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"A pressing challenge in the modern health care system is the gap between education and clinical practice. Emerging technologies have the potential to bridge this gap by creating the kind of team-based learning environments and clinical approaches that are increasingly necessary in the modern health care system both in the United States and around the world. To explore these technologies and their potential for improving education and practice, the National Academies of Sciences, Engineering, and Medicine hosted a workshop in November 2017. Participants explored effective use of technologies as tools for bridging identified gaps within and between health professions education and practice in order to optimize learning, performance and access in high-, middle-, and low-income areas while ensuring the well-being of the formal and informal health workforce. This publication summarizes the presentations and discussions from the workshop"--

The 2006 Institute of Medicine (IOM) consensus study report From Cancer Patient to Cancer Survivor: Lost in Transition made recommendations to improve the quality of care that cancer survivors receive, in recognition that cancer survivors are at risk for significant physical, psychosocial, and financial repercussions from cancer and its treatment. Since then, efforts to recognize and address the unique needs of cancer survivors have increased, including an emphasis on improving the evidence base for cancer survivorship care and identifying best practices in the delivery of high-quality cancer survivorship care. To examine progress in cancer survivorship care since the Lost in Transition report, the National Cancer Policy Forum of the National Academies of Sciences, Engineering, and Medicine held a workshop in July 2017, in Washington, DC. Workshop participants highlighted potential opportunities to improve the planning, management, and delivery of cancer survivorship care. This publication summarizes the presentations and discussions from the workshop.

Solving the world's health challenges requires multidisciplinary collaborations that bring together the talents, experiences, resources, and ideas from multiple sectors. These collaborations in global health frequently occur through public-private partnerships (PPPs) in which public and private parties share risks, responsibilities, and decision-making processes with the objective of collectively and more effectively addressing a common goal. However, these numerous stakeholders bring varying strengths and resources to global health partnerships, but they also bring their own organizational cultures, regulations, and expectations. Managing partnerships among them is complex and requires intentional and thoughtful governance. Over the last several decades, as the number of interested stakeholders, resources invested, and initiatives launched within the global health field has grown, effective governance of global health PPPs has become increasingly critical. To explore the role of governance in PPPs for global health, the Forum on Public-Private Partnerships for Global Health and Safety convened a workshop. Participants explored best practices, common challenges, and lessons learned in the varying approaches to partnership governance. They also highlighted key issues in the governance of PPPs for global health with the goal of increasing their effectiveness in improving health outcomes. This publication summarizes the presentations and discussions from the workshop.

Graduate medical education (GME) is critical to the career development of individual physicians, to the functioning of many teaching institutions, and to the production of our physician workforce. However, recent reports have called for substantial reform of GME. The current lack of established GME outcome measures limits our ability to assess the impact of individual graduates, the performance of residency programs and teaching institutions, and the collective contribution of GME graduates to the physician workforce. To examine the opportunities and challenges in measuring and assessing GME outcomes, the National Academies of Sciences, Engineering, and Medicine held a workshop on October 10-11, 2017, in Washington, DC. Workshop participants discussed: meaningful and measurable outcomes of GME; possible metrics that could be used to track these GME outcomes; possible mechanisms for collecting, collating, analyzing, and reporting these data; and further work to accomplish this ambitious goal. This publication summarizes the presentations and discussions from the workshop.

Genomic applications are being integrated into a broad range of clinical and research activities at health care systems across the United States. This trend can be attributed to a variety of factors, including the declining cost of genome sequencing and the potential for improving health outcomes and cutting the costs of care. The goals of these genomics-based programs may be to identify individuals with clinically actionable variants as a way of preventing disease, providing diagnoses for patients with rare diseases, and advancing research on genetic contributions to health and disease. Of particular interest are genomics- based screening programs, which will, in this publication, be clinical screening programs that examine genes or variants in unselected populations in order to identify individuals who are at an increased risk for a particular health concern (e.g., diseases, adverse drug outcomes) and who might benefit from clinical interventions. On November 1, 2017, the National Academies of Sciences, Engineering, and Medicine hosted a public workshop to explore the challenges and opportunities associated with integrating genomics-based screening programs into health care systems. This workshop was developed as a way to explore the challenges and opportunities associated with integrating genomics-based programs in health care systems in the areas of evidence collection, sustainability, data sharing, infrastructure, and equity of access. This publication summarizes the presentations and discussions from the workshop.

On February 26-27, 2014, the National Academies of Sciences, Engineering, and Medicine's Forum on Global Violence Prevention convened a workshop titled Mental Health and Violence: Opportunities for Prevention and Early Intervention. The workshop brought together advocates and experts in public health and mental health, anthropology, biomedical science, criminal justice, global health and development, and neuroscience to examine experience, evidence, and practice at the intersection of mental health and violence. Participants explored how violence impacts mental health and how mental health influences violence and discussed approaches to improve research and practice in both domains. This publication summarizes the presentations and discussions from the workshop"--

"Rural counties make up about 80 percent of the land area of the United States, but they contain less than 20 percent of the U.S. population. The relative sparseness of the population in rural areas is one of many factors that influence the health and well-being of rural Americans. Rural areas have histories, economies, and cultures that differ from those of cities and from one rural area to another. Understanding these differences is critical to taking steps to improve health and well-being in rural areas and to reduce health disparities among rural populations. To explore the impacts of economic, demographic, and social issues in rural communities and to learn about asset-based approaches to addressing the associated challenges, the National Academies of Sciences, Engineering, and Medicine held a workshop on June 13, 2017. This publication summarizes the presentations and discussions from the workshop"--

"Many different groups of people are subject to stereotypes. Positive stereotypes (e.g., "older and wiser") may provide a benefit to the relevant groups. However, negative stereotypes of aging and of disability continue to persist and, in some cases, remain socially acceptable. Research has shown that when exposed to negative images of aging, older persons demonstrate poor physical and cognitive performance and function, while those who are exposed to positive images of aging (or who have positive self-perceptions of aging) demonstrate better performance and function. Furthermore, an individual's expectations about and perceptions of aging can predict future health outcomes. To better understand how stereotypes affect older adults and individuals with disabilities, the National Academies of Sciences, Engineering, and Medicine, with support from AARP, convened a public workshop on October 10, 2017. This publication summarizes the presentations and discussions from the workshop"--

For the past 17 years, the U.S. National Commission on Mathematics Instruction (USNC/MI) has held workshops with mathematics educators from countries that typically perform well on international assessments and have a history of strong mathematics education programs, such as Japan, China, and South Korea. Finland is among this group. Even though its mathematics education system has some common characteristics with other top-performing nations, such as a great social respect for the teaching profession, it also has unique characteristics. The USNC/MI, a standing committee of the National Academies of Sciences, Engineering, and Medicine, planned a workshop at which U.S. and Finnish mathematics educators could exchange information and ideas about the preparation of new mathematics teachers and the means of providing them with support and professional development throughout their careers. While this is not the first time U.S. and Finnish mathematics educators have discussed educational practices, this workshop focused primarily on teacher development in both nations in the context of mathematics education. This publication summarizes the presentations and discussions from the workshop.

The National Academies of Sciences, Engineering, and Medicine's Army Research Laboratory Technical Assessment Board (ARLTAB) provides biennial assessments of the scientific and technical quality of the research, development, and analysis programs at the Army Research Laboratory (ARL), focusing on ballistics sciences, human sciences, information sciences, materials sciences, and mechanical sciences. This interim report summarizes the findings of the ARLTAB for the first year of this biennial assessment; the current report addresses approximately half the portfolio for each campaign; the remainder will be assessed in 2018.

"The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience"--

Instructional materials are a key means to achieving the goals of science education--an enterprise that yields unique and worthwhile benefits to individuals and society. As states and districts move forward with adoption and implementation of the Next Generation Science Standards (NGSS) or work on improving their instruction to align with A Framework for K-12 Science Education (the Framework), instructional materials that align with this new vision for science education have emerged as one of the key mechanisms for creating high-quality learning experiences for students. In response to the need for more coordination across the ongoing efforts to support the design and implementation of instructional materials for science education, the National Academies of Sciences, Engineering, and Medicine convened a public workshop in June 2017. The workshop focused on the development of instructional materials that reflect the principles of the Framework and the NGSS. This publication summarizes the presentations and discussions from the workshop.

Spacecraft depend on electronic components that must perform reliably over missions measured in years and decades. Space radiation is a primary source of degradation, reliability issues, and potentially failure for these electronic components. Although simulation and modeling are valuable for understanding the radiation risk to microelectronics, there is no substitute for testing, and an increased use of commercial-off-the- shelf parts in spacecraft may actually increase requirements for testing, as opposed to simulation and modeling. Testing at the Speed of Light evaluates the nation's current capabilities and future needs for testing the effects of space radiation on microelectronics to ensure mission success and makes recommendations on how to provide effective stewardship of the necessary radiation test infrastructure for the foreseeable future.

To explore how the use of technology can facilitate progress toward globally recognized health priorities, the Forum on Public-Private Partnerships for Global Health and Safety organized a public workshop. Participants identified and explored the major challenges and opportunities for developing and implementing digital health strategies within the global, country, and local context, and framed the case for cross-sector and cross-industry collaboration, engagement, and investment in digital health strategies. This publication summarizes the presentations and discussions from the workshop.

The Intelligence Community Studies Board of the National Academies of Sciences, Engineering, and Medicine convened a workshop on August 9-10, 2017 to examine challenges in machine generation of analytic products from multi-source data. Workshop speakers and participants discussed research challenges related to machine-based methods for generating analytic products and for automating the evaluation of these products, with special attention to learning from small data, using multi-source data, adversarial learning, and understanding the human-machine relationship. This publication summarizes the presentations and discussions from the workshop.

Continuing education, continuing professional development, and high-value continuing professional development exist along a continuum. Continuing education (CE) often is associated with didactic learning methods, such as lectures and seminars, which take place in auditoriums and classrooms, and is often viewed by health professionals as merely a path to maintaining licensure and certification through the accumulation of credits. Continuing professional development (CPD), in contrast, embraces a wider array of learning formats and methods that are driven by learners. The Global Forum on Innovation in Health Professional Education hosted a workshop in April 2017 to explore the value proposition for CPD. Forum members and workshop participants gathered to learn about innovative CPD programs around the world, to consider the perspectives of those who invest in CPD, and to discuss the business case for CPD. This publication summarizes the presentations and discussions from the workshop.

The increasingly diverse ethnic composition of the United States population has created a profound and ongoing demographic shift, and public health and health care organizations face many challenges as they move to address and adapt to this change. To better understand how the public health and health care communities can meet the challenges of serving an increasingly diverse population, the Roundtable on Health Literacy conducted a public workshop on facilitating health communication with immigrant, refugee, and migrant populations through the use of health literate approaches. The goal of the workshop was to identify approaches that will enable organizations that serve these ethnically and culturally diverse populations in a manner that allows all members of these communities to obtain, process, and understand basic health information and the services needed to make appropriate health and personal decisions. This publication summarizes the presentations and discussions from the workshop--Publishers website.

"Following a series of natural disasters, including Hurricane Katrina, that revealed shortcomings in the nation's ability to effectively alert populations at risk, Congress passed the Warning, Alert, and Response Network (WARN) Act in 2006. Today, new technologies such as smart phones and social media platforms offer new ways to communicate with the public, and the information ecosystem is much broader, including additional official channels, such as government social media accounts, opt-in short message service (SMS)-based alerting systems, and reverse 911 systems; less official channels, such as main stream media outlets and weather applications on connected devices; and unofficial channels, such as first person reports via social media. Traditional media have also taken advantage of these new tools, including their own mobile applications to extend their reach of beyond broadcast radio, television, and cable. Furthermore, private companies have begun to take advantage of the large amounts of data about users they possess to detect events and provide alerts and warnings and other hazard-related information to their users. More than 60 years of research on the public response to alerts and warnings has yielded many insights about how people respond to information that they are at risk and the circumstances under which they are most likely to take appropriate protective action. Some, but not all, of these results have been used to inform the design and operation of alert and warning systems, and new insights continue to emerge. Emergency Alert and Warning Systems reviews the results of past research, considers new possibilities for realizing more effective alert and warning4 systems, explores how a more effective national alert and warning system might be created and some of the gaps in our present knowledge, and sets forth a research agenda to advance the nation's alert and warning capabilities"--Publisher's description.

On March 13, 2017, the Roundtable on Environmental Health Sciences, Research, and Medicine and the Roundtable on Population Health Improvement jointly convened a 1-day public workshop in Washington, DC, to explore potential strategies for public health, environmental health, health care, and related stakeholders to help communities and regions to address and mitigate the health effects of climate change. Participants discussed the perspectives of civic, government, business, and health-sector leaders, and existing research, best practices, and examples that inform stakeholders and practitioners on approaches to support mitigation of and adaptation to climate change and its effects on population health. This publication summarizes the presentations and discussions from the workshop.

Two members of the Committee on Human Rights (CHR), NAS member Mary Jane West-Eberhard and NAS/NAE member Morton Panish, undertook a mission to Guatemala to observe the trial of two high-level Guatemalan military officials who were charged with ordering the murder of Guatemalan anthropologist Myrna Mack. She was stabbed to death in 1990, two days after a report for which she was principal researcher, "Assistance and Control: Policies Toward Internally Displaced Populations in Guatemala," was published by the Georgetown University Press. Ms. Mack had been doing research on and writing about the unjust treatment of the internally displaced people in Guatemala. Thirteen years after Ms. Mack's murder--after the case had gone through dozens of courts and countless delays--a general and colonel in the Guatemalan military intelligence apparatus were brought to trial, and one was convicted. This marked the first time in Guatemalan history that a high-level military official had been brought to justice for atrocities he committed during Guatemala's 30-year civil war. This report summarizes the one-month trial proceedings.

"Neuroinflammation is a burgeoning area of interest in academia and biopharma, with a broadly acknowledged role in many central nervous system (CNS) disorders. However, there is little agreement on the pathophysiological mechanisms that underlie the manifestations of neuroinflammation in the CNS compartment and how neuroinflammation operates as a driver and also as a consequence of disease in the brain. Moreover, another unclear area is how to translate increased understanding of the mechanisms that underlie neuroinflammation and its manifestations in the CNS to therapeutics. To address these gaps in understanding mechanisms and how to translate that understanding into therapeutics, the Forum on Neuroscience and Nervous System Disorders of the National Academies of Sciences, Engineering, and Medicine convened a workshop on March 20-21, 2017, bringing together key leaders in the field from industry, academia, and governmental agencies to explore the role and mechanisms of neuroinflammation in a variety of CNS diseases. The workshop also considered strategies to advance the identification and validation of biomarkers of neuroinflammation that could accelerate development of therapies, bringing much-needed treatments to patients with disorders ranging from neuroinflammatory diseases such as multiple sclerosis (MS) to neuropsychiatric disorders such as depression. This publication summarizes the presentations and discussions from the workshop"--Publisher's description.

"The search for life is one of the most active fields in space science and involves a wide variety of scientific disciplines, including planetary science, astronomy and astrophysics, chemistry, biology, chemistry, and geoscience. In December 2016, the Space Studies Board hosted a workshop to explore the possibility of habitable environments in the solar system and in exoplanets, techniques for detecting life, and the instrumentation used. This publication summarizes the presentations and discussions from the workshop"--

What foods should Americans eat to promote their health, and in what amounts? What is the scientific evidence that supports specific recommendations for dietary intake to reduce the risk of multifactorial chronic disease? These questions are critically important because dietary intake has been recognized to have a role as a key determinant of health. As the primary federal source of consistent, evidence-based information on dietary practices for optimal nutrition, the Dietary Guidelines for Americans (DGA) have the promise to empower Americans to make informed decisions about what and how much they eat to improve health and reduce the risk of chronic disease. The adoption and widespread translation of the DGA requires that they be universally viewed as valid, evidence-based, and free of bias and conflicts of interest to the extent possible. However, this has not routinely been the case. A first short report meant to inform the 2020 review cycle explored how the advisory committee selection process can be improved to provide more transparency, eliminate bias, and include committee members with a range of viewpoints. This second and final report recommends changes to the DGA process to reduce and manage sources of bias and conflicts of interest, improve timely opportunities for engagement by all interested parties, enhance transparency, and strengthen the science base of the process.

Research conducted over the past two decades has shown that poor patient understanding of medication instructions is an important contributor to the more than 1 million medication errors and adverse drug events that lead to office and emergency room visits, hospitalizations, and even death. Patients who have limited literacy skills, who have multiple comorbidities, and who are elderly face the greatest risk, and limited literacy skills are significantly associated with inadequate understanding and use of prescription instructions and precautions. The Agency for Healthcare Research and Quality notes that only 12 percent of U.S. adults have proficient health literacy that allows them to interpret a prescription label correctly. Given the importance of health literacy to the proper use of medications, and the apparent lack of progress in improving medication adherence, the Roundtable on Health Literacy formed an ad hoc committee to plan and conduct a 1-day public workshop that featured invited presentations and discussion of the role and challenges regarding clarity of communication on medication. Participants focused on using health literacy principles to address clarity of materials, decision aids, and other supportive tools and technologies regarding risks, benefits, alternatives, and health plan coverage. This publication summarizes the presentations and discussions from the workshop.

"The Survey of Income and Program Participation (SIPP) is a national, longitudinal household survey conducted by the Census Bureau. SIPP serves as a tool to evaluate the effectiveness of government-sponsored social programs and to analyze the impacts of actual or proposed modifications to those programs. SIPP was designed to fill a need for data that would give policy makers and researchers a much better grasp of how effectively government programs were reaching their target populations, how participation in different programs overlapped, and to what extent and under what circumstances people transitioned into and out of these programs. SIPP was also designed to answer questions about the short-term dynamics of employment, living arrangements, and economic well-being"--Page 1.

"Although ecosystems, humans, and fire have coexisted for millennia, changes in geology, ecology, hydrology, and climate as well as sociocultural, regulatory, and economic factors have converged to make wildland fire management exceptionally challenging for U.S. federal, state, and local authorities. Given the mounting, unsustainable costs and difficulty translating existing wildland fire science into policy, the National Academies of Sciences, Engineering, and Medicine organized a 1-day workshop to focus on how a century of wildland fire research can contribute to improving wildland fire management. This publication summarizes the presentations and discussions from the workshop"--Publisher's description.

"In October 2016, the National Academies of Sciences, Engineering, and Medicine's Roundtable on Population Health Improvement hosted a workshop to explore sustainable financing structures that reflect a recognition of the health and non-health factors that shape the well-being of U.S. communities. The goals of the workshop were to learn from the long-term, sustainable financing strategies used in other sectors, to explore how those approaches could be applied to population health, and to consider structures that work across sectors. This publication summarizes the presentations and discussions from the workshop"--

"Advances in cancer research have led to an improved understanding of the molecular mechanisms underpinning the development of cancer and how the immune system responds to cancer. This influx of research has led to an increasing number and variety of therapies in the drug development pipeline, including targeted therapies and associated biomarker tests that can select which patients are most likely to respond, and immunotherapies that harness the body's immune system to destroy cancer cells. Compared with standard chemotherapies, these new cancer therapies may demonstrate evidence of benefit and clearer distinctions between efficacy and toxicity at an earlier stage of development. However, there is a concern that the traditional processes for cancer drug development, evaluation, and regulatory approval could impede or delay the use of these promising cancer treatments in clinical practice. This has led to a number of efforts--by patient advocates, the pharmaceutical industry, and the Food and Drug Administration (FDA)--to accelerate the review of promising new cancer therapies, especially for cancers that currently lack effective treatments. However, generating the necessary data to confirm safety and efficacy during expedited drug development programs can present a unique set of challenges and opportunities. To explore this new landscape in cancer drug development, the National Academies of Sciences, Engineering, and Medicine developed a workshop held in December 2016. This workshop convened cancer researchers, patient advocates, and representatives from industry, academia, and government to discuss challenges with traditional approaches to drug development, opportunities to improve the efficiency of drug development, and strategies to enhance the information available about a cancer therapy throughout its life cycle in order to improve its use in clinical practice. This publication summarizes the presentations and discussions from the workshop"--

"Millions of people--infants, children, adults, and their families--are currently coping with serious illness in the United States. Efforts are intensifying to improve overall care quality through the delivery of person-centered and family-oriented services, for patients of all ages and across disease stages, care settings, and specialties. While aging Baby Boomers are increasing the proportion of patients in the Medicare population over time, the sickest and most vulnerable patients needing health system support and other services to meet their complex needs can be found across the age spectrum and in a broad range of care settings, from perinatal care to geriatric care. Recognizing the need to thoughtfully consider and address the challenges and opportunities in efforts to improve care quality and value, the Roundtable on Quality Care for People with Serious Illness of the National Academies of Sciences, Engineering, and Medicine held the public workshop Integrating the Patient and Caregiver Voice into Serious Illness Care, on December 15, 2016, in Washington, DC. This workshop was the first in a series planned by the roundtable, and was designed specifically to bring together diverse personal perspectives and experiences about priorities and values that are important to patients and families coping with serious illness, and to consider solutions that support integration of these priorities and values in practice. This publication summarizes the presentations and discussions from the workshop"--

"This proceedings summarizes the presentations and discussions at the 1-day public workshop on Principles and Practices for Federal Program Evaluation, which was in held Washington, DC. in October 2016"--Page 1.