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Current assisted reproductive technologies such as in vitro fertilization (IVF) do not enable all prospective parents to have genetically related children. The National Academies Board on Health Sciences Policy hosted a workshop in April 2023 to explore the development of in vitro-derived human eggs and sperm from pluripotent stem cells through a process known as in vitro gametogenesis (IVG). Speakers emphasized the impacts of the potential biotechnology on research and reproductive medicine should clinical IVG ever be approved, along with the many social, ethical, legal, and technical considerations its development raises. This proceedings document summarizes workshop discussions.

The transition to renewable energy has spurred many efforts to scale up the U.S. portfolio of efficient clean energy resources, including the development of offshore wind farms. The Nantucket Shoals region off the coast of Massachusetts is the first large scale wind farm installation under development in U.S. waters. To ensure Nantucket Shoals region offshore wind energy installations are being planned, constructed, and developed in an environmentally responsible way, the Bureau of Ocean Energy Management (BOEM) asked the National Academies to evaluate the potential for offshore wind farms in the Nantucket Shoals region to affect oceanic physical processes, and, in turn, how those hydrodynamic alterations might affect local to regional ecosystems. Of particular interest to BOEM are the potential effects of hydrodynamic changes on zooplankton productivity and aggregations, which may affect foraging for the critically endangered North Atlantic right whale. This report found the impacts of offshore wind projects on the North Atlantic right whale and the availability of their prey in the Nantucket Shoals region will likely be difficult to distinguish from the significant impacts of climate change and other influences on the ecosystem. Further study and monitoring of the oceanography and ecology of the Nantucket Shoals region is needed to fully understand the impact of future wind farms. This report recommends the Bureau of Ocean Energy Management, the National Oceanic and Atmospheric Administration, and others should promote observational studies and modeling that will advance understanding of potential hydrodynamic effects and their consequent impacts on ecology in the Nantucket Shoals region during all phases of wind energy development.

The Survey of Income and Program Participation (SIPP) is one of the U.S. Census Bureau's major surveys with features making it a uniquely valuable resource for researchers and policy analysts. However, the Census Bureau faces the challenge of protecting the confidentiality of survey respondents which has become increasingly difficult because numerous databases exist with personal identifying information that collectively contain data on household finances, home values, purchasing behavior, and other SIPP-relevant characteristics. A Roadmap for Disclosure Avoidance in the Survey of Income and Program Participation addresses these issues and how to make data from SIPP available to researchers and policymakers while protecting the confidentiality of survey respondents. The report considers factors such as evolving privacy risks, development of new methods for protecting privacy, the nature of the data collected through SIPP, the practice of linking SIPP data with administrative data, the types of data products produced, and the desire to provide timely access to SIPP data. The report seeks to balance minimizing the risk of disclosure against allowing researchers and policymakers to have timely access to data that support valid inferences.

Addressing climate change is essential and possible, and it offers a host of benefits - from better public health to new economic opportunities. The United States has a historic opportunity to lead the way in decarbonization by transforming its current energy system to one with net-zero emissions of carbon dioxide. Recent legislation has set the nation on the path to reach its goal of net zero by 2050 in order to avoid the worst consequences of climate change. However, even if implemented as designed, current policy will get the United States only part of the way to its net-zero goal. Accelerating Decarbonization in the United States provides a comprehensive set of actionable recommendations to help policymakers achieve a just and equitable energy transition over the next decade and beyond, including policy, technology, and societal dimensions. This report addresses federal and subnational policy needs to overcome implementation barriers and gaps with a focus on energy justice, workforce development, public health, and public engagement. The report also presents a suite of recommendations for the electricity, transportation, built environment, industrial, fossil fuels, land use, and finance sectors.

Before the COVID-19 pandemic, research demonstrated a significant impact of family caregiving responsibilities on the careers of professionals who work in science, technology, engineering, mathematics, and medicine (STEMM) - especially women. The COVID-19 pandemic increased public recognition of the challenges experienced by caregivers in STEMM fields and created a sense of urgency among many stakeholders. As part of the information-gathering stage of a forthcoming consensus study to address the barriers faced by caregivers, of all genders, in STEMM fields, the Committee on Policies and Practices for Supporting Family Caregivers Working in Science, Engineering, and Medicine organized two national symposia on February 27 and March 27, 2023. Scholars and leaders from a range of sectors convened to identify evidence-based interventions that can support the recruitment, retention, and advancement of caregivers in science, engineering, and medical fields. This publication summarizes the presentations and discussion of the symposia.

The National Academies Roundtable on Population Health Improvement hosted a workshop in February 2022, A Population Health Workforce to Meet 21st Century Challenges and Opportunities. The event, building upon the proceedings from their March 2019 workshop, Dialogue about the Workforce for Population Health Improvement, was further informed by the ongoing COVID-19 pandemic, the effects of climate change, and recent attention to and expenditure on the public health workforce. Workshop discussions explored the scope of work and work settings for public health and population health workers; the state of the workforce including attrition and gaps in specific roles and disciplines; and challenges to training, recruiting, and retaining workers. This Proceedings of a Workshop summarizes the presentations and discussions held during the workshop.

Since 1790, the U.S. census has been a recurring, essential civic ceremony in which everyone counts; it reaffirms a commitment to equality among all, as political representation is explicitly tied to population counts. Assessing the 2020 Census looks at the quality of the 2020 Census and its constituent operations, drawing appropriate comparisons with prior censuses. The report acknowledges the extraordinary challenges the Census Bureau faced in conducting the census and provides guidance as it plans for the 2030 Census. In addition, the report encourages research and development as the goals and designs for the 2030 Census are developed, urging the Census Bureau to establish a true partnership with census data users and government partners at the state, local, tribal, and federal levels.

From April 25-26, 2023 the Committee on National Statistics of the National Academies of Sciences, Engineering, and Medicine convened a workshop to identify challenges in and opportunities for measuring suicide in the law enforcement occupation. Experts in the field met to identify ways to improve the measurement of suicide by current and former police and corrections officers, dispatchers, and other sworn and civilian personnel, in public and private organizations. This proceedings provides a synthesis of key themes identified during the workshop.

Complementary feeding refers to the introduction of foods other than human milk or formula to an infants diet. In response to a request from the Centers for Disease Control and Prevention, the National Academies Health and Medicine Division convened the Committee on Complementary Feeding Interventions for Infants and Young Children under Age 2 to conduct a consensus study scoping review of peer-reviewed literature and other publicly available information on interventions addressing complementary feeding of infants and young children. The interventions studied took place in the U.S. and other high-income country health care systems; early care and education settings; university cooperative extension programs; the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC); home visiting programs; and other settings. This consensus study report summarizes evidence and provides information on interventions that could be scaled up or implemented at a community or state level.

Despite calls to increase diversity throughout the engineering education enterprise and years of efforts by and collaborations between universities, K-12 schools, and professional societies and other education- or equity-related organizations, Black or African-American individuals, American Indian or Alaska Native individuals, and Hispanic or Latine individuals of any race do not participate in engineering education and occupations at parity, defined as the same proportions as their representation in the US population. To review current and past efforts and explore ways to progress to a more diverse engineering profession and reach parity in comparison to the US population, the National Academy of Engineering (NAE) convened a virtual 3-day workshop series on March 18, March 30, and April 20, 2022. Attendees considered existing collaborations between extramural initiatives that support engineering student success and universities seeking to recruit and retain these students in undergraduate and advanced engineering education. Participants also shared potential new approaches for enhancing coordination among the various levels of the engineering education system to reach parity. This publication summarizes the presentation and discussion of the workshop.

On May 23, 2023, the National Academies of Sciences, Engineering, and Medicine Board on Behavioral, Cognitive, and Sensory Sciences hosted a workshop titled Current Practices and Challenges for Identifying and Managing Suicide Risk Among Veterans in Non-Department of Veterans Affairs (VA) Healthcare Systems to explore the landscape of veteran health care and suicide risk; consider strategies to identify veterans who receive their health care outside of the VHA; and identify best practices for suicide risk identification and care for VA-purchased care in community and at non-VA entities. This proceedings presents a summary of the presentation and discussion of the workshop.

"Experiencing poverty during childhood can lead to lasting harmful effects that compromise not only children's health and welfare but can also hinder future opportunities for economic mobility, which may be passed on to future generations. This cycle of economic disadvantage weighs heavily not only on children and families experiencing poverty but also the nation, reducing overall economic output and placing increased burden on the educational, criminal justice, and health care systems. Reducing Intergenerational Poverty examines key drivers of long- term, intergenerational poverty, including the racial disparities and structural factors that contribute to this cycle. The report assesses existing research on the effects on intergenerational poverty of income assistance, education, health, and other intervention programs and identifies evidence-based programs and policies that have the potential to significantly reduce the effects of the key drivers of intergenerational poverty. The report also examines the disproportionate effect of disadvantage to different racial/ethnic groups. In addition, the report identifies high-priority gaps in the data and research needed to help develop effective policies for reducing intergenerational poverty in the United States."--Publisher's website.

Artificial intelligence (AI) has the potential to aid new mathematical discoveries. Particularly as the amount of data available grows beyond what any person can study, AI can be useful in its power to identify patterns in data and refine relationships between properties. Sponsored by the National Science Foundation, the National Academies of Sciences, Engineering, and Medicine Board on Mathematical Sciences and Analytics convened a 3-day public virtual workshop on June 12-14, 2023, to bring together stakeholders to discuss the state of the art and current challenges and opportunities to advance research in using AI for mathematical reasoning. This publication summarizes the presentations and discussion of the workshop.

On March 20 and 21, 2023, the Board on Science Education at the National Academies of Sciences, Engineering, and Medicine hosted a workshop titled Effective Health Communication within the Current Information Environment and the Role of the Federal Government. Workshop speakers and participants, a majority of whom were working in government agencies in federal health communication or leadership positions, joined both in person in Washington, D.C. as well as virtually to explore the current health information environment as it pertains to public trust and behavior change, explore how federal health agencies can communicate effectively within the current information environment and what is needed to support effective health communication moving forward. This publication summarizes the presentations and discussion of the workshop.

Pediatric subspecialists are critical to ensuring quality care and pursuing research to improve prevention, diagnosis, and treatment for children. However, there are substantial disincentives to pursuing a career as a pediatric subspecialist, which are often heightened for individuals from groups underrepresented in medicine, and more effective collaboration with primary care clinicians is needed. Changing health care needs, increasing care complexity, and access barriers to pediatric subspecialty care have raised concerns about the current and future availability of pediatric subspecialty care and research. In response, the National Academies, with support from a coalition of sponsors, formed the Committee on the Pediatric Subspecialty Workforce and Its Impact on Child Health and Well-Being to recommend strategies and actions to ensure an adequate pediatric subspecialty physician workforce to support broad access to high quality subspecialty care and a robust research portfolio to advance the health and health care of infants, children, and adolescents. This report outlines recommendations that, if fully implemented, can improve the quality of pediatric medical subspecialty care through a well-supported, superbly trained, and appropriately used primary care, subspecialty, and physician-scientist workforce.

A key step towards reducing the burden of central nervous system (CNS) disorders is the identification of disease-specific biomarkers that can help predict, monitor, and guide treatment development. Recent technological advances have led to an increased number of biomarkers for different CNS disorders, providing the opportunity to generate multimodal biomarkers. While multimodal biomarkers can serve as promising tools to better diagnose and make accurate disease assessments, there remain challenges in current data collection, standardization, and validation practices that impede in their development. Recognizing the need for increased CNS biomarker integration, the National Academies Forum on Neuroscience and Nervous System Disorders hosted a public workshop in March 2023 to explore steps toward this goal, including data collection for biomarker discovery, development, validation, and assessment of clinical utility. This Proceedings of a Workshop summarizes the discussions held during the workshop.

Today, with a changing climate putting pressure on communities and ecosystems worldwide, goals for a carbon-neutral economy mean that renewable and low-carbon energy sources are being presented as solutions. While these cleaner energy sources have the potential to reduce risk to the environment and bring energy security closer to a reality, questions remain about the stability of the energy supply chain, the ability to meet energy demand reliably, and the best ways to produce fair and equitable outcomes in an energy transition. To serve as a catalyst for developing new insights and coordination around the energy transition, the Gulf Research Program at the National Academies of Sciences, Engineering, and Medicine convened a 2-day workshop in Washington, DC, called Navigating the Energy Transition in the Gulf of Mexico. Based around two scenarios in the year 2050 - one in which a carbon neutral economy is achieved and another in which robust dependence on fossil fuels remains - this serious gaming event stimulated the sharing of ideas, concerns, and cascading impacts from participants across academia, industry, government, and Gulf communities. This publication summarizes the activities, presentations, and discussion of the workshop.

The National Academies Global Forum on Innovation in Health Professional Education hosted a multi-day workshop series in March and April 2023 to explore the potential of artificial intelligence (AI) in health professions education. Speakers at the workshops provided background on AI; discussed the social, cultural, policy, legal, and regulatory considerations to integrating AI into health care and training; considered the skills health professionals will need as educators and providers to effectively use AI in practice; and explored needs for educating the next generation of health workers. Speakers took consideration of the bias, burden, health equity concerns that introducing AI into clinical education would bring. This Proceedings of a Workshop summarizes the discussions held during the workshop.

Responding to climate change will entail massive socio-emotional and behavioral changes. Translating policies, investments, or built infrastructure-reshaping mandates into real and sustained local impact that incorporates accountability and culture change will require hands-on work. Adaptive societal responses to climate change will succeed or fail based on the attitudes, behaviors, social cohesion and capital, organizational and emotional strengths, and collective impact and input of all stakeholders. To consider how to integrate, align, and converge the broad mix of social, behavioral, and cognitive sciences to produce new insights and inform efforts for enhanced human responses to environmental change, Board on Environmental Change and Society of the National Academies of Sciences, Engineering and Medicine convened this 2023 workshop, entitled Committee on Integrating the Human Sciences to Scale Societal Responses to Environmental Change: A Workshop. The workshop was intended to investigate ways to accelerate and deepen conversations within the social sciences and to focus on synthesis, especially for the purpose of increasing community capacity to understand and effectively respond to climate change-induced environmental changes - at scales ranging from the individual to the household to the community, and all the way up to the level of state and international governance. This publication summarizes the presentations and discussion of the workshop.

The Department of Veterans Affairs (VA) provides health care and other benefits to eligible veterans with physical and mental injuries or illnesses (conditions) related to their military service. When the scientific information needed to connect a veterans service or a particular military exposure with their diagnosed condition is nonexistent, impossible to obtain, or incomplete, VA may make a presumption of service connection using a formalized decision process. In 2022, VA instituted a series of changes intended to ensure the presumption decision process was more scientifically based, fair, consistent, transparent, timely, and veteran-centric. The PACT Act of 2022 called for a National Academies committee to review the VA revised process document used to identify medical conditions to evaluate for presumption status, the factors that such an evaluation entails, and the governance process for the review and approval of a presumption recommendation. This resulting report, Review of the Department of Veterans Affairs Presumption Decision Process, contains the committee findings, conclusions, and recommendations.

The mental and behavioral health care needs of Americans, including veterans, have substantially grown over the past few decades. As the nations largest provider of mental health care, the U.S. Department of Veterans Affairs (VA) faces some of the greatest challenges in meeting the mental health care needs of its population. These challenges are exacerbated by a shrinking mental health care workforce and provider shortages in low-income and rural communities. To address these challenges, and at the request of VA, the National Academies of Sciences, Engineering, and Medicine Forum on Mental Health and Substance Use Disorders held a public workshop on Improving Access to High-Quality Mental Health Care for Veterans to explore the U.S. landscape for mental health care services, including telehealth services. The workshop considered ways to improve veterans timely access to high-quality care for mental health conditions. In particular, it explored internal and external best practices for three critical needs for mental health access (known as tripartite access in VA): urgent/crisis, engagement, and sustained access. This proceedings document summarizes discussions at the workshop.

Formaldehyde is widely present in the environment and is one of the highest production chemicals by volume, used in manufactured goods including wood products, permanent press fabrics, and household products. It is also formed by combustion sources and is present in smoke from cigarettes and other tobacco products, and in emissions from gas stoves and open fireplaces. In carrying out its mission to protect human health, the U.S. Environmental Protection Agency (EPA) identifies and characterizes the health hazards of chemicals found in the environment through its Integrated Risk Information System (IRIS) Program, which has reviewed the human health hazards resulting from formaldehyde exposure in several assessments. This report is a continuation of guidance from the National Academies on draft IRIS assessments of formaldehyde and other aspects of the IRIS program. This report reviews the 2022 Draft Assessment with regard to its adequacy and transparency in evaluating the scientific literature, use of appropriate methods to synthesize the current state-of-the science, and presentations of conclusions that are supported by the scientific evidence. The report concludes that the 2022 Draft Assessment follows the advice of prior National Academies reports and that its findings on hazard and quantitative risk are supported by the evidence identified. However, revisions are needed to ensure that users can find and follow the methods used in each step of the assessment for each health outcome.

The National Academies National Cancer Policy Forum hosted a Summer 2022 workshop to explore the current state of knowledge regarding risk factors for cancer and best practices for cancer prevention and risk reduction interventions. Speakers reviewed the current evidence base, examined best practices and innovative approaches for clinic- and population-based cancer prevention, and discussed strategies to promote effective communication about cancer prevention. This Proceedings of a Workshop summarizes the discussions held during the workshop. This workshop is the second in a series examining policy issues in cancer prevention and cancer screening. The first workshop, which took place in 2020, focused on advancing the development and implementation of effective, high-quality cancer screening.

The National Academies Global Forum on Innovation in Health Professional Education hosted a Fall 2022 workshop series to explore the various needs of an aging population and an ideal health workforce with the numbers and skillset to match those needs. Discussions included the composition of the intended health workforce, training requirements for each level of care provider, who would provide the training and education, and in what setting the training would take place. Given these considerations and learner reluctance to work with elder adults, implementation science was introduced as a path forward. Implementation science is the study of methods and strategies that facilitate the use of evidence-based practice and research into regular use by practitioners and policymakers. This proceedings document summarizes workshop discussions.

"The National Academies Roundtable on Obesity Solutions hosted an April, July, and October, 2022 workshop series to explore the gaps in knowledge within the foundational drivers of obesity. Facilitating action will require improved health communication, deconstructing structural racism, and recognizing the biased mental models and social norms at odds with obesity solutions. Speakers discussed future research in evidence-based solutions and potential ways to translate current evidence into practice. This Proceedings of a Workshop summarizes the discussions held during the workshop."--

Population surveys collect information from participants by asking questions. Today, many surveys also collect biologic specimens that can be used to analyze a respondents DNA and other biomarkers. The National Health and Nutrition Examination Survey (NHANES) is a population survey that also administers a physical examination, collects biospecimens, and reports some test results (e.g., cholesterol levels) to the participant. While visiting communities large and small throughout the country, NHANES collects health and nutrition data from a representative sample of individuals through in-person interviews and health examinations that take place at special mobile examination centers. The examination component consists of medical, dental, and physiological examinations, as well as laboratory tests. On December 2, 7, and 8, 2022, a workshop was convened to focus on anticipated future collections of genomic data by NHANES. The 2022 workshop explored ethical considerations and current practices for returning genomic information from active research and population surveys. This Proceedings of a Workshop summarizes the presentations and discussions at the workshop.

Despite the integral contribution of oral health to general health status, it continues to be treated as a marginalized and less important practice of health care. Minimizing its importance begins with how U.S. dental professionals are educated. The National Academies Global Forum on Innovation in Health Professional Education held a public workshop in November 2022 to discuss definitions of community-engaged oral health and its application within, between, and across health professions. Discussions emphasized lifelong learning, the social determinants of health and community engagement, and the development of innovative approaches and models for oral health workforce education and training in a global context. This Proceedings of a Workshop summarizes the discussions held during the workshop.

Racially and ethnically minoritized populations and tribal communities often face preventable inequities in health outcomes due to structural disadvantages and diminished opportunities around health care, employment, education, and more. Federal Policy to Advance Racial, Ethnic, and Tribal Health Equity analyzes how past and current federal policies may create, maintain, and/or amplify racial, ethnic, and tribal health inequities. This report identifies key features of policies that have served to reduce inequities and makes recommendations to help achieve racial, ethnic, and tribal health equity.

The National Strategy for a Resilient Public Health Supply Chain lays out the U.S. government vision to protect the health and security of Americans by ensuring a supply chain for personal protective equipment (PPE) and technology (PPT), medical devices, medicines, and other public health supplies that is resilient against disruptions from pandemics and other biological threats. Additional forethought and collaboration amongst policy makers, manufacturers, and users is needed to make PPE and PPT innovation, standardization, stockpiling, and use more resilient. The National Academies convened a public workshop in March 2023 to explore innovative approaches and technologies needed to update and streamline the U.S. standardization system for PPE and PPT in support of supply chain resiliency. Discussions included ways to improve the effectiveness, safety, supply stability, and accessibility of PPE and PPT designed for use in health care settings, by critical infrastructure workers, and by the general public. This Proceedings of a Workshop summarizes the discussions held during the workshop.

Foreign-funded language and culture institutes exist on U.S. campuses beyond Confucius Institutes (CIs)--Chinese government-funded centers established by the Chinese Communist Party to extend the reach of Chinese language and culture and to enhance worldwide opinion of China through offering classes in Mandarin Chinese and highlighting positive aspects of Chinese culture. Regardless of the sponsoring nation, foreign-funded language and culture institutes may pose risks for U.S. host institutions regarding academic freedom, freedom of expression, governance, and national security. This is particularly true if the values of the sponsoring nation do not align with the democratic values held in the United States and if the sponsoring nation is suspected of engaging in activities adversely affecting human rights, academic freedom, freedom of expression, association, dissent, and U.S. national security. This report explores the role of other foreign-funded institutes at U.S. institutions of higher education, describing characteristics and features of such institutes; determining characteristics and features of foreign-funded institutes at U.S. institutions of higher education that could be flags for institutions to engage in further deliberation and vetting prior to entering into a partnership; identifying implementable practices for U.S. institutions of higher education to ensure appropriate operations; and continuing exploration of what role the sensitivity of the research conducted on campus should play in determining which foreign-funded partnerships are appropriate. Foreign-Funded Language and Culture Institutes at U.S. Institutions of Higher Education recommends actions that U.S. colleges and universities can take to minimize risks associated with hosting foreign-funded language and culture institutions, such as a CI, on or near campus and protect academic freedom and national security.