Bøger udgivet af National Academies Press

"Space-based observations have transformed our understanding of Earth, its environment, the solar system and the universe at large. During past decades, driven by increasingly advanced science questions, space observatories have become more sophisticated and more complex, with costs often growing to billions of dollars. Although these kinds of ever-more-sophisticated missions will continue into the future, small satellites, ranging in mass between 500 kg to 0.1 kg, are gaining momentum as an additional means to address targeted science questions in a rapid, and possibly more affordable, manner. Within the category of small satellites, CubeSats have emerged as a space-platform defined in terms of (10 cm x 10 cm x 10 cm)- sized cubic units of approximately 1.3 kg each called "U's." Historically, CubeSats were developed as training projects to expose students to the challenges of real-world engineering practices and system design. Yet, their use has rapidly spread within academia, industry, and government agencies both nationally and internationally. In particular, CubeSats have caught the attention of parts of the U.S. space science community, which sees this platform, despite its inherent constraints, as a way to affordably access space and perform unique measurements of scientific value. The first science results from such CubeSats have only recently become available; however, questions remain regarding the scientific potential and technological promise of CubeSats in the future. Achieving Science with CubeSats reviews the current state of the scientific potential and technological promise of CubeSats. This report focuses on the platform's promise to obtain high- priority science data, as defined in recent decadal surveys in astronomy and astrophysics, Earth science and applications from space, planetary science, and solar and space physics (heliophysics); the science priorities identified in the 2014 NASA Science Plan; and the potential for CubeSats to advance biology and microgravity research. It provides a list of sample science goals for CubeSats, many of which address targeted science, often in coordination with other spacecraft, or use "sacrificial," or high-risk, orbits that lead to the demise of the satellite after critical data have been collected. Other goals relate to the use of CubeSats as constellations or swarms deploying tens to hundreds of CubeSats that function as one distributed array of measurements"--

"The Workshop on Integrating New Measures of Trauma into the Substance Abuse and Mental Health Services Administration's (SAMHSA) Data Collection Programs, held in Washington, D.C. in December 2015, was organized as part of an effort to assist SAMHSA and the Office of the Assistant Secretary for Planning and Evaluation of the U.S. Department of Health and Human Services in their responsibilities to expand the collection of behavioral health data to include measures of trauma. The main goals of the workshop were to discuss options for collecting data and producing estimates on exposure to traumatic events and PTSD, including available measures and associated possible data collection mechanisms. This report summarizes the presentations and discussions from the workshop"--Publisher's website.

-Among the many troubling aspects of the rising prevalence of obesity in the United States and elsewhere in recent years, the growth of early childhood overweight and obesity stands out. To explore what is known about effective and innovative interventions to counter obesity in young children, the National Academies of Sciences, Engineering, and Medicine's Roundtable on Obesity Solutions held a workshop in October 2015. The workshop brought together many of the leading researchers on obesity in young children to describe the state of the science and potential solutions based on that research. Participants explored sustainable collaborations and new insights into the implementation of interventions and policies, particularly those related to nutrition and physical activity, for the treatment and prevention of obesity in young children. Obesity in the Early Childhood Years summarizes the presentations and discussions from the workshop---Publisher's description.

"The United States manufactured significant quantities of chemical weapons during the Cold War and the years prior. Because the chemical weapons are aging, storage constitutes an ongoing risk to the facility workforces and to the communities nearby. In addition, the Chemical Weapons Convention treaty stipulates that the chemical weapons be destroyed. The United States has destroyed approximately 90 percent of the chemical weapons stockpile located at seven sites. Due to public opposition to the use of incineration to destroy the BGAD stockpile, Congress mandated that non- incineration technologies be identified for use at BGCAPP. As a result, the original BGCAPP design called for munitions to be drained of agent and then for the munition bodies to be washed out using high-pressure hot water. However as part of a larger package of modifications called Engineering Change Proposal 87 (ECP-87), the munition washout step was eliminated. Effects of the Deletion of Chemical Agent Washout on Operations at the Blue Grass Chemical Agent Destruction Pilot Plant examines the impacts of this design change on operations at BGCAPP and makes recommendations to guide future decision making"--Publisher's description.

-To derive statistics about crime - to estimate its levels and trends, assess its costs to and impacts on society, and inform law enforcement approaches to prevent it - a conceptual framework for defining and thinking about crime is virtually a prerequisite. Developing and maintaining such a framework is no easy task, because the mechanics of crime are ever evolving and shifting: tied to shifts and development in technology, society, and legislation. Interest in understanding crime surged in the 1920s, which proved to be a pivotal decade for the collection of nationwide crime statistics. Now established as a permanent agency, the Census Bureau commissioned the drafting of a manual for preparing crime statistics-intended for use by the police, corrections departments, and courts alike. The new manual sought to solve a perennial problem by suggesting a standard taxonomy of crime. Shortly after the Census Bureau issued its manual, the International Association of Chiefs of Police in convention adopted a resolution to create a Committee on Uniform Crime Records -to begin the process of describing what a national system of data on crimes known to the police might look like. The key distinction between the rigorous classification proposed in this report and the -classifications- that have come before in U.S. crime statistics is that it is intended to partition the entirety of behaviors that could be considered criminal offenses into mutually exclusive categories. Modernizing Crime Statistics: Report 1: Defining and Classifying Crime assesses and makes recommendations for the development of a modern set of crime measures in the United States and the best means for obtaining them. This first report develops a new classification of crime by weighing various perspectives on how crime should be defined and organized with the needs and demands of the full array of crime data users and stakeholders---Publisher's description.

-The Institute of Medicine Roundtable on Health Literacy convened a 1-day public workshop to explore the relationship between palliative care and health literacy, and the importance of health literate communication in providing high-quality delivery of palliative care. Health Literacy and Palliative Care summarizes the discussions that occurred throughout the workshop and highlights the key lessons presented, practical strategies, and the needs and opportunities for improving health literacy in the United States---

Bullying has long been tolerated as a rite of passage among children and adolescents. There is an implication that individuals who are bullied must have "asked for" this type of treatment, or deserved it. Sometimes, even the child who is bullied begins to internalize this idea. For many years, there has been a general acceptance and collective shrug when it comes to a child or adolescent with greater social capital or power pushing around a child perceived as subordinate. But bullying is not developmentally appropriate; it should not be considered a normal part of the typical social grouping that occurs throughout a child's life. Although bullying behavior endures through generations, the milieu is changing. Historically, bulling has occurred at school, the physical setting in which most of childhood is centered and the primary source for peer group formation. In recent years, however, the physical setting is not the only place bullying is occurring. Technology allows for an entirely new type of digital electronic aggression, cyberbullying, which takes place through chat rooms, instant messaging, social media, and other forms of digital electronic communication. Composition of peer groups, shifting demographics, changing societal norms, and modern technology are contextual factors that must be considered to understand and effectively react to bullying in the United States. Youth are embedded in multiple contexts and each of these contexts interacts with individual characteristics of youth in ways that either exacerbate or attenuate the association between these individual characteristics and bullying perpetration or victimization. Recognizing that bullying behavior is a major public health problem that demands the concerted and coordinated time and attention of parents, educators and school administrators, health care providers, policy makers, families, and others concerned with the care of children, this report evaluates the state of the science on biological and psychosocial consequences of peer victimization and the risk and protective factors that either increase or decrease peer victimization behavior and consequences.

"Since 1969, the National Assessment of Educational Progress (NAEP) has been providing policymakers, educators, and the public with reports on academic performance and progress of the nation's students. The assessment is given periodically in a variety of subjects: mathematics, reading, writing, science, the arts, civics, economics, geography, U.S. history, and technology and engineering literacy. NAEP is given to representative samples of students across the U.S. to assess the educational progress of the nation as a whole. Since 1992, NAEP results have been reported in relation to three achievement levels: basic, proficient, and advanced. However, the use of achievement levels has provoked controversy and disagreement, and evaluators have identified numerous concerns. This publication evaluates the NAEP student achievement levels in reading and mathematics in grades 4, 8, and 12 to determine whether the achievement levels are reasonable, reliable, valid, and informative to the public, and recommends ways that the setting and use of achievement levels can be improved"--Publisher's description.

Genetically engineered (GE) crops were first introduced commercially in the 1990s. After two decades of production, some groups and individuals remain critical of the technology based on their concerns about possible adverse effects on human health, the environment, and ethical considerations. At the same time, others are concerned that the technology is not reaching its potential to improve human health and the environment because of stringent regulations and reduced public funding to develop products offering more benefits to society. While the debate about these and other questions related to the genetic engineering techniques of the first 20 years goes on, emerging genetic-engineering technologies are adding new complexities to the conversation. Genetically Engineered Crops builds on previous related Academies reports published between 1987 and 2010 by undertaking a retrospective examination of the purported positive and adverse effects of GE crops and to anticipate what emerging genetic-engineering technologies hold for the future. This report indicates where there are uncertainties about the economic, agronomic, health, safety, or other impacts of GE crops and food, and makes recommendations to fill gaps in safety assessments, increase regulatory clarity, and improve innovations in and access to GE technology.

Summary of the Indo-U.S. Workshop on Challenges of Emerging Infections and Global Health Safety, held November 18-20, 2014 on the campus of the Indian National Science Academy.

"On March 10-11, 2016, the National Academies of Sciences, Engineering, and Medicine held a public symposium on potential U.S. government policies for the oversight of gain-of-function (GOF) research. This was the Academies' second meeting held at the request of the U.S. government to provide a mechanism to engage the life sciences community and the broader public and solicit feedback on optimal approaches to ensure effective federal oversight of GOF research as part of a broader U.S. government deliberative process. The first symposium, held in December 2014, examined the underlying scientific and technical questions surrounding the potential risks and benefits of GOF research involving pathogens with pandemic potential. The second symposium focused on discussion of the draft recommendations regarding GOF research of a Working Group of the National Science Advisory Board for Biosecurity. This report summarizes the key issues and ideas identified during the second symposium"--

"The field of endeavors known as 'regulatory science' has grown out of the need to link and integrate knowledge within and among basic science research, clinical research, clinical medicine, and other specific scientific disciplines whose focus, aggregation, and ultimate implementation could inform biomedical product development and regulatory decision making. Substantial efforts have been devoted to defining regulatory science and communicating its value and role across the scientific and regulatory ecosystems. Investments are also being made in technology infrastructure, regulatory systems, and workforce development to support and advance this burgeoning discipline. In October 2015, the National Academies of Sciences, Engineering, and Medicine held a public workshop to facilitate dialogue among stakeholders about the current state and scope of regulatory science, opportunities to address barriers to the discipline's success, and avenues for fostering collaboration across sectors. Participants explored key needs for strengthening the discipline of regulatory science, including considering what are the core components of regulatory science infrastructure to foster innovation in medical product development. This report summarizes the presentations and discussions from the workshop"--Publisher's description.

"Implementation research is designed to 'generate insights and knowledge about implementation processes, barriers, facilitators, and strategies', explained Brian Mittman, a research scientist at Kaiser Permanente Research. Workshop speakers examined issues that pertain to genomic medicine, gathering evidence during implementation, and using genomic medicine to improve population health."--Page 3.

Advanced computing capabilities are used to tackle a rapidly growing range of challenging science and engineering problems, many of which are compute- and data-intensive as well. Demand for advanced computing has been growing for all types and capabilities of systems, from large numbers of single commodity nodes to jobs requiring thousands of cores; for systems with fast interconnects; for systems with excellent data handling and management; and for an increasingly diverse set of applications that includes data analytics as well as modeling and simulation. Since the advent of its supercomputing centers, the National Science Foundation (NSF) has provided its researchers with state-of-the-art computing systems. The growth of new models of computing, including cloud computing and publically available by privately held data repositories, opens up new possibilities for NSF. In order to better understand the expanding and diverse requirements of the science and engineering community and the importance of a new broader range of advanced computing infrastructure, the NSF requested that the National Research Council carry out a study examining anticipated priorities and associated tradeoffs for advanced computing. Future Directions for NSF Advanced Computing Infrastructure to Support U.S. Science and Engineering in 2017-2020 provides a framework for future decision-making about NSF's advanced computing strategy and programs. It offers recommendations aimed at achieving four broad goals: (1) position the U.S. for continued leadership in science and engineering, (2) ensure that resources meet community needs, (3) aid the scientific community in keeping up with the revolution in computing, and (4) sustain the infrastructure for advanced computing.

"In September 2015, the National Academies of Sciences, Engineering, and Medicine's Food and Nutrition Board convened a workshop in Washington, DC, to discuss how communications and marketing impact consumer knowledge, skills, and behavior around food, nutrition, and healthy eating. The workshop was divided into three sessions, each with specific goals that were developed on policy makers and the role of policy as a macro-level channel of communication. Session 3 explored the current state of the science concerning how food literacy can be strengthened through communication tools and strategies. This report summarizes the presentations and discussions from the workshop"--Publisher's description.

"The U.S. Congress asked the National Academy of Sciences to conduct a technical study on lessons learned from the Fukushima Daiichi nuclear accident for improving safety and security of commercial nuclear power plants in the United States. This study was carried out in two phases: Phase 1, issued in 2014, focused on the causes of the Fukushima Daiichi accident and safety-related lessons learned for improving nuclear plant systems, operations, and regulations exclusive of spent fuel storage. This Phase 2 report focuses on three issues: (1) lessons learned from the accident for nuclear plant security, (2) lessons learned for spent fuel storage, and (3) reevaluation of conclusions from previous Academies studies on spent fuel storage"--

The Small Business Innovation Research (SBIR) program is one of the largest examples of U.S. public-private partnerships, and was established in 1982 to encourage small businesses to develop new processes and products and to provide quality research in support of the U.S. government's many missions. The U.S. Congress tasked the National Research Council with undertaking a comprehensive study of how the SBIR program has stimulated technological innovation and used small businesses to meet federal research and development needs, and with recommending further improvements to the program. In the first round of this study, an ad hoc committee prepared a series of reports from 2004 to 2009 on the SBIR program at the five agencies responsible for 96 percent of the program's operations--including the NASA. In a follow-up to the first round, NASA requested from the Academies an assessment focused on operational questions in order to identify further improvements to the program. Public-private partnerships like SBIR are particularly important since today's knowledge economy is driven in large part by the nation's capacity to innovate. One of the defining features of the U.S. economy is a high level of entrepreneurial activity. Entrepreneurs in the United States see opportunities and are willing and able to assume risk to bring new welfare-enhancing, wealth-generating technologies to the market. Yet, although discoveries in various fields present new opportunities, converting these discoveries into innovations for the market involves substantial challenges. The American capacity for innovation can be strengthened by addressing the challenges faced by entrepreneurs.

In recent years, the U.S. federal government has invested approximately $463 billion annually in interventions that affect the overall health and well-being of children and youth, while state and local budgets have devoted almost double that amount. The potential returns on these investments may not only be substantial but also have long-lasting effects for individuals and succeeding generations of their families. Ideally, those tasked with making these investments would have available to them the evidence needed to determine the cost of all required resources to fully implement and sustain each intervention, the expected returns of the investment, to what extent these returns can be measured in monetary or nonmonetary terms, and who will receive the returns and when. As a result of a number of challenges, however, such evidence may not be effectively produced or applied. Low-quality evidence and/or a failure to consider the context in which the evidence will be used may weaken society's ability to invest wisely, and also reduce future demand for this and other types of evidence. Advancing the Power of Economic Evidence to Inform Investments in Children, Youth, and Families highlights the potential for economic evidence to inform investment decisions for interventions that support the overall health and well-being of children, youth, and families. This report describes challenges to the optimal use of economic evidence, and offers recommendations to stakeholders to promote a lasting improvement in its quality, utility, and use.

Estimates indicate that as many as 1 in 4 Americans will experience a mental health problem or will misuse alcohol or drugs in their lifetimes. These disorders are among the most highly stigmatized health conditions in the United States, and they remain barriers to full participation in society in areas as basic as education, housing, and employment. Improving the lives of people with mental health and substance abuse disorders has been a priority in the United States for more than 50 years. The Community Mental Health Act of 1963 is considered a major turning point in America's efforts to improve behavioral healthcare. It ushered in an era of optimism and hope and laid the groundwork for the consumer movement and new models of recovery. The consumer movement gave voice to people with mental and substance use disorders and brought their perspectives and experience into national discussions about mental health. However over the same 50-year period, positive change in American public attitudes and beliefs about mental and substance use disorders has lagged behind these advances. Stigma is a complex social phenomenon based on a relationship between an attribute and a stereotype that assigns undesirable labels, qualities, and behaviors to a person with that attribute. Labeled individuals are then socially devalued, which leads to inequality and discrimination. This report contributes to national efforts to understand and change attitudes, beliefs and behaviors that can lead to stigma and discrimination. Changing stigma in a lasting way will require coordinated efforts, which are based on the best possible evidence, supported at the national level with multiyear funding, and planned and implemented by an effective coalition of representative stakeholders. Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma Change explores stigma and discrimination faced by individuals with mental or substance use disorders and recommends effective strategies for reducing stigma and encouraging people to seek treatment and other supportive services. It offers a set of conclusions and recommendations about successful stigma change strategies and the research needed to inform and evaluate these efforts in the United States.

Engineering has long gravitated toward great human ambitions: navigation of the oceans, travel to the moon and back, Earth exploration, national security, industrial and agricultural revolutions, communications, and transportation. Some ambitions have been realized, some remain unfulfilled, and some are yet to be determined. In 2008 a committee of distinguished engineers, scientists, entrepreneurs, and visionaries set out to identify the most important, tractable engineering system challenges that must be met in this century for human life as we know it to continue on this planet. For the forum at the National Academy of Engineering's 2015 annual meeting, 7 of the 18 committee members who formulated the Grand Challenges for Engineering in 2008 reflected on what has happened in the seven year since. Grand Challenges for Engineering: Imperatives, Prospects, and Priorities summarizes the discussions and presentations from this forum.

-Hepatitis B and C cause most cases of hepatitis in the United States and the world. The two diseases account for about a million deaths a year and 78 percent of world's hepatocellular carcinoma and more than half of all fatal cirrhosis. In 2013 viral hepatitis, of which hepatitis B virus (HBV) and hepatitis C virus (HCV) are the most common types, surpassed HIV and AIDS to become the seventh leading cause of death worldwide. The world now has the tools to prevent hepatitis B and cure hepatitis C. Perfect vaccination could eradicate HBV, but it would take two generations at least. In the meantime, there is no cure for the millions of people already infected. Conversely, there is no vaccine for HCV, but new direct-acting antivirals can cure 95 percent of chronic infections, though these drugs are unlikely to reach all chronically-infected people anytime soon. This report, the first of two, examines the feasibility of hepatitis B and C elimination in the United States and identifies critical success factors. The phase two report will outline a strategy for meeting the elimination goals discussed in this report---

"Health care is in the midst of a dramatic transformation in the United States. Spurred by technological advances, economic imperatives, and governmental policies, information technologies are rapidly being applied to health care in an effort to improve access, enhance quality, and decrease costs. At the same time, the use of technologies by the consumers of health care is changing how people interact with the health care system and with health information. These changes in health care have the potential both to exacerbate and to diminish the stark disparities in health and well-being that exist among population groups in the United States. If the benefits of technology flow disproportionately to those who already enjoy better coverage, use, and outcomes than disadvantaged groups, heath disparities could increase. But if technologies can be developed and implemented in such a way to improve access and enhance quality for the members of all groups, the ongoing transformation of health care could reduce the gaps among groups while improving health care for all. To explore the potential for further insights into, and opportunities to address, disparities in underserved populations the National Academies of Sciences, Engineering, and Medicine held a workshop in October 2014. The workshop focused on (1) how communities are using digital health technologies to improve health outcomes for racial and ethnic minority populations, (2) how community engagement can improve access to high-quality health information for members of these groups, and (3) on models of successful technology-based strategies to reduce health disparities. This report summarizes the presentations and discussions at the workshop"--

Introduction -- Part I. Background. The trucking and bus industries -- Consequences of fatigue from insufficient sleep -- Hours-of-service regulations -- Part II. Current research data and methods. Data sources -- Research methodology and principles: assessing causality -- Part III. Current research findings. Fatigue, hours of service, and highway safety -- Fatigue and health and wellness -- Technological countermeasures for and corporate management of fatigue --Part IV. Research directions. Research directions for fatigue and highway safety -- Research directions for studying the impact of fatigue on commercial motor vehicle drivers' health and wellness -- Appendix. Biographical sketches of panel members and staff.

The Centers for Medicare & Medicaid Services (CMS) have been moving from volume-based, fee-for-service payment to value-based payment (VBP), which aims to improve health care quality, health outcomes, and patient care experiences, while also controlling costs. Since the passage of the Patient Protection and Affordable Care Act of 2010, CMS has implemented a variety of VBP strategies, including incentive programs and risk-based alternative payment models. Early evidence from these programs raised concerns about potential unintended consequences for health equity. Specifically, emerging evidence suggests that providers disproportionately serving patients with social risk factors for poor health outcomes (e.g., individuals with low socioeconomic position, racial and ethnic minorities, gender and sexual minorities, socially isolated persons, and individuals residing in disadvantaged neighborhoods) may be more likely to fare poorly on quality rankings and to receive financial penalties, and less likely to receive financial rewards. The drivers of these disparities are poorly understood, and differences in interpretation have led to divergent concerns about the potential effect of VBP on health equity. Some suggest that underlying differences in patient characteristics that are out of the control of providers lead to differences in health outcomes. At the same time, others are concerned that differences in outcomes between providers serving socially at-risk populations and providers serving the general population reflect disparities in the provision of health care. Systems Practices for the Care of Socially At-Risk Populations seeks to better distinguish the drivers of variations in performance among providers disproportionately serving socially at-risk populations and identifies methods to account for social risk factors in Medicare payment programs. This report identifies best practices of high-performing hospitals, health plans, and other providers that serve disproportionately higher shares of socioeconomically disadvantaged populations and compares those best practices of low-performing providers serving similar patient populations. It is the second in a series of five brief reports that aim to inform the Office of the Assistant Secretary of Planning and Evaluation (ASPE) analyses that account for social risk factors in Medicare payment programs mandated through the Improving Medicare Post-Acute Care Transformation (IMPACT) Act.

"In June 2007 the Forum on Microbial Threats hosted a workshop to explore the dynamic relationships among host, pathogen(s), vector(s), and ecosystems that characterize vector-borne diseases. Revisiting this topic in September 2014, the forum examined trends and patterns in the incidence and prevalence of vector-borne diseases in an increasingly interconnected and ecologically disturbed world, as well as recent developments to meet these dynamic threats. This public workshop featured invited presentations and discussions that described the emergence and global movement of vector-borne diseases, considered research priorities for understanding their biology and ecology, and assessed global preparedness for and progress toward their prevention, control, and mitigation."--

Electricity is the lifeblood of modern society, and for the vast majority of people that electricity is obtained from large, interconnected power grids. However, the grid that was developed in the 20th century, and the incremental improvements made since then, including its underlying analytic foundations, is no longer adequate to completely meet the needs of the 21st century. The next-generation electric grid must be more flexible and resilient. While fossil fuels will have their place for decades to come, the grid of the future will need to accommodate a wider mix of more intermittent generating sources such as wind and distributed solar photovoltaics. Achieving this grid of the future will require effort on several fronts. There is a need for continued shorter-term engineering research and development, building on the existing analytic foundations for the grid. But there is also a need for more fundamental research to expand these analytic foundations. Analytic Research Foundations for the Next-Generation Electric Grid provide guidance on the longer-term critical areas for research in mathematical and computational sciences that is needed for the next-generation grid. It offers recommendations that are designed to help direct future research as the grid evolves and to give the nation's research and development infrastructure the tools it needs to effectively develop, test, and use this research.

"The U.S. Social Security Administration (SSA) provides benefits to disabled adults and children, offering vital financial support to more than 19 million disabled Americans. Of that group, approximately 5.5 million have been deemed -- by virtue of youth or mental or physical impairment - incapable of managing or directing the management of their benefits. Hence, a representative payee has been appointed to receive and disburse SSA payments for these beneficiaries to ensure that their basic needs for shelter, food, and clothing are met. Periodically, however, concerns have been expressed about the accuracy of the process by which SSA determines whether beneficiaries are capable of managing their benefits, with some evidence suggesting that underdetection of incapable recipients may be a particular problem. The importance of creating as accurate a process as possible for incapability determinations is underscored by the consequences of incorrectly identifying recipients either as incapable when they can manage their benefits or as capable when they cannot. Failure to identify beneficiaries who are incapable of managing their funds means abandoning a vulnerable population to potential homelessness, hunger, and disease. Informing Social Security's Process for Financial Capability Determination considers capability determination processes used by other similar benefit programs, abilities required to manage, and direct the management of, benefits, and effective methods and measures for assessing capability. This report evaluates SSA's capability determination process for adult beneficiaries and provides recommendations for improving the accuracy and efficiency of the agency's policy and procedures for making these determinations"--

"As climate has warmed over recent years, a new pattern of more frequent and more intense weather events has unfolded across the globe. Climate models simulate such changes in extreme events, and some of the reasons for the changes are well understood. Warming increases the likelihood of extremely hot days and nights, favors increased atmospheric moisture that may result in more frequent heavy rainfall and snowfall, and leads to evaporation that can exacerbate droughts. Even with evidence of these broad trends, scientists cautioned in the past that individual weather events couldn't be attributed to climate change. Now, with advances in understanding the climate science behind extreme events and the science of extreme event attribution, such blanket statements may not be accurate. The relatively young science of extreme event attribution seeks to tease out the influence of human-cause climate change from other factors, such as natural sources of variability like El Niano, as contributors to individual extreme events. Event attribution can answer questions about how much climate change influenced the probability or intensity of a specific type of weather event. As event attribution capabilities improve, they could help inform choices about assessing and managing risk, and in guiding climate adaptation strategies. This report examines the current state of science of extreme weather attribution, and identifies ways to move the science forward to improve attribution capabilities."--from publisher's description.

The World Health Organization defines the social determinants of health as "the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life." These forces and systems include economic policies, development agendas, cultural and social norms, social policies, and political systems. In an era of pronounced human migration, changing demographics, and growing financial gaps between rich and poor, a fundamental understanding of how the conditions and circumstances in which individuals and populations exist affect mental and physical health is imperative. Educating health professionals about the social determinants of health generates awareness among those professionals about the potential root causes of ill health and the importance of addressing them in and with communities, contributing to more effective strategies for improving health and health care for underserved individuals, communities, and populations. Recently, the National Academies of Sciences, Engineering, and Medicine convened a workshop to develop a high-level framework for such health professional education. A Framework for Educating Health Professionals to Address the Social Determinants of Health also puts forth a conceptual model for the framework's use with the goal of helping stakeholder groups envision ways in which organizations, education, and communities can come together to address health inequalities.

-Living independently and participating in one community are priorities for many people. In many regions across the United States, there are programs that support and enable people with disabilities and older adults to live where they choose and with whom they choose and to participate fully in their communities. Tremendous progress has been made. However, in many cases, the programs themselves - and access to them - vary not only between states but also within states. Many programs are small, and even when they prove to be successful they are still not scaled up to meet the needs of the many people who would benefit from them. The challenges can include insufficient workforce, insufficient funding, and lack of evidence demonstrating effectiveness or value. To get a better understanding of the policies needed to maximize independence and support community living and of the research needed to support implementation of those policies, the National Academies of Sciences, Engineering, and Medicine convened a public workshop in October 2015. Participants explored policies in place that promote independence and community living for older adults and people with physical disabilities, and identified policies and gaps in policies that can be barriers to independence and the research needed to support changing those policies. This report summarizes the presentations and discussions from the workshop---Publisher's description.