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Indigenous communities experience higher risks for suicide compared to the general U.S. population, with suicide as the second-leading cause of death among Indigenous children and young adults in North America. To reduce this trend, it is essential for prevention and intervention efforts to build on scientific evidence; cultural and local knowledge; and the best community, family, and institutional practices to reduce risk and increase protection. The Forum on Mental Health and Substance Use Disorders and the Forum for Children's Well-Being at the National Academies of Sciences, Engineering, and Medicine convened a three-part virtual public workshop on April 26, 2022, May 13, 2022, and June 10, 2022, to examine suicide risk and protective factors in Indigenous populations, discuss culturally appropriate and effective suicide prevention policies and programs, explore existing data systems and how data can be used for tracking suicide rates, and consider opportunities for action. This Proceedings highlights presentations and discussions from the workshop.

An estimated 10 percent of children in the United States are living with disabilities, including a disproportionate number of children living in poverty and children of marginalized racial and ethnic groups. During the pandemic, children with disabilities suffered disproportionately compared to their peers without disabilities. To learn more about what policies and practices might be sustained or implemented beyond the pandemic to support children with disabilities and their families, the Board on Children, Youth, and Families hosted a workshop on June 13-15, 2022. Workshop presenters included service providers, researchers, government leaders, youth with disabilities, and caregivers of children and youth with disabilities. In this workshop, practices were identified that could improve the system of care for children with disabilities as well as improve access to services for underserved and marginalized populations.

Adolescence is a crucial period of life for the prevention of substance use disorders. Research has shown that early intervention can significantly reduce rates of substance use disorder in adulthood. To learn more about effective family-focused interventions in primary care settings for preventing substance use disorder, the National Academies of Sciences, Engineering, and Medicine hosted a workshop on May 5-6, 2022. The proceedings from that workshop explores existing efforts to incorporate family-focused interventions into state health care policies. It also examines barriers to implementing such interventions as well as lessons learned from successful efforts to scale up these interventions.

The onset of COVID-19 pandemic and inundation of the U.S. health care system emphasized infrastructural and health professional education vulnerabilities. A planning committee of the National Academies of Sciences, Engineering, and Medicine Global Forum on Innovation in Health Professional Education conducted a series of public workshops in the fall of 2021 to explore whether students and trainees should be viewed as members of the health workforce, particular in times of emergency as was experienced during the COVID-19 public health crisis. The planning committee gathered educators, students, administrators, and health professionals to share ideas, experiences, and data to strategize expansion of learning opportunities for medical trainees and enhancement of medical preparedness to unforeseen crises without compromising the quality of patient care. The workshops explored issues such as identifying evidence on value-added roles for students to serve in the delivery of care and in a public health capacity, and balancing the role of learners as consumers (tuition payers) and not licensed providers versus members of the health workforce. This Proceedings highlights presentations and discussions from the workshop.

The Intelligence Community Studies Board of the National Academies of Sciences, Engineering, and Medicine convened a 2-day virtual workshop on December 17 and 21, 2021, to explore insights from world-class experts and technologists familiar with the extensive range of issues associated with anticipating rare events--those characterized by a very low probability of occurring--of major significance. Over the course of the 2-day workshop, the speakers discussed analytical methods, computational advances, data sources, and risk assessment approaches for anticipating rare events, including natural disasters, pandemics, anthropogenic threats, and widespread technological change. This proceedings is a factual summary of the presentations and discussion of the workshop.

"Climate change, driven by increases in human-produced greenhouse gases and particles (collectively referred to as GHGs), is the most serious environmental issue facing society. The need to reduce GHGs has become urgent as heat waves, heavy rain events, and other impacts of climate change have become more frequent and severe. Since the Paris Agreement was adopted in 2015, more than 136 countries, accounting for about 80% of total global GHG emissions, have committed to achieving net-zero emissions by 2050. A growing number of cities, regional governments, and industries have also made pledges to reduce emissions. Providing decision makers with useful, accurate, and trusted GHG emissions information is a crucial part of this effort. This report examines existing and emerging approaches used to generate and evaluate GHG emissions information at global to local scales. The report develops a framework for evaluating GHG emissions information to support and guide policy makers about its use in decision making. The framework identifies six criteria or pillars that can be used to evaluate and improve GHG emissions information: usability and timeliness, information transparency, evaluation and validation, completeness, inclusivity, and communication. The report recommends creating a coordinated repository or clearinghouse to operationalize the six pillars, for example, by providing timely, transparent, traceable information; standardized data formats; and governance mechanisms that are coordinated, trusted, and inclusive of the global community."--Publisher's website.

U.S. leadership in technology innovation is central to our nation's interests, including its security, economic prosperity, and quality of life. Our nation has created a science and technology ecosystem that fosters innovation, risk taking, and the discovery of new ideas that lead to new technologies through robust collaborations across and within academia, industry, and government, and our research and development enterprise has attracted the best and brightest scientists, engineers, and entrepreneurs from around the world. The quality and openness of our research enterprise have been the basis of our global leadership in technological innovation, which has brought enormous advantages to our national interests. In today's rapidly changing landscapes of technology and competition, however, the assumption that the United States will continue to hold a dominant competitive position by depending primarily on its historical approach of identifying specific and narrow technology areas requiring controls or restrictions is not valid. Further challenging that approach is the proliferation of highly integrated and globally shared platforms that power and enable most modern technology applications. To review the protection of technologies that have strategic importance for national security in an era of openness and competition, Protecting U.S. Technological Advantage considers policies and practices related to the production and commercialization of research in domains critical to national security. This report makes recommendations for changes to technology protection policies and practices that reflect the current realities of how technologies are developed and incorporated into new products and processes.

Coeur d'Alene Lake in northern Idaho is an invaluable natural, recreational, and economic resource for communities in Idaho and eastern Washington. Starting in the late 1880s, mining in the Lake's watershed sent heavy metals and other mining wastes into the Lake, resulting in contamination of lake sediments with lead, cadmium, arsenic, and zinc that persists today. The watershed was designated a Superfund site and cleanup has been ongoing for 30 years. However, the Lake's environmental quality and cleanup is overseen by a Lake Management Plan, originally implemented by the Coeur d'Alene Tribe and the state of Idaho. A major focus of that plan is whether lakeshore development might promote low-oxygen (anoxic) conditions that could release toxic metals from lake sediments back into the water column. This report analyzes water quality data collected from the Lake and the watershed over the past 30 years. The analyses indicate that, although the Lake is still heavily contaminated, concentrations of metals in the major inputs to the Lake have declined, and there is no evidence that phosphorus concentrations have been increasing in the last decade or that low-oxygen events are becoming more common. However, the shorelines of the Lake, where exposure to metals or harmful algae is more likely, are not currently monitored. Protecting the water quality of Coeur d'Alene Lake will require that monitoring efforts be expanded to provide an early warning of deteriorating conditions, regular syntheses of data, and targeted studies--all coordinated among interest groups--followed by application of those results to managing the Lake.

Approximately 7.4 million people in the United States live with an intellectual or developmental disability (IDD), defined by the Centers for Disease Control and Prevention as "a group of conditions due to an impairment in physical, learning, language, or behavior areas. These conditions begin during the developmental period, may impact day-to-day functioning, and usually last throughout a person's lifetime." Individuals with IDD and their caretakers face exceptional barriers to staying healthy and accessing appropriate health services. Among these barriers are difficulty finding care providers that are adequately trained in meeting their specialized needs, unwieldy payment structures, and a lack of coordination between the various systems of care with which patients with IDD may interact (e.g., education, social work, various segments of the health care system). The National Academies of Sciences, Engineering, and Medicine hosted a workshop to discuss promising innovations in (1) workforce development, (2) financing and payment, and (3) care coordination; and to share visions for improved systems of care. Participants noted that while many existing approaches could serve as models for improving care, large changes will need to be made in these 3 facets of the care system in order to make them accessible to all IDD patients. This publication summarizes the presentations and discussions of the workshop.

Measuring and analyzing public opinion comes with tremendous challenges, as evidenced by recent struggles to predict election outcomes and to anticipate mass mobilizations. The National Academies of Sciences, Engineering, and Medicine publication Measurement and Analysis of Public Opinion: An Analytic Framework presents in-depth information from experts on how to collect and glean insights from public opinion data, particularly in conditions where contextual issues call for applying caveats to those data. The Analytic Framework is designed specifically to help intelligence community analysts apply insights from the social and behavioral sciences on state-of-the-art approaches to analyze public attitudes in non- Western populations. Sponsored by the intelligence community, the National Academies' Board on Behavioral, Cognitive, and Sensory Sciences hosted a 2-day hybrid workshop on March 8-9, 2022, to present the Analytic Framework and to demonstrate its application across a series of hypothetical scenarios that might arise for an intelligence analyst tasked with summarizing public attitudes to inform a policy decision. Workshop participants explored cutting-edge methods for using large-scale data as well as cultural and ethical considerations for the collection and use of public opinion data. This publication summarizes the presentations and discussions of the workshop.

Since around 1980, fewer Americans than before are doing better than their parents had - that is, more are experiencing downward social and economic mobility in terms of occupational status and income. This trend in downward mobility is occurring amidst high and rising levels of inequality in income, wealth, health, and life expectancy. To better understand the factors that influence social and economic mobility, the Committee on Population and the Committee on National Statistics hosted a workshop on February 14-15, 2022. The proceedings from this workshop identify key priorities for future research and data collection to improve social and economic mobility.

Oil and natural gas represent more than 50 percent of the worldwide energy supply, with high energy demand driven by population growth and improving standards of living. Despite significant progress in reducing the amount of oil in the sea from consumption, exploration, transportation, and production, risks remain. This report, the fourth in a series, documents the current state-of-knowledge on inputs, fates and effects of oil in the sea, reflecting almost 20 additional years of research, including long-term effects from spills such as the Exxon Valdez and a decade-long boom in oil spill science research following the Deepwater Horizon oil spill. The report finds that land-based sources of oil are the biggest input of oil to the sea, far outweighing other sources, and it also notes that the effects of chronic inputs on the marine environment, such as land-based runoff, are very different than that from an acute input, such as a spill. Steps to prevent chronic land-based oil inputs include reducing gasoline vehicle usage, improving fuel efficiency, increasing usage of electric vehicles, replacing older vehicles. The report identifies research gaps and provides specific recommendations aimed at preventing future accidental spills and ensuring oil spill responders are equipped with the best response tools and information to limit oil's impact on the marine environment.

Historically, the U.S. national data infrastructure has relied on the operations of the federal statistical system and the data assets that it holds. Throughout the 20th century, federal statistical agencies aggregated survey responses of households and businesses to produce information about the nation and diverse subpopulations. The statistics created from such surveys provide most of what people know about the well-being of society, including health, education, employment, safety, housing, and food security. The surveys also contribute to an infrastructure for empirical social- and economic-sciences research. Research using survey-response data, with strict privacy protections, led to important discoveries about the causes and consequences of important societal challenges and also informed policymakers. Like other infrastructure, people can easily take these essential statistics for granted. Only when they are threatened do people recognize the need to protect them. Toward a 21st Century National Data Infrastructure: Mobilizing Information for the Common Good develops a vision for a new data infrastructure for national statistics and social and economic research in the 21st century. This report describes how the country can improve the statistical information so critical to shaping the nation's future, by mobilizing data assets and blending them with existing survey data.

Affecting technological systems at a global-scale, space weather can disrupt high-frequency radio signals, satellite-based communications, navigational satellite positioning and timing signals, spacecraft operations, and electric power delivery with cascading socioeconomic effects resulting from these disruptions. Space weather can also present an increased health risk for astronauts, as well as aviation flight crews and passengers on transpolar flights. In 2019, the National Academies was approached by the National Aeronautics and Space Administration, the National Oceanic and Atmospheric Administration, and the National Science Foundation to organize a workshop that would examine the operational and research infrastructure that supports the space weather enterprise, including an analysis of existing and potential future measurement gaps and opportunities for future enhancements. This request was subsequently modified to include two workshops, the first ("Phase I") of which occurred in two parts on June 16-17 and September 9-11, 2020. The Phase II workshop occurred on April 11-14, 2022, with sessions on agency updates, research needs, data science, observational and modeling needs, and emerging architectures relevant to the space weather research community and with ties to operational needs. This publication summarizes the presentation and discussion of that workshop.

The widespread adoption of electric vehicles will play a critical role in decarbonizing the transportation sector as the nation moves toward net-zero emissions. Recent announcements from automakers and the federal government, as well as provisions in the Infrastructure Investment and Jobs Act of 2021, aim to stimulate electric vehicle (EV) deployment, and ongoing technology improvements continue to make EVs a more affordable and practical option. However, many challenges remain to meet the needs of all buyers and drivers and to ensure that manufacturing supply chains and the electric system can support this large-scale transformation. As a follow-up activity to its 2021 report Assessment of Technologies for Improving Light-Duty Vehicle Fuel Economy - 2025-2035, the National Academies of Sciences, Engineering, and Medicine convened a 4-day virtual workshop on October 25-28, 2021, to identify some of the challenges to widespread EV deployment and discuss policy, technical, and market strategies to help federal agencies and other stakeholders plan for the future. This publication summarizes the presentation and discussion of the workshop.

Encryption is a process for making information unreadable by an adversary who does not possess a specific key that is required to make the encrypted information readable. The inverse process, making information that has been encrypted readable, is referred to as decryption. Cryptography has become widespread and is used by private as well as governmental actors. It also enables authentication and underlies the safe use of the Internet and computer systems by individuals and organizations worldwide. Emerging cryptographic technologies offer capabilities such as the ability to process encrypted information without first decrypting it. At the request of the Office of the Director of National Intelligence, this report identifies potential scenarios that would describe the balance between encryption and decryption over the next 10 to 20 years and assesses the national security and intelligence implications of each scenario. For each of these scenarios, Cryptography and the Intelligence Community identifies risks, opportunities, and actions. Attention to the findings should enable the Intelligence Community to prepare for the future and to recognize emerging trends and developments and respond appropriately.

Wildfires in America are becoming larger, more frequent, and more destructive, driven by climate change and existing land management practices. Many of these fires occur at the wildland-urban interface (WUI), areas where development and wildland areas overlap and which are increasingly at risk of devastating fires as communities continue to expand into previously undeveloped areas. Unlike conventional wildfires, WUI fires are driven in part by burning of homes, cars, and other human-made structures, and in part by burning vegetation. The interaction of these two types of fires can lead to public health effects that are unique to WUI fires. This report evaluates existing and needed chemistry information that decision-makers can use to mitigate WUI fires and their potential health impacts. It describes key fuels of concern in WUI fires, especially household components like siding, insulation, and plastic, examines key pathways for exposure, including inhalation and ingestion, and identifies communities vulnerable to exposures. The report recommends a research agenda to inform response to and prevention of WUI fires, outlining needs in characterizing fuels, and predicting emissions and toxicants.

This report reviews Federal Communications Commission order FCC 20-48, which authorized Ligado Networks LLC to operate a low-power terrestrial radio network adjacent to the Global Positioning System (GPS) frequency band. It considers how best to evaluate harmful interference to civilian and defense users of GPS, the potential for harmful interference to GPS users and DOD activities, and the effectiveness and feasibility of the mitigation measures proposed in the FCC order.

Psychiatric illnesses - such as major depressive disorder, anxiety disorder, substance use disorder, and posttraumatic stress disorder (PTSD) - are widely prevalent and represent a substantial health burden worldwide. Yet, conventional medications for mental illnesses often fail to provide relief to patients' disruptive and disabling symptoms. Existing and emerging evidence that psychedelics (e.g., LSD and psilocybin) and entactogens (e.g., MDMA) may be useful as tools to alleviate mental illness has sparked a renaissance of interest by investigators, clinicians, drug developers, and patient advocates in recent years. While promising data on therapeutic efficacy has energized research and development, resolving the mechanisms of action will be important for optimizing the efficacy and safety of these medicines. Further, evaluating the effect of psychedelics and entactogens on mood and behavior comes with unique challenges still in need of resolution. These include unresolved questions relating to blinding, placebo and nocebo effects, and the impact of psychosocial contexts. In response to this renewed interest, the National Academies of Sciences, Engineering, and Medicine's Forum on Neuroscience and Nervous System Disorders convened a workshop on March 29-30, 2022. The workshop brought together a diverse group of stakeholders to explore the use of psychedelics and entactogens as treatments for psychiatric disorders. This Proceedings of a Workshop summarizes the presentations and discussions of the workshop.

Structural racism refers to the public and private policies, institutional practices, norms, and cultural representations that inherently create unequal freedom, opportunity, value, resources, advantage, restrictions, constraints, or disadvantage for individuals and populations according to their race and ethnicity both across the life course and between generations. Developing a research agenda on structural racism includes consideration of the historical and contemporary policies and other structural factors that explicitly or implicitly affect the health and well-being of individuals, families, and communities, as well as strategies to measure those factors. The Committee on Population of the National Academies of Sciences, Engineering, and Medicine convened a 2-day public workshop on May 16-17, 2022, to identify and discuss the mechanisms through which structural racism operates, with a particular emphasis on health and well-being; to develop an agenda for future research and data collection on structural racism; and to strengthen the evidence base for policy making. Speaker presentations and workshop discussions provided insights into known sources of structural racism and rigorous models of health inequity, revealed novel sources and approaches informed by other disciplines and related fields, and highlighted key research and data priorities for future work on structural racism and health inequity.

Despite advances in the delivery of high-quality cancer care and improvements in patient outcomes in recent years, disparities in cancer incidence, care, and patient outcomes persist. To examine opportunities to improve health equity across the cancer care continuum, the National Cancer Policy Forum and the Roundtable on the Promotion of Health Equity hosted a public workshop, Promoting Health Equity in Cancer Care, on October 25 and October 26, 2021. This virtual workshop featured presentations and panel discussions on topics that included: opportunities to improve equitable access to affordable, high-quality cancer care; strategies to identify and address the intersectionality of structural racism and implicit bias in cancer care delivery; the potential for quality measurement and payment mechanisms to incentivize health equity in cancer care delivery; and clinical practice data collection efforts to better assess and care for people living with and beyond cancer. This publication summarizes the presentation and discussion of the workshop.

The U.S. space science community includes thousands of scientists across multiple disciplines that influence and are influenced by the many engineers, technicians, and support personnel that are part of the space research enterprise. Over one-third of NASA's budget is devoted to space science, and the agency currently operates over 50 space missions in the fields of astrophysics, Earth science, solar and space physics, planetary science, and the biological and physical sciences. The strength of NASA science lies with its people, both those who work directly for the agency and the thousands of researchers and professionals who are funded by NASA grants and contracts. At the request of NASA, this report examines the foundation for healthy and vital research communities. Foundations of a Healthy and Vital Research Community for NASA Science identifies the characteristics of a healthy and vital research community, defines implementable measures for assessing the health and vitality of a research community, describes the types of data that NASA should be collecting to enable future assessments of the health and vitality of the scientific work force, and recommends best practices to improve the health and vitality of NASA's research communities.

In recent decades, production processes of intermediate and final products have been increasingly fragmented across countries in what are called global value chains (GVCs). GVCs may involve companies in one country outsourcing stages of production to unrelated entities in other countries, multinational enterprises (MNEs) offshoring stages of production to units of the MNE overseas, or both. GVCs can also involve completely independent companies merely sourcing their parts from whichever upstream company may be the most competitive, with no control arrangement necessarily involved. The changing global trade environment and the changes in firms' behavior have raised new and more complicated issues for policy makers and have made it difficult for them to understand the extent and operations of GVCs and their spillover effects on national and local economies. To improve the understanding, measurement, and valuation of GVCs, the Innovation Policy Forum at the National Academies of Sciences, Engineering, and Medicine convened a workshop, "Innovation, Global Value Chains, and Globalization Measurement" May 5-7, 2021. This proceedings has been prepared by the workshop rapporteurs as a factual summary of what occurred at the workshop.

The National Academies of Sciences, Engineering, and Medicine's Roundtable on Obesity Solutions convened a three-part workshop series that explored how structural racism, weight bias and stigma, and health communication intersect with obesity, gaps in the evidence base, and challenges and opportunities for long-term, systems-wide strategies needed to reduce the incidence and prevalence of obesity. Through diverse examples across different levels and sectors of society, the workshops explored how to leverage the connections between these three drivers and innovative data-driven and policy approaches to inform actionable priorities for individuals, organizations, and policymakers to make lasting systems change.

The U.S. Equal Employment Opportunity Commission (EEOC) expanded EEO-1 data collection for reporting years 2017 to 2018 in an effort to improve its ability to investigate and address pay disparities between women and men and between different racial and ethnic groups. These pay disparities are well documented in national statistics. For example, the U.S. Census Bureau (2021) found that Black and Hispanic women earned only 63 percent and 55 percent as much, respectively, of what non-Hispanic White men earned. Evaluation of Compensation Data Collected Through the EEO-1 Form examines the quality of pay data collected using the EEO-1 form and provides recommendations for future data collection efforts. The report finds that there is value in the expanded EEO-1 data, which are unique among federal surveys by providing employee pay, occupation, and demographic data at the employer level. Nonetheless, both short-term and longer-term improvements are recommended to address significant concerns in employer coverage, conceptual definitions, data measurement, and collection protocols. If implemented, these recommendations could improve the breadth and strength of EEOC data for addressing pay equity, potentially reduce employer burden, and better support employer self-assessment.

Involvement with the juvenile justice system can impact young people's physical and mental health and well-being throughout their lives, as well as the health and well-being of their families and communities. Youth of color are more likely to become involved with the juvenile justice system, and suffer worse outcomes in sentencing, during incarceration, and after release. The National Academies of Sciences, Engineering, and Medicine's Roundtable on the Promotion of Health Equity convened a workshop to discuss the impact that juvenile justice system involvement has on the health and well-being of adolescents, families, and communities of color; examine policies that are successful in improving outcomes; and explore what needs to be done to improve all aspects of encounters with the juvenile justice system. The workshop suggested pursuing alternatives to traditional juvenile justice systems that would allow adolescents to stay in their communities rather than in detention, responding to behavioral problems in youth with interventions that promote health and positive development rather than punishment, and tailoring interventions and programming to participants' cultural background and gender identity. This report summarizes the proceedings of the workshop.

Regular use of sunscreens has been shown to reduce the risk of sunburn and skin cancer, and slow photoaging of skin. Sunscreens can rinse off into water where people are swimming or wading, and can also enter bodies of water through wastewater such as from bathing or showering. As a result, the ultraviolet (UV) filters - the active ingredients in sunscreens that reduce the amount of UV radiation on skin - have been detected in the water, sediment, and animal tissues in aquatic environments. Because the impact of these filters on aquatic ecosystems is not fully understood, assessment is needed to better understand their environmental impacts. This report calls on the U.S. Environmental Protection Agency to conduct an ecological risk assessment of UV filters to characterize the possible risks to aquatic ecosystems and the species that live in them. EPA should focus on environments more likely to be exposed such as those with heavy recreational use, or where wastewater and urban runoff enter the water. The risk assessment should cover a broad range of species and biological effects and could consider potential interacting effects among UV filters and with other environmental stresses such as climate change. In addition, the report describes the role of sunscreens in preventing skin cancer and what is known about how human health could be affected by potential changes in usage. While the need for a risk assessment is urgent, research is needed to advance understanding of both risks to the environment from UV filters and impacts to human health from changing sunscreen availability and usage.

In thousands of communities across the United States, drinking water is contaminated with chemicals known as perfluoroalkyl and polyfluoroalkyl substances (PFAS). PFAS are used in a wide range of products, such as non-stick cookware, water and stain repellent fabrics, and fire-fighting foam, because they have properties that repel oil and water, reduce friction, and resist temperature changes. PFAS can leak into the environment where they are made, used, disposed of, or spilled. PFAS exposure has been linked to a number of adverse health effects including certain cancers, thyroid dysfunction, changes in cholesterol, and small reductions in birth weight. This report recommends that the Centers for Disease Control and Prevention (CDC) update its clinical guidance to advise clinicians to offer PFAS blood testing to patients who are likely to have a history of elevated exposure, such as those with occupational exposures or those who live in areas known to be contaminated. If testing reveals PFAS levels associated with an increased risk of adverse effects, patients should receive regular screenings and monitoring for these and other health impacts. Guidance on PFAS Exposure, Testing, and Clinical Follow-Up recommends that the CDC, Agency for Toxic Substances and Disease Registry (ATSDR), and public health departments support clinicians by creating educational materials on PFAS exposure, potential health effects, the limitations of testing, and the benefits and harms of testing.

On May 18-19, 2021, the Condensed Matter and Materials Research Committee of the National Academies of Sciences, Engineering, and Medicine convened a public workshop to examine the frontiers of research on moiré quantum matter. Participants at the workshop discussed the challenges and possibilities that this new material presents. This publication summarizes the presentations and discussion of the workshop.