Bøker av National Academies Of Sciences Engineeri

"The U.S. Social Security Administration (SSA) administers programs that provide disability benefits. Once SSA establishes the presence of a severe impairment, it determines whether the impairment meets the criteria in the Listing of Impairments (Listings) that qualify a candidate for disability benefits. The current Listings that address hearing loss treated with cochlear implantation contain criteria that evaluate hearing ability through a speech recognition test called the Hearing in Noise Test (HINT). Since its development in 1994, the HINT has been widely used to measure cochlear implant candidacy and postoperative outcomes. However, the test characteristics, the state of cochlear implant technology, and the environment that made the HINT a common choice of assessment in 1994 are different in 2021. The HINT has several limitations in its characteristics and deviation from its intended use. At the request of SSA, the National Academies of Sciences, Engineering, and Medicine convened a consensus study committee to identify and recommend generalized testing procedures and criteria for evaluating the level of functional hearing ability needed to make a disability determination in adults and children after cochlear implantation. The committee's report, Evaluating Hearing Loss for Individuals with Cochlear Implants, details and supports its findings, conclusions, and recommendations based on published evidence and professional judgment." --

"Each year, tens of millions of individuals in the U.S. suffer from neurological and psychiatric disorders including neurodegenerative diseases such as Alzheimer's Disease and Parkinson's Disease, and psychiatric disorders such as autism spectrum disorder, depression and schizophrenia. Treatments for these diseases are often completely lacking or only partially effective, due in large part to the difficulty of conducting brain research and the complexity of the brain itself. Researchers in recent years have developed new models to better represent and study the human brain. The three models considered in this report, all of which generate and use pluripotent stem cells from healthy individuals and patients, are human neural organoids, human neural transplants, and human-animal neural chimeras. The Emerging Field of Human Neural Organoids, Transplants, and Chimeras: Science, Ethics, and Governance reviews the status of research, considers its benefits and risks, discusses associated ethical issues, and considers governance mechanisms for this type of research." --

"Over the past several decades, fertility rates have fallen substantially in low- and middle-income countries, and efforts to limit fertility, primarily through the implementation of family planning programs, have become increasingly widespread. Although there is a substantial scholarly literature on the determinants of contraceptive use and other measures to limit fertility and on the resulting differentials in fertility, relatively little is known about the role played by women's empowerment as both a determinant and a consequence of fertility decline. In addition, there continues to be little consensus about the link between fertility decline and broader societal impacts, including economic development. The National Academies of Sciences, Engineering, and Medicine convened a workshop, "Family Planning, Women's Empowerment, and Population and Societal Impacts," in September 2020. This event brought together experts and stakeholders to discuss conceptual, methodological, and policy issues regarding the relationships among family planning, women's empowerment, fertility decline, and population and societal impacts. The discussion was intended to inform research and policy focused on the issues of women's roles and empowerment and on longstanding questions surrounding the determinants and consequences of fertility reduction behavior. This publication summarizes the presentations and discussion of the workshop." --

"One in five people in the United States had a sexually transmitted infection (STI) on any given day in 2018, totaling nearly 68 million estimated infections. STIs are often asymptomatic (especially in women) and are therefore often undiagnosed and unreported. Untreated STIs can have severe health consequences, including chronic pelvic pain, infertility, miscarriage or newborn death, and increased risk of HIV infection, genital and oral cancers, neurological and rheumatological effects. In light of this, the Centers for Disease Control and Prevention, through the National Association of County and City Health Officials, commissioned the National Academies of Sciences, Engineering, and Medicine to convene a committee to examine the prevention and control of sexually transmitted infections in the United States and provide recommendations for action. In 1997, the Institute of Medicine released a report, The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Although significant scientific advances have been made since that time, many of the problems and barriers described in that report persist today; STIs remain an underfunded and comparatively neglected field of public health practice and research. The committee reviewed the current state of STIs in the United States, and the resulting report, Sexually Transmitted Infections: Advancing a Sexual Health Paradigm, provides advice on future public health programs, policy, and research." --

Regenerative medicine products, which are intended to repair or replace damaged cells or tissues in the body, include a range of therapeutic approaches such as cell- and gene-based therapies, engineered tissues, and non-biologic constructs. The current approach to characterizing the quality of a regenerative medicine product and the manufacturing process often involves measuring as many endpoints as possible, but this approach has proved to be inadequate and unsustainable. The Forum on Regenerative Medicine of the National Academies of Sciences, Engineering, and Medicine convened experts across disciplines for a 2-day virtual public workshop to explore systems thinking approaches and how they may be applied to support the identification of relevant quality attributes that can help in the optimization of manufacturing and streamline regulatory processes for regenerative medicine. A broad array of stakeholders, including data scientists, physical scientists, industry researchers, regulatory officials, clinicians, and patient representatives, discussed new advances in data acquisition, data analysis and theoretical frameworks, and how systems approaches can be applied to the development of regenerative medicine products that can address the unmet needs of patients. This publication summarizes the presentation and discussion of the workshop.

Climate change is creating impacts that are widespread and severe for individuals, communities, economies, and ecosystems around the world. While efforts to reduce emissions and adapt to climate impacts are the first line of defense, researchers are exploring other options to reduce warming. Solar geoengineering strategies are designed to cool Earth either by adding small reflective particles to the upper atmosphere, by increasing reflective cloud cover in the lower atmosphere, or by thinning high-altitude clouds that can absorb heat. While such strategies have the potential to reduce global temperatures, they could also introduce an array of unknown or negative consequences. This report concludes that a strategic investment in research is needed to enhance policymakers' understanding of climate response options. The United States should develop a transdisciplinary research program, in collaboration with other nations, to advance understanding of solar geoengineering's technical feasibility and effectiveness, possible impacts on society and the environment, and social dimensions such as public perceptions, political and economic dynamics, and ethical and equity considerations. The program should operate under robust research governance that includes such elements as a research code of conduct, a public registry for research, permitting systems for outdoor experiments, guidance on intellectual property, and inclusive public and stakeholder engagement processes.

Accumulating evidence gathered over the past three decades has demonstrated a biological basis for differences between men and women with respect to clinical features and treatment responses to several neuropsychiatric, neurodevelopmental, and neurodegenerative disorders. Dramatic sex differences have also been identified in the brain transcriptomes of individuals with multiple brain disorders, including depression, posttraumatic stress disorder, and autism. The brain transcriptome includes all of the messenger RNA as well as the non-protein-coding RNA molecules expressed in brain tissue and thus represents gene activity. To explore these sex-based transcriptomic differences further, the National Academies of Sciences, Engineering, and Medicine's Forum on Neuroscience and Nervous System Disorders hosted a workshop on September 23, 2020, titled Sex Differences in Brain Disorders: Emerging Transcriptomic Evidence and Implications for Therapeutic Development. The workshop brought together a broad spectrum of stakeholders to share cutting-edge emerging evidence, discuss challenges, and identify future opportunities and potential directions. This publication summarizes the presentation and discussion of the workshop.

"Millions of people are living with dementia in the United States and globally. To live well with dementia, people need care, services, and supports that reflect their values and preferences, build on their strengths and abilities, promote well-being, and address needs that evolve as cognitive impairment deepens. Persons living with dementia co-manage their care with or rely on the support of a wide range of care partners and caregivers, including spouses, other family members and friends, and direct care workers in homes or residential care settings. While dementia care has improved since the 1970s, many individuals still lack access to high-quality care and are not living as well as they might. Disadvantaged groups, especially racial and ethnic minorities, still face challenges in access to care, services, and supports, due to deep and persistent inequities. Meeting the Challenge of Caring for Persons Living with Dementia and Their Care Partners and Caregivers: A Way Forward examines the complex body of evidence on dementia care and informs decision making about which interventions are ready to be broadly disseminated and implemented. It also offers a blueprint to guide future research using rigorous, cutting-edge methods that are inclusive, equitable, and yield critical information for real-world implementation, toward the ultimate goal of better supporting persons living with dementia and their care partners and caregivers in living as well as possible." --

To explore various aspects of faculty development, the Global Forum on Innovation in Health Professional Education of the National Academies of Sciences, Engineering, and Medicine held a virtual workshop in August 2020 titled Health Professions Faculty for the Future. At the workshop, presenters provided examples of how educators are using effective teaching strategies and of practices in health professional education. This publication summarizes the presentation and discussion of the workshop.

The world is transforming its energy system from one dominated by fossil fuel combustion to one with net-zero emissions of carbon dioxide (CO2), the primary anthropogenic greenhouse gas. This energy transition is critical to mitigating climate change, protecting human health, and revitalizing the U.S. economy. To help policymakers, businesses, communities, and the public better understand what a net-zero transition would mean for the United States, the National Academies of Sciences, Engineering and Medicine convened a committee of experts to investigate how the U.S. could best decarbonize its transportation, electricity, buildings, and industrial sectors. This report, Accelerating Decarbonization of the United States Energy System, identifies key technological and socio-economic goals that must be achieved to put the United States on the path to reach net-zero carbon emissions by 2050. The report presents a policy blueprint outlining critical near-term actions for the first decade (2021-2030) of this 30-year effort, including ways to support communities that will be most impacted by the transition.

Cancer is the second leading cause of death among adults in the United States after heart disease. However, improvements in cancer treatment and earlier detection are leading to growing numbers of cancer survivors. As the number of cancer survivors grows, there is increased interest in how cancer and its treatments may affect a person's ability to work, whether the person has maintained employment throughout the treatment or is returning to work at a previous, current, or new place of employment. Cancer-related impairments and resulting functional limitations may or may not lead to disability as defined by the U.S. Social Security Administration (SSA), however, adults surviving cancer who are unable to work because of cancer-related impairments and functional limitations may apply for disability benefits from SSA. At the request of SSA, Diagnosing and Treating Adult Cancers and Associated Impairments provides background information on breast cancer, lung cancer, and selected other cancers to assist SSA in its review of the listing of impairments for disability assessments. This report addresses several specific topics, including determining the latest standards of care as well as new technologies for understanding disease processes, treatment modalities, and the effect of cancer on a person's health and functioning, in order to inform SSA's evaluation of disability claims for adults with cancer.

The U.S. Department of Energy (DOE) and its predecessor agencies have conducted activities to develop atomic energy for civilian and defense purposes since the initiation of the World War II Manhattan Project in 1942. These activities took place at large federal land reservations of hundreds of square miles involving industrial-scale operations, but also at many smaller federal and non-federal sites such as uranium mines, materials processing and manufacturing facilities. The nuclear weapons and energy production activities at these facilities produced large quantities of radioactive and hazardous wastes and resulted in widespread groundwater and soil contamination at these sites. DOE initiated a concerted effort to clean up these sites beginning in the 1980s. Many of these sites have been remediated and are in long-term caretaker status, closed or repurposed for other uses. Review of the Effectiveness and Efficiency of Defense Environmental Cleanup Activities of the Department of Energy's Office of Environmental Management: First Report provides background information on the sites currently assigned to the DOE's Office of Environmental Management that are undergoing cleanup; discusses current practices for management and oversight of the cleanups; offers findings and recommendations on such practices and how progress is measured against them; and considers the contracts under which the cleanups proceed and how these have been and can be structured to include incentives for improved cost and schedule performance.

Student wellbeing is foundational to academic success. One recent survey of postsecondary educators found that nearly 80 percent believed emotional wellbeing is a "very" or "extremely" important factor in student success. Studies have found the dropout rates for students with a diagnosed mental health problem range from 43 percent to as high as 86 percent. While dealing with stress is a normal part of life, for some students, stress can adversely affect their physical, emotional, and psychological health, particularly given that adolescence and early adulthood are when most mental illnesses are first manifested. In addition to students who may develop mental health challenges during their time in postsecondary education, many students arrive on campus with a mental health problem or having experienced significant trauma in their lives, which can also negatively affect physical, emotional, and psychological wellbeing. The nation's institutions of higher education are seeing increasing levels of mental illness, substance use and other forms of emotional distress among their students. Some of the problematic trends have been ongoing for decades. Some have been exacerbated by the COVID-19 pandemic and resulting economic consequences. Some are the result of long-festering systemic racism in almost every sphere of American life that are becoming more widely acknowledged throughout society and must, at last, be addressed. Mental Health, Substance Use, and Wellbeing in Higher Education lays out a variety of possible strategies and approaches to meet increasing demand for mental health and substance use services, based on the available evidence on the nature of the issues and what works in various situations. The recommendations of this report will support the delivery of mental health and wellness services by the nation's institutions of higher education.

To address approaches to the respirator approval process in the current landscape for both occupational and non-occupational use of respirators, the National Academies of Sciences, Engineering, and Medicine's Standing Committee on Personal Protective Equipment for Workplace Safety and Health convened a virtual workshop, Current Issues in the Assessment of Respiratory Protective Devices: Nontraditional Workers and Public Use on August 4-5, 2020. Additionally, the workshop considered gaps in respiratory protection for outdoor workers and the general public. This publication summarizes the presentation and discussion of the workshop.--Publisher's website.

"The Committee on National Statistics of the National Academies of Sciences, Engineering, and Medicine convened a 2-day public workshop from December 11-12, 2019, to discuss the suite of data products the Census Bureau will generate from the 2020 Census. The workshop featured presentations by users of decennial census data products to help the Census Bureau better understand the uses of the data products and the importance of these uses and help inform the Census Bureau's decisions on the final specification of 2020 data products. This publication summarizes the presentation and discussion of the workshop." --

The conditions and characteristics of correctional facilities - overcrowded with rapid population turnover, often in old and poorly ventilated structures, a spatially concentrated pattern of releases and admissions in low-income communities of color, and a health care system that is siloed from community public health - accelerates transmission of the novel coronavirus (SARS-CoV-2) responsible for COVID-19. Such conditions increase the risk of coming into contact with the virus for incarcerated people, correctional staff, and their families and communities. Relative to the general public, moreover, incarcerated individuals have a higher prevalence of chronic health conditions such as asthma, hypertension, and cardiovascular disease, making them susceptible to complications should they become infected. Indeed, cumulative COVID-19 case rates among incarcerated people and correctional staff have grown steadily higher than case rates in the general population. Decarcerating Correctional Facilities during COVID-19 offers guidance on efforts to decarcerate, or reduce the incarcerated population, as a response to COIVD-19 pandemic. This report examines best practices for implementing decarceration as a response to the pandemic and the conditions that support safe and successful reentry of those decarcerated.

"During the last century and today, the Tennessee walking horse has been used primarily for pleasure and show competition. Unique and natural to the breed is a smooth four-beat "running walk" gait. In the 1950s the accentuated or exaggerated running walk, known as the "big lick" became popular at high-level competitions. The combination of exaggerated high-action step in front and long stride behind is still considered desirable in today's horse show competitions, and it is often achieved through soring. Soring is the practice of applying a substance or mechanical device to the lower limb of a horse that will create enough pain that the horse will exaggerate its gait to relieve the discomfort. In 1970 Congress put into law the Horse Protection Act (HPA) to specifically address the practice of soring by prohibiting the showing, exhibition, or sale of Tennessee walking horses that are found to be sore. Sadly, soring is still being done even after 50 years of HPA enforcement. This report reviews the methods for detecting soreness in horses, in hopes of advancing the goal of ultimately eliminating the act of soring in horses and improving the welfare of Tennessee walking horses. A Review of Methods for Detecting Soreness in Horses examines what is known about the quality and consistency of available methods to identify soreness in horses; identifies potential new and emerging methods, approaches, and technologies for detecting hoof and pastern pain and its causes; and identifies research and technology needs to improve the reliability of methods to detect soreness. This independent study will help ensure that HPA inspection protocols are based on sound scientific principles that can be applied with consistency and objectivity." --

Over the past decade there has been a growing interest in sustainability education in colleges and universities across the United States, with a marked increase in the number of undergraduate and graduate degree programs, research institutes, and centers focused on sustainability. Evidence-based core competencies for interdisciplinary sustainability programs can provide suitable guidance for curricular and program development, research, policy, communication, and pedagogical approaches at academic institutions. They can also serve as a guide for students to select academic programs and potential career options, a reference for employers to understand qualifications of graduates, and the foundation for a potential specialized accreditation for interdisciplinary sustainability programs. The growing demand for well-qualified sustainability professionals within the public, private, and nonprofit sectors also points to the value of developing core competencies. Strengthening Sustainability Programs and Curricula at the Undergraduate and Graduate Levels provides expert insights for strengthening the emerging discipline of sustainability in higher education in the United States. This report describes the local, national, and global landscape related to sustainability education; examines the history and current status of sustainability education programs in the United States and globally; discusses employment prospects for sustainability graduates in terms of the opportunities and the skills that employers seek; and addresses diversity, equity, and inclusion in sustainability-related education and employment.

"Committe on the role of authentic STEM learning experiences in developing interest and competencies for computing"

The radio frequency spectrum is a limited resource with ever increasing demand from an expansive range of applications--all the way from commercial, such as mobile phones, to scientific, such as hurricane monitoring from space. Since radio waves do not stop at national borders, international regulation is necessary to ensure effective use of the radio spectrum for all parties. Every 2 to 5 years, the International Telecommunication Union convenes a World Radiocommunication Conference (WRC) to review and revise the international radio regulations. This report provides guidance to U.S. spectrum managers and policymakers as they prepare for the WRC in 2019. While the resulting document is targeted primarily at U.S. agencies dealing with radio spectrum issues, other Administrations and foreign scientific users may find its recommendations useful in their own WRC planning.

"Plasma Science and Engineering transforms fundamental scientific research into powerful societal applications, from materials processing and healthcare to forecasting space weather. Plasma Science: Enabling Technology, Sustainability, Security and Exploration discusses the importance of plasma research, identifies important grand challenges for the next decade, and makes recommendations on funding and workforce. This publication will help federal agencies, policymakers, and academic leadership understand the importance of plasma research and make informed decisions about plasma science funding, workforce, and research directions." --

On December 5, 2019, the Roundtable on Population Health Improvement of the National Academies of Sciences, Engineering, and Medicine convened a workshop to explore the factors that affect the health and well-being of middle-school-aged adolescents. The workshop included presentations on the risk factors of poor physical, social, and emotional outcomes and their prevalence; the identification of resilience factors; current policies and programs designed to support middle school success and address issues of equity and financing as they apply to these; and how the health and human services sectors can support and align with the education sector to promote health and well-being in middle school. This publication summarizes the presentations and discussions that took place during the workshop.

With rapidly rising rates of mental health disorders, changing patterns of occurrence, and increasing levels of morbidity, the need for a better understanding of the developmental origins and influence of mental health on children's behavioral health outcomes has become critical. This need for better understanding extends to both the growing prevalence of mental health disorders as well as the role and impact of neurodevelopmental pathways in their onset and expression. Addressing these changes in disease patterns and effects on children and families will require a multifaceted approach that goes beyond simply making changes to clinical care or adding personnel to the health services system. New policies, financing, and implementation can put established best practices and numerous research findings from around the country into action. The Maternal and Child Health Life Course Intervention Research Network and the Forum for Children's Well-Being at the National Academies of Sciences, Engineering, and Medicine jointly organized a webinar series to explore how mental health disorders develop over the life course, with a special emphasis on prenatal, early, middle, and later childhood development. This series centered on identifying gaps in our knowledge, exploring possible new strategies for using existing data to enhance understanding of the developmental origins of mental disorders, reviewing potential approaches to prevention and optimization, and proposing new ways of framing how to understand, address, and prevent these disorders from a life course development perspective. This publication summarizes the presentations and discussions from the series.

"The Food and Nutrition Board (FNB) of the National Academies of Sciences, Engineering, and Medicine was convened in 1940 in response to a request from the U.S. National Defense Advisory Commission to the National Academy of Sciences for aid in studying problems of nutrition in the United States. Today the FNB is the focal point for activities concerned with food, nutrition, and food safety, and their roles in health maintenance and disease prevention. Now in its 80th year, the FNB has continued its growth and expanded its reach both domestically and internationally, providing visionary leadership across a range of nutrition and food science issues toward the improvement of human health. In honor of its 80 years of service to the nation, the FNB convened a public symposium to review the origin and history, policy influence, and future directions of the FNB. This publication summarizes the presentations of the event."--

Adolescence is a dynamic time for both brain development and social pressures, making it a critical period to understand mental, emotional, and behavioral health, yet it is often overlooked in terms of policies and service interventions, which makes many young people feel unheard when communicating their own challenges. To explore best practices in providing and supporting adolescent health services and key messaging and communication strategies related to the mental, emotional, and behavioral health of adolescents, the National Academies of Sciences, Engineering, and Medicine's Forum for Children's Well-Being held a workshop on May 5, 2020. The workshop featured a panel of youth representatives who shared their own experiences related to mental, emotional, and behavioral health. This publication summarizes the presentation and discussion of the workshop.

In late 2016, U.S. Embassy personnel in Havana, Cuba, began to report the development of an unusual set of symptoms and clinical signs. For some of these patients, their case began with the sudden onset of a loud noise, perceived to have directional features, and accompanied by pain in one or both ears or across a broad region of the head, and in some cases, a sensation of head pressure or vibration, dizziness, followed in some cases by tinnitus, visual problems, vertigo, and cognitive difficulties. Other personnel attached to the U.S. Consulate in Guangzhou, China, reported similar symptoms and signs to varying degrees, beginning in the following year. As of June 2020, many of these personnel continue to suffer from these and/or other health problems. Multiple hypotheses and mechanisms have been proposed to explain these clinical cases, but evidence has been lacking, no hypothesis has been proven, and the circumstances remain unclear. The Department of State asked the National Academies to review the cases, their clinical features and management, epidemiologic investigations, and scientific evidence in support of possible causes, and advise on approaches for the investigation of potential future cases. In An Assessment of Illness in U.S. Government Employees and Their Families at Overseas Embassies, the committee identifies distinctive clinical features, considers possible causes, evaluates plausible mechanisms and rehabilitation efforts, and offers recommendations for future planning and responses.