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Developing a Multidisciplinary and Multispecialty Workforce for Patients with Cancer, from Diagnosis to Survivorship: Proceedings Of A Workshop
by National Academies of Sciences, Engineering, and Medicine Health and Medicine Division Board on Global Health Global Forum on Innovation in Health Professional Education Board on Health Care Services National Cancer Policy ForumPatients living with and beyond cancer often require care from a wide range of clinicians as they navigate cancer diagnosis, treatment, and survivorship care. To examine opportunities to improve equitable access to high-quality multispecialty and multidisciplinary expert care for people living with and beyond cancer, the National Academies National Cancer Policy Forum hosted a public workshop in collaboration with the Global Forum on Innovation in Health Professional Education.
Adult Attention-Deficit/Hyperactivity Disorder: Diagnosis, Treatment, And Implications For Drug Development: Proceedings Of A Workshop
by National Academies of Sciences, Engineering, and Medicine Health and Medicine Division Board on Health Sciences Policy Forum on Neuroscience and Nervous System Disorders Forum on Drug Discovery, Development, and TranslationAttention deficit/hyperactivity disorder (ADHD) diagnosis and treatment among adults has increased over the past decade in the U.S. and globally. Evidence suggests adults with ADHD may be more likely to develop a substance use disorder, and there are concerns that nonmedical use of prescription stimulants could lead to misuse, overdose, or toxicity. In December 2023, The National Academies Forum on Drug Discovery, Development, and Translation and Forum on Neuroscience and Nervous System Disorders held a public workshop to examine the diagnosis and treatment of adults with ADHD and explore the challenges and opportunities for the development of new therapeutics. The workshop was supported, in part, through a grant (PAR-23-072) from the Center for Drug Evaluation and Research at the FDA.
The Food Forum 30th Anniversary: Proceedings Of A Symposium
by National Academies of Sciences, Engineering, and Medicine Health and Medicine Division Food and Nutrition Board Food ForumThe National Academies’ Food Forum celebrated its 30th anniversary in November 2023 with a symposium reflecting on its contributions and developments in the field of nutrition, food, and agriculture. Discussions covered the history of the Food Forum and how it has informed research, policy, and industry practices in light of challenges to food safety and security, climate change, and health equity.
Mitigating Arboviral Threat and Strengthening Public Health Preparedness: Proceedings of a Workshop
by National Academies of Sciences, Engineering, and Medicine Health and Medicine Division Board on Global Health Forum on Microbial ThreatsArboviruses, or viruses carried by arthropods like mosquitoes or ticks, are responsible for hundreds of thousands of deaths worldwide each year. As the climate changes globally, the geographic distribution of these diseases, including Zika, dengue, chikungunya, West Nile, and yellow fever, are steadily expanding. The National Academies Forum on Microbial Threats hosted a public workshop in December 2023 to explore avenues of threat reduction from known and emerging arboviral diseases in the context of public health preparedness and capacity building. The workshop featured talks from experts in entomology, public health, ecology, virology, immunology, disease modeling, and urban planning.
Sex and Gender Identification and Implications for Disability Evaluation
by National Academies of Sciences, Engineering, and Medicine Health and Medicine Division Board on Health Care Services Committee on Sex and Gender Identification and Implications for Disability EvaluationTransgender and gender diverse (TGD) people and people with variations in sex traits (VSTs) can experience serious health challenges and often have a greater burden of disability or greater morbidity from chronic disease compared with the general population. “Transgender and gender diverse” refers to people whose gender identity differs from what is typically associated with their sex recorded at birth. “Variations in sex traits” refers to genetic, anatomical, and hormonal variations that affect the genitourinary tract and reproduction systems; individuals with VSTs may have a sex and/or gender identity that differs from their sex recorded at birth. The U.S. Social Security Administration (SSA) asked the National Academies to convene a committee of experts to evaluate how contemporary conceptions of sex and gender in medicine and current clinical guidelines impact disability determinations. The resulting report offers conclusions in key areas including (1) the collection of data on sex and gender identity, (2) disability considerations for SSA’ Listings of Impairments (medical criteria that apply to the evaluation of disability) with sex-specific diagnostic criteria, (3) inclusive language in disability Listings of Impairments, and (4) guidance for adjudicators on assessing disability for TGD applicants and applicants with VSTs.
Assessing and Advancing Progress in the Delivery of High-Quality Cancer Care: Proceedings of a Workshop
by National Academies of Sciences, Engineering, and Medicine Health and Medicine Division Board on Health Care Services National Cancer Policy Forum2023 marked the 10-year anniversary of the National Academies Institute of Medicine consensus report, "Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis." The National Cancer Policy Forum and the American Society of Clinical Oncology co-hosted a public workshop in October 2023 to provide an opportunity for the cancer community to gauge progress on the implementation of the report recommendations and to discuss persistent challenges in achieving excellent and equitable cancer care. Workshop speakers considered actions that could be taken to improve progress, as well as aspects of cancer care that have changed over the past decade and thus might require new strategies to advance the delivery of high-quality cancer care.
Report of the Treasurer: For the Year Ended December 31, 2023
by National Academy of SciencesThis Report of the Treasurer of the National Academy of Sciences presents the financial position and results of operations as well as a review of the endowment and other long-term investments portfolio activities of our Academy for the year ended December 31, 2023.
International Talent Programs in the Changing Global Environment
by National Academies of Sciences, Engineering, and Medicine Policy and Global Affairs U.S. Science and Innovation Policy Theme Committee on International Talent Programs in the Changing Global EnvironmentThe U.S. science, technology, engineering, and mathematics (STEM) workforce plays a vital role in fostering and sustaining innovation, economic competitiveness, and national security. This workforce currently depends, and for the foreseeable future will depend, on both international and domestic talent. Foreign STEM talent contributes to domestic innovation, economic growth, and U.S. leadership in science and technology and also expands perspectives and networks essential to future scientific collaborations and discoveries. At the request of the U.S. Department of Defense, this report reviews foreign and domestic talent or incentive programs and their corresponding scientific, economic, and national security benefits. International Talent Programs in the Changing Global Environment makes recommendations to improve the effectiveness of U.S. mechanisms for attracting and retaining international students and scholars relative to the programs and incentives other nations use to support national research capabilities, especially in national security and defense-related fields.
A New Era in Space: Ensuring the Future of Biological and Physical Sciences Research: A Decadal Survey for 2023-2032
by National Academies of Sciences, Engineering, and Medicine Division on Engineering and Physical Sciences Aeronautics and Space Engineering Board Space Studies Board Committee on Biological and Physical Sciences Research in Space 2023-2032Research in biological and physical sciences in space provides the critical scientific and technological foundations that make space exploration possible. This booklet summarizes recent advances in the biological and physical sciences that have changed our understanding of the factors important to human, plant, animal, and microbial health, and then highlights research needs to make transformative advances in space.
Reforming the Coast Guard’s Certificate of Compliance Program for Liquefied Gas Carriers: Promoting Efficient Implementation and Safety Effectiveness
by National Academies of Sciences, Engineering, and Medicine Transportation Research Board Consensus and Advisory Studies Committee on Improving the Efficiency and Effectiveness of the Coast Guard Certificate of Compliance Examination Program for Gas CarriersAs liquefied gas exports from U.S. ports have grown rapidly in recent years, reforms are needed to a U.S. Coast Guard program that examines liquefied gas carriers (LGCs). Going forward, this growth in LGC exports and arrivals is likely to increase the demand for gas carrier exams by Coast Guard marine inspectors, of which there is a chronic shortage. TRB Special Report 350: Reforming the Coast Guard’s Certificate of Compliance Program for Liquefied Gas Carriers: Promoting Efficient Implementation and Safety Effectiveness from the Transportation Research Board of the National Academies of Sciences, Engineering, and Medicine, was requested by Congress out of concern for the Coast Guard’s ability to examine the increasing number of foreign tank ships that load liquefied gas for transport overseas. The National Academies’ committee concluded that the time is right for Congress to revisit the Certificate of Compliance program’s requirements mandating the frequency of exams and to allow the Coast Guard greater flexibility to decide when and how to examine individual LGCs using indicators of risk.
Tackling the Road Safety Crisis: Saving Lives Through Research and Action
by National Academies of Sciences, Engineering, and Medicine Transportation Research Board Consensus and Advisory Studies Division Committee on Transitioning Evidence-Based Road Safety Research into PracticeThe United States faces a road safety crisis: the fatal crash rate per mile traveled has been climbing for the past decade, and crashes involving vulnerable road users pedestrians, bicyclists, and others who share the roads with motor vehicles have grown the fastest. Furthermore, motor vehicle death rates in the United States are three to four times higher than other high-income nations in Europe and Asia. TRB Special Report 354: Tackling the Road Safety Crisis: Saving Lives Through Research and Action, from the Transportation Research Board of the National Academies of Sciences, Engineering, and Medicine, addresses this crisis, responding to a request from the Federal Highway Administration, the American Association of State Highway and Transportation Officials, and the Insurance Institute for Highway Safety. The study makes a series of recommendations to the U.S. Department of Transportation, including establishing a coordinated, data-driven national road safety research strategy across all federally funded safety programs and improving the efficiency of moving crash intervention research results into practice. The study also calls for systematic research to confirm the validity of safety guidance for practitioners and eliminate outdated and unproven guidance. To accomplish these recommendations and raise the profile of U.S. road safety efforts, the study calls for the establishment of a National Road Safety Research Center.
Emerging Hazards in Commercial Aviation—Report 2: Ensuring Safety During Transformative Changes
by National Academies of Sciences, Engineering, and Medicine Transportation Research Board Committee on Emerging Trends in Aviation SafetyAs commercial aviation evolves, it is essential to ensure aviation safety as transformative technologies and new industry entrants emerge. Supporting the safe adoption of innovation will require updating Federal Aviation Administration (FAA) processes for certifying novel aircraft designs, developing performance-based standards for flight-critical functions, and improving data collection and analysis to detect potential safety issues. Strengthening safety culture at FAA and across the aviation industry is also necessary as new players and technologies are introduced. TRB Special Report 351: Emerging Hazards in Commercial Aviation—Report 2: Ensuring Safety During Transformative Changes, from the Transportation Research Board of the National Academies of Sciences, Engineering, and Medicine, was requested by Congress and FAA in order to help identify, monitor, understand, and address emerging aviation safety risks. This report marks the second installment of a series of six reports to be issued within a span of 10 years by the National Academies' Committee on Emerging Trends in Aviation Safety.
Intermodal Chassis Provisioning and Supply Chain Efficiency: Equipment Availability, Choice, and Quality
by National Academies of Sciences, Engineering, and Medicine Transportation Research Board Consensus and Advisory Studies Division Committee on the Best Practices for the Efficient Supply of Chassis for Transporting Intermodal ContainersContainer shipping was brought to a near standstill following the onset of the COVID-19 pandemic in 2020, but the demand for containerized cargo surged later that year and during 2021 and 2022 as the economy rebounded. Additional logistics capacity could not be brought online fast enough to meet the increased demand, and chassis were among the many transportation assets in short supply and out of position. TRB Special Report 352: Intermodal Chassis Provisioning and Supply Chain Efficiency: Equipment Availability, Choice, and Quality, released this week from TRB and the National Academies of Sciences, Engineering, and Medicine, provides recommendations in response to a request from the U.S. Congress for the National Academies to study “best practices for on-terminal or near-terminal chassis pools that provide service to marine terminal operators, motor carriers, railroads, and other stakeholders that use the chassis pools, with the goal of optimizing supply chain efficiency and effectiveness” for the Federal Maritime Commission.
Long Freight Trains: Ensuring Safe Operations, Mitigating Adverse Impacts
by National Academies of Sciences, Engineering, and Medicine Transportation Research Board Consensus and Advisory Studies Division Committee on the Impact of Trains Longer Than 7,500 FeetLonger trains have more cars, possibly a greater variety of car types and sizes, and more requirements for power distributed across the train in comparison with shorter manifest trains. Because of this and other factors, the Federal Railroad Administration (FRA) should revise the Risk Reduction Program (RRP) rule to require railroads to address all major operational changes in their RRPs in an explicit and comprehensive manner. TRB Special Report 353: Long Freight Trains: Ensuring Safe Operation, Mitigating Adverse Impacts, from the Transportation Research Board of the National Academies of Sciences, Engineering, and Medicine, examines in response to a request from the U.S. Congress the safety challenges arising from the operation of longer freight trains, and particularly from the increased use of longer manifest trains that transport a mix of freight in many different types of railcars. The report makes several other recommendations to FRA and also examines issues such as the impact of increasing freight train length on the frequency and duration of blocked highway-rail grade crossings and the scheduling and efficient operations of Amtrak intercity passenger trains.
Research on the Dynamics of Climate and the Macroeconomy: Proceedings Of A Workshop
by National Academies of Sciences, Engineering, and Medicine Division of Behavioral and Social Sciences and Education Board on Environmental Change and Society Policy and Global Affairs Division Board on Science, Technology, and Economic Policy Division on Life and Earth Studies Board on Atmospheric Sciences and Climate Roundtable of Macroeconomics and Climate-Related Risks and OpportunitiesUnderstanding the intricate relationship between climate dynamics and the macroeconomy is crucial for informed policy and long-term planning. However, there is a gap between climate modeling and the understanding of its full macroeconomic effects, partly due to challenges such as nonlinear climate dynamics, feedback loops, and model complexity. To address this, the National Academies of Sciences, Engineering, and Medicine, under the auspices of the Roundtable on Macroeconomics and Climate-Related Risks and Opportunities, convened a workshop on November 1-2, 2023, to consider the state of knowledge on cascading, compounding, and nonlinear physical climate risks and their implications for the macroeconomy. Through panels of invited speakers and interactive breakout discussions, the workshop focused on physical climate risks and explored how different disciplines assess and model impacts. Workshop discussions explored current and historical examples of shocks to the macroeconomy and how those have been modeled, and experts shared some of the lessons they have learned that may be relevant to policy makers today.
Developing and Assessing Ideas for Social and Behavioral Research to Speed Efficient and Equitable Industrial Decarbonization: Proceedings Of A Workshop
by National Academies of Sciences, Engineering, and Medicine Division on Engineering and Physical Sciences Board on Energy and Environmental Systems Division of Behavioral and Social Sciences and Education Board on Environmental Change and SocietyInterest in decarbonizing various sectors of the U.S. economy has produced a rich body of scholarly research, policy studies, and practitioner reports on technology pathways and scenarios, with a particular focus on the power sector, vehicles, and buildings. The research on nontechnological issues associated with decarbonization is much sparser in general, and this is particularly true for the difficult-to-decarbonize industrial sector. In February 2024, the National Academies of Sciences, Engineering, and Medicine hosted a public workshop designed to inform the development of ideas for a national interdisciplinary social sciences research agenda relating to an efficient and equitable clean energy transition in the U.S. industrial sector. The workshop planning committee solicited and commissioned several papers aimed at outlining key societal challenges and needs that require social science insights and tools to build a social compact for industrial decarbonization. At the workshop, an interdisciplinary group of social scientists, engineers, community groups, and experts from industry and government explored the social science research needs on these issues. This proceedings of the workshop describes the presentations and discussions.
Ending Unequal Treatment: Strategies To Achieve Equitable Health Care And Optimal Health For All
by National Academies of Sciences, Engineering, and Medicine Health and Medicine Division Board on Population Health and Public Health Practice Board on Health Care Services Committee on Unequal Treatment Revisited: The Current State of Racial and Ethnic Disparities in Health CareRacial and ethnic inequities in health and health care impact individual well-being, contribute to millions of premature deaths, and cost the United States hundreds of billions of dollars annually. Addressing these inequities is vital to improving the health of the nation’s most disadvantaged communities—and will also help to achieve optimal health for all. In 2003, the Institute of Medicine examined these inequities in Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Because disparities persist, the National Academies convened an expert committee with support from the Agency for Healthcare Research and Quality and the National Institutes of Health. The committee’s report reviews the major drivers of health care disparities, provides insight into successful and unsuccessful interventions, identifies gaps in the evidence base, and makes recommendations to advance health equity.
The Current Status and Future Direction of High-Magnetic-Field Science and Technology in the United States
by National Academies of Sciences, Engineering, and Medicine Division on Earth and Life Studies Division on Engineering and Physical Sciences Nuclear and Radiation Studies Board Board on Physics and Astronomy National Materials and Manufacturing Board Committee on the Current Status and Future Direction of High-Magnetic-Field Science in the United States, Phase IIHigh magnetic fields are a vital tool in many areas of science and technology that impact our everyday lives. Magnetic resonance imaging enables a wide range of medical diagnostics and research, while nuclear magnetic resonance is critical for drug discovery research and more. High magnetic fields are an essential component to many proposed fusion energy reactors and are necessary to push the boundaries towards the development of new quantum technologies and semiconductors. At the request of the National Science Foundation, the National Academies organized a study to identify scientific opportunities and key applications for high-magnetic-field science and technology for the next decade and beyond. This report explores the current state and future prospects for high-magnetic-field technologies and recommends actions to support the workforce, facilities, magnet development, and critical materials access necessary to promote U.S. innovation.
Launching Lifelong Health by Improving Health Care for Children, Youth, and Families
by National Academies of Sciences, Engineering, and Medicine Health and Medicine Division Board on Health Care Services Division of Behavioral and Social Sciences and Education Board on Children, Youth, and Families Committee on Improving the Health and Wellbeing of Children and Youth through Health Care System TransformationEnsuring every child is on an optimal trajectory to a healthy and productive adulthood is imperative for the nation’s future. Investments in children and families improves child health, but also health equity, education outcomes, workforce productivity, and cost-effectiveness in public spending. Despite advances in health care, children, especially those from historically marginalized groups, face rising rates of chronic diseases, obesity, and mental health challenges. Launching Lifelong Health by Improving Health Care for Children, Youth, And Families presents a vision for transforming the child and adolescent health care system. This report also examines how the health care system can be better positioned to equitably address the needs of all children and families and leverage community supports. This requires transforming key components, such as health care financing, public health investment, community partnerships, and accountability strategies, to encourage team-based care delivery models and attention to and health promotion, prevention, and root causes of health disparities.
A Plan to Promote Defense Research at Minority-Serving Institutions
by National Academies of Sciences, Engineering, and Medicine Policy and Global Affairs Board on Higher Education and Workforce Committee on the Development of a Plan to Promote Defense Research at Historically Black Colleges and Universities, Tribal Colleges and Universities, Hispanic-Serving Institutions, and Other Minority-Serving Institutions André N. Porter Erin Lynch Andrea ChristelleEngaging the full breadth of talent in the United States is an important component of growing and sustaining dominance in research and development (R&D) and supporting national security into the future. By 2030, one-fifth of Americans will be above age 65 and at or nearing retirement from the workforce. Estimates of race and ethnic demographic changes between 2016 and 2030 show a decrease in the non-Hispanic white population and an increase in terms of both number and share of all other demographic groups, and this trend will continue to increase. These population shifts signal a citizenry and workforce that will be increasingly diverse. For the United States to maintain its global competitiveness and protect its security interests, targeted support is needed to cultivate talent from communities throughout the nation. The nation's more than 800 Minority-Serving Institutions (MSIs) provide an impactful and cost-effective opportunity to focus on cultivating the current and future U.S. population for careers in science, technology, engineering, and mathematics (STEM), including in fields critical to the U.S. Department of Defense (DOD). At the request of DOD, this report identifies tangible frameworks for increasing the participation of MSIs in defense-related research and development and identifies the necessary mechanisms for elevating minority serving institutions to R1 status (doctoral universities with very high research activity) on the Carnegie Classifications of Institutions of Higher Education scale.
Practices for Controlling Tunnel Leaks
by National Academies of Sciences, Engineering, and Medicine Transportation Research Board National Cooperative Highway Research Program Katie Clever Thomas R. Leckrone Martha AversoWater infiltration is a common problem in tunnels. Such infiltration accelerates the deterioration of the structure and elements within and creates hazards in the form of icicles and slippery roadways. The severity of water infiltration often reflects various factors, so determining the appropriate remedy is challenging and frequently requires an extensive investigation to understand the source and location of the leak, the structural details of the tunnel, and the geology of the surrounding substrate. NCHRP Synthesis 627: Practices for Controlling Tunnel Leaks, from TRB’s National Cooperative Highway Research Program, documents the methods and practices used by state department of transportation tunnel owners to control tunnel leaks.
Practices to Identify and Mitigate PFAS Impacts on Highway Construction Projects and Maintenance Operations
by National Academies of Sciences, Engineering, and Medicine Transportation Research Board National Cooperative Highway Research Program Roy E. Sturgill Jr. Joseph A. CharbonnetPer- and polyfluoroalkyl substances (PFAS) are a class of more than 6,000 contaminants of emerging concern that can harm both ecosystems and human health. These anthropogenic compounds contain carbon fluorine bonds that make them stable and persistent in the environment, earning them the nickname “forever chemicals.” NCHRP Synthesis 630: Practices to Identify and Mitigate PFAS Impacts on Highway Construction Projects and Maintenance Operations, from TRB’s National Cooperative Highway Research Program, documents current state departments of transportation practices for identifying locations of potential PFAS contamination and mitigating the impacts of PFAS related to highway construction and maintenance operations. This study considers PFAS impact and mitigation efforts in all phases of highway project development (planning, design, right-of-way acquisition), construction, and maintenance.
Use of Marginal and Unconventional-Source Coal Ashes in Concrete
by National Academies of Sciences, Engineering, and Medicine Transportation Research Board National Cooperative Highway Research Program Prannoy Suraneni R. Douglas Hooton Lisa Burris Christopher ShearerIn recent years, supplies of high-quality, freshly produced coal ash have declined due to increasing environmental controls and shutdowns of coal-fired powerplants in the United States and elsewhere. While supply has decreased, demand for coal ash for concrete construction is the same or greater, as coal ash is a crucial component for producing sustainable and durable concrete. NCHRP Research Report 1105: Use of Marginal and Unconventional-Source Coal Ashes in Concrete, from TRB’s National Cooperative Highway Research Program, aims (1) to propose revisions to AASHTO M 295 Standard Specification for Coal Fly Ash and Raw or Calcined Natural Pozzolan for Use in Concrete to allow use of unconventional coal ashes while not compromising the desired properties of the fresh and hardened concrete, and (2) to provide guidelines for using coal ash not meeting the proposed revised specification.
Assessing Lifecycle and Human Costs of Bus Operator Workstation Design and Components
by National Academies of Sciences, Engineering, and Medicine Transportation Research Board Transit Cooperative Research Program Matthew Parkinson Yiqi Zhang Andris Freivalds Eunsik Kim Songlin WuDriving trucks and buses is a physically demanding occupation that carries one of the highest injury rates of major occupational categories in the United States. Drivers often work in postures that increase risk of low back pain and other musculoskeletal disorders, slow their response time, and put them at increased risk for acute injuries due to crashes. TCRP Research Report 247: Assessing Lifecycle and Human Costs of Bus Operator Workstation Design and Components, from TRB’s Transit Cooperative Research Program, creates an easy-to-use toolkit for predicting the long-term safety of and promoting a healthy environment in bus operator workstations. Supplemental to the report is a spreadsheet tool.
Artificial Intelligence Opportunities for State and Local DOTs: A Research Roadmap
by National Academies of Sciences, Engineering, and Medicine Transportation Research Board National Cooperative Highway Research Program Alejandra Medina Laurel Glenn Debanjan Datta Surendrabikram Thapa Tammy Trimble Matthew Camden Aditi Manke Abhijit SarkarArtificial intelligence (AI) has revolutionized various areas in departments of transportation (DOTs), such as traffic management and optimization. Through predictive analytics and real-time data processing, AI systems show promise in alleviating congestion, reducing travel times, and enhancing overall safety by alerting drivers to potential hazards. AI-driven simulations are also used for testing and improving transportation systems, saving time and resources that would otherwise be needed for physical tests. NCHRP Web-Only Document 403: Artificial Intelligence Opportunities for State and Local DOTs: A Research Roadmap, from TRB’s National Cooperative Highway Research Program, details possible steps for state and local DOTs to adopt AI in their pipelines.