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"Microbial threats, including endemic and emerging infectious diseases and antimicrobial resistance, can cause not only substantial health consequences but also enormous disruption to economic activity worldwide. While scientific advances have undoubtedly strengthened our ability to respond to and mitigate the mortality of infectious disease threats, events over the past two decades have illustrated our continued vulnerability to economic consequences from these threats. To assess the current understanding of the interaction of infectious disease threats with economic activity and suggest potential new areas of research, the National Academies of Sciences, Engineering, and Medicine planned a 1.5-day public workshop on understanding the economics of microbial threats. This workshop built on prior work of the Forum on Microbial Threats and aimed to help transform current knowledge into immediate action. This publication summarizes the presentations and discussions from the workshop"--

In the quest to mitigate the buildup of greenhouse gases in Earth's atmosphere, researchers and policymakers have increasingly turned their attention to techniques for capturing greenhouse gases such as carbon dioxide and methane, either from the locations where they are emitted or directly from the atmosphere. Once captured, these gases can be stored or put to use. While both carbon storage and carbon utilization have costs, utilization offers the opportunity to recover some of the cost and even generate economic value. While current carbon utilization projects operate at a relatively small scale, some estimates suggest the market for waste carbon-derived products could grow to hundreds of billions of dollars within a few decades, utilizing several thousand teragrams of waste carbon gases per year. Gaseous Carbon Waste Streams Utilization: Status and Research Needs assesses research and development needs relevant to understanding and improving the commercial viability of waste carbon utilization technologies and defines a research agenda to address key challenges. The report is intended to help inform decision making surrounding the development and deployment of waste carbon utilization technologies under a variety of circumstances, whether motivated by a goal to improve processes for making carbon-based products, to generate revenue, or to achieve environmental goals.

"A consensus study report of The National Academies of Sciences, Engineering, Medicine."

"Adults age 65 and older make up the fastest-growing segment of the U.S. population. At the same time, the complexity of health care delivery continues to grow, creating challenges that are magnified for older adults, given that age is one of the highest correlates of low health literacy. This creates a shared obligation between health care and the health care team to use the principles, tools, and practices of health literacy so that patients and families of older adults can more easily navigate discussions related to chronic disease, polypharmacy, long-term care, palliative care, insurance complexities, the social determinants of health, and other factors that create challenges for older adults, particularly among underserved populations nationwide. To gain a better understanding of the health communication challenges among older adults and their professional and family caregivers and how those challenges affect the care older adults receive, the National Academies of Sciences, Engineering, and Medicine's Roundtable on Health Literacy convened a 1-day public workshop featuring presentations and discussions that examined the effect of low health literacy on the health of older adults. This publication summarizes the presentations and discussions from the workshop" --

"Vehicle weight reduction is an effective strategy for reducing fuel consumption in civilian vehicles. For combat vehicles, it presents not only an important opportunity to reduce fuel use and associated logistics, but also important advantages in transport and mobility on the battlefield. Although there have been numerous efforts in the past to reduce the overall weight of combat vehicles, combat vehicle weight has continued to increase over time due to new threats and missions. On December 8 and 9, 2014, the National Academies of Sciences, Engineering, and Medicine held a workshop to explore opportunities in lightweight materials for armored vehicles. This was the ninth workshop in an ongoing series for the U.S. military on materials and manufacturing issues. The workshop discussed future advances in weight reduction by materials substitution for vehicles, including such topics as armor, structure, automotive parts, and armaments. This publication summarizes the presentations and discussions from the workshop"-- Provided by publisher.

The mental health and well-being of health professionals is a topic that is broad, exceptionally relevant, and urgent to address. It is both a local and a global issue, and affects professionals in all stages of their careers. To explore this topic, the Global Forum on Innovation in Health Professional Education held a 1.5 day workshop. This publication summarizes the presentations and discussions from the workshop.

Requested by NASA, this study offers a science strategy for astrobiology that outlines key scientific questions, identifies the most promising research in the field, and indicates the extent to which the mission priorities in existing decadal surveys address the search for life's origin, evolution, distribution, and future in the universe. This report makes recommendations for advancing the research, obtaining the measurements, and realizing NASA's goal to search for signs of life in the universe.--

The Forum on Cyber Resilience of the National Academies of Sciences, Engineering, and Medicine hosted the Workshop on Recoverability as a First-Class Security Objective on February 8, 2018, in Washington, D.C. The workshop featured presentations from several experts in industry, research, and government roles who spoke about the complex facets of recoverability--that is, the ability to restore normal operations and security in a system affected by software or hardware failure or a deliberate attack. This publication summarizes the presentations and discussions from the workshop.

"The Edwards Aquifer in south-central Texas is the primary source of water for one of the fastest growing cities in the United States, San Antonio, and it also supplies irrigation water to thousands of farmers and livestock operators. It is also the source water for several springs and rivers, including the two largest freshwater springs in Texas that form the San Marcos and Comal Rivers. The unique habitat afforded by these spring-fed rivers has led to the development of species that are found in no other locations on Earth. Due to the potential for variations in spring flow caused by both human and natural causes, these species are continuously at risk and have been recognized as endangered under the federal Endangered Species Act (ESA). In an effort to manage the river systems and the aquifer that controls them, the Edwards Aquifer Authority (EAA) and stakeholders have developed a Habitat Conservation Plan (HCP). The HCP seeks to effectively manage the river-aquifer system to ensure the viability of the ESA-listed species in the face of drought, population growth, and other threats to the aquifer. This report is the third and final product of a three-phase study to provide advice to the EAA on various aspects of the HCP that will ultimately lead to improved management of the Edwards Aquifer. This final report focuses on the biological goals and objectives found in the HCP for each of the listed species."--

"Modern science is ever more driven by computations and simulations. In particular, the state of the art in space and Earth science often arises from complex simulations of climate, space weather, and astronomical phenomena. At the same time, scientific work requires data processing, presentation, and analysis through broadly available proprietary and community software. Implicitly or explicitly, software is central to science. Scientific discovery, understanding, validation, and interpretation are all enhanced by access to the source code of the software used by scientists. This report investigates and recommends options for NASA's Science Mission Directorate (SMD) as it considers how to establish a policy regarding open source software to complement its existing policy on open data. In particular, the report reviews existing data and software policies and the lessons learned from the implementation of those policies, summarizes community perspectives, and presents policy options and recommendations for implementing an open source software policy for NASA SMD."--Publisher's description.

"Solving problems related to use of water resources will be of paramount importance in coming decades as increasing pressure from growing populations, climate change, extreme weather, and aging water-related infrastructure threaten water availability and quality. The Water Mission Area (WMA) of the U.S. Geological Survey (USGS) has a long-established reputation for collecting and delivering high-quality, unbiased scientific information related to the nation's water resources. WMA observations help inform decisions ranging from rapid responses during emergencies such as hurricanes, floods, and forest fires, to the long-term management of water resources. Produced at the request of USGS, this report identifies the nation's highest-priority water science and resources challenges over the next 25 years. Future Water Priorities for the Nation summarizes WMA's current water science and research portfolio, and recommends strategic opportunities for WMA to more effectively address the most pressing challenges"--

"Millions of Americans of all ages face the challenge of living with serious illnesses such as advanced cancer, heart, or lung disease. Many people with serious illness are increasingly cared for in community settings. While the number of community-based programs to provide care for those with serious illness has grown significantly, the quality of care provided is not consistent across geographic locations or care settings. Care for the serious illness population often features gaps in coordination across sites of care and poor patient and family perceptions as to the quality of care provided. In an effort to better understand and facilitate discussions about the challenges and opportunities related to identifying and implementing quality measures for accountability purposes in community-based serious illness care, the National Academies of Sciences, Engineering, and Medicine held a public workshop on April 17, 2018, in Washington, DC. Workshop participants explored the current state of quality measurement for people with serious illness, their families, and caregivers, with the aim of identifying next steps toward effectively implementing measures to drive improvement in the quality of community-based care for those facing serious illness. This publication summarizes the presentations and discussions from the workshop"--Publisher's description.

There are many reasons to be curious about the way people learn, and the past several decades have seen an explosion of research that has important implications for individual learning, schooling, workforce training, and policy. In 2000, How People Learn: Brain, Mind, Experience, and School: Expanded Edition was published and its influence has been wide and deep. The report summarized insights on the nature of learning in school-aged children; described principles for the design of effective learning environments; and provided examples of how that could be implemented in the classroom. Since then, researchers have continued to investigate the nature of learning and have generated new findings related to the neurological processes involved in learning, individual and cultural variability related to learning, and educational technologies. In addition to expanding scientific understanding of the mechanisms of learning and how the brain adapts throughout the lifespan, there have been important discoveries about influences on learning, particularly sociocultural factors and the structure of learning environments. How People Learn II: Learners, Contexts, and Cultures provides a much-needed update incorporating insights gained from this research over the past decade. The book expands on the foundation laid out in the 2000 report and takes an in-depth look at the constellation of influences that affect individual learning. How People Learn II will become an indispensable resource to understand learning throughout the lifespan for educators of students and adults.

"Rapid advances in cancer research, the development of new and more sophisticated approaches to diagnostic testing, and the growth in targeted cancer therapies are transforming the landscape of cancer diagnosis and care. These innovations have contributed to improved outcomes for patients with cancer, but they have also increased the complexity involved in diagnosis and subsequent care decisions. To examine opportunities to improve cancer diagnosis and care, the National Academies of Sciences, Engineering, and Medicine developed a two-workshop series. The first workshop, held on February 12-13, 2018, in Washington, DC, focused on potential strategies to ensure that patients have access to appropriate expertise and technologies in oncologic pathology and imaging to inform their cancer diagnosis and treatment planning, as well as assessment of treatment response and surveillance. This publication chronicles the presentations and discussions at the workshop."--

The past decade has delivered remarkable discoveries in the study of exoplanets. Hand-in-hand with these advances, a theoretical understanding of the myriad of processes that dictate the formation and evolution of planets has matured, spurred on by the avalanche of unexpected discoveries. Appreciation of the factors that make a planet hospitable to life has grown in sophistication, as has understanding of the context for biosignatures, the remotely detectable aspects of a planet's atmosphere or surface that reveal the presence of life. Exoplanet Science Strategy highlights strategic priorities for large, coordinated efforts that will support the scientific goals of the broad exoplanet science community. This report outlines a strategic plan that will answer lingering questions through a combination of large, ambitious community-supported efforts and support for diverse, creative, community-driven investigator research.

In 2015, building on the advances of the Millennium Development Goals, the United Nations adopted Sustainable Development Goals that include an explicit commitment to achieve universal health coverage by 2030. However, enormous gaps remain between what is achievable in human health and where global health stands today, and progress has been both incomplete and unevenly distributed. In order to meet this goal, a deliberate and comprehensive effort is needed to improve the quality of health care services globally. Crossing the Global Quality Chasm: Improving Health Care Worldwide focuses on one particular shortfall in health care affecting global populations: defects in the quality of care. This study reviews the available evidence on the quality of care worldwide and makes recommendations to improve health care quality globally while expanding access to preventive and therapeutic services, with a focus in low-resource areas. Crossing the Global Quality Chasm emphasizes the organization and delivery of safe and effective care at the patient/provider interface. This study explores issues of access to services and commodities, effectiveness, safety, efficiency, and equity. Focusing on front line service delivery that can directly impact health outcomes for individuals and populations, this book will be an essential guide for key stakeholders, governments, donors, health systems, and others involved in health care.

"Since 1965 the foreign-born population of the United States has swelled from 9.6 million or 5 percent of the population to 45 million or 14 percent in 2015. Today, about one-quarter of the U.S. population consists of immigrants or the children of immigrants. Given the sizable representation of immigrants in the U.S. population, their health is a major influence on the health of the population as a whole. On average, immigrants are healthier than native-born Americans. Yet, immigrants also are subject to the systematic marginalization and discrimination that often lead to the creation of health disparities. To explore the link between immigration and health disparities, the Roundtable on the Promotion of Health Equity held a workshop in Oakland, California, on November 28, 2017. This summary of that workshop highlights the presentations and discussions of the workshop"--Publisher's description.

"Reliable, affordable, and technically recoverable energy is central to the nation's economic and social vitality. The United States is both a major consumer of geologically based energy resources from around the world and - increasingly of late - a developer of its own energy resources. Understanding the national and global availability of those resources as well as the environmental impacts of their development is essential for strategic decision making related to the nation's energy mix. The U.S. Geological Survey Energy Resources Program is charged with providing unbiased and publicly available national- and regional-scale assessments of the location, quantity, and quality of geologically based energy resources and with undertaking research related to their development. At the request of the Energy Resources Program (ERP), this publication considers the nation's geologically based energy resource challenges in the context of current national and international energy outlooks. Future Directions for the U.S. Geological Survey's Energy Resources Program examines how ERP activities and products address those challenges and align with the needs federal and nonfederal consumers of ERP products. This study contains recommendations to develop ERP products over the next 10-15 years that will most effectively inform both USGS energy research priorities and the energy needs and priorities of the U.S. government"--Publisher's description.

Late last year, the National Academy of Engineering (NAE) convened a workshop on Preparing the Engineering and Technical Workforce for Adaptability and Resilience to Change. The workshop springs from the earlier NAE report Making Value for America which described the ongoing transformation in the way in which products and services are conceived, designed, made, and distributed. The workshop focused on the challenges facing the workforce in light of these dramatic changes in the production process, especially the need to constantly renew and learn new skills. The workshop served to increase stakeholders' understanding of both the importance of workforce adaptability and the definition and characteristics of adaptability. It also provided an opportunity to share known best practices for fostering adaptability, including identification of barriers and multiple pathways for overcoming those barriers. As important, it helped to identify needs for future study and development. This publication summarizes the presentations and discussions from the workshop.

"In spring 2011 the National Academies of Sciences, Engineering, and Medicine produced a report outlining the next decade in planetary sciences. That report, titled Vision and Voyages for Planetary Science in the Decade 2013-2022, and popularly referred to as the "decadal survey," has provided high-level prioritization and guidance for NASA's Planetary Science Division. Other considerations, such as budget realities, congressional language in authorization and appropriations bills, administration requirements, and cross-division and cross-directorate requirements (notably in retiring risk or providing needed information for the human program) are also necessary inputs to how NASA develops its planetary science program. In 2016 NASA asked the National Academies to undertake a study assessing NASA's progress at meeting the objectives of the decadal survey. After the study was underway, Congress passed the National Aeronautics and Space Administration Transition Authorization Act of 2017 which called for NASA to engage the National Academies in a review of NASA's Mars Exploration Program. NASA and the Academies agreed to incorporate that review into the midterm study. That study has produced this report, which serves as a midterm assessment and provides guidance on achieving the goals in the remaining years covered by the decadal survey as well as preparing for the next decadal survey, currently scheduled to begin in 2020"--

"Disasters tend to cross political, jurisdictional, functional, and geographic boundaries. As a result, disasters often require responses from multiple levels of government and multiple organizations in the public and private sectors. This means that public and private organizations that normally operate independently must work together to mount an effective disaster response. To identify and understand approaches to aligning health care system incentives with the American public's need for a health care system that is prepared to manage acutely ill and injured patients during a disaster, public health emergency, or other mass casualty event, the National Academies of Sciences, Engineering, and Medicine hosted a 2-day public workshop on March 20 and 21, 2018. This publication summarizes the presentations and discussions from the workshop"--Publisher's description.

"On December 5, 2017, the Food Forum hosted a public workshop titled Nutrigenomics and the Future of Nutrition in Washington, DC, to review current knowledge in the field of nutrigenomics as it relates to nutrition. Workshop participants explored the influence of genetic and epigenetic expression on nutritional status and the potential impact of personalized nutrition on health maintenance and chronic disease prevention. The workshop also investigated the clinical implications of nutrigenomics, key public health and regulatory policy considerations presented in the context of emerging nutrigenomics applications to personalized nutrition, and the challenges to globalization of public health guidance that may be informed by nutrigenomic research"--Publisher's description.

"Understanding of protons and neutrons, or 'nucleons'--the building blocks of atomic nuclei--has advanced dramatically, both theoretically and experimentally, in the past half century. A central goal of modern nuclear physics is to understand the structure of the proton and neutron directly from the dynamics of their quarks and gluons governed by the theory of their interactions, quantum chromodynamics (QCD), and how nuclear interactions between protons and neutrons emerge from these dynamics. With deeper understanding of the quark-gluon structure of matter, scientists are poised to reach a deeper picture of these building blocks, and atomic nuclei themselves, as collective many-body systems with new emergent behavior. The development of a U.S. domestic electron-ion collider (EIC) facility has the potential to answer questions that are central to completing an understanding of atoms and integral to the agenda of nuclear physics today. This study assesses the merits and significance of the science that could be addressed by an EIC, and its importance to nuclear physics in particular and to the physical sciences in general. It evaluates the significance of the science that would be enabled by the construction of an EIC, its benefits to U.S. leadership in nuclear physics, and the benefits to other fields of science of a U.S.-based EIC"--Publisher's description.

"The field of health literacy has evolved from one focused on individuals to one that recognizes that health literacy is multidimensional. While communicating in a health literate manner is important for everyone, it is particularly important when communicating with those with limited health literacy who also experience more serious medication errors, higher rates of hospitalization and use of the emergency room, poor health outcomes, and increased mortality. Over the past decade, research has shown that health literacy interventions can significantly impact various areas including health care costs, outcomes, and health disparities. To understand the extent to which health literacy has been shown to be effective at contributing to the Quadruple Aim of improving the health of communities, providing better care, providing affordable care, and improving the experience of the health care team, the National Academies of Sciences, Engineering, and Medicine convened a public workshop on building the case for health literacy. This publication summarizes the presentations and discussions from the workshop, and highlights important lessons about the role of health literacy in meeting the Quadruple Aim, case studies of organizations that have adopted health literacy, and discussions among the different stakeholders involved in making the case for health literacy"--

"According to the Centers for Disease Control and Prevention (CDC), 115 Americans die each day from an opioid overdose, which averages one death every 12.5 minutes. Between 1999 and 2016, the number of drug overdoses catapulted by 300 percent, with injection drug use increasing by 93 percent between 2004 and 2014 and opioid-related hospital admissions increasing by 58 percent over the past decade. And an inexorable sequela of the opioid epidemic is the spread of infectious diseases. To address these infectious disease consequences of the opioid crisis, a public workshop titled Integrating Infectious Disease Considerations with Response to the Opioid Epidemic was convened on March 12 and 13, 2018, by the National Academies of Sciences, Engineering, and Medicine. Participants discussed strategies to prevent and treat infections in people who inject drugs, especially ways to work efficiently though the existing public health and medical systems. This publication summarizes the presentations and discussions from the workshop"--

"Chronic homelessness is a highly complex social problem of national importance. The problem has elicited a variety of societal and public policy responses over the years, concomitant with fluctuations in the economy and changes in the demographics of and attitudes toward poor and disenfranchised citizens. In recent decades, federal agencies, nonprofit organizations, and the philanthropic community have worked hard to develop and implement programs to solve the challenges of homelessness, and progress has been made. However, much more remains to be done. Importantly, the results of various efforts, and especially the efforts to reduce homelessness among veterans in recent years, have shown that the problem of homelessness can be successfully addressed. Although a number of programs have been developed to meet the needs of persons experiencing homelessness, this report focuses on one particular type of intervention: permanent supportive housing (PSH). Permanent Supportive Housing focuses on the impact of PSH on health care outcomes and its cost-effectiveness. The report also addresses policy and program barriers that affect the ability to bring the PSH and other housing models to scale to address housing and health care needs"--Publisher's description.

"The Centers for Disease Control and Prevention (CDC) established the Strategic National Stockpile (SNS) with a focus on procuring and managing medical countermeasures (MCM) designed to address chemical, biological, radiological, and nuclear events and attacks by weapons of mass destruction. The stockpile is a repository of antibiotics, chemical antidotes, antitoxins, vaccines, antiviral drugs, and other medical material organized to respond to a spectrum of public health threats. Over time, the mission of the SNS has informally evolved to address other large-scale catastrophes, such as hurricanes or outbreaks of pandemic disease, and rare acute events, such as earthquakes or terror attacks. When disaster strikes, states can request deployment of SNS assets to augment resources available to state, local, tribal, or territorial public health agencies. CDC works with federal, state, and local health officials to identify and address their specific needs and, according to the stated mission of the SNS, ensure that the right resources reach the right place at the right time"--

For nearly a century, scientific advances have fueled progress in U.S. agriculture to enable American producers to deliver safe and abundant food domestically and provide a trade surplus in bulk and high-value agricultural commodities and foods. Today, the U.S. food and agricultural enterprise faces formidable challenges that will test its long-term sustainability, competitiveness, and resilience. On its current path, future productivity in the U.S. agricultural system is likely to come with trade-offs. The success of agriculture is tied to natural systems, and these systems are showing signs of stress, even more so with the change in climate. More than a third of the food produced is unconsumed, an unacceptable loss of food and nutrients at a time of heightened global food demand. Increased food animal production to meet greater demand will generate more greenhouse gas emissions and excess animal waste. The U.S. food supply is generally secure, but is not immune to the costly and deadly shocks of continuing outbreaks of food-borne illness or to the constant threat of pests and pathogens to crops, livestock, and poultry. U.S. farmers and producers are at the front lines and will need more tools to manage the pressures they face. Science Breakthroughs to Advance Food and Agricultural Research by 2030 identifies innovative, emerging scientific advances for making the U.S. food and agricultural system more efficient, resilient, and sustainable. This report explores the availability of relatively new scientific developments across all disciplines that could accelerate progress toward these goals. It identifies the most promising scientific breakthroughs that could have the greatest positive impact on food and agriculture, and that are possible to achieve in the next decade (by 2030).

"Openness and sharing of information are fundamental to the progress of science and to the effective functioning of the research enterprise. The advent of scientific journals in the 17th century helped power the Scientific Revolution by allowing researchers to communicate across time and space, using the technologies of that era to generate reliable knowledge more quickly and efficiently. Harnessing today's stunning, ongoing advances in information technologies, the global research enterprise and its stakeholders are moving toward a new open science ecosystem. Open science aims to ensure the free availability and usability of scholarly publications, the data that result from scholarly research, and the methodologies, including code or algorithms, that were used to generate those data. Open Science by Design is aimed at overcoming barriers and moving toward open science as the default approach across the research enterprise. This report explores specific examples of open science and discusses a range of challenges, focusing on stakeholder perspectives. It is meant to provide guidance to the research enterprise and its stakeholders as they build strategies for achieving open science and take the next steps"--

Technological advances in noninvasive neuroimaging, neurophysiology, genome sequencing, and other methods together with rapid progress in computational and statistical methods and data storage have facilitated large-scale collection of human genomic, cognitive, behavioral, and brain-based data. The rapid development of neurotechnologies and associated databases has been mirrored by an increase in attempts to introduce neuroscience and behavioral genetic evidence into legal proceedings. In March 2018, the National Academies of Science, Engineering and Medicine organized a workshop in order to explore the current uses of neuroscience and bring stakeholders from neuroscience and legal societies together in both the United Kingdom and the United States. Participants worked together to advance an understanding of neurotechnologies that could impact the legal system and the state of readiness to consider these technologies and where appropriate, to integrate them into the legal system. This publication summarizes the presentations and discussions from the workshop.