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Note: This is the French translation of Recent Fertility Trends in Sub-Saharan Africa. Fertility rates and population growth influence economic development. The marked declines in fertility seen in some developing nations have been accompanied by slowing population growth, which in turn provided a window of opportunity for rapid economic growth. For many sub-Saharan African nations, this window has not yet opened because fertility rates have not declined as rapidly there as elsewhere. Fertility rates in many sub-Saharan African countries are high: the total rate for the region is estimated to be 5.1 births per woman, and rates that had begun to decline in many countries in the region have stalled. High rates of fertility in these countries are likely to contribute to continued rapid population growth: the United Nations projects that the region's population will increase by 1.2 billion by 2050, the highest growth among the regions for which there are projections. In June 2015, the Committee on Population organized a workshop to explore fertility trends and the factors that have influenced them. The workshop committee was asked to explore history and trends related to fertility, proximate determinants and other influences, the status and impact of family planning programs, and prospects for further reducing fertility rates. This study will help donors, researchers, and policy makers better understand the factors that may explain the slow pace of fertility decline in this region, and develop methods to improve family planning in sub-Saharan Africa.

"The National Academies of Sciences, Engineering, Medicine."

This is the fourth in a series of five letter reports that provide an independent review of the more than 30 evidence reports that NASA has compiled on human health risks for long-duration and exploration spaceflights.This letter report reviews eight evidence reports and examines the quality of the evidence, analysis, and overall construction of each report; identifies existing gaps in report content; and provides suggestions for additional sources of expert input.

"Cyber-physical systems (CPS) are 'engineered systems that are built from, and depend upon, the seamless integration of computational algorithms and physical components.' CPS can be small and closed, such as an artificial pancreas, or very large, complex, and interconnected, such as a regional energy grid. CPS engineering focuses on managing inter- dependencies and impact of physical aspects on cyber aspects, and vice versa. With the development of low-cost sensing, powerful embedded system hardware, and widely deployed communication networks, the reliance on CPS for system functionality has dramatically increased. These technical developments in combination with the creation of a workforce skilled in engineering CPS will allow the deployment of increasingly capable, adaptable, and trustworthy systems"--

"The penetration of solid-state lighting (SSL) has increased dramatically since the publication of the National Research Council (NRC) report Assessment of Advanced Solid-State Lighting in 2013. The Committee on Assessment of Solid-State Lighting, Phase 2 has been surprised by this rapid adoption and the accompanying diversity of applications of SSL, which has been driven largely by the dramatic decline in the retail price of lamps and luminaires, and recognition of the unique qualities of the light emitting diode (LED) light source. Improvements in lamp performance, the introduction of innovative applications, improved compatibility of lamps with controls, and the integration of LED lamps in systems have all contributed to this rapid acceptance. Examples of exploiting the special characteristics of SSL are the introduction to steerable headlamps in cars, the use of spectral control to prevent lighting-induced damage to artwork, and more efficient and controllable street lighting. Accompanying this growth in the SSL market has been the rapid decline of compact fluorescent lamps (CFLs) from retail shelves"--Preface, page vii.

Using science to improve science communication -- The complexities of communicating science -- The nature of science-related public controversies -- Communicating science in a complex, competitive communication environment -- Building the knowledge base for effective science communication -- References -- Appendix A: Agendas of public meetings -- Appendix B: Biographical sketches of Committee members and staff.

The Department of Homeland Security's (DHS's) BioWatch program aims to provide an early indication of an aerosolized biological weapon attack. The first generation of BioWatch air samplers were deployed in 2003. The current version of this technology, referred to as Generation 2 (Gen-2), uses daily manual collection and testing of air filters from each monitor, a process that can take 12 to 36 hours to detect the presence of biological pathogens. Until April 2014, DHS pursued a next-generation autonomous detection technology that aimed to shorten the time from sample collection to detection to less than 6 hours, reduce the cost of analysis, and increase the number of detectable biological pathogens. Because of concerns about the cost and effectiveness of the proposed Generation 3 system (Gen-3), DHS cancelled its acquisition plans for the next-generation surveillance system. In response to the cancellation announcement, Congress asked the Government Accountability Office (GAO) to conduct a review of the program and the proposed system enhancements that would have been incorporated in BioWatch Gen-3. However, Mike Walter, BioWatch Program manager, Office of Health Affairs, DHS, said that DHS did not agree with all of GAO's characterizations of the BioWatch program efforts described in this review. In response to this, DHS requested that the National Academies of Sciences, Engineering, and Medicine conduct a workshop to further explore the findings of the 2015 GAO report and discuss the impact these findings may have with regard to the future development of the technical capabilities of the BioWatch program. Workshop participants also discussed existing and possible collaborations between BioWatch, public health laboratories, and other stakeholders that could contribute to the enhancement of biosurveillance capabilities at the federal, state, and local levels. This publication summarizes the presentations and discussions from the workshop.

"The most recent Ebola epidemic that began in late 2013 alerted the entire world to the gaps in infectious disease emergency preparedness and response. The regional outbreak that progressed to a significant public health emergency of international concern (PHEIC) in a matter of months killed 11,310 and infected more than 28,616. While this outbreak bears some unique distinctions to past outbreaks, many characteristics remain the same and contributed to tragic loss of human life and unnecessary expenditure of capital: insufficient knowledge of the disease, its reservoirs, and its transmission; delayed prevention efforts and treatment; poor control of the disease in hospital settings; and inadequate community and international responses. Recognizing the opportunity to learn from the countless lessons of this epidemic, the National Academies of Sciences, Engineering, and Medicine convened a workshop in March 2015 to discuss the challenges to successful outbreak responses at the scientific, clinical, and global health levels. Workshop participants explored the epidemic from multiple perspectives, identified important questions about Ebola that remained unanswered, and sought to apply this understanding to the broad challenges posed by Ebola and other emerging pathogens, to prevent the international community from being taken by surprise once again in the face of these threats. This publication summarizes the presentations and discussions from the workshop"--

On January 20, 2015, President Obama announced the Precision Medicine Initiative (PMI) in his State of the Union address. The PMI, by developing new approaches for detecting, measuring, and analyzing a wide range of biomedical information including molecular, genomic, cellular, clinical, behavioral, physiological, and environmental parameters, is intended to enable a new era of medicine in which researchers, providers, and patients work together to develop individualized care. Part of this effort included the creation of a national, large-scale research participant group, or cohort. The PMI Cohort Program is aimed at extending precision medicine to many diseases, including both rare and common diseases such as diabetes, heart disease, Alzheimer's disease, obesity, and mental illnesses such as depression, bipolar disorder, and schizophrenia, by building a national research cohort of 1 million or more U.S. participants. An important challenge to assembling the PMI Cohort will be to reach individuals who are socioeconomically disadvantaged. Individuals who are socioeconomically disadvantaged have lower health literacy; often belong to racial, ethnic, and minority communities; and are often less likely to participate in research studies and biorepositories. To explore possible strategies and messaging designs, the Roundtable on Health Literacy formed an ad hoc committee charged with planning and conducting a 1-day public workshop on the intersection of health literacy and precision medicine. The workshop participants discussed a variety of topics including an overview of precision medicine and its potential, the relevance of health literacy to the success of precision medicine efforts, and perspectives and understanding of different groups, such as health care providers, consumers, and insurers. This publication summarizes the presentations and discussions from the workshop.

"The Air Force (USAF) has continuously sought to improve the speed with which it develops new capabilities to accomplish its various missions in air, space, and cyberspace. Historically, innovation has been a key part of USAF strategy, and operating within an adversary's OODA loop (observe, orient, decide, act) is part of Air Force DNA. This includes the ability to deploy technological innovations faster than do our adversaries. The Air Force faces adversaries with the potential to operate within the USAF's OODA loop, and some of these adversaries are already deploying innovations faster than the USAF. The Role of Experimentation Campaigns in the Air Force Innovation Life Cycle examines the current state of innovation and experimentation in the Air Force and best practices in innovation and experimentation in industry and other government agencies. This report also explores organizational changes needed to eliminate the barriers that deter innovation and experimentation and makes recommendations for the successful implementation of robust innovation and experimentation by the Air Force"--Publisher's description.

In July 2016 The National Academies of Sciences, Engineering, and Medicine convened a workshop with the goal of bringing together industrial and organizational (I-O) psychologists, experts on personnel selection and testing, forensic scientists, and other researchers whose work has a nexus with workforce needs in the forensic science field with a focus on pattern evidence. Participants reviewed the current status of selection and training of forensic scientists who specialize in pattern evidence and discussed how tools used in I-O psychology to understand elements of a task and measure aptitude and performance could address challenges in the pattern evidence domain of the forensic sciences. This publication summarizes the presentations and discussions from the workshop.

With the worst human refugee crisis since World War II as the backdrop, from March 16 through March 18, 2016, the National Academies of Sciences, Engineering, and Medicine, in partnership with UNICEF and the King Abdullah Bin Abdulaziz International Center for Inter-religious and Intercultural Dialogue (KAICIID), held a workshop in Amman, Jordan, to explore topics related to investing in young children for peaceful societies. Over the course of the workshop, researchers, policy makers, program practitioners, funders, youth, and other experts came together to understand the effects of conflict and violence on children, women, and youth across areas of health, education, nutrition, social protection, and other domains. The goal of the workshop was to continue to fill in gaps in knowledge and explore opportunities for discourse through a process of highlighting the science and practice. This publication summarizes the presentations and discussions from the workshop.

The Office of the Under Secretary of Defense (Personnel & Readiness), referred to throughout this report as P&R, is responsible for the total force management of all Department of Defense (DoD) components including the recruitment, readiness, and retention of personnel. Its work and policies are supported by a number of organizations both within DoD, including the Defense Manpower Data Center (DMDC), and externally, including the federally funded research and development centers (FFRDCs) that work for DoD. P&R must be able to answer questions for the Secretary of Defense such as how to recruit people with an aptitude for and interest in various specialties and along particular career tracks and how to assess on an ongoing basis service members' career satisfaction and their ability to meet new challenges. P&R must also address larger-scale questions, such as how the current realignment of forces to the Asia-Pacific area and other regions will affect recruitment, readiness, and retention. While DoD makes use of large-scale data and mathematical analysis in intelligence, surveillance, reconnaissance, and elsewhere--exploiting techniques such as complex network analysis, machine learning, streaming social media analysis, and anomaly detection--these skills and capabilities have not been applied as well to the personnel and readiness enterprise. Strengthening Data Science Methods for Department of Defense Personnel and Readiness Missions offers and roadmap and implementation plan for the integration of data analysis in support of decisions within the purview of P&R.

Description based on online resource (NAP website, viewed Dec. 13, 2016).

"Cities have experienced an unprecedented rate of growth in the last decade. More than half the world's population lives in urban areas, with the U.S. percentage at 80 percent. Cities have captured more than 80 percent of the globe's economic activity and offered social mobility and economic prosperity to millions by clustering creative, innovative, and educated individuals and organizations. Clustering populations, however, can compound both positive and negative conditions, with many modern urban areas experiencing growing inequality, debility, and environmental degradation. The spread and continued growth of urban areas presents a number of concerns for a sustainable future, particularly if cities cannot adequately address the rise of poverty, hunger, resource consumption, and biodiversity loss in their borders. Intended as a comparative illustration of the types of urban sustainability pathways and subsequent lessons learned existing in urban areas, this study examines specific examples that cut across geographies and scales and that feature a range of urban sustainability challenges and opportunities for collaborative learning across metropolitan regions. It focuses on nine cities across the United States and Canada (Los Angeles, CA, New York City, NY, Philadelphia, PA, Pittsburgh, PA, Grand Rapids, MI, Flint, MI, Cedar Rapids, IA, Chattanooga, TN, and Vancouver, Canada), chosen to represent a variety of metropolitan regions, with consideration given to city size, proximity to coastal and other waterways, susceptibility to hazards, primary industry, and several other factors"--Publisher's description.

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

"While there are examples of successful weapon systems acquisition programs within the U.S. Air Force (USAF), many of the programs are still incurring cost growth, schedule delays, and performance problems. The USAF now faces serious challenges in acquiring and maintaining its weapons systems as it strives to maintain its current programs; add new capabilities to counter evolving threats; and reduce its overall program expenditures. Owning the technical baseline is a critical component of the Air Forces ability to regain and maintain acquisition excellence. Owning the technical baseline allows the government acquisition team to manage and respond knowledgeably and effectively to systems development, operations, and execution, thereby avoiding technical and other programmatic barriers to mission success. Additionally, owning the technical baseline ensures that government personnel understand the user requirements, why a particular design and its various features have been selected over competing designs, and what the options are to pursue alternative paths to the final product given unanticipated cost, schedule, and performance challenges. Owning the Technical Baseline for Acquisition Programs in the U.S. Air Force discusses the strategic value to the Air Force of owning the technical baseline and the risk of not owning it and highlights key aspects of how agencies other than the Air Force own the technical baseline for their acquisition programs. This report identifies specific barriers to owning the technical baseline for the Air Force and makes recommendations to help guide the Air Force in overcoming those barriers"--Publisher's description.

On March 3-4, 2016, the National Academies of Sciences, Engineering, and Medicine's Forum on Neuroscience and Nervous System Disorders held a workshop in Washington, DC, bringing together key stakeholders to discuss opportunities for improving the integrity, efficiency, and validity of clinical trials for nervous system disorders. Participants in the workshop represented a range of diverse perspectives, including individuals not normally associated with traditional clinical trials. The purpose of this workshop was to generate discussion about not only what is feasible now, but what may be possible with the implementation of cutting-edge technologies in the future.

In February 2016, the National Academies of Sciences, Engineering, and Medicine held a workshop to explore options for expanding the Substance Abuse and Mental Health Services Administration's (SAMHSA) behavioral health data collections to include measures of recovery from substance use and mental disorder. Participants discussed options for collecting data and producing estimates of recovery from substance use and mental disorders, including available measures and associated possible data collection mechanisms. This publication summarizes the presentations and discussions from the workshop.

"Many factors contribute to variability in Earth's climate on a range of timescales, from seasons to decades. Natural climate variability arises from two different sources: (1) internal variability from interactions among components of the climate system, for example, between the ocean and the atmosphere, and (2) natural external forcings, such as variations in the amount of radiation from the Sun. External forcings on the climate system also arise from some human activities, such as the emission of greenhouse gases (GHGs) and aerosols. The climate that we experience is a combination of all of these factors. Understanding climate variability on the decadal timescale is important to decision-making. Planners and policy makers want information about decadal variability in order to make decisions in a range of sectors, including for infrastructure, water resources, agriculture, and energy. In September 2015, the National Academies of Sciences, Engineering, and Medicine convened a workshop to examine variability in Earth's climate on decadal timescales, defined as 10 to 30 years. During the workshop, ocean and climate scientists reviewed the state of the science of decadal climate variability and its relationship to rates of human-caused global warming, and they explored opportunities for improvement in modeling and observations and assessing knowledge gaps. Frontiers in Decadal Climate Variability summarizes the presentations and discussions from the workshop"--Publisher's description.

The Physical Measurement Laboratory (PML) at the National Institute of Standards and Technology (NIST) is dedicated to three fundamental and complementary tasks: (1) increase the accuracy of our knowledge of the physical parameters that are the foundation of our technology-driven society; (2) disseminate technologies by which these physical parameters can be accessed in a standardized way by the stakeholders; and (3) conduct research at both fundamental and applied levels to provide knowledge that may eventually lead to advances in measurement approaches and standards. This report assesses the scientific and technical work performed by the PML and identifies salient examples of accomplishments, challenges, and opportunities for improvement for each of its nine divisions.

The environment for women's health has changed over the last 25 years. Increased use of automobiles can lead to health risks from lack of physical activity. There has also been an increase in access to and consumption of unhealthy food. Other changes in the past 2 to 3 decades include the significant increase in the number of women who are heads of households and responsible for all aspects of a household and family. Many women now are also having children later in life, which poses interesting issues for both biology and sociology. The growing stress faced by women and the effect of stress on health and illness are issues that need a more comprehensive examination, as do issues of mental health and mental illness, which have been more common and thus increasingly prominent issues for U.S. women. In September 2015, the National Academies of Sciences, Engineering, and Medicine convened a workshop to shed light on important determinants, consequences, effects, and issues attending the relative disadvantage of women in the United States in comparison with women in other economically advanced nations. This report summarizes the presentations and discussions from the workshop.

In times of rapid change and constrained resources, measures that are important, focused, and reliable are vital. However there is an overabundance of measures available for evaluating various aspects of population health and previous efforts to simplify existing sets to meet the needs of all decision makers have been unsuccessful. The National Academies of Sciences, Engineering, and Medicine convened a workshop to explore the status and uses of measures and measurement in the work of improving population health. Participants explored existing and emerging population health metric sets and characteristics of metrics necessary for stakeholder action across multiple sectors. This report summarizes the presentations and discussions from the workshop.

Human spaceflight is inherently risky, with numerous potential hazards posed at each phase of a mission. Potential health risks during spaceflights include short-term health consequences from being in microgravity, as well as long-term health consequences that arise, or continue, months or years after a flight. Additional health considerations are risks posed by exposure to environmental contaminants onboard spacecraft. Because the International Space Station and spacecraft are closed environments that require recirculation of air and water supplies, some contamination of the air and water will occur. Even with onboard air and water purification systems, chemicals will accumulate in the air and water as they recirculate or are recycled onboard. Therefore, it is necessary for the National Aeronautics and Space Administration (NASA) to identify hazardous contaminants and determine exposure levels that are not expected to pose a health risk to astronauts. NASA uses spacecraft maximum allowance concentrations (SMACs) and spacecraft water exposure guidelines (SWEGs) to provide guidance on acceptable exposures to air and water contaminants during normal operations and emergency situations. Refinements to the Methods for Developing Spacecraft Exposure Guidelines updates the methods for establishing SMACs and SWEGs and assists NASA with identifying chemicals that need updated SMACs or SWEGs and new chemicals for which these guidelines should be developed.

Though cancer was once considered to be a problem primarily in wealthy nations, low- and middle-income countries now bear a majority share of the global cancer burden, and cancer often surpasses the burden of infectious diseases in these countries. Effective low-cost cancer control options are available for some malignancies, with the World Health Organization estimating that these interventions could facilitate the prevention of approximately one-third of cancer deaths worldwide. But these interventions remain inaccessible for many people in the world, especially those residing in low-resource communities that are characterized by a lack of funds - on an individual or societal basis - to cover health infrastructure and care costs. Few guidelines and strategies for cancer control consider the appropriateness and feasibility of interventions in low-resource settings, and may undermine the effectiveness of these efforts. For example, interventions that are designed for high-resource settings may not account for important considerations in low-resource settings, such as resource constraints, infrastructure requirements, or whether a community has the capacity to deliver downstream cancer care. Patients in resource-constrained communities continue to face delayed diagnoses of cancer, potentially resulting in the diagnosis of later stage cancers and worsened patient outcomes. In addition, social stigmas, geopolitical issues, and cultural norms may limit access to cancer care in certain communities. Recognizing the challenges of providing cancer care in these settings, the National Academies of Sciences, Engineering, and Medicine developed a workshop series examining cancer care in low-resource communities. This report summarizes the presentations and discussions from the first workshop, which focused on cancer prevention and early detection.

The proliferation of consumer-facing technology and personal health information technology has grown steadily over the past decade, and has certainly exploded over the past several years. Many people have embraced smartphones and wearable health-monitoring devices to track their fitness and personal health information. Providers have made it easier for patients and caregivers to access health records and communicate through online patient portals. However, the large volume of health-related information that these devices can generate and input into a health record can also lead to an increased amount of confusion on the part of users and caregivers. The Institute of Medicine convened a workshop to explore health literate practices in health information technology and then provide and consider the ramifications of this rapidly growing field on the health literacy of users. Health Literacy and Consumer-Facing Technology summarizes the discussions and presentations from this workshop, highlighting the lessons presented, practical strategies, and the needs and opportunities for improving health literacy in consumer-facing technology.

Workshop speakers explored factors that affect trust in science and scientific findings on such issues as childhood vaccination, cancer screenings, and synthetic biology. Participants also discussed challenges within the scientific community to address trust and potential pathways toward improved public engagement in science.--

Reliable and valid forensic science analytic techniques are critical to a credible, fair, and evidence-based criminal justice system. There is widespread agreement that the scientific foundation of some currently available forensic science methods needs strengthening and that additional, more efficient techniques are urgently needed. These needs can only be met through sustained research programs explicitly designed to ensure and improve the reliability and validity of current methods and to foster the development and use of new and better techniques. This task is challenging due to the broad nature of the field. Concerns have been raised repeatedly about the ability of the criminal justice system to collect and analyze evidence efficiently and to be fair in its verdicts. Although significant progress has been made in some forensic science disciplines, the forensic science community still faces many challenges. Federal leadership, particularly in regard to research and the scientific validation of forensic science methods, is needed to help meet the pressing issues facing state and local jurisdictions. This report reviews the progress made by the National Institute of Justice (NIJ) to advance forensic science research since the 2009 report, Strengthening Forensic Science in the United States: A Path Forward and the 2010 report, Strengthening the National Institute of Justice. Support for Forensic Science Research examines the ways in which NIJ develops its forensic science research priorities and communicates those priorities as well as its findings to the scientific and forensic practitioner communities in order to determine the impact of NIJ forensic science research programs and how that impact can be enhanced.

"In 2014, the Air Force Studies Board conducted two workshops to review current research practices employed by the Air Force Office of Scientific Research (AFOSR). Improving the Air Force Scientific Discovery Mission summarizes the presentation and discussion of these two workshops. This report explores the unique drivers associated with management of a 6.1 basic research portfolio in the Department of Defense and investigates current and future practices that may further the effective and efficient management of basic research on behalf of the Air Force." --

Planetary protection is a guiding principle in the design of an interplanetary mission, aiming to prevent biological contamination of both the target celestial body and the Earth. The protection of high-priority science goals, the search for life and the understanding of the Martian organic environment may be compromised if Earth microbes carried by spacecraft are grown and spread on Mars. This has led to the definition of Special Regions on Mars where strict planetary protection measures have to be applied before a spacecraft can enter these areas. At NASA's request, the community-based Mars Exploration Program Analysis Group (MEPAG) established the Special Regions Science Analysis Group (SR-SAG2) in October 2013 to examine the quantitative definition of a Special Region and proposed modifications to it, as necessary, based upon the latest scientific results. Review of the MEPAG Report on Mars Special Regions reviews the conclusions and recommendations contained in MEPAG's SR-SAG2 report and assesses their consistency with current understanding of both the Martian environment and the physical and chemical limits for the survival and propagation of microbial and other life on Earth. This report provides recommendations for an update of the planetary protection requirements for Mars Special Regions.