Almost 25 years have passed since the Demography of Aging (1994) was published by the National Research Council. Future Directions for the Demography of Aging is, in many ways, the successor to that original volume. The Division of Behavioral and Social Research at the National Institute on Aging (NIA) asked the National Academies of Sciences, Engineering, and Medicine to produce an authoritative guide to new directions in demography of aging. The papers published in this report were originally presented and discussed at a public workshop held in Washington, D.C., August 17-18, 2017. The workshop discussion made evident that major new advances had been made in the last two decades, but also that new trends and research directions have emerged that call for innovative conceptual, design, and measurement approaches. The report reviews these recent trends and also discusses future directions for research on a range of topics that are central to current research in the demography of aging. Looking back over the past two decades of demography of aging research shows remarkable advances in our understanding of the health and well-being of the older population. Equally exciting is that this report sets the stage for the next two decades of innovative research-a period of rapid growth in the older American population.
Huanglongbing (HLB) or citrus greening, first observed more than a hundred years ago in Asia, is the most serious disease threat to the citrus-growing industry worldwide due to its complexity, destructiveness, and incalcitrance to management. First detected in Florida in 2005, HLB is now widespread in the state and threatens the survival of the Florida citrus industry despite substantial allocation of research funds by Florida citrus growers and federal and state agencies. As the HLB epidemic raged in 2008, Florida citrus growers began allocating funds for HLB research in hopes of finding short-, medium-, and long-term solutions. This effort created the Citrus Research and Development Foundation (CRDF), an organization with oversight responsibility for HLB research and development efforts in Florida. This report provides an independent review of the portfolio of research projects that have been or continue to be supported by the CRDF. It seeks to identify ways to retool HLB research--which, despite significantly increasing understanding of the factors involved in HLB, has produced no major breakthroughs in controlling the disease--and accelerate the development of durable tools and strategies that could help abate the damage caused by HLB and prevent the possible collapse of the Florida citrus industry.
When discussing the risk of introducing drones into the National Airspace System, it is necessary to consider the increase in risk to people in manned aircraft and on the ground as well as the various ways in which this new technology may reduce risk and save lives, sometimes in ways that cannot readily be accounted for with current safety assessment processes. The Committee on Assessing the Risks of Unmanned Aircraft Systems (UAS) Integration examined the various ways that risk can be defined and applied to integrating UAS into the National Airspace System managed by the Federal Aviation Administration (FAA). The committee looked at recent developments in this field and consulted numerous experts in academia, industry, and government. The committee developed 11 recommendations that are presented in this report.
"The built environment--the physical world made up of the homes, buildings, streets, and infrastructure within which people live, work, and play--underwent changes during the 20th and 21st centuries that contributed to a sharp decline in physical activity and affected access to healthy foods. Those developments contributed in turn to the weight gain observed among Americans in recent decades. Many believe, therefore, that policies and practices that affect the built environment could affect obesity rates in the United States and improve the health of Americans. The National Academies of Sciences, Engineering, and Medicine convened a workshop in September 2017 to improve understanding of the roles played by the built environment in the prevention and treatment of obesity and to identify promising strategies in multiple sectors that can be scaled up to create more healthful and equitable environments. This publication summarizes the presentations and discussions from the workshop" --Publisher's description.
"Scientific advances over the past several decades have accelerated the ability to engineer existing organisms and to potentially create novel ones not found in nature. Synthetic biology, which collectively refers to concepts, approaches, and tools that enable the modification or creation of biological organisms, is being pursued overwhelmingly for beneficial purposes ranging from reducing the burden of disease to improving agricultural yields to remediating pollution. Although the contributions synthetic biology can make in these and other areas hold great promise, it is also possible to imagine malicious uses that could threaten U.S. citizens and military personnel. Making informed decisions about how to address such concerns requires a realistic assessment of the capabilities that could be misused. To that end, the U.S. Department of Defense, working with other agencies involved in biodefense, asked the National Academies of Sciences, Engineering, and Medicine to develop a framework to guide an assessment of the security concerns related to advances in synthetic biology, to assess the levels of concern warranted for such advances, and to identify options that could help mitigate those concerns"--
"Recommended intake levels for nutrients and other dietary components were designed initially to prevent nutrient deficiency diseases in a given population, and the original methodological approach used to derive intake values did not include consideration for other applications. However, with the increasing globalization of information and the identification of a variety of factors specific to different population subgroups (e.g., young children and women of reproductive age) that influence their nutritional needs, there has been increasing recognition of the need to consider methodological approaches to deriving nutrient reference values (NRVs) that are applicable across countries and that take into account the varying needs of different population subgroups. There is a need for guidance and recommendations about methodological approaches, as well as their potential for application to an international process for the development of NRVs, and particularly for young children and women of reproductive age. Harmonization of Approaches to Nutrient Reference Values: Applications to Young Children and Women of Reproductive Age examines these issues and makes recommendations for a unified approach to developing NRVs that would be acceptable globally"--Publisher's description.
"The urban built environment is a prime setting for microbial transmission, because just as cities serve as hubs for migration and international travel, components of the urban built environment serve as hubs that drive the transmission of infectious disease pathogens. The risk of infectious diseases for many people living in slums is further compounded by their poverty and their surrounding physical and social environment, which is often overcrowded, is prone to physical hazards, and lacks adequate or secure housing and basic infrastructure, including water, sanitation, or hygiene services. To examine the role of the urban built environment in the emergence and reemergence of infectious diseases that affect human health, the National Academies of Sciences, Engineering, and Medicine planned a public workshop. This publication summarizes the presentations and discussions from the workshop"--Publisher's description.
Over the past decade, resilience has gained significant traction across the nation and innovative programs are showing exciting progress in building resilient communities. For communities to be prepared for future extreme weather and climate events, as well as the chronic daily stressors, the momentum of implementing and taking action to build community resilience should continue to be fostered and expanded. Building on its many efforts dedicated to increasing and enhancing resilience, the Resilient America Roundtable hosted the State of Resilience Leadership Forum and Community Workshop on June 28 and 29, 2016. This activity brought together diverse decision makers, experts, practitioners, and community stakeholders, including representatives from academia, government, the private sector, foundations, and nonprofit organizations, to consider the results of years of investment, experimentation, and research in building resilience, take stock of these many initiatives and efforts, and share their experiences in building more resilient communities. This publication summarizes the presentations and discussions from the workshop.
"Precision medicine is focused on the individual and will require the rapid and accurate identification and prioritization of causative factors of disease. To move forward and accelerate the delivery of the anticipated benefits of precision medicine, developing predictable, reproducible, and reliable animal models will be essential. In order to explore the topic of animal-based research and its relevance to precision medicine, the National Academies of Sciences, Engineering, and Medicine convened a 2-day workshop on October 5 and 6, 2017. The workshop was designed to focus on the development, implementation, and interpretation of model organisms to advance and accelerate the field of precision medicine. Participants examined the extent to which next-generation animal models, designed using patient data and phenotyping platforms targeted to reveal and inform disease mechanisms, will be essential to the successful implementation of precision medicine. This publication summarizes the presentations and discussions from the workshop"--Publisher's description.
"During the 2016 presidential election, America's election infrastructure was targeted by actors sponsored by the Russian government. Securing the Vote: Protecting American Democracy examines the challenges arising out of the 2016 federal election, assesses current technology and standards for voting, and recommends steps that the federal government, state and local governments, election administrators, and vendors of voting technology should take to improve the security of election infrastructure. In doing so, the report provides a vision of voting that is more secure, accessible, reliable, and verifiable"--Publisher's description.
Improved observations of the atmospheric boundary layer (BL) and its interactions with the ocean, land, and ice surfaces have great potential to advance science on a number of fronts, from improving forecasts of severe storms and air quality to constraining estimates of trace gas emissions and transport. Understanding the BL is a crucial component of model advancements, and increased societal demands for extended weather impact forecasts (from hours to months and beyond) highlight the need to advance Earth system modeling and prediction. New observing technologies and approaches (including in situ and ground-based, airborne, and satellite remote sensing) have the potential to radically increase the density of observations and allow new types of variables to be measured within the BL, which will have broad scientific and societal benefits. In October 2017, the National Academies of Sciences, Engineering, and Medicine convened a workshop to explore the future of BL observations and their role in improving modeling and forecasting capabilities. Workshop participants discussed the science and applications drivers for BL observation, emerging technology to improve observation capabilities, and strategies for the future. This publication summarizes presentations and discussions from the workshop.
"A consensus study report of The National Academies of Sciences, Engineering, Medicine."
The U.S. system of graduate education in science, technology, engineering, and mathematics (STEM) has served the nation and its science and engineering enterprise extremely well. In many ways, it is the "gold standard" for graduate STEM education in the world as evidenced by, among other measures, the substantial number of international students coming to the United States to study. Over the course of their education, graduate students become involved in advancing the frontiers of discovery, as well as in making significant contributions to the growth of the U.S. economy, its national security, and the health and well-being of its people. However, continuous, dramatic innovations in research methods and technologies, changes in the nature and availability of work, shifts in demographics, and expansions in the scope of occupations needing STEM expertise raise questions about how well the current STEM graduate education system is meeting the full array of 21st-century needs. Indeed, recent surveys of employers and graduates and studies of graduate education suggest that many graduate programs do not adequately prepare students to translate their knowledge into impact in multiple careers.
Delivering high-quality cancer care to all patients presents numerous challenges, including difficulties with care coordination and access. Patient navigation is a community-based service delivery intervention designed to promote access to timely diagnosis and treatment of cancer and other chronic diseases by eliminating barriers to care, and has often been proposed and implemented to address these challenges. However, unresolved questions include where patient navigation programs should be deployed, and which patients should be prioritized to receive navigation services when resources are limited. To address these issues and facilitate discussion on how to improve navigation services for patients with cancer, the National Cancer Policy Forum of the National Academies of Sciences, Engineering, and Medicine held a workshop on November 13 and 14, 2017. At this workshop, a broad range of experts and stakeholders, including clinicians, navigators, researchers, and patients, explored which patients need navigation and who should serve as navigators, and the benefits of navigation and current gaps in the evidence base.
Understanding, quantifying, and tracking atmospheric methane and emissions is essential for addressing concerns and informing decisions that affect the climate, economy, and human health and safety. Atmospheric methane is a potent greenhouse gas (GHG) that contributes to global warming. While carbon dioxide is by far the dominant cause of the rise in global average temperatures, methane also plays a significant role because it absorbs more energy per unit mass than carbon dioxide does, giving it a disproportionately large effect on global radiative forcing. In addition to contributing to climate change, methane also affects human health as a precursor to ozone pollution in the lower atmosphere. Improving Characterization of Anthropogenic Methane Emissions in the United States summarizes the current state of understanding of methane emissions sources and the measurement approaches and evaluates opportunities for methodological and inventory development improvements. This report will inform future research agendas of various U.S. agencies, including NOAA, the EPA, the DOE, NASA, the U.S. Department of Agriculture (USDA), and the National Science Foundation (NSF).
Workshop held at the Keck Center, Washington, DC on October 11, 2017.
"Millions of people in the United States live with serious illnesses such as cancer, heart disease, chronic obstructive pulmonary disorder (COPD), amyotrophic lateral sclerosis, Parkinson's disease, and dementia--often for many years. Those facing serious illness have a range of interconnected medical and non-medical needs, and the way their care is financed has a large impact on the care they receive. Medicare is the predominant payer, but both Medicaid and private payers also play significant roles in financing care for serious illness. In an effort to address the complex needs of people with serious illness, public and private health care payers are testing innovative financing strategies and alternative payment models. These innovative approaches signal a gradual transition from the traditional-fee-for-service system that pays providers based on the quantity of services to a system based on the value of care provided and a heightened focus on improved quality of care at lower cost. To explore this evolving financing and payment landscape for serious illness care within public- and private-sector programs, the Roundtable on Quality Care for People with Serious Illness developed a workshop, Financing and Payment Strategies to Support High-Quality Care for People with Serious Illness. The workshop convened clinicians, researchers, policy analysts, and patient advocates, as well as representatives from academia, government and private health care plans, and insurers to discuss challenges and opportunities in financing high-quality care for people with serious illness. This publication summarizes the presentations and discussions from the workshop"--
Although the general public in the United States assumes children to be generally healthy and thriving, a substantial and growing number of children have at least one chronic health condition. Many of these conditions are associated with disabilities and interfere regularly with children's usual activities, such as play or leisure activities, attending school, and engaging in family or community activities. In their most severe forms, such disorders are serious lifelong threats to children's social, emotional well-being and quality of life, and anticipated adult outcomes such as for employment or independent living. However, pinpointing the prevalence of disability among children in the U.S. is difficult, as conceptual frameworks and definitions of disability vary among federal programs that provide services to this population and national surveys, the two primary sources for prevalence data. Opportunities for Improving Programs and Services for Children with Disabilities provides a comprehensive analysis of health outcomes for school-aged children with disabilities. This report reviews and assesses programs, services, and supports available to these children and their families. It also describes overarching program, service, and treatment goals; examines outreach efforts and utilization rates; identifies what outcomes are measured and how they are reported; and describes what is known about the effectiveness of these programs and services.
In May 2017, the committee convened a workshop in which participants discussed educational models to build relevant foundational, translational, and professional skills for data scientists in various roles; the use of high-impact educational practices in the delivery of data science education; and strategies for broad participation in data science education that rely on formal modes of evaluation and assessment. Participants focused on the ways in which students, institutions, and programs could change in the coming decade, as well as how these changes will affect future plans for data science education.
"The U.S. Census Bureau maintains an important portfolio of economic statistics programs, including quinquennial economic censuses, annual economic surveys, and quarterly and monthly indicator surveys. Government, corporate, and academic users rely on the data to understand the complexity and dynamism of the U.S. economy. Historically, the Bureau's economic statistics programs developed sector by sector (e.g., separate surveys of manufacturing, retail trade, and wholesale trade), and they continue to operate largely independently. Consequently, inconsistencies in questionnaire content, sample and survey design, and survey operations make the data not only more difficult to use, but also more costly to collect and process and more burdensome to the business community than they could be. This report reviews the Census Bureau's annual economic surveys. Specifically, it examines the design, operations, and products of 11 surveys and makes recommendations to enable them to better answer questions about the evolving economy"--Publisher's description
"A Consensus Study Report of the National Academies of Sciences, Engineering, Medicine."
The National Academies of Sciences, Engineering, and Medicine convened a public workshop in September 2017 to explore the evidence for achieving global harmonization of methodological approaches to establishing nutrient intake recommendations. Participants reviewed current nutrient intake recommendations, discussed the feasibility of harmonizing approaches to setting such recommendations globally, examined the development of principles by which they may be applied in diverse contexts that relate to individuals or populations, or regulatory purposes, and examined perceptions and acceptance of nutrient intake recommendations by different stakeholders. This publication summarizes the presentations and discussions from the workshop.
"Since the 2010 Deepwater Horizon blowout and oil spill, efforts to improve safety in the offshore oil industry have resulted in the adoption of new technological controls, increased promotion of safety culture, and the adoption of new data collection systems to improve both safety and performance. As an essential element of a positive safety culture, operators and regulators are increasingly integrating strategies that empower workers to participate in process safety decisions that reduce hazards and improve safety. While the human factors of personal safety have been widely studied and widely adopted in many high-risk industries, process safety - the application of engineering, design, and operative practices to address major hazard concerns - is less well understood from a human factors perspective, particularly in the offshore oil industry. The National Academies of Sciences, Engineering, and Medicine organized a workshop in January 2018 to explore best practices and lessons learned from other high-risk, high-reliability industries for the benefit of the research community and of citizens, industry practitioners, decision makers, and officials addressing safety in the offshore oil industry. This publication summarizes the presentations and discussions from the workshop"--Publisher's description.
"BioWatch is the Department of Homeland Security's (DHS's) system for detecting an aerosolized biological attack using collectors that are positioned strategically across the country to continuously monitor the air for biological threats. As currently deployed, BioWatch collectors draw air through filters that field technicians collect daily and transport to laboratories, where professional technicians analyze the material collected on the filter for evidence of biological threats. As part of the BioWatch program's efforts to enhance its effectiveness and capabilities, particularly with regard to detecting biological threats in challenging indoor environments, DHS requested the National Academies of Sciences, Engineering, and Medicine hold a workshop to explore alternative and effective biodetection systems for aerosolized biological agents that would meet BioWatch's technical and operational requirements, integrate into the existing system architecture and public health infrastructure, and be deployable by 2027. This publication summarizes the presentations and discussions from the workshop"--Publisher's description.
The surface of the human body and its mucous membranes are heavily colonized by microorganisms. Our understanding of the contributions that complex microbial communities make to health and disease is advancing rapidly. Most microbiome research to date has focused on the mouse as a model organism for delineating the mechanisms that shape the assembly and dynamic operations of microbial communities. However, the mouse is not a perfect surrogate for studying different aspects of the microbiome and how it responds to various environmental and host stimuli, and as a result, researchers have been conducting microbiome studies in other animals. To examine the different animal models researchers employ in microbiome studies and to better understand the strengths and weaknesses of each of these model organisms as they relate to human and nonhuman health and disease, the Roundtable on Science and Welfare in Laboratory Animal Use of the National Academies of Sciences, Engineering, and Medicine convened a workshop in December 2016. The workshop participants explored how to improve the depth and breadth of analysis of microbial communities using various model organisms, the challenges of standardization and biological variability that are inherent in gnotobiotic animal-based research, the predictability and translatability of preclinical studies to humans, and strategies for expanding the infrastructure and tools for conducting studies in these types of models. This publication summarizes the presentations and discussions from the workshop.
Oil and gas well completion and stimulation technologies to develop unconventional hydrocarbon resources in the United States have evolved over the past several decades, particularly in relation to the development of shale oil and shale gas. Shale oil and shale gas resources and the technology associated with their production are often termed "unconventional" because the oil and gas trapped inside the shale or other low-permeability rock formation cannot be extracted using conventional technologies. Since about 2005, the application of these technologies to fields in the U.S. have helped produce natural gas and oil in volumes that allowed the country to reduce its crude oil imports by more than 50% and to become a net natural gas exporter. The regional and national economic and energy advances gained through production and use of these resources have been accompanied, however, by rapid expansion of the infrastructure associated with the development of these fields and public concern over the impacts to surface- and groundwater, air, land, and communities where the resources are extracted. The intent of the first day of the workshop of the National Academies of Sciences, Engineering, and Medicine's Roundtable on Unconventional Hydrocarbon Development was to discuss onshore unconventional hydrocarbon development in the context of potential environmental impacts and the ways in which the risks of these kinds of impacts can be managed. Specifically, the workshop sought to examine the lifecycle development of these fields, including decommissioning and reclamation of wells and related surface and pipeline infrastructure, and the approaches from industry practice, scientific research, and regulation that could help to ensure management of the operations in ways that minimize impacts to the environment throughout their active lifetimes and after operations have ceased. This publication summarizes the presentations and discussions from the workshop.
"Chronic pain is one of the most prevalent, costly, and disabling health conditions in the United States. Estimates show that more than 11 percent of the American population suffer from chronic pain, yet the federal pain research investment has been minimal. In parallel with a gradual increased recognition of the problems of treating chronic pain, the opioid epidemic has emerged as a growing public health emergency. The intersection of these two crises lies in the fact that an unintended consequence of treating pain has been an increasing number of opioid prescriptions and diversion of drugs for illicit purposes. In May 2017, the National Institutes of Health (NIH), and the National Institute on Drug Abuse announced a public-private partnership to develop solutions to the opioid crisis and cut in half the time it takes to develop non-addictive analgesics. To advance the planning of NIH's anticipated public-private partnerships, the National Academies' Forum on Neuroscience and Nervous Systems Disorders hosted a public workshop that brought together a diverse group of stakeholders from academia, federal agencies, advocacy organizations and companies developing therapeutics for pain and opioid use disorders. Participants discussed potential strategies to accelerate development of non-addictive pain medications and treatments for opioid use disorders. This publication summarizes the presentations and discussions from the workshop"--
Prior to 2012, unmanned aircraft systems (UAS) technology had been primarily used by the military and hobbyists, but it has more recently transitioned to broader application, including commercial and scientific applications, as well as to expanded military use. These new uses encroach on existing structures for managing the nation's airspace and present significant challenges to ensure that UASs are coordinated safely and suitably with existing manned aircraft and air traffic management systems, particularly with the National Airspace System (NAS). Of particular concern is the interaction between human pilots, operators, or controllers and increasingly automated systems. Enhanced understanding of these interactions is essential to avoid unintended consequences, especially as new technologies emerge. In order to explore these issues, the National Academies of Sciences, Engineering, and Medicine organized a 2-day workshop in January 2018. This publication summarizes the presentations and discussions from the workshop.
Although the ocean-and the resources within-seem limitless, there is clear evidence that human impacts such as overfishing, habitat destruction, and pollution disrupt marine ecosystems and threaten the long-term productivity of the seas. Declining yields in many fisheries and decay of treasured marine habitats, such as coral reefs, has heightened interest in establishing a comprehensive system of marine protected areas (MPAs)-areas designated for special protection to enhance the management of marine resources. Therefore, there is an urgent need to evaluate how MPAs can be employed in the United States and internationally as tools to support specific conservation needs of marine and coastal waters. Marine Protected Areas compares conventional management of marine resources with proposals to augment these management strategies with a system of protected areas. The volume argues that implementation of MPAs should be incremental and adaptive, through the design of areas not only to conserve resources, but also to help us learn how to manage marine species more effectively.
"The second State of the Climate Cycle Report (SOCCR2) aims to elucidate the fundamental physical, chemical, and biological aspects of the carbon cycle and to discuss the challenges of accounting for all major carbon stocks and flows for the North American continent. This assessment report has broad value, as understanding the carbon cycle is not just an academic exercise. Rather, this understanding can provide an important foundation for making a wide variety of societal decisions about land use and natural resource management, climate change mitigation strategies, urban planning, and energy production and consumption ... To ensure that SOCCR2 is scientifically credible and effectively communicates, the USGCRP asked the National Academies of Sciences, Engineering, and Medicine to review the draft document (during the same time period in which the draft SOCCR2 report was available for public comment). The Academies appointed an ad hoc expert Committee to conduct this review, and offered here are the Committee's findings and recommendations"--
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