Bøger udgivet af National Academies Press

When Congress authorized the National Flood Insurance Program (NFIP) in 1968, it intended for the program to encourage community initiatives in flood risk management, charge insurance premiums consistent with actuarial pricing principles, and encourage the purchase of flood insurance by owners of flood prone properties, in part, by offering affordable premiums. The NFIP has been reauthorized many times since 1968, most recently with the Biggert-Waters Flood Insurance Reform Act of 2012 (BW 2012). In this most recent reauthorization, Congress placed a particular emphasis on setting flood insurance premiums following actuarial pricing principles, which was motivated by a desire to ensure future revenues were adequate to pay claims and administrative expenses. BW 2012 was designed to move the NFIP towards risk-based premiums for all flood insurance policies. The result was to be increased premiums for some policyholders that had been paying less than NFIP risk-based premiums and to possibly increase premiums for all policyholders. Recognition of this possibility and concern for the affordability of flood insurance is reflected in sections of the Homeowner Flood Insurance Affordability Act of 2014 (HFIAA 2014). These sections called on FEMA to propose a draft affordability framework for the NFIP after completing an analysis of the efforts of possible programs for offering "means-tested assistance" to policyholders for whom higher rates may not be affordable. BW 2012 and HFIAA 2014 mandated that FEMA conduct a study, in cooperation with the National Academies of Sciences, Engineering, and Medicine, which would compare the costs of a program of risk-based rates and means-tested assistance to the current system of subsidized flood insurance rates and federally funded disaster relief for people without coverage. Production of two reports was agreed upon to fulfill this mandate. This second report proposes alternative approaches for a national evaluation of affordability program policy options and includes lessons for the design of a national study from a proof-of-concept pilot study.

Review of NASA's Evidence Reports on Human Health Risks 2015 Letter Report is the third in a series of five reports from the Institute of Medicine that will independently review more than 30 evidence reports that the National Aeronautics and Space Administration has compiled on human health risks for long-duration and exploration space flights. This report builds on the 2008 IOM report Review of NASA's Human Research Program Evidence Books: A Letter Report, which provided an initial and brief review of the evidence reports. This letter report reviews seven evidence reports and examines the quality of the evidence, analysis, and overall construction of each report; identifies existing gaps in report content; and provides suggestions for additional sources of expert input. The report analyzes each evidence report's overall quality, which included readability; internal consistency; the source and breadth of cited evidence; identification of existing knowledge and research gaps; authorship expertise; and, if applicable, response to recommendations from the 2008 IOM letter report.--

Between 1963 and 1969, the U.S. military carried out a series of tests, termed Project SHAD (Shipboard Hazard and Defense), to evaluate the vulnerabilities of U.S. Navy ships to chemical and biological warfare agents. These tests involved use of active chemical and biological agents, stimulants, tracers, and decontaminants. Approximately 5,900 military personnel, primarily from the Navy and Marine Corps, are reported to have been included in Project SHAD testing. In the 1990s some veterans who participated in the SHAD tests expressed concerns to the Department of Veterans Affairs (VA) that they were experiencing health problems that might be the result of exposures in the testing. These concerns led to a 2002 request from VA to the Institute of Medicine (IOM) to carry out an epidemiological study of the health of SHAD veterans and a comparison population of veterans who had served on similar ships or in similar units during the same time period. In response to continuing concerns, Congress in 2010 requested an additional IOM study. This second study expands on the previous IOM work by making use of additional years of follow up and some analysis of diagnostic data from Medicare and the VA health care system.

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 areas such as genomics, bioinformatics, and nanotechnology 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. Public-private partnerships are one means to help entrepreneurs bring new ideas to market. The Small Business Technology Transfer (STTR) and the Small Business Innovation Research (SBIR) program form one of the largest examples of U.S. public-private partnerships. In the SBIR Reauthorization Act of 2000, 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. When reauthorizing the SBIR and STTR programs in 2011, Congress expanded the study mandate to include a review of the STTR program. This report builds on the methodology and outcomes from the previous review of SBIR and assesses the STTR program.

The market for high-skilled workers is becoming increasingly global, as are the markets for knowledge and ideas. While high-skilled immigrants in the United States represent a much smaller proportion of the workforce than they do in countries such as Australia, Canada, and the United Kingdom, these immigrants have an important role in spurring innovation and economic growth in all countries and filling shortages in the domestic labor supply. This report summarizes the proceedings of a Fall 2014 workshop that focused on how immigration policy can be used to attract and retain foreign talent. Participants compared policies on encouraging migration and retention of skilled workers, attracting qualified foreign students and retaining them post-graduation, and input by states or provinces in immigration policies to add flexibility in countries with regional employment differences, among other topics. They also discussed how immigration policies have changed over time in response to undesired labor market outcomes and whether there was sufficient data to measure those outcomes.

Since its creation by the Institute of Medicine (IOM) in 2007, the Roundtable on the Promotion of Health Equity and the Elimination of Health Disparities has been fostering dialogue on racial and ethnic disparities in health and health care, examining the development of programs and strategies to reduce disparities, and encouraging the emergence of new leadership focused on health equity. For the past several years, a prominent topic of discussion within the roundtable has been the Patient Protection and Affordable Care Act (ACA). The ACA has multiple provisions specific to race, ethnicity, and language and other provisions with significant implications for racially and ethnically diverse populations. In April 2013, the roundtable held a workshop to address many issues surrounding the ACA, including expansion of coverage, delivery systems, and access points, service delivery and payment reform, public-private partnerships, and challenges to the safety net. This report summarizes the presentations and discussions from the workshop.

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 National Science Foundation (NSF). Building on the outcomes from the first round, this second round presents the committee's second review of the NSF SBIR program's operations. 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 areas such as genomics, bioinformatics, and nanotechnology 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.

Summary of the National Research Council Committee on Population Workshop on Recent Trends in Fertility in Sub-Saharan Africa, June 15-16, 2015. Held at the National Academy of Sciences Building in Washington, D.C.

In 2013 the Institute of Medicine (IOM) Roundtable on Population Health Improvement organized a workshop to discuss opportunities to foster a health in all policies approach in non-health sectors such as housing, transportation, defense, education, and others. Much of the discussion focused on public-sector organizations, and roundtable members saw the need for further discussion of the role of the private sector, both as stakeholder and partner. On June 4, 2015, the roundtable convened a follow-up workshop focused on applying a health lens to the role and potential of businesses in improving economic well-being and community health outcomes. Participants explored what businesses can offer the movement to improve population health and areas of potential, as well as models for how businesses can impact the determinants of health, and developed a platform for discussing how to promote and support health in all business practices, policies, and investments. This report summarizes the presentations and discussions from the workshop.

Students who participate in scientific research as undergraduates report gaining many benefits from the experience. However, undergraduate research done independently under a faculty member's guidance or as part of an internship, regardless of its individual benefits, is inherently limited in its overall impact. Faculty members and sponsoring companies have limited time and funding to support undergraduate researchers, and most institutions have available (or have allocated) only enough human and financial resources to involve a small fraction of their undergraduates in such experiences. Many more students can be involved as undergraduate researchers if they do scientific research either collectively or individually as part of a regularly scheduled course. Course-based research experiences have been shown to provide students with many of the same benefits acquired from a mentored summer research experience, assuming that sufficient class time is invested, and several different potential advantages. In order to further explore this issue, the Division on Earth and Life Studies and the Division of Behavioral and Social Sciences and Education organized a convocation meant to examine the efficacy of engaging large numbers of undergraduate students who are enrolled in traditional academic year courses in the life and related sciences in original research, civic engagement around scientific issues, and/or intensive study of research methods and scientific publications at both two- and four-year colleges and universities. Participants explored the benefits and costs of offering students such experiences and the ways that such efforts may both influence and be influenced by issues such as institutional governance, available resources, and professional expectations of faculty. Integrating Discovery-Based Research into the Undergraduate Curriculum summarizes the presentations and discussions from this event.

The workshop summarized in this report was organized as part of a study sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Office of the Assistant Secretary for Planning and Evaluation of the U.S. Department of Health and Human Services, with the goal of assisting SAMHSA in its responsibilities of expanding the collection of behavioral health data in several areas. The workshop brought together experts in child mental health, psychiatric epidemiology and survey methods to facilitate discussion of the most suitable measures and mechanisms for producing estimates of serious emotional disturbance in children, which are necessary to enable the distribution of block grants that support state-level mental health services for children. The report discusses existing measures and data on mental disorders and functional impairment, challenges associated with collecting these data in large-scale population-based studies, as well as study design and estimation options.

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) began 40 years ago as a pilot program and has since grown to serve over 8 million pregnant women, and mothers of and their infants and young children. Today the program serves more than a quarter of the pregnant women and half of the infants in the United States, at an annual cost of about $6.2 billion. Through its contribution to the nutritional needs of pregnant, breastfeeding, and post-partum women; infants; and children under 5 years of age; this federally supported nutrition assistance program is integral to meeting national nutrition policy goals for a significant portion of the U.S. population. To assure the continued success of the WIC, Congress mandated that the Food and Nutrition Service of the U.S. Department of Agriculture (USDA) reevaluate the program's food packages every 10 years. In 2014, the USDA asked the Institute of Medicine to undertake this reevaluation to ensure continued alignment with the goals of the Dietary Guidelines for Americans. This, the second report of this series, provides a summary of the work of phase I of the study, and serves as the analytical underpinning for phase II in which the committee will report its final conclusions and recommendations.

The U.S. Department of Agriculture Economic Research Service (USDA/ERS) maintains four highly related but distinct geographic classification systems to designate areas by the degree to which they are rural. The original urban-rural code scheme was developed by the ERS in the 1970s. Rural America today is very different from the rural America of 1970 described in the first rural classification report. At that time migration to cities and poverty among the people left behind was a central concern. The more rural a residence, the more likely a person was to live in poverty, and this relationship held true regardless of age or race. Since the 1970s the interstate highway system was completed and broadband was developed. Services have become more consolidated into larger centers. Some of the traditional rural industries, farming and mining, have prospered, and there has been rural amenity-based in-migration. Many major structural and economic changes have occurred during this period. These factors have resulted in a quite different rural economy and society since 1970. In April 2015, the Committee on National Statistics convened a workshop to explore the data, estimation, and policy issues for rationalizing the multiple classifications of rural areas currently in use by the Economic Research Service (ERS). Participants aimed to help ERS make decisions regarding the generation of a county rural-urban scale for public use, taking into consideration the changed social and economic environment. This report summarizes the presentations and discussions from the workshop.

"In order to better understand the critical issues pertaining to the concept of performance standards for laboratory animal use, the Institute for Laboratory Animal Research Roundtable on Science and Welfare in Laboratory Animal Use held a public workshop on April 20-21, 2015. The purpose of the workshop was to promote the appropriate and responsible care of animals in research, to provide a balanced and civil forum for discussion and collaboration, and to help build transparency and trust among stakeholders. Participants addressed the challenges of defining, developing, implementing, assessing, and validating performance standards to ensure "optimal practices, management, and operations." This report summarizes the presentations and discussions from the workshop"--Publisher's description.

In 2008, the U.S. federal government issued fully approved physical activity guidelines for the first time. The idea that physical activity impacts health can be traced as far back as Hippocrates, and the science around the linkages between physical activity and health has continuously accumulated. On April 14-15, 2015, the Institute of Medicine's Roundtable on Obesity Solutions held a 2-day workshop to explore the state of the science regarding the impact of physical activity in the prevention and treatment of overweight and obesity and to highlight innovative strategies for promoting physical activity across different segments of the population. This report summarizes the presentations and discussions from this workshop.

The Small Business Innovation Research (SBIR) and Small Business Technology Transfer (STTR) programs provide federal research and development funding to small businesses. In 2008, the National Research Council completed a comprehensive assessment of the SBIR and STTR programs. The first-round study found that the programs were "sound in concept and effective in practice." Building on the outcomes from the Phase I study, this second phase examines both topics of general policy interest that emerged during the first phase and topics of specific interest to individual agencies, and provides a second snapshot to measure the program's progress against its legislative goals.

The integration and coordination of health, education, nutrition, social protection, and other services have the potential to improve the lives of children and their caregivers around the world. However, integration and coordination of policies and programs affecting early childhood development can create both risks and benefits. In different localities, these services are more or less effective in achieving their objectives. They also are more or less coordinated in delivering services to the same recipients, and in some cases services are delivered by integrated multisectoral organizations. The result is a rich arena for policy analysis and change and a complex challenge for public- and private-sector organizations that are seeking to improve the lives of children. To examine the science and policy issues involved in coordinating investments in children and their caregivers, the Forum on Investing in Young Children Globally held a workshop in Hong Kong on March 14-15, 2015. Held in partnership with the Centre for Health Education and Health Promotion and Wu Yee Sun College of the Chinese University of Hong Kong, the workshop brought together researchers, policy makers, program practitioners, and other experts from 22 countries. This report highlights the presentations and discussions of the event.

NASA's Earth Science Division (ESD) conducts a wide range of satellite and suborbital missions to observe Earth's land surface and interior, biosphere, atmosphere, cryosphere, and oceans as part of a program to improve understanding of Earth as an integrated system. Earth observations provide the foundation for critical scientific advances and environmental data products derived from these observations are used in resource management and for an extraordinary range of societal applications including weather forecasts, climate projections, sea level change, water management, disease early warning, agricultural production, and the response to natural disasters. As the complexity of societal infrastructure and its vulnerability to environmental disruption increases, the demands for deeper scientific insights and more actionable information continue to rise. To serve these demands, NASA's ESD is challenged with optimizing the partitioning of its finite resources among measurements intended for exploring new science frontiers, carefully characterizing long-term changes in the Earth system, and supporting ongoing societal applications. This challenge is most acute in the decisions the Division makes between supporting measurement continuity of data streams that are critical components of Earth science research programs and the development of new measurement capabilities. This report seeks to establish a more quantitative understanding of the need for measurement continuity and the consequences of measurement gaps. Continuity of NASA's Earth's Observations presents a framework to assist NASA's ESD in their determinations of when a measurement or dataset should be collected for durations longer than the typical lifetimes of single satellite missions.

The electromagnetic spectrum is a vital part of our environment. Measures of radio frequency emissions from natural phenomena enable both practical applications, such as weather predictions and studies of the changing of Earth's climate here at home, and reveal the physical properties of cosmic sources. The spectrum is therefore a resource to be used wisely now and to be protected for future generations. Handbook of Frequency Allocations and Spectrum Protection for Scientific Uses: Second Edition sets forth the principles for the allocation and protection of spectral bands for services using the radio spectrum for scientific research. This report describes the radio frequency bands used by scientific services and includes relevant regulatory information and discussion of scientific use of frequency bands. This reference will guide spectrum managers and spectrum regulatory bodies on science issues and serve as a resource to scientists and other spectrum users.

"The Standing Committee on Defense Materials Manufacturing and Infrastructure (DMMI) convened a workshop on August 6-7, 2014, to discuss related to applying materials state awareness to condition-based maintenance and system life cycle management"--Page 1.

"The US Global Change Research Program (USGCRP) is a collection of 13 Federal entities charged by law to assist the United States and the world to understand, assess, predict, and respond to human-induced and natural processes of global change. As the understanding of global change has evolved over the past decades and as demand for scientific information on global change has increased, the USGCRP has increasingly focused on research that can inform decisions to cope with current climate variability and change, to reduce the magnitude of future changes, and to prepare for changes projected over coming decades. Overall, the current breadth and depth of research in these agencies is insufficient to meet the country's needs, particularly to support decision makers. This report provides a rationale for evaluating current program membership and capabilities and identifying potential new agencies and departments in the hopes that these changes will enable the program to more effectively inform the public and prepare for the future. It also offers actionable recommendations for adjustments to the methods and procedures that will allow the program to better meet its stated goals"--

Report of the Enabling Rapid Response and Sustained Capability with Medical Countermeasures to Mitigate Risk of Emerging Infectious Diseases: an Institute of Medicine Workshop which took place at the National Academy of Sciences Building in Washington, D.C. on March 26-27, 2015.

If the United States is to sustain its economic prosperity, quality of life, and global competitiveness, it must continue to have an abundance of secure, reliable, and affordable energy resources. There have been many improvements in the technology and capability of the electric grid over the past several decades. Many of these advances to the grid depend on complex mathematical algorithms and techniques, and as the complexity of the grid has increased, the analytical demands have also increased. The workshop summarized in this report was developed as part of an ongoing study of the Committee on Analytical Research Foundations for the Next-Generation Electric Grid. Mathematical Sciences Research Challenges for the Next-Generation Electric Grid summarizes the presentations and discussions from this workshop. This report identifies critical areas of mathematical and computational research that must be addressed for the next-generation electric transmission and distribution system and to identify future needs and ways that current research efforts in these areas could be adjusted or augmented.

In April 2015, the Institute of Medicine convened a workshop to explore the potential uses of simulation and other types of modeling for the purpose of selecting and refining potential strategies, ranging from interventions to investments, to improve the health of communities and the nation's health. Participants worked to identify how modeling could inform population health decision making based on lessons learned from models that have been, or have not been, used successfully, opportunities and barriers to incorporating models into decision making, and data needs and opportunities to leverage existing data and to collect new data for modeling. This report summarizes the presentations and discussions from this workshop.--

The National Nuclear Security Administration (NNSA) is responsible for providing and maintaining the capabilities necessary to sustain a safe, secure, and reliable nuclear weapons stockpile for the nation and its allies. Major responsibility for meeting the NNSA missions falls to the three NNSA laboratories: Los Alamos National Laboratory (LANL), Lawrence Livermore National Laboratory (LLNL), and Sandia National Laboratories (SNL). The NNSA National Security Laboratories contribute to that goal by maintaining the skills and capabilities necessary for stewardship of a reliable nuclear stockpile and also by maintaining a high level of technical credibility, which is a component of the nuclear deterrent. Since 1992 it has been U.S. policy not to conduct explosion tests of nuclear weapons. The resulting technical challenges have been substantial. Whereas a nuclear test was in some sense the ultimate "peer review" of the performance of a particular NEP design, the cessation of nuclear testing necessitated a much greater reliance on both intralab and interlab expert peer review to identify potential problems with weapon designs and define the solution space. This report assesses the quality and effectiveness of peer review of designs, development plans, engineering and scientific activities, and priorities related to both nuclear and non-nuclear aspects of nuclear weapons, as well as incentives for effective peer review. It also explores how the evolving mission of the NNSA laboratories might impact peer review processes at the laboratories that relate to nuclear weapons.

"The Forum on Promoting Children's Cognitive, Affective, and Behavioral Health held a workshop in Washington, DC, on April 1-2, 2015, titled "Opportunities to Promote Children's Behavioral Health: Health Care Reform and Beyond"--P.1-2.

-Providing Sustainable Mental Health Care in Kenya: a Workshop, Villa Rosa Kempinski, Chiromo Road, Nairobi, Kenya, January 13-14, 2015---Page 75.

Passenger screening at commercial airports in the United States has gone through significant changes since the events of September 11, 2001. In response to increased concern over terrorist attacks on aircrafts, the Transportation Security Administration (TSA) has deployed security systems of advanced imaging technology (AIT) to screen passengers at airports. To date (December 2014), TSA has deployed AITs in U.S. airports of two different technologies that use different types of radiation to detect threats: millimeter wave and X-ray backscatter AIT systems. X-ray backscatter AITs were deployed in U.S. airports in 2008 and subsequently removed from all airports by June 2013 due to privacy concerns. TSA is looking to deploy a second-generation X-ray backscatter AIT equipped with privacy software to eliminate production of an image of the person being screened in order to alleviate these concerns. This report reviews previous studies as well as current processes used by the Department of Homeland Security and equipment manufacturers to estimate radiation exposures resulting from backscatter X-ray advanced imaging technology system use in screening air travelers. Airport Passenger Screening Using Backscatter X-Ray Machines examines whether exposures comply with applicable health and safety standards for public and occupational exposures to ionizing radiation and whether system design, operating procedures, and maintenance procedures are appropriate to prevent over exposures of travelers and operators to ionizing radiation. This study aims to address concerns about exposure to radiation from X-ray backscatter AITs raised by Congress, individuals within the scientific community, and others.

At a time when lesbian, gay, bisexual, and transgender individuals--often referred to under the umbrella acronym LGBT--are becoming more visible in society and more socially acknowledged, clinicians and researchers are faced with incomplete information about their health status. While LGBT populations often are combined as a single entity for research and advocacy purposes, each is a distinct population group with its own specific health needs. Furthermore, the experiences of LGBT individuals are not uniform and are shaped by factors of race, ethnicity, socioeconomic status, geographical location, and age, any of which can have an effect on health-related concerns and needs. The Health of Lesbian, Gay, Bisexual, and Transgender People assesses the state of science on the health status of LGBT populations, identifies research gaps and opportunities, and outlines a research agenda for the National Institute of Health. The report examines the health status of these populations in three life stages: childhood and adolescence, early/middle adulthood, and later adulthood. At each life stage, the committee studied mental health, physical health, risks and protective factors, health services, and contextual influences. To advance understanding of the health needs of all LGBT individuals, the report finds that researchers need more data about the demographics of these populations, improved methods for collecting and analyzing data, and an increased participation of sexual and gender minorities in research. The Health of Lesbian, Gay, Bisexual, and Transgender People is a valuable resource for policymakers, federal agencies including the National Institute of Health (NIH), LGBT advocacy groups, clinicians, and service providers.