research on effective STEM education practices, and identifying some conditions that promote and limit school- and student-level success in STEM. The book also looks at where further work is needed to develop appropriate data sources. The book will serve as a guide to policy makers; decision makers at the school and district levels; local, state, and federal government agencies; curriculum developers; educators; and parent and education advocacy groups.
Review of the Department of Defense Test Protocols for Combat Helmets considers the technical issues relating to test protocols for military combat helmets. At the request of the DOD Director of Operational Test and Evaluation, this report evaluates the adequacy of the Advanced Combat Helmet test protocol for both first article testing and lot acceptance testing, including its use of the metrics of probability of no penetration and the upper tolerance limit (used to evaluate backface deformation). The report evaluates appropriate use of statistical techniques in gathering data; adequacy of current helmet testing procedures; procedures for the conduct of additional analysis of penetration and backface deformation data; and scope of characterization testing relative to the benefit of the information obtained.
The microbiome is integral to human physiology, health, and disease. The microbiome is arguably the most intimate connection that humans have with their external environment, mostly through diet. Given the emerging nature of research on the microbiome, some important methodology issues might still have to be resolved with respect to undersampling and a lack of causal and mechanistic studies. Dietary interventions intended to have an impact on host biology via their impact on the microbiome are being developed, and the market for these products is seeing tremendous success. However, the current regulatory framework poses challenges to industry interest and investment.
At more than 3 million in number, nurses make up the single largest segment of the health care work force. They also spend the greatest amount of time in delivering patient care as a profession. Nurses therefore have valuable insights and unique abilities to contribute as partners with other health care professionals in improving the quality and safety of care as envisioned in the Affordable Care Act (ACA) enacted this year.
Nurses should be fully engaged with other health professionals and assume leadership roles in redesigning care in the United States. To ensure its members are well-prepared, the profession should institute residency training for nurses, increase the percentage of nurses who attain a bachelor's degree to 80 percent by 2020, and double the number who pursue doctorates. Furthermore, regulatory and institutional obstacles -- including limits on nurses' scope of practice -- should be removed so that the health system can reap the full benefit of nurses' training, skills, and knowledge in patient care.
In this book, the Institute of Medicine makes recommendations for an action-oriented blueprint for the future of nursing.
Making and maintaining an accurate flood map is neither simple nor inexpensive. Even after an investment of more than $1 billion to take flood maps into the digital world, only 21 percent of the population has maps that meet or exceed national flood hazard data quality thresholds. Even when floodplains are mapped with high accuracy, land development and natural changes to the landscape or hydrologic systems create the need for continuous map maintenance and updates.
Mapping the Zone examines the factors that affect flood map accuracy, assesses the benefits and costs of more accurate flood maps, and recommends ways to improve flood mapping, communication, and management of flood-related data.
Prevention practices have emerged in a variety of settings, including programs for selected at-risk populations (such as children and youth in the child welfare system), school-based interventions, interventions in primary care settings, and community services designed to address a broad array of mental health needs and populations.
Preventing Mental, Emotional, and Behavioral Disorders Among Young People updates a 1994 Institute of Medicine book, Reducing Risks for Mental Disorders, focusing special attention on the research base and program experience with younger populations that have emerged since that time.
Researchers, such as those involved in prevention science, mental health, education, substance abuse, juvenile justice, health, child and youth development, as well as policy makers involved in state and local mental health, substance abuse, welfare, education, and justice will depend on this updated information on the status of research and suggested directions for the field of mental health and prevention of disorders.
How Students Learn: History, Mathematics, and Science in the Classroom builds on the discoveries detailed in the bestselling How People Learn. Now, these findings are presented in a way that teachers can use immediately, to revitalize their work in the classroom for even greater effectiveness.
Organized for utility, the book explores how the principles of learning can be applied in teaching history, science, and math topics at three levels: elementary, middle, and high school. Leading educators explain in detail how they developed successful curricula and teaching approaches, presenting strategies that serve as models for curriculum development and classroom instruction. Their recounting of personal teaching experiences lends strength and warmth to this volume.
The book explores the importance of balancing studentsâ€™ knowledge of historical fact against their understanding of concepts, such as change and cause, and their skills in assessing historical accounts. It discusses how to build straightforward science experiments into true understanding of scientific principles. And it shows how to overcome the difficulties in teaching math to generate real insight and reasoning in math students. It also features illustrated suggestions for classroom activities.
How Students Learn offers a highly useful blend of principle and practice. It will be important not only to teachers, administrators, curriculum designers, and teacher educators, but also to parents and the larger community concerned about childrenâ€™s education.
The new Framework and the NGSS are designed to guide educators in significantly altering the way K-12 science is taught. The Framework is aimed at making science education more closely resemble the way scientists actually work and think, and making instruction reflect research on learning that demonstrates the importance of building coherent understandings over time. It structures science education around three dimensions - the practices through which scientists and engineers do their work, the key crosscutting concepts that cut across disciplines, and the core ideas of the disciplines - and argues that they should be interwoven in every aspect of science education, building in sophistication as students progress through grades K-12.
Developing Assessments for the Next Generation Science Standards recommends strategies for developing assessments that yield valid measures of student proficiency in science as described in the new Framework. This report reviews recent and current work in science assessment to determine which aspects of the Framework's vision can be assessed with available techniques and what additional research and development will be needed to support an assessment system that fully meets that vision. The report offers a systems approach to science assessment, in which a range of assessment strategies are designed to answer different kinds of questions with appropriate degrees of specificity and provide results that complement one another.
Developing Assessments for the Next Generation Science Standards makes the case that a science assessment system that meets the Framework's vision should consist of assessments designed to support classroom instruction, assessments designed to monitor science learning on a broader scale, and indicators designed to track opportunity to learn. New standards for science education make clear that new modes of assessment designed to measure the integrated learning they promote are essential. The recommendations of this report will be key to making sure that the dramatic changes in curriculum and instruction signaled by Framework and the NGSS reduce inequities in science education and raise the level of science education for all students.
To explore this potential, Learning Science: Computer Games, Simulations, and Education, reviews the available research on learning science through interaction with digital simulations and games. It considers the potential of digital games and simulations to contribute to learning science in schools, in informal out-of-school settings, and everyday life. The book also identifies the areas in which more research and research-based development is needed to fully capitalize on this potential.
Learning Science will guide academic researchers; developers, publishers, and entrepreneurs from the digital simulation and gaming community; and education practitioners and policy makers toward the formation of research and development partnerships that will facilitate rich intellectual collaboration. Industry, government agencies and foundations will play a significant role through start-up and ongoing support to ensure that digital games and simulations will not only excite and entertain, but also motivate and educate.
Opportunities in Protection Materials Science and Technology for Future Army Applications explores the current theoretical and experimental understanding of the key issues surrounding protection materials, identifies the major challenges and technical gaps for developing the future generation of lightweight protection materials, and recommends a path forward for their development. It examines multiscale shockwave energy transfer mechanisms and experimental approaches for their characterization over short timescales, as well as multiscale modeling techniques to predict mechanisms for dissipating energy. The report also considers exemplary threats and design philosophy for the three key applications of armor systems: (1) personnel protection, including body armor and helmets, (2) vehicle armor, and (3) transparent armor.
Opportunities in Protection Materials Science and Technology for Future Army Applications recommends that the Department of Defense (DoD) establish a defense initiative for protection materials by design (PMD), with associated funding lines for basic and applied research. The PMD initiative should include a combination of computational, experimental, and materials testing, characterization, and processing research conducted by government, industry, and academia.
Against the back-drop of these stark realities, the Air Force requested the National Research Council (NRC) of the National Academies, under the auspices of the Air Force Studies Board to conduct and in-depth assessment of current and future Air Force weapon system sustainment initiatives and recommended future courses of action for consideration by the Air Force.
Examination of the U.S. Air Force's Aircraft Sustainment Needs in the Future and Its Strategy to Meet Those Needs addresses the following topics:
Assess current sustainment investments, infrastructure, and processes for adequacy in sustaining aging legacy systems and their support equipment. Determine if any modifications in policy are required and, if so, identify them and make recommendations for changes in Air Force regulations, policies, and strategies to accomplish the sustainment goals of the Air Force. Determine if any modifications in technology efforts are required and, if so, identify them and make recommendations regarding the technology efforts that should be pursued because they could make positive impacts on the sustainment of the current and future systems and equipment of the Air Force. Determine if the Air Logistics Centers have the necessary resources (funding, manpower, skill sets, and technologies) and are equipped and organized to sustain legacy systems and equipment and the Air Force of tomorrow. Identify and make recommendations regarding incorporating sustainability into future aircraft designs.
CBM produced water management can be challenging for regulatory agencies, CBM well operators, water treatment companies, policy makers, landowners, and the public because of differences in the quality and quantity of produced water; available infrastructure; costs to treat, store, and transport produced water; and states' legal consideration of water and produced water. Some states consider produced water as waste, whereas others consider it a beneficial byproduct of methane production. Thus, although current technologies allow CBM produced water to be treated to any desired water quality, the majority of CBM produced water is presently being disposed of at least cost rather than put to beneficial use.
This book specifically examines the Powder River, San Juan, Raton, Piceance, and Uinta CBM basins in the states of Montana, Wyoming, Colorado, New Mexico, and Utah. The conclusions and recommendations identify gaps in data and information, potential beneficial uses of CBM produced water and associated costs, and challenges in the existing regulatory framework.
• The evolving role of EMS as an integral component of the overall health care system.
• EMS system planning, preparedness, and coordination at the federal, state, and local levels.
• EMS funding and infrastructure investments.
• EMS workforce trends and professional education.
• EMS research priorities and funding.
Emergency Medical Services is one of three books in the Future of Emergency Care series. This book will be of particular interest to emergency care providers, professional organizations, and policy makers looking to address the deficiencies in emergency care systems.
Pathways to Exploration explores the case for advancing this endeavor, drawing on the history of rationales for human spaceflight, examining the attitudes of stakeholders and the public, and carefully assessing the technical and fiscal realities. This report recommends maintaining the long-term focus on Mars as the horizon goal for human space exploration. With this goal in mind, the report considers funding levels necessary to maintain a robust tempo of execution, current research and exploration projects and the time/resources needed to continue them, and international cooperation that could contribute to the achievement of spaceflight to Mars. According to Pathways to Exploration, a successful U.S. program would require sustained national commitment and a budget that increases by more than the rate of inflation.
In reviving a U.S. human exploration program capable of answering the enduring questions about humanity's destiny beyond our tiny blue planet, the nation will need to grapple with the attitudinal and fiscal realities of the nation today while staying true to a small but crucial set of fundamental principles for the conduct of exploration of the endless frontier. The recommendations of Pathways to Exploration provide a clear map toward a human spaceflight program that inspires students and citizens by furthering human exploration and discovery, while taking into account the long-term commitment necessary to achieve this goal.
Training Physicians for Public Health Careers focuses on the critical roles that physicians play in maintaining and strengthening the public health system, identifies what these physicians need to know to engage in effective public health actions, explores the kinds of training programs that can be used to prepare physicians for public health roles, and examines how these training programs can be funded. Medical schools, schools of public health, health care and public health care professionals, medical students and students of public health will find this of special interest.
The recommendations in this book focus on changes in NASA policies that would directly reduce or eliminate the cost growth of Earth and space science missions. Large cost growth is a concern for Earth and space science missions, and it can be a concern for other missions as well. If the cost growth is large enough, it can create liquidity problems for NASA's Science Mission Directorate that in turn cause cost profile changes and development delays that amplify the overall cost growth for other concurrent and/or pending missions. Addressing cost growth through the allocation of artificially high reserves is an inefficient use of resources because it unnecessarily diminishes the portfolio of planned flights. The most efficient use of resources is to establish realistic budgets and reserves and effective management processes that maximize the likelihood that mission costs will not exceed reserves. NASA is already taking action to reduce cost growth; additional steps, as recommended herein, will help improve NASA's mission planning process and achieve the goal of ensuring frequent mission opportunities for NASA Earth and space science.
In late 2011, the United States Congress directed the NASA Office of Inspector General to commission a "comprehensive independent assessment of NASA's strategic direction and agency management." Subsequently, NASA requested that the National Research Council (NRC) conduct this independent assessment. In the spring of 2012, the NRC Committee on NASA's Strategic Direction was formed and began work on its task. The committee determined that, only with a national consensus on the agency's future strategic directionalong the lines described in the full NRC reportcan NASA continue to deliver the wonder, the knowledge, the national security and economic benefits, and the technology that have been typified by its earlier history. NASA's Strategic Direction and the Need for a National Consensus summarizes the findings and recommendations of the committee.
Musculoskeletal Disorders and the Workplace examines the scientific basis for connecting musculoskeletal disorders with the workplace, considering people, job tasks, and work environments. A multidisciplinary panel draws conclusions about the likelihood of causal links and the effectiveness of various intervention strategies. The panel also offers recommendations for what actions can be considered on the basis of current information and for closing information gaps.
This book presents the latest information on the prevalence, incidence, and costs of musculoskeletal disorders and identifies factors that influence injury reporting. It reviews the broad scope of evidence: epidemiological studies of physical and psychosocial variables, basic biology, biomechanics, and physical and behavioral responses to stress. Given the magnitude of the problem-approximately 1 million people miss some work each year-and the current trends in workplace practices, this volume will be a must for advocates for workplace health, policy makers, employers, employees, medical professionals, engineers, lawyers, and labor officials.
The Health of Lesbian, Gay, Bisexual, and Transgender People assesses the state of science on the health status of LGBT populations, identifies research gaps and opportunities, and outlines a research agenda for the National Institute of Health. The report examines the health status of these populations in three life stages: childhood and adolescence, early/middle adulthood, and later adulthood. At each life stage, the committee studied mental health, physical health, risks and protective factors, health services, and contextual influences. To advance understanding of the health needs of all LGBT individuals, the report finds that researchers need more data about the demographics of these populations, improved methods for collecting and analyzing data, and an increased participation of sexual and gender minorities in research.
The Health of Lesbian, Gay, Bisexual, and Transgender People is a valuable resource for policymakers, federal agencies including the National Institute of Health (NIH), LGBT advocacy groups, clinicians, and service providers.
Safety of Silicone Breast Implants presents a well-documented, thoughtful exploration of the safety of these devices, drawing conclusions from the available research base and suggesting further questions to be answered. This book also examines the sensitive issues surrounding women's decisions about implants. In reaching conclusions, the committee reviews:
The history of the silicone breast implant and the development of its chemistry.
The wide variety of U.S.-made implants and their regulation by the Food and Drug Administration.
Frequency and consequences of local complications from implants.
The evidence for and against links between implants and autoimmune disorders, connective tissue disease, neurological problems, silicone in breast milk, or a proposed new syndrome.
Evidence that implants may be associated with lower frequencies of breast cancer.
Safety of Silicone Breast Implants provides a comprehensive, well-organized review of the science behind one of the most significant medical controversies of our time.
Innovation in Global Industries challenges this thinking. The book, a collection of individually authored studies, examines in detail structural changes in the innovation process in 10 service as well as manufacturing industries: personal computers; semiconductors; flat-panel displays; software; lighting; biotechnology; pharmaceuticals; financial services; logistics; and venture capital. There is no doubt that overall there has been an acceleration in global sourcing of innovation and an emergence of new locations of research capacity and advanced technical skills, but the patterns are highly variable. Many industries and some firms in nearly all industries retain leading-edge capacity in the United States. However, the book concludes that is no reason for complacency about the future outlook. Innovation deserves more emphasis in firm performance measures and more sustained support in public policy.
Innovation in Global Industries will be of special interest to business people and government policy makers as well as professors, students, and other researchers of economics, management, international affairs, and political science.
When the committee began its work in 1999, the Army, the Navy, and the Air Force had recently experienced recruiting shortfalls. By the early 2000s, all the Services were meeting their goals; however, in the first half of calendar year 2005, both the Army and the Marine Corps experienced recruiting difficulties and, in some months, shortfalls. When recruiting goals are not being met, scientific guidance is needed to inform policy decisions regarding the advisability of lowering standards and the impact of any change on training time and cost, job performance, attrition, and the health of the force.
Assessing Fitness for Military Enlistment examines the current physical, medical, and mental health standards for military enlistment in light of (1) trends in the physical condition of the youth population; (2) medical advances for treating certain conditions, as well as knowledge of the typical course of chronic conditions as young people reach adulthood; (3) the role of basic training in physical conditioning; (4) the physical demands and working conditions of various jobs in today's military services; and (5) the measures that are used by the Services to characterize an individual's physical condition. The focus is on the enlistment of 18- to 24-year-olds and their first term of service.
Licensed nurses and unlicensed nursing assistants are critical participants in our national effort to protect patients from health care errors. The nature of the activities nurses typically perform â€" monitoring patients, educating home caretakers, performing treatments, and rescuing patients who are in crisis â€" provides an indispensable resource in detecting and remedying error-producing defects in the U.S. health care system.
During the past two decades, substantial changes have been made in the organization and delivery of health care â€" and consequently in the job description and work environment of nurses. As patients are increasingly cared for as outpatients, nurses in hospitals and nursing homes deal with greater severity of illness. Problems in management practices, employee deployment, work and workspace design, and the basic safety culture of health care organizations place patients at further risk.
This newest edition in the groundbreaking Institute of Medicine Quality Chasm series discusses the key aspects of the work environment for nurses and reviews the potential improvements in working conditions that are likely to have an impact on patient safety.
While certain processes have improved or become more efficient, and certain practices have been outlawed or amended, the sheer scale of global consumption and its attendant impacts continue to be major challenges we face in the transition to sustainability. Third-party certification systems have emerged over the last 15 years as a tool with some promise. There has been anecdotal evidence of success, but to date the overall impact of certified goods and services has been small. Moreover, definitions of sustainable vary across sectors and markets, and rigorous assessments of these programs have been few and far between.
In order to take a step in learning from this field of practice, the National Academies' Science and Technology for Sustainability Program held a workshop to illuminate the decision making process of those who purchase and produce certified goods and services. It was also intended to help clarify the scope and limitations of the scientific knowledge that might contribute to the economic success of certified products. The workshop, summarized in this volume, involved presentations and discussions with approximately 40 invited experts from academia, business, government, and nongovernmental organizations.
The Committee on Hydrologic Science was established by the National Research Council in 1999 to identify priorities for hydrologic science that will ensure its vitality as a scientific discipline in service of societal needs. This charge will be performed principally through a series of studies that provide scientific advice on the hydrologic aspects of national program and U.S. hydrologic contributions to international programs.
This first report contains a preliminary assessment of the hydrologic science content of the U.S. Global Change Research Program (USGCRP). Because this is a short and focused report, little effort is spent to reaffirm the established and successful elements of the USGCRP. In fact, the Committee generally endorses the findings of the National Research Council (NRC) report Global Environmental Change: Research Pathways for the Next Decade (NRC, 1998a; the so-called Pathways report) in this respect. Instead the attention here is directed toward the most critical missing hydrologic science elements in the FY2000 USGCRP. This brings the focus to the terrestrial component of the water cycle. The integrative nature of terrestrial hydrology could significantly strengthen the USGCRP.
The overall quality of ARL's technical staff and their work continues to be impressive, as well as the relevance of their work to Army needs. ARL continues to exhibit a clear, passionate concern for the end user of its technology--the soldier in the field. While two directorates have large program-support missions, there is considerable customer-support work across the directorates, which universally demonstrate mindfulness of the importance of transitioning technology to support immediate and near-term Army needs. ARL staff also continue to expand their involvement with the wider scientific and engineering community.
This involvement includes monitoring relevant developments elsewhere, engaging in significant collaborative work (including the Collaborative Technology Alliances), and sharing work through peer reviews. In general, ARL is working very well within an appropriate research and development niche and has been demonstrating significant accomplishments.
The prevailing messages throughout the seminar series as demonstrated by the lectures in this book are how much we have accomplished over the past 50 years, how profound are our discoveries, how much contributions from the space program affect our daily lives, and yet how much remains to be done. The age of discovery in space and Earth science is just beginning. Opportunities abound that will forever alter our destiny.
Public Law 105-78 requested that the National Research Council study whether an equivalency scale could be developed that would allow test scores from existing commercial tests and state assessments to be compared with each other and with the National Assessment of Education Progress.
In this book, the committee reviewed research literature on the statistical and technical aspects of creating valid links between tests and how the content, use, and purposes of education testing in the United States influences the quality and meaning of those links. The book summarizes relevant prior linkage studies and presents a picture of the diversity of state testing programs. It also looks at the unique characteristics of the National Assessment of Educational Progress.
Uncommon Measures provides an answer to the question posed by Congress in Public Law 105-78, suggests criteria for evaluating the quality of linkages, and calls for further research to determine the level of precision needed to make inferences about linked tests. In arriving at its conclusions, the committee acknowledged that ultimately policymakers and educators must take responsibility for determining the degree of imprecision they are willing to tolerate in testing and linking. This book provides science-based information with which to make those decisions.
International nongovernmental organizations (NGOs) have stepped in to address the dire humanitarian situation. This study looks at four organizations that support local health care in the eastern DRC: the International Rescue Committee (IRC), Malteser, Medical Emergency Relief International (Merlin), and the Association Régionale d'Approvisionnement en Médicaments Essentiels (ASRAMES). The study makes a comparison of the management and financing approaches of these four organizations by collecting and comparing qualitative and quantitative data on their interaction with the (remaining) local health providers and the local population.
Specific objectives of the study are:
1. To identify which management and financing approaches, including the setting of fees, are used by the four NGOs supporting healthcare in the eastern DRC.
2. To determine how these financing approaches affect utilization rates in the health zones supported by the four NGOs.
3. To assess how these utilization rates compare with donor and humanitarian standards.
4. To determine at what level fees must be set to allow for cost recovery or cost sharing in health facilities.
5. To identify the managerial problems confronting the four NGOs.
Many epidemiological and public health studies focus on the interaction between health providers and target groups. Supporting Local Health Care in a Chronic Crisis: Management and Financing Approaches in the Eastern Democratic Republic of the Congo concentrates more on how the relationship between the supporting NGOs and the local health system actually develops. In addition, a common aspect of many of the epidemiological and public health studies is the search for an optimal, or at least appropriate, management and financing approach.
While the R&A program is essential to the development and support of NASA's diverse set of space and Earth science missions, defining and articulating an appropriate scale for mission-enabling activities have posed a challenge throughout NASA's history. This volume identifies the appropriate roles for mission-enabling activities and metrics for assessing their effectiveness. Furthermore, the book evaluates how, from a strategic perspective, decisions should be made about balance between mission-related and mission-enabling elements of the overall program as well as balance between various elements within the mission-enabling component. Collectively, these efforts will help SMD to make a good program even better.
This report discusses the biennial assessment process used by ARLTAB and its five panels; provides detailed assessments of each of the ARL core technical competency areas reviewed during the 2013-2014 period; and presents findings and recommendations common across multiple competency areas.
Understanding Earth's Deep Past provides an assessment of both the demonstrated and underdeveloped potential of the deep-time geologic record to inform us about the dynamics of the global climate system. The report describes past climate changes, and discusses potential impacts of high levels of atmospheric greenhouse gases on regional climates, water resources, marine and terrestrial ecosystems, and the cycling of life-sustaining elements. While revealing gaps in scientific knowledge of past climate states, the report highlights a range of high priority research issues with potential for major advances in the scientific understanding of climate processes. This proposed integrated, deep-time climate research program would study how climate responded over Earth's different climate states, examine how climate responds to increased atmospheric carbon dioxide and other greenhouse gases, and clarify the processes that lead to anomalously warm polar and tropical regions and the impact on marine and terrestrial life.
In addition to outlining a research agenda, Understanding Earth's Deep Past proposes an implementation strategy that will be an invaluable resource to decision-makers in the field, as well as the research community, advocacy organizations, government agencies, and college professors and students.
Nuclear Physics is the latest volume of the series. The book describes current activity in understanding nuclear structure and symmetries, the behavior of matter at extreme densities, the role of nuclear physics in astrophysics and cosmology, and the instrumentation and facilities used by the field. It makes recommendations on the resources needed for experimental and theoretical advances in the coming decade.
Resources for Teaching Middle School Science, developed by the National Science Resources Center (NSRC), is a valuable tool for identifying and selecting effective science curriculum materials that will engage students in grades 6 through 8. The volume describes more than 400 curriculum titles that are aligned with the National Science Education Standards.
This completely new guide follows on the success of Resources for Teaching Elementary School Science, the first in the NSRC series of annotated guides to hands-on, inquiry-centered curriculum materials and other resources for science teachers.
The curriculum materials in the new guide are grouped in five chapters by scientific area--Physical Science, Life Science, Environmental Science, Earth and Space Science, and Multidisciplinary and Applied Science. They are also grouped by type--core materials, supplementary units, and science activity books.
Each annotation of curriculum material includes a recommended grade level, a description of the activities involved and of what students can be expected to learn, a list of accompanying materials, a reading level, and ordering information.
The curriculum materials included in this book were selected by panels of teachers and scientists using evaluation criteria developed for the guide. The criteria reflect and incorporate goals and principles of the National Science Education Standards. The annotations designate the specific content standards on which these curriculum pieces focus.
In addition to the curriculum chapters, the guide contains six chapters of diverse resources that are directly relevant to middle school science. Among these is a chapter on educational software and multimedia programs, chapters on books about science and teaching, directories and guides to science trade books, and periodicals for teachers and students.
Another section features institutional resources. One chapter lists about 600 science centers, museums, and zoos where teachers can take middle school students for interactive science experiences. Another chapter describes nearly 140 professional associations and U.S. government agencies that offer resources and assistance.
Authoritative, extensive, and thoroughly indexed--and the only guide of its kind--Resources for Teaching Middle School Science will be the most used book on the shelf for science teachers, school administrators, teacher trainers, science curriculum specialists, advocates of hands-on science teaching, and concerned parents.
In Unequal Treatment, a panel of experts documents this evidence and explores how persons of color experience the health care environment. The book examines how disparities in treatment may arise in health care systems and looks at aspects of the clinical encounter that may contribute to such disparities. Patientsâ€™ and providersâ€™ attitudes, expectations, and behavior are analyzed.
How to intervene? Unequal Treatment offers recommendations for improvements in medical care financing, allocation of care, availability of language translation, community-based care, and other arenas. The committee highlights the potential of cross-cultural education to improve providerâ€"patient communication and offers a detailed look at how to integrate cross-cultural learning within the health professions. The book concludes with recommendations for data collection and research initiatives. Unequal Treatment will be vitally important to health care policymakers, administrators, providers, educators, and students as well as advocates for people of color.
Children with autism are challenged by the most essential human behaviors. They have difficulty interacting with other people-often failing to see people as people rather than simply objects in their environment. They cannot easily communicate ideas and feelings, have great trouble imagining what others think or feel, and in some cases spend their lives speechless. They frequently find it hard to make friends or even bond with family members. Their behavior can seem bizarre.
Education is the primary form of treatment for this mysterious condition. This means that we place important responsibilities on schools, teachers and children's parents, as well as the other professionals who work with children with autism. With the passage of the Individuals with Disabilities Education Act of 1975, we accepted responsibility for educating children who face special challenges like autism. While we have since amassed a substantial body of research, researchers have not adequately communicated with one another, and their findings have not been integrated into a proven curriculum.
Educating Children with Autism outlines an interdisciplinary approach to education for children with autism. The committee explores what makes education effective for the child with autism and identifies specific characteristics of programs that work. Recommendations are offered for choosing educational content and strategies, introducing interaction with other children, and other key areas.
This book examines some fundamental issues, including:
How children's specific diagnoses should affect educational assessment and planning How we can support the families of children with autism Features of effective instructional and comprehensive programs and strategies How we can better prepare teachers, school staffs, professionals, and parents to educate children with autism What policies at the federal, state, and local levels will best ensure appropriate education, examining strategies and resources needed to address the rights of children with autism to appropriate education.
Children with autism present educators with one of their most difficult challenges. Through a comprehensive examination of the scientific knowledge underlying educational practices, programs, and strategies, Educating Children with Autism presents valuable information for parents, administrators, advocates, researchers, and policy makers.
Research indicates that for most youth, the period of risky experimentation does not extend beyond adolescence, ceasing as identity becomes settled with maturity. Much adolescent involvement in criminal activity is part of the normal developmental process of identity formation and most adolescents will mature out of these tendencies. Evidence of significant changes in brain structure and function during adolescence strongly suggests that these cognitive tendencies characteristic of adolescents are associated with biological immaturity of the brain and with an imbalance among developing brain systems. This imbalance model implies dual systems: one involved in cognitive and behavioral control and one involved in socio-emotional processes. Accordingly adolescents lack mature capacity for self-regulations because the brain system that influences pleasure-seeking and emotional reactivity develops more rapidly than the brain system that supports self-control. This knowledge of adolescent development has underscored important differences between adults and adolescents with direct bearing on the design and operation of the justice system, raising doubts about the core assumptions driving the criminalization of juvenile justice policy in the late decades of the 20th century.
It was in this context that the Office of Juvenile Justice and Delinquency Prevention (OJJDP) asked the National Research Council to convene a committee to conduct a study of juvenile justice reform. The goal of Reforming Juvenile Justice: A Developmental Approach was to review recent advances in behavioral and neuroscience research and draw out the implications of this knowledge for juvenile justice reform, to assess the new generation of reform activities occurring in the United States, and to assess the performance of OJJDP in carrying out its statutory mission as well as its potential role in supporting scientifically based reform efforts.
The Guide for the Care and Use of Laboratory Animals provides a framework for the judgments required in the management of animal facilities. This updated and expanded resource of proven value will be important to scientists and researchers, veterinarians, animal care personnel, facilities managers, institutional administrators, policy makers involved in research issues, and animal welfare advocates.
STEM Integration in K-12 Education makes recommendations for designers of integrated STEM experiences, assessment developers, and researchers to design and document effective integrated STEM education. This report will help to further their work and improve the chances that some forms of integrated STEM education will make a positive difference in student learning and interest and other valued outcomes.
Historically, drug repurposing has been largely an unintentional, serendipitous process that took place when a drug was found to have an offtarget effect or a previously unrecognized on-target effect that could be used for identifying a new indication. Perhaps the most recognizable example of such a successful repositioning effort is sildenafil. Originally developed as an anti-hypertensive, sildenafil, marketed as Viagra and under other trade names, has been repurposed for the treatment of erectile dysfunction and pulmonary arterial hypertension. Viagra generated more than $2 billion worldwide in 2012 and has recently been studied for the treatment of heart failure.
Given the widespread interest in drug repurposing, the Roundtable on Translating Genomic-Based Research for Health of the Institute of Medicine hosted a workshop on June 24, 2013, in Washington, DC, to assess the current landscape of drug repurposing activities in industry, academia, and government. Stakeholders, including government officials, pharmaceutical company representatives, academic researchers, regulators, funders, and patients, were invited to present their perspectives and to participate in workshop discussions. Drug Repurposing and Repositioning is the summary of that workshop. This report examines enabling tools and technology for drug repurposing; evaluates the business models and economic incentives for pursuing a repurposing approach; and discusses how genomic and genetic research could be positioned to better enable a drug repurposing paradigm.