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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.

Humans are potentially exposed to more than 80,000 toxic chemicals in the environment, yet their impacts on brain health and disease are not well understood. The sheer number of these chemicals has overwhelmed the ability to determine their individual toxicity, much less potential interactive effects. Early life exposures to chemicals can have permanent consequences for neurodevelopment and for neurodegeneration in later life. Toxic effects resulting from chemical exposure can interact with other risk factors such as prenatal stress, and persistence of some chemicals in the brain over time may result in cumulative toxicity. Because neurodevelopmental and neurodegenerative disorders - such as attention-deficit hyperactivity disorder and Parkinson's disease - cannot be fully explained by genetic risk factors alone, understanding the role of individual environmental chemical exposures is critical. On June 25, 2020, the National Academies of Sciences, Engineering, and Medicine's Forum on Neuroscience and Nervous System Disorders hosted a workshop to lay the foundation for future advances in environmental neuroscience. The workshop was designed to explore new opportunities to bridge the gap between what is known about the genetic contribution to brain disorders and what is known, and not known, about the contribution of environmental influences, as well as to discuss what is known about how genetic and environmental factors interact. This publication summarizes the presentation and discussion of the workshop.

Behavioral health conditions, which include mental health and substance use disorders, affect approximately 20 percent of Americans. Of those with a substance use disorder, approximately 60 percent also have a mental health disorder. As many as 80 percent of patients with behavioral health conditions seek treatment in emergency rooms and primary care clinics, and between 60 and 70 percent of them are discharged without receiving behavioral health care services. More than two-thirds of primary care providers report that they are unable to connect patients with behavioral health providers because of a shortage of mental health providers and health insurance barriers. Part of the explanation for the lack of access to care lies in a historical legacy of discrimination and stigma that makes people reluctant to seek help and also led to segregated and inhumane services for those facing mental health and substance use disorders. In an effort to understanding the challenges and opportunities of providing essential components of care for people with mental health and substance use disorders in primary care settings, the National Academies of Sciences, Engineering, and Medicine's Forum on Mental Health and Substance Use Disorders convened three webinars held on June 3, July 29, and August 26, 2020. The webinars addressed efforts to define essential components of care for people with mental health and substance use disorders in the primary care setting for depression, alcohol use disorders, and opioid use disorders; opportunities to build the health care workforce and delivery models that incorporate those essential components of care; and financial incentives and payment structures to support the implementation of those care models, including value-based payment strategies and practice-level incentives. This publication summarizes the presentations and discussion of the webinars.

Across the United States, millions of acres of land have been so disturbed by human activities or severe climate events that significant portions of their native plant communities have been lost and their ecosystems have been seriously compromised. Restoring impaired ecosystems requires a supply of diverse native plant seeds that are well suited to the climates, soils, and other living species of the system. Native seeds are also in demand for applications in urban land management, roadside maintenance, conservation agriculture, and other restorative activities that take into account the connection between native plant communities and the increasingly urgent need for resilient landscapes. Given the varied climatic and environmental niches of the more than 17,000 native plant species of the United States, supplying the desired seed types and species mixes for this wide range of activities is a challenge. As the first phase of a nationwide analysis of the full scope of needs for native plant seeds, this interim report describes the participants in the native plant seed supply chain, makes preliminary observations, and proposes an information-gathering plan for the second phase of the assessment.

As part of the overall disability determination process, the Social Security Administration uses a step-by-step approach to understand how severe an individual's condition is and whether it meets program criteria for disability. The use of various types of biomarkers has been suggested as a way to strengthen the amount and quality of objective evidence available to the review process. At the request of the Social Security Administration, the National Academies of Sciences, Engineering, and Medicine's Board on Health Care Services organized a virtual workshop on July 21, 2020, titled The State of the Science of the Use of Biomarkers to Establish the Presence and Severity of Impairments. Workshop discussions focused on the current and potential uses for biomarkers; explored legal and ethical implications associated with biomarker use in clinical decision making; and considered the possible uses of nongenetic biomarkers as tools for the diagnosis or prognosis of the severity of specific physical and mental impairments. This publication summarizes the presentations and discussion of the workshop.

"Young people develop health literacy skills in a variety of environments, facing critical thinking challenges about their health from school, home and family life, peers and social life, and online. To explore the development of health literacy skills in youth, the Roundtable on Health Literacy convened a workshop on November 19, 2019, in Washington, DC. Presenters at the workshop discussed factors relating to health literacy skills and ways to further develop those skills among youth from early childhood to young adulthood. This publication summarizes the presentation and discussion of the workshop."--

The COVID-19 pandemic is resulting in widespread and ongoing changes to how the K-12 education system functions, including disruptions to science teaching and learning environments. Students and teachers are all figuring out how to do schooling differently, and districts and states are working overtime to reimagine systems and processes. This is difficult and stressful work in the middle of the already stressful and sometimes traumatic backdrop of the global pandemic. In addition, students with disabilities, students of color, immigrants, English learners, and students from under-resourced communities have been disproportionately affected, both by the pandemic itself and by the resulting instructional shifts. Teaching K-12 Science and Engineering During a Crisis aims to describe what high quality science and engineering education can look like in a time of great uncertainty and to support practitioners as they work toward their goals. This book includes guidance for science and engineering practitioners - with an emphasis on the needs of district science supervisors, curriculum leads, and instructional coaches. Teaching K-12 Science and Engineering During a Crisis will help K-12 science and engineering teachers adapt learning experiences as needed to support students and their families dealing with ongoing changes to instructional and home environments and at the same time provide high quality in those experiences.

More than 3.7 million U.S. service members have participated in operations taking place in the Southwest Asia Theater of Military Operations since 1990. These operations include the 1990-1991 Persian Gulf War, a post-war stabilization period spanning 1992 through September 2001, and the campaigns undertaken in the wake of the September 11, 2001, attacks. Deployment to Iraq, Kuwait, Saudi Arabia, Bahrain, Gulf of Aden, Gulf of Oman, Oman, Qatar, the United Arab Emirates, and Afghanistan exposed service members to a number of airborne hazards, including oil-well fire smoke, emissions from open burn pits, dust and sand suspended in the air, and exhaust from diesel vehicles. The effects of these were compounded by stressors like excessive heat and noise that are inevitable attributes of service in a combat environment. Respiratory Health Effects of Airborne Hazards Exposures in the Southwest Asia Theater of Military Operations reviews the scientific evidence regarding respiratory health outcomes in veterans of the Southwest Asia conflicts and identifies research that could feasibly be conducted to address outstanding questions and generate answers, newly emerging technologies that could aid in these efforts, and organizations that the Veterans Administration might partner with to accomplish this work.

In the wake of a large-scale disaster, from the initial devastation through the long tail of recovery, protecting the health and well-being of the affected individuals and communities is paramount. Accurate and timely information about mortality and significant morbidity related to the disaster are the cornerstone of the efforts of the disaster management enterprise to save lives and prevent further health impacts. Conversely, failure to accurately capture mortality and significant morbidity data undercuts the nation's capacity to protect its population. Information about disaster-related mortality and significant morbidity adds value at all phases of the disaster management cycle. As a disaster unfolds, the data are crucial in guiding response and recovery priorities, ensuring a common operating picture and real-time situational awareness across stakeholders, and protecting vulnerable populations and settings at heightened risk. A Framework for Assessing Mortality and Morbidity After Large-Scale Disasters reviews and describes the current state of the field of disaster-related mortality and significant morbidity assessment. This report examines practices and methods for data collection, recording, sharing, and use across state, local, tribal, and territorial stakeholders; evaluates best practices; and identifies areas for future resource investment.

Biological collections are a critical part of the nation's science and innovation infrastructure and a fundamental resource for understanding the natural world. Biological collections underpin basic science discoveries as well as deepen our understanding of many challenges such as global change, biodiversity loss, sustainable food production, ecosystem conservation, and improving human health and security. They are important resources for education, both in formal training for the science and technology workforce, and in informal learning through schools, citizen science programs, and adult learning. However, the sustainability of biological collections is under threat. Without enhanced strategic leadership and investments in their infrastructure and growth many biological collections could be lost. Biological Collections: Ensuring Critical Research and Education for the 21st Century recommends approaches for biological collections to develop long-term financial sustainability, advance digitization, recruit and support a diverse workforce, and upgrade and maintain a robust physical infrastructure in order to continue serving science and society. The aim of the report is to stimulate a national discussion regarding the goals and strategies needed to ensure that U.S. biological collections not only thrive but continue to grow throughout the 21st century and beyond.

Approximately 30 percent of the edible food produced in the United States is wasted and a significant portion of this waste occurs at the consumer level. Despite food's essential role as a source of nutrients and energy and its emotional and cultural importance, U.S. consumers waste an estimated average of 1 pound of food per person per day at home and in places where they buy and consume food away from home. Many factors contribute to this waste--consumers behaviors are shaped not only by individual and interpersonal factors but also by influences within the food system, such as policies, food marketing and the media. Some food waste is unavoidable, and there is substantial variation in how food waste and its impacts are defined and measured. But there is no doubt that the consequences of food waste are severe: the wasting of food is costly to consumers, depletes natural resources, and degrades the environment. In addition, at a time when the COVID-19 pandemic has severely strained the U.S. economy and sharply increased food insecurity, it is predicted that food waste will worsen in the short term because of both supply chain disruptions and the closures of food businesses that affect the way people eat and the types of food they can afford. A National Strategy to Reduce Food Waste at the Consumer Level identifies strategies for changing consumer behavior, considering interactions and feedbacks within the food system. It explores the reasons food is wasted in the United States, including the characteristics of the complex systems through which food is produced, marketed, and sold, as well as the many other interconnected influences on consumers' conscious and unconscious choices about purchasing, preparing, consuming, storing, and discarding food. This report presents a strategy for addressing the challenge of reducing food waste at the consumer level from a holistic, systems perspective.

Providing a reliable and resilient supply of electric power to communities across the United States has always posed a complex challenge. Utilities must support daily operations to serve a diverse array of customers across a heterogeneous landscape while simultaneously investing in infrastructure to meet future needs, all while juggling an enormous array of competing priorities influenced by costs, capabilities, environmental and social impacts, regulatory requirements, and consumer preferences. A rapid pace of change in technologies, policies and priorities, and consumer needs and behaviors has further compounded this challenge in recent years. The National Academies of Sciences, Engineering, and Medicine convened a workshop on February 3, 2020 to explore strategies for incorporating new technologies, planning and operating strategies, business models, and architectures in the U.S. electric power system. Speakers and participants from industry, government, and academia discussed available models for long-term transmission and distribution planning, as well as the broader context of how these models are used and future opportunities and needs. This publication summarizes the presentations and discussions from the workshop.

"New York City's municipal water supply system provides about 1 billion gallons of drinking water a day to over 8.5 million people in New York City and about 1 million people living in nearby Westchester, Putnam, Ulster, and Orange counties. The combined water supply system includes 19 reservoirs and three controlled lakes with a total storage capacity of approximately 580 billion gallons. The city's Watershed Protection Program is intended to maintain and enhance the high quality of these surface water sources. Review of the New York City Watershed Protection Program assesses the efficacy and future of New York City's watershed management activities. The report identifies program areas that may require future change or action, including continued efforts to address turbidity and responding to changes in reservoir water quality as a result of climate change."--Publisher's website

The COVID-19 pandemic has presented unprecedented challenges to the nation's K-12 education system. The rush to slow the spread of the virus led to closures of schools across the country, with little time to ensure continuity of instruction or to create a framework for deciding when and how to reopen schools. States, districts, and schools are now grappling with the complex and high-stakes questions of whether to reopen school buildings and how to operate them safely if they do reopen. These decisions need to be informed by the most up-to-date evidence about the SARS-CoV-2 virus that causes COVID-19; about the impacts of school closures on students and families; and about the complexities of operating school buildings as the pandemic persists. Reopening K-12 Schools During the COVID-19 Pandemic: Prioritizing Health, Equity, and Communities provides guidance on the reopening and operation of elementary and secondary schools for the 2020-2021 school year. The recommendations of this report are designed to help districts and schools successfully navigate the complex decisions around reopening school buildings, keeping them open, and operating them safely.

The National Academies of Sciences, Engineering, and Medicine held the workshop Applying Big Data to Address the Social Determinants of Health in Oncology on October 28-29, 2019, in Washington, DC. This workshop examined social determinants of health (SDOH) in the context of cancer, and considered opportunities to effectively leverage big data to improve health equity and reduce disparities. The workshop featured presentations and discussion by experts in technology, oncology, and SDOH, as well as representatives from government, industry, academia, and health care systems. This publication summarizes the presentations and discussions from the workshop.