Bøger udgivet af National Academies Press

In 2012, the National Defense Authorization Act (NDAA), section 818, outlined new requirements for industry to serve as the lead in averting counterfeits in the defense supply chain. Subsequently, the House Armed Services Committee, in its report on the Fiscal Year 2016 NDAA, noted that the pending sale of IBM's microprocessor fabrication facilities to Global Foundries created uncertainty about future access of the United States to trusted state-of-the-art microelectronic components and directed the Comptroller General to assess the Department of Defense's (DoD's) actions and measures to address this threat. In this context, the National Academies of Sciences, Engineering, and Medicine convened a workshop to facilitate an open dialogue with leading industry, academic, and government experts to (1) define the current technological and policy challenges with maintaining a reliable and secure source of microelectronic components; (2) review the current state of acquisition processes within the Air Force for acquiring reliable and secure microelectronic components; and (3) explore options for possible business models within the national security complex that would be relevant for the Air Force acquisition community. This publication summarizes the results of the workshop.

New Worlds, New Horizons in Astronomy and Astrophysics (NWNH), the report of the 2010 decadal survey of astronomy and astrophysics, put forward a vision for a decade of transformative exploration at the frontiers of astrophysics. This vision included mapping the first stars and galaxies as they emerge from the collapse of dark matter and cold clumps of hydrogen, finding new worlds in a startlingly diverse population of extrasolar planets, and exploiting the vastness and extreme conditions of the universe to reveal new information about the fundamental laws of nature. NWNH outlined a compelling program for understanding the cosmic order and for opening new fields of inquiry through the discovery areas of gravitational waves, time-domain astronomy, and habitable planets. Many of these discoveries are likely to be enabled by cyber-discovery and the power of mathematics, physics, and imagination. To help realize this vision, NWNH recommended a suite of innovative and powerful facilities, along with balanced, strong support for the scientific community engaged in theory, data analysis, technology development, and measurements with existing and new instrumentation. Already in the first half of the decade, scientists and teams of scientists working with these cutting-edge instruments and with new capabilities in data collection and analysis have made spectacular discoveries that advance the NWNH vision. New Worlds, New Horizons: A Midterm Assessment reviews the responses of NASA's Astrophysics program, NSF's Astronomy program, and DOE's Cosmic Frontiers program to NWNH. This report describes the most significant scientific discoveries, technical advances, and relevant programmatic changes in astronomy and astrophysics over the years since the publication of the decadal survey, and assesses how well the Agencies' programs address the strategies, goals, and priorities outlined in the 2010 decadal survey.

Historically, the United States has been a world leader in aerospace endeavors in both the government and commercial sectors. A key factor in aerospace leadership is continuous development of advanced technology, which is critical to U.S. ambitions in space, including a human mission to Mars. To continue to achieve progress, NASA is currently executing a series of aeronautics and space technology programs using a roadmapping process to identify technology needs and improve the management of its technology development portfolio. NASA created a set of 14 draft technology roadmaps in 2010 to guide the development of space technologies. In 2015, NASA issued a revised set of roadmaps. A significant new aspect of the update has been the effort to assess the relevance of the technologies by listing the enabling and enhancing technologies for specific design reference missions (DRMs) from the Human Exploration and Operations Mission Directorate and the Science Mission Directorate. NASA Space Technology Roadmaps and Priorities Revisited prioritizes new technologies in the 2015 roadmaps and recommends a methodology for conducting independent reviews of future updates to NASA's space technology roadmaps, which are expected to occur every 4 years.

A decade ago, the U.S. chemical industry was in decline. Of the more than 40 chemical manufacturing plants being built worldwide in the mid-2000s with more than $1 billion in capitalization, none were under construction in the United States. Today, as a result of abundant domestic supplies of affordable natural gas and natural gas liquids resulting from the dramatic rise in shale gas production, the U.S. chemical industry has gone from the world's highest-cost producer in 2005 to among the lowest-cost producers today. The low cost and increased supply of natural gas and natural gas liquids provides an opportunity to discover and develop new catalysts and processes to enable the direct conversion of natural gas and natural gas liquids into value-added chemicals with a lower carbon footprint. The economic implications of developing advanced technologies to utilize and process natural gas and natural gas liquids for chemical production could be significant, as commodity, intermediate, and fine chemicals represent a higher-economic-value use of shale gas compared with its use as a fuel. To better understand the opportunities for catalysis research in an era of shifting feedstocks for chemical production and to identify the gaps in the current research portfolio, the National Academies of Sciences, Engineering, and Medicine conducted an interactive, multidisciplinary workshop in March 2016. The goal of this workshop was to identify advances in catalysis that can enable the United States to fully realize the potential of the shale gas revolution for the U.S. chemical industry and, as a result, to help target the efforts of U.S. researchers and funding agencies on those areas of science and technology development that are most critical to achieving these advances. This publication summarizes the presentations and discussions from the workshop.

"In September 2015, the National Academies of Sciences, Engineering, and Medicine hosted a workshop to explore the basic and translational research needs for population health science, and to discuss specific research priorities and actions to foster population health improvement. The workshop was designed to provide frameworks for understanding population health research and its role in shaping and having an effect on population health, identify individual and institutional facilitators and challenges regarding the production, communication, and use of research for population health improvement, and identify key areas for future research critical to the advancement of population health improvement. This publication summarizes the presentations and discussions from the workshop"--

Gulf Coast communities and natural resources suffered extensive direct and indirect damage as a result of the largest accidental oil spill in US history, referred to as the Deepwater Horizon (DWH) oil spill. Notably, natural resources affected by this major spill include wetlands, coastal beaches and barrier islands, coastal and marine wildlife, seagrass beds, oyster reefs, commercial fisheries, deep benthos, and coral reefs, among other habitats and species. Losses include an estimated 20% reduction in commercial fishery landings across the Gulf of Mexico and damage to as much as 1,100 linear miles of coastal salt marsh wetlands. This historic spill is being followed by a restoration effort unparalleled in complexity and magnitude in U.S. history. Legal settlements in the wake of DWH led to the establishment of a set of programs tasked with administering and supporting DWH-related restoration in the Gulf of Mexico. In order to ensure that restoration goals are met and money is well spent, restoration monitoring and evaluation should be an integral part of those programs. However, evaluations of past restoration efforts have shown that monitoring is often inadequate or even absent. Effective Monitoring to Evaluate Ecological Restoration in the Gulf of Mexico identifies best practices for monitoring and evaluating restoration activities to improve the performance of restoration programs and increase the effectiveness and longevity of restoration projects. This report provides general guidance for restoration monitoring, assessment, and synthesis that can be applied to most ecological restoration supported by these major programs given their similarities in restoration goals. It also offers specific guidance for a subset of habitats and taxa to be restored in the Gulf including oyster reefs, tidal wetlands, and seagrass habitats, as well as a variety of birds, sea turtles, and marine mammals.

In February 2016, the National Academies of Sciences, Engineering, and Medicine held a workshop in which speakers shared strategies for individuals, organizations, and communities to advance racial and health equity. Participants discussed increasing awareness about the role of historical contexts and dominant narratives in interpreting data and information about different racial and ethnic groups, framing messages for different social and political outcomes, and readying people to institutionalize practices, policies, and partnerships that advance racial and health equity. This publication serves as a factual summary of the presentations and discussions from the workshop.

In March 2015, the National Academies of Sciences, Engineering, and Medicine held a workshop to explore the role that chemical exposures may play in the development of obesity. The obesity epidemic that has gripped the United States and much of the developed world for the past several decades has proved remarkably resistant to the various approaches tried by clinicians and public health officials to fight it. This raises the possibility that, in addition to the continued exploration of consumer understanding and behavior, new approaches that go beyond the standard focus on energy intake and expenditure may also be needed to combat the multifactorial problem of obesity. The speakers at the workshop discussed evidence from both studies with animal models and human epidemiological studies that exposure to environmental chemicals is linked both to weight gain and to glucose tolerance, insulin sensitivity, inflammation, and other aspects of the metabolic syndrome. In addition to conventional environmental chemical exposures, this workshop also included one panel to discuss the potential role of other exposures, including sugar, artificial sweeteners, and antibiotics, in aiding or causing obesity. The participants also examined possible biological pathways and mechanisms underlying the potential linkages. This publication summarizes the presentations and discussions from the workshop.

Decades of research have demonstrated that the parent-child dyad and the environment of the family--which includes all primary caregivers--are at the foundation of children's well- being and healthy development. From birth, children are learning and rely on parents and the other caregivers in their lives to protect and care for them. The impact of parents may never be greater than during the earliest years of life, when a child's brain is rapidly developing and when nearly all of her or his experiences are created and shaped by parents and the family environment. Parents help children build and refine their knowledge and skills, charting a trajectory for their health and well-being during childhood and beyond. The experience of parenting also impacts parents themselves. For instance, parenting can enrich and give focus to parents' lives; generate stress or calm; and create any number of emotions, including feelings of happiness, sadness, fulfillment, and anger. Parenting of young children today takes place in the context of significant ongoing developments. These include: a rapidly growing body of science on early childhood, increases in funding for programs and services for families, changing demographics of the U.S. population, and greater diversity of family structure. Additionally, parenting is increasingly being shaped by technology and increased access to information about parenting. Parenting Matters identifies parenting knowledge, attitudes, and practices associated with positive developmental outcomes in children ages 0-8; universal/preventive and targeted strategies used in a variety of settings that have been effective with parents of young children and that support the identified knowledge, attitudes, and practices; and barriers to and facilitators for parents' use of practices that lead to healthy child outcomes as well as their participation in effective programs and services. This report makes recommendations directed at an array of stakeholders, for promoting the wide-scale adoption of effective programs and services for parents and on areas that warrant further research to inform policy and practice. It is meant to serve as a roadmap for the future of parenting policy, research, and practice in the United States.

Immunotherapy is a form of cancer therapy that harnesses the body's immune system to destroy cancer cells. In recent years, immunotherapies have been developed for several cancers, including advanced melanoma, lung cancer, and kidney cancer. In some patients with metastatic cancers who have not responded well to other treatments, immunotherapy treatment has resulted in complete and durable responses. Given these promising findings, it is hoped that continued immunotherapy research and development will produce better cancer treatments that improve patient outcomes. With this promise, however, there is also recognition that the clinical and biological landscape for immunotherapies is novel and not yet well understood. For example, adverse events with immunotherapy treatment are quite different from those experienced with other types of cancer therapy. Similarly, immunotherapy dosing, therapeutic responses, and response time lines are also markedly different from other cancer therapies. To examine these challenges and explore strategies to overcome them, the National Academies of Sciences, Engineering, and Medicine held a workshop in February and March of 2016. This report summarizes the presentations and discussions from the workshop.

This book is the third in a series of five brief reports that aim to inform ASPE analyses that account for social risk factors in Medicare payment programs mandated through the IMPACT Act. This report builds on the conceptual relationships and empirical associations between social risk factors and performance indicators used in value-based payment identified in the first report to provide guidance on which factors could be considered for Medicare accounting purposes, criteria to identify these factors, and methods to do so in ways that can improve care and promote greater health equity for socially at-risk patients.--

"The U.S. Global Change Research Program (USGCRP) was established in 1990 to "assist the nation and the world to understand, assess, predict, and respond to human-induced and natural processes of global change. A key responsibility for the program is to conduct National Climate Assessments (NCAs) every 4 years. These assessments are intended to inform the nation about observed changes in climate, the current status of the climate, and anticipated trends for the future. The USGCRP hopes that government entities from federal agencies to small municipalities, citizens, communities, and businesses will rely on these assessments of climate related risks for planning and decision making. The third NCA (NCA3) was published in 2014 and work on the fourth is beginning. The USGCRP asked the Board on Environmental Change and Society of the National Academies of Sciences, Engineering, and Medicine to conduct a workshop to explore ways to frame the NCA4 and subsequent NCA reports in terms of risks to society. The workshop was intended to collect experienced views on how to characterize and communicate information about climate-related hazards, risks, and opportunities that will support decision makers in their efforts to reduce greenhouse gas emissions, reduce vulnerability to likely changes in climate, and increase resilience to those changes. Characterizing Risk in Climate Change Assessments summarizes the presentations and discussions from the workshop"--Publisher's description.

In 1999 the National Academies of Sciences, Engineering, and Medicine released a landmark report, Our Common Journey: A Transition toward Sustainability, which attempted to "reinvigorate the essential strategic connections between scientific research, technological development, and societies' efforts to achieve environmentally sustainable improvements in human well-being."1 The report emphasized the need for place-based and systems approaches to sustainability, proposed a research strategy for using scientific and technical knowledge to better inform the field, and highlighted a number of priorities for actions that could contribute to a sustainable future. The past 15 years have brought significant advances in observational and predictive capabilities for a range of natural and social systems, as well as development of other tools and approaches useful for sustainability planning. In addition, other frameworks for environmental decision making, such as those that focus on climate adaptation or resilience, have become increasingly prominent. A careful consideration of how these other approaches might intersect with sustainability is warranted, particularly in that they may affect similar resources or rely on similar underlying scientific data and models. ? To further the discussion on these outstanding issues, the National Academies of Sciences, Engineering, and Medicine convened a workshop on January 14-15, 2016. Participants discussed progress in sustainability science during the last 15 years, potential opportunities for advancing the research and use of scientific knowledge to support a transition toward sustainability, and challenges specifically related to establishing indicators and observations to support sustainability research and practice. This report summarizes the presentations and discussions from the workshop.

Older adults are a growing demographic group in the United States, and a range of physical, social, financial, and cultural factors affect their nutritional status. Metabolic and physiologic changes that accompany normal aging modify the nutritional requirements of older adults. An examination of evidence is needed to better understand how nutritional status is associated with aging and risk of mortality or chronic disease among older adults. Underpinning many, if not most, nutritional problems in older adults is socioeconomic status. Therefore, understanding access challenges to healthy food, including geographic, financial, and transportation barriers, also is needed to better understand how to meet the nutritional needs of older adults. On October 28-29, 2015, the Food and Nutrition Board convened a workshop, Meeting the Dietary Needs of Older Adults, in Washington, DC. Participants examined factors in the physical, social, and cultural environment that affect the ability of older adults to meet their daily dietary needs. This report summarizes the presentations and discussions from the workshop.

"The U.S. Environmental Protection Agency (EPA) defines PM as a mixture of extremely small particles and liquid droplets comprising a number of components, including 'acids (such as nitrates and sulfates), organic chemicals, metals, soil or dust particles, and allergens (such as fragments of pollen and mold spores)'. The health effects of outdoor exposure to particulate matter (PM) are the subject of both research attention and regulatory action. Although much less studied to date, indoor exposure to PM is gaining attention as a potential source of adverse health effects. Indoor PM can originate from outdoor particles and also from various indoor sources, including heating, cooking, and smoking. Levels of indoor PM have the potential to exceed outdoor PM levels. Understanding the major features and subtleties of indoor exposures to particles of outdoor origin can improve our understanding of the exposure--response relationship on which ambient air pollutant standards are based. The EPA's Indoor Environments Division commissioned the National Academies of Sciences, Engineering, and Medicine to hold a workshop examining the issue of indoor exposure to PM more comprehensively and considering both the health risks and possible intervention strategies. Participants discussed the ailments that are most affected by particulate matter and the attributes of the exposures that are of greatest concern, exposure modifiers, vulnerable populations, exposure assessment, risk management, and gaps in the science. This report summarizes the presentations and discussions from the workshop"--

"The aging and evolving racial and ethnic composition of the U.S. population has the United States in the midst of a profound demographic shift and health care organizations face many issues as they move to address and adapt to this change. In their drive to adequately serve increasingly diverse communities, health care organizations are searching for approaches that will enable them to provide information and service to all persons, regardless of age, race, cultural background, or language skills, in a manner that facilitates understanding and use of that information to make appropriate health decisions. To better understand how the dynamic forces operating in health care today impact the delivery of services in a way that is health literate, culturally competent, and in an appropriate language for patients and their families, the National Academies of Sciences, Engineering, and Medicine conducted a public workshop on the integration of health literacy, cultural competency, and language access services. Participants discussed skills and competencies needed for effective health communication, including health literacy, cultural competency, and language access services; interventions and strategies for integration; and differing perspectives such as providers and systems, patients and families, communities, and payers. This report summarizes the presentations and discussions from the workshop"--Publisher's description.

The U.S. Department of State charged the Academies with the task of producing a protocol for development of standard operating procedures (SOPs) that would serve as a complement to the Chemical Laboratory Safety and Security: A Guide to Prudent Chemical Management and be included with the other materials in the 2010 toolkit. To accomplish this task, a committee with experience and knowledge in good chemical safety and security practices in academic and industrial laboratories with awareness of international standards and regulations was formed. The hope is that this toolkit expansion product will enhance the use of the previous reference book and the accompanying toolkit, especially in developing countries where safety resources are scarce and experience of operators and end-users may be limited.

The 2012 National Research Council report Continuing Innovation in Information Technology illustrates how fundamental research in information technology (IT), conducted at industry and universities, has led to the introduction of entirely new product categories that ultimately became billion-dollar industries. The central graphic from that report portrays and connects areas of major investment in basic research, university-based research, and industry research and development; the introduction of important commercial products resulting from this research; billion-dollar-plus industries stemming from it; and present-day IT market segments and representative U.S. firms whose creation was stimulated by the decades-long research. At a workshop hosted by the Computer Science and Telecommunications Board on March 5, 2015, leading academic and industry researchers and industrial technologists described key research and development results and their contributions and connections to new IT products and industries, and illustrated these developments as overlays to the 2012 "tire tracks" graphic. The principal goal of the workshop was to collect and make available to policy makers and members of the IT community first-person narratives that illustrate the link between government investments in academic and industry research to the ultimate creation of new IT industries. This report provides summaries of the workshop presentations organized into five broad themes - (1) fueling the innovation pipeline, (2) building a connected world, (3) advancing the hardware foundation, (4) developing smart machines, and (5) people and computers - and ends with a summary of remarks from the concluding panel discussion.

Large catastrophic events, or rare acute events, may cause situations in which a local jurisdiction's medicines and medical supplies are not sufficient to provide care to the population it serves. In these cases of natural or engineered disasters, such as a terrorist attack, influenza pandemic, or earthquake, state or local authorities can request that the federal government provide assets from the Strategic National Stockpile to augment the state and local jurisdictions' resources. The Centers for Disease Control and Prevention's (CDC's) Strategic National Stockpile (SNS) is the nation's repository of antibiotics, chemical antidotes, antitoxins, vaccines, antiviral drugs, and other medical materiel designed to supplement and resupply state and local public health agencies in the event of an emergency. The materiel is intended to support national health security and is managed by the Office of Public Health Preparedness and Response's (OPHPR's) Division of Strategic National Stockpile (DSNS). The stated mission of the SNS is to prepare and support partners and provide the right resources at the right time to secure the nation's health. The National Academies of Sciences, Engineering, and Medicine organized a two-day public workshop to explore opportunities to improve the efficiency, effectiveness, and sustainable methods used by the CDC's SNS to distribute medical countermeasures and other supplies during disasters and other public health emergencies, especially those which result in disruption of physical infrastructure such as the electrical grid, central roadways, bridges, and tunnels within the impacted community. Participants explored relevant distribution lessons learned from other federal agency stockpiles and the private sector as well as opportunities to develop public-private collaborations in the purchase, warehousing, management, and distribution of medical countermeasures. This report summarizes the presentations and discussions from the workshop.

Obesity has come to the forefront of the American public health agenda. The increased attention has led to a growing interest in quantifying obesity prevalence and determining how the prevalence has changed over time. Estimates of obesity prevalence and trends are fundamental to understanding and describing the scope of issue. Policy makers, program planners, and other stakeholders at the national, state, and local levels are among those who search for estimates relevant to their population(s) of interest to inform their decision-making. The differences in the collection, analysis, and interpretation of data have given rise to a body of evidence that is inconsistent and has created barriers to interpreting and applying published reports. As such, there is a need to provide guidance to those who seek to better understand and use estimates of obesity prevalence and trends. Assessing Prevalence and Trends in Obesity examines the approaches to data collection, analysis, and interpretation that have been used in recent reports on obesity prevalence and trends at the national, state, and local level, particularly among U.S. children, adolescents, and young adults. This report offers a framework for assessing studies on trends in obesity, principally among children and young adults, for policy making and program planning purposes, and recommends ways decision makers and others can move forward in assessing and interpreting reports on obesity trends.

Students, parents, and government agencies need as much information as possible about the outcomes of the higher education experience and the extent to which they can expect a fair return on their investment in higher education.In order to better understand the concept of quality - enabling students to acquire knowledge in a variety of disciplines and deep knowledge in at least one discipline, as well as to develop a range of skills and habits of mind that prepare them for career success, engaged citizenship, intercultural competence, social responsibility, and continued intellectual growth - an ad hoc planning committee of the National Academies of Sciences, Engineering, and Medicine Board on Higher Education and Workforce, with funding from the Lumina Foundation, organized a workshop in Washington, D.C., on December 14-15, 2015.This report summarizes the presentations and discussion of that event.

Advances in trauma care have accelerated over the past decade, spurred by the significant burden of injury from the wars in Afghanistan and Iraq. Between 2005 and 2013, the case fatality rate for United States service members injured in Afghanistan decreased by nearly 50 percent, despite an increase in the severity of injury among U.S. troops during the same period of time. But as the war in Afghanistan ends, knowledge and advances in trauma care developed by the Department of Defense (DoD) over the past decade from experiences in Afghanistan and Iraq may be lost. This would have implications for the quality of trauma care both within the DoD and in the civilian setting, where adoption of military advances in trauma care has become increasingly common and necessary to improve the response to multiple civilian casualty events. Intentional steps to codify and harvest the lessons learned within the military's trauma system are needed to ensure a ready military medical force for future combat and to prevent death from survivable injuries in both military and civilian systems. This will require partnership across military and civilian sectors and a sustained commitment from trauma system leaders at all levels to assure that the necessary knowledge and tools are not lost. A National Trauma Care System defines the components of a learning health system necessary to enable continued improvement in trauma care in both the civilian and the military sectors. This report provides recommendations to ensure that lessons learned over the past decade from the military's experiences in Afghanistan and Iraq are sustained and built upon for future combat operations and translated into the U.S. civilian system.

The United Nations Sustainable Development Goals for 2015-2030 strive for a world that is "just, equitable, and inclusive," in which everyone receives care, education, and opportunities to thrive. Yet many children are living on the margins of society, face multiple disadvantages, and are excluded from full participation in all that life has to offer. To examine the science, economics, and politics of investing in the health, education, nutrition, and social protection of children at the margins, the National Academies of Sciences, Engineering, and Medicine held a workshop in Prague, Czech Republic in November 2015. Held in partnership with the Open Society Foundations and the International Step by Step Association, the workshop convened a diverse group of stakeholders from around the world for 2 days of discussion. This report summarizes the presentations and discussions from the workshop.

"Companies today are operating in a more complex and competitive environment where traditional models for doing business are no longer sufficient and expectations of business are growing both internally and externally. Many companies have long and robust histories of contributing to their communities as well as to more global societal needs, but this has been done primarily and historically through philanthropy and more traditional corporate social responsibility. However, companies are increasingly seeking greater alignment of these activities with their business interests in order to increase their value proposition. These same companies are also under increased pressure to build their business in a sustainable manner through innovative approaches. The National Academies of Sciences, Engineering, and Medicine convened a workshop to explore the concept of shared value for global health and safety stakeholders in both the public and private sectors; roles, responsibilities, incentives, and opportunities for different stakeholders engaging in global health and safety initiatives in low- and middle-income countries; and the potential of partnerships and collaboration for improved outcomes for all stakeholders, including the communities they serve. Participants considered potential opportunities for creating shared value for all organizations, specifically the creation and impact of shared value through an organization's core products and services, through employee health and wellness programs, and through community or population health investments. This report summarizes the presentations and discussions from the workshop"--Publisher's description.

The integrity of knowledge that emerges from research is based on individual and collective adherence to core values of objectivity, honesty, openness, fairness, accountability, and stewardship. Integrity in science means that the organizations in which research is conducted encourage those involved to exemplify these values in every step of the research process. Understanding the dynamics that support - or distort - practices that uphold the integrity of research by all participants ensures that the research enterprise advances knowledge. The 1992 report Responsible Science: Ensuring the Integrity of the Research Process evaluated issues related to scientific responsibility and the conduct of research. It provided a valuable service in describing and analyzing a very complicated set of issues, and has served as a crucial basis for thinking about research integrity for more than two decades. However, as experience has accumulated with various forms of research misconduct, detrimental research practices, and other forms of misconduct, as subsequent empirical research has revealed more about the nature of scientific misconduct, and because technological and social changes have altered the environment in which science is conducted, it is clear that the framework established more than two decades ago needs to be updated. Responsible Science served as a valuable benchmark to set the context for this most recent analysis and to help guide the committee's thought process. Fostering Integrity in Research identifies best practices in research and recommends practical options for discouraging and addressing research misconduct and detrimental research practices.

Research on gene drive systems is rapidly advancing. Many proposed applications of gene drive research aim to solve environmental and public health challenges, including the reduction of poverty and the burden of vector-borne diseases, such as malaria and dengue, which disproportionately impact low and middle income countries. However, due to their intrinsic qualities of rapid spread and irreversibility, gene drive systems raise many questions with respect to their safety relative to public and environmental health. Because gene drive systems are designed to alter the environments we share in ways that will be hard to anticipate and impossible to completely roll back, questions about the ethics surrounding use of this research are complex and will require very careful exploration. Gene Drives on the Horizon outlines the state of knowledge relative to the science, ethics, public engagement, and risk assessment as they pertain to research directions of gene drive systems and governance of the research process. This report offers principles for responsible practices of gene drive research and related applications for use by investigators, their institutions, the research funders, and regulators.

More than 2 million Americans below age 24 self-identify as being of American Indian or Alaska Native descent. Many of the serious behavioral, emotional, and physical health concerns facing young people today are especially prevalent with Native youth (e.g., depression, violence, and substance abuse). Adolescent Native Americans have death rates two to five times the rate of whites in the same age group because of higher levels of suicide and a variety of risky behaviors (e.g., drug and alcohol use, inconsistent school attendance). Violence, including intentional injuries, homicide, and suicide, accounts for three-quarters of deaths for Native American youth ages 12 to 20. Suicide is the second leading cause of death--and 2.5 times the national rate--for Native youth ages 15 to 24. Arrayed against these health problems are vital cultural strengths on which Native Americans can draw. At a workshop held in 2012, by the National Academies of Sciences, Engineering, and Medicine, presenters described many of these strengths, including community traditions and beliefs, social support networks, close-knit families, and individual resilience. In May 2014, the Academies held a follow-up workshop titled Advancing Health Equity for Native American Youth. Participants discussed issues related to (1) the visibility of racial and ethnic disparities in health and health care as a national problem, (2) the development of programs and strategies by and for Native and Indigenous communities to reduce disparities and build resilience, and (3) the emergence of supporting Native expertise and leadership. This report summarizes the presentations and discussions from the workshop.

The central purpose of all research is to create new knowledge. In the geographical sciences this is driven by a desire to create new knowledge about the relations between space, place, and the anthropogenic and non-anthropogenic features and processes of the Earth. But some research goes beyond these modest aims and creates new opportunities for further research, or affects the process of knowledge acquisition more broadly, or changes the way other researchers in a domain think about the world and go about their business. Due to its positive impacts, transformative research can be regarded as inherently having greater value than more conventional research, and funding agencies clearly regard transformative research as something to be encouraged and funded through special programs. Assessments of transformative research funding initiatives are few and provide a mixed picture of their effectiveness. The challenge is whether transformative research can be identified at the time it is proposed rather than after it has been conducted, communicated, and its influence on the discipline has become clear. Fostering Transformative Research in the Geographical Sciences reviews how transformative research has emerged in the past, what its early markers were, and makes recommendations for how it can be nurtured in the future.

Introduction -- Hearing loss: extent, impact, and research needs -- Hearing health care services: improving access and quality -- Hearing technologies: expanding options -- Improving affordability of services and technologies -- Engaging a wider community: awareness, education, and support -- Opportunities for action -- Appendix A: Meeting agendas -- Appendix B: Committee biographies.