Introduction to JavaScript Object Notation

Examines the staged introduction of pay for performance into Medicare. Offers options for implementing payment incentives to provide better value for America's health care investments. Features

Presents an introduction to the complex subject of biotechnology for general readers.

It is hoped that the present report will provide a readable introduction to emerging techniques of biomedical imaging for mathematical scientists and physics and encourage some of them to apply their

"Armor plays a significant role in the protection of warriors. During the course of history, the introduction of new materials and improvements in the materials already used to construct armor has led

"The human-mediated introduction of species to regions of the world they could never reach by natural means has had great impacts on the environment, the economy, and society. In the ocean, these inva

"The United States spends approximately $4 million each year searching for near-Earth objects (NEOs). The objective is to detect those that may collide with Earth. The majority of this funding support

The development of minimally invasive approaches to screen for multiple tumor types at one time could potentially improve health outcomes; however, the clinical utility of multicancer detection (MCD) testing has yet to be established. The National Academies National Cancer Policy Forum held a workshop in October 2024 to explore the current scientific understanding and clinical use of MCD testing, as well as implications for cancer care and outcomes for all patients.

The Scholarship of Teaching and Learning (SOTL) is a systematic and evidence-based approach to examining teaching and improving learning that is openly shared. In the summer and fall of 2024, the National Academies Global Forum on Innovation in Health Professional Education held a public workshop series exploring current and future applications of SOTL to health professional education and elevating its critical value for advancing health professional workforce development across the education to practice continuum. This Proceedings of a Workshop highlights the presentations and discussions that occurred at the workshop.

Active shooter drills have become a standard practice in nearly all U.S. schools, yet their potential impact on students and educators has received limited attention. School Active Shooter Drills: Mitigating Risks to Mental, Emotional, and Behavioral Health explores how these drills are conducted and how to reduce potential harm while supporting school safety. Developed by a committee of experts in education, school safety, public health, pediatrics, child and adolescent development, psychiatry, psychology, neuroscience, public policy, and criminology, this report provides an in-depth review of current practices and offers guidance. The report provides suggestions for implementing practices that promote prevention and preparedness while supporting well-being, and foster learning environments where students and staff feel safe, capable, and supported. School Active Shooter Drills finds that while drills aim to enhance preparedness, they often vary dramatically in intensity and design, f

Chronic wasting disease (CWD) is a fatal, infectious prion disease affecting the central nervous system of some species of Cervidae-animals such as deer, elk, and moose. Recognized as a disease in the 1980s but suspected to have been present in the United States for decades longer, CWD affects both captive and free-ranging cervids and has been reported in 35 states and five Canadian provinces of North America as of August 1, 2024. The potential ramifications of the increasing spread of CWD are serious, and include negative impacts on ecosystems, and large economic costs for agencies with management responsibilities related to cervids and for industries that depend on cervids or cervid products. Cultural and food security impacts for communities with traditions tied to cervid hunting are also impacted. In 2020, Congress passed America's Conservation Enhancement (ACE) Act (P.L. 116-188), directing the U.S. Fish and Wildlife Service to lead a task force for addressing CWD in the United St

As the largest U.S. employer, the Department of Defense (DoD) is a major provider of training and development. Given the complex and increasingly unpredictable operational landscape within which the military operates across land, sea, air, cyberspace, and space, continuous learning is vital in the military. Military learners must acquire diverse skills, from communication to using advanced technology, and retain those skills for use when necessary. Success in learning - and the ability to retain and transfer what is learned to military missions - is directly linked with military innovation, operational success, and the success of our nation. Adult Learning in the Military Context examines motivations shaping learning, contextual and equity factors, emerging learning technologies, effective approaches to assessment, and provides a research agenda. This report highlights that adult learners are most motivated when learning aligns with personal goals but notes that military structures may

Despite decades of ongoing efforts to improve racial and ethnic diversity in clinical trials, many gaps remain in achieving demographic representation in clinical studies. In May 2024, the National Academies Forum on Drug Discovery, Development, and Translation, in collaboration with the National Cancer Policy Forum, hosted a public workshop to explore system-level changes and initiatives across organizations and sectors to improve representation, data collection, and reporting in clinical trials and progress tracking in the United States.

Infant formula is a primary or supplementary source of nutrition for many infants in the U.S. Consequently, disruptions to the supply of infant formula can have a severe impact on infants' health and well-being. In late 2021 and early 2022, a recall of specific infant formula products, followed by a pause in production, resulted in a widespread, national shortage. The incident demonstrated that additional risk management planning is needed to protect infants from the consequences of potential future supply chain disruptions. In 2023, the U.S. Food and Drug Administration contracted with the National Academies to convene an expert committee to examine and report on challenges in supply, market competition, and regulation of infant formula. The resulting consensus study report explains policy and marketplace vulnerabilities that were exposed during the shortage, describes the extent to which actions taken by relevant stakeholders addressed these vulnerabilities, identifies remaining gaps

2023 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.

Racial 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.

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

Advances in biomedical science, data science, engineering, and technology are leading to high-pace innovation with potential to transform health and medicine. These innovations simultaneously raise important ethical and social issues, including how to fairly distribute their benefits and risks. The National Academies of Sciences, Engineering, and Medicine, in collaboration with the National Academy of Medicine, established the Committee on Creating a Framework for Emerging Science, Technology, and Innovation in Health and Medicine to provide leadership and engage broad communities in developing a framework for aligning the development and use of transformative technologies with ethical and equitable principles. The committees resulting report describes a governance framework for decisions throughout the innovation life cycle to advance equitable innovation and support an ecosystem that is more responsive to the needs of a broader range of individuals and is better able to recognize and

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

While there is a limited data on safety-sensitive professionals, substance use disorders potentially affect pilots and flight attendants at the same rate as the general population - around 15 percent - but due to the high-risk nature of their jobs, aircraft operators are held to a higher standard for substance misuse on the job. To protect the safety of the public and the aviation workforce, the Human Intervention Motivation Study (HIMS) and the Flight Attendant Drug and Alcohol Program (FADAP) were launched to help treat critical aviation workers - pilots and flight attendants, respectively - who misuse substances. In response to a congressional mandate, this new report reviews available evidence on the effectiveness of HIMS and FADAP and offers recommendations for improving these programs.

The world confronts an existential challenge in responding to climate change, resulting in an urgent need to reduce greenhouse gas emissions from all sectors of the economy. What will it take for new and advanced nuclear reactors to play a role in decarbonization? Nuclear power provides a significant portion of the worlds low-carbon electricity, and advanced nuclear technologies have the potential to be smaller, safer, less expensive to build, and better integrated with the modern grid. However, if the United States wants advanced nuclear reactors to play a role in its plans for decarbonization, there are many key challenges that must be overcome at the technical, economic, and regulatory levels. Laying the Foundation for New and Advanced Nuclear Reactors in the United States discusses how the United States could support the successful commercialization of advanced nuclear reactors with a set of near-term policies and practices. The recommendations of this report address the need to cl

COVID-19 has proven among the worst public health crises in a generation. Public health emergencies (PHE) have always been anticipated. Despite the growing field of PHE preparedness and planning since the turn of the twenty-first century and the preparedness plans and exercises developed, the U.S. experienced a suboptimal national response to the emergence of COVID-19 in early 2020 compared to other countries. To explore the U.S. PHE preparedness enterprise, the National Academies Forum on Medical and Public Health Preparedness for Disasters and Emergencies convened a workshop in May 2022. They invited participants from government, NGO, and private sector organizations to consider key components, success stories, and failure points in order to identify opportunities for more effective catastrophic disaster, pandemic, and other large scale PHEs planning at the federal, state, local, tribal, and territorial levels. This Proceedings of a Workshop summarizes the discussions held during the

Over the past century, the Everglades has been dramatically altered by drainage and water management infrastructure intended to improve flood management, urban water supply, and agricultural production. Less than half of the original Everglades remain, and these remnants compete for water with urban and agricultural interests, all the while being impaired by contaminated runoff. The Comprehensive Everglades Restoration Plan (CERP) was established in 2000 as a joint effort by the state and federal government to reverse the decline of the ecosystem. The multibillion project aims to restore the ecosystem over the course of 30 to 40 years by reestablishing the natural hydrological characteristics of the Everglades where feasible and ultimately creating a water system that serves both the natural and human needs of South Florida. Since 2004, a National Academies committee has provided a series of independent, peer-reviewed assessments of CERP progress. Implementation of CERP projects has oc

Historically Black Colleges and Universities (HBCUs) and other minority institutions (MIs) represent a valuable resource to expand the Department of Defense's (DoD) government and extramural workforce and science and technology enterprise. The more than 400 public and private HBCUs, Tribal Colleges and Universities, Hispanic-Serving Institutions, and other two- and four-year MIs are positioned to make strong and uniquely important contributions to the defense research enterprise, offering DoD an opportunity to widen its talent pool and diversify STEM research and ultimately strengthen its ability to support national security. Defense Research Capacity at Historically Black Colleges and Universities and Other Minority Institutions examines the status of DoD research at HBCUs and MIs, including the methods and means necessary to advance research capacity at these institutions in order to comprehensively address the national security and defense needs of the United States. This report off

To examine the potential role of companion animals as sentinels of relevant, shared environmental exposures that may affect human aging and cancer, the National Cancer Policy Forum held a workshop in collaboration with the Forum on Aging, Disability, and Independence and the Standing Committee on the Use of Emerging Science for Environmental Health Decisions to explore this promising and underutilized pathway for research. Presentations and panel discussions covered the current state of the science and pathways for accelerating research, along with opportunities and challenges for using this novel translational approach to exposure science to advance human health. This Proceedings of a Workshop outlines the presentations and discussions that occurred during the workshop.

The Forum on Regenerative Medicine of the National Academies of Sciences, Engineering, and Medicine convened a two-day virtual public workshop to address knowledge gaps in the understanding of promising approaches to manipulate the immune system and/or the regenerative medicine product to improve outcomes of tissue repair and regeneration in patients. The workshop, titled Understanding the Role of the Immune System in Improving Tissue Regeneration, explored the role of the immune system in the success or failure of regenerative medicine therapies. Participants considered potential strategies to effectively prepare patients' immune systems to accept regenerative therapies and increase the likelihood of successful clinical outcomes and also discussed risks associated with modulating the immune system. This Proceedings of a Workshop highlights the presentations and discussions that occurred during the workshop.

Valued for its ecological richness and economic value, the U.S. Gulf of Mexico is under substantial pressure from human activities. The Deepwater Horizon platform explosion and oil spill significantly damaged Gulf ecosystems and led to the largest ecological restoration investment in history. The unprecedented number and diversity of restoration activities provide valuable information for future restoration efforts, but assessment efforts are hampered by many factors, including the need to evaluate the interaction of multiple stressors and consider long-term environmental trends such as sea level rise, increasing hurricane intensity, and rising water temperatures. This report offers a comprehensive approach to assess restoration activities beyond the project scale in the face of a changing environment. A main component of this approach is using different types of scientific evidence to develop multiple lines of evidence to evaluate restoration efforts at regional scales and beyond, esp

Overwhelming evidence exists that exposure to outdoor fine particulate matter (PM2.5) is associated with a range of short-term and chronic health impacts, including asthma exacerbation, acute and chronic bronchitis, heart attacks, increased susceptibility to respiratory infections, and premature death, with the burden of these health effects falling more heavily on underserved and marginalized communities. Although less studied to date, indoor exposure to PM2.5 is also gaining attention as a potential source of adverse health effects, particularly given that Americans spend 90 percent of their lives indoors and indoor PM2.5 levels can exceed outdoor levels. To better understand the sources of indoor PM2.5, the possible health effects of exposure to indoor PM2.5, and engineering approaches and interventions to reduce those exposure risks, the National Academies of Sciences, Engineering, and Medicine convened a virtual workshop, Indoor Exposure to Fine Particulate Matter and Practical Mi

The early to mid-1990s saw a large surge in U.S. cigar consumption, including premium cigars. Based on recent import data, premium cigar use may be increasing, though they currently make up a small percent of the total U.S. cigar market. Premium cigars have also been the subject of legal and regulatory efforts for the past decade. In 1998, the National Cancer Institute undertook a comprehensive review of available knowledge about cigars - the only one to date. The resulting research recommendations have largely not been addressed, and many of the identified information gaps persist. Furthermore, there is no single, consistent definition of premium cigars, making research challenging. In response, the Food and Drug Administration (FDA) and the National Institutes of Health commissioned the National Academies of Sciences, Engineering, and Medicine to convene a committee of experts to address this issue. The resulting report, Premium Cigars: Patterns of Use, Marketing, and Health Effects,

Over the past century, the work of chemical engineers has helped transform societies and the lives of individuals, from the synthetic fertilizers that helped feed the world to the development of novel materials used in fuels, electronics, medical devices, and other products. Chemical engineers' ability to apply systems-level thinking from molecular to manufacturing scales uniquely positions them to address today's most pressing problems, including climate change and the overuse of resources by a growing population. New Directions in Chemical Engineering details a vision to guide chemical engineering research, innovation, and education over the next few decades. This report calls for new investments in U.S. chemical engineering and the interdisciplinary, cross-sector collaborations necessary to advance the societal goals of transitioning to a low-carbon energy system, ensuring our production and use of food and water is sustainable, developing medical advances and engineering solutions

The National Science Foundation (NSF) has played a key role over the past several decades in advancing understanding of Earth's systems by funding research on atmospheric, ocean, hydrologic, geologic, polar, ecosystem, social, and engineering-related processes. Today, however, those systems are being driven like never before by human technologies and activities. Our understanding has struggled to keep pace with the rapidity and magnitude of human-driven changes, their impacts on human and ecosystem sustainability and resilience, and the effectiveness of different pathways to address those challenges. Given the urgency of understanding human-driven changes, NSF will need to sustain and expand its efforts to achieve greater impact. The time is ripe to create a next-generation Earth systems science initiative that emphasizes research on complex interconnections and feedbacks between natural and social processes. This will require NSF to place an increased emphasis on research inspired by

The U.S. Department of State, through its Bureau of International Narcotics and Law Enforcement Affairs (INL), provides foreign assistance and supports capacity building for criminal justice systems and police organizations in approximately 90 countries around the world. It has a mandate to strengthen fragile states, support democratic transitions, and stabilize conflict-affected societies by helping partner countries develop effective and accountable criminal justice sector institutions and systems. While the science of policing outcomes has grown in recent years, it is limited in context, with much of the research conducted on policing taking place in the Global North countries (e.g., the United Kingdom and United States). It is also limited in purpose, with much research focused on examining crime reduction as opposed to examining the harms to the public as the result of crimes, violence, and any effects of policing activities. At the request of INL, Policing to Promote the Rule of

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 collect

In September 2016, the National Academies of Sciences, Engineering, and Medicine convened a workshop to examine trends and patterns in aging and factors related to healthy aging in the United States,

"Implementation research is designed to 'generate insights and knowledge about implementation processes, barriers, facilitators, and strategies', explained Brian Mittman, a research scientist at Kaise

"Floods take a heavy toll on society, costing lives, damaging buildings and property, disrupting livelihoods, and sometimes necessitating federal disaster relief, which has risen to record levels in r

THE NATIONAL ACADEMIES™Advisers to the Nation on Science, Engineering, and MedicineThe nation turns to the National Academies---National Academy of Sciences. National Academy of Engineering,

"In the past decade, a number of state, local, and tribal jurisdictions have begun to take significant steps to overhaul their juvenile justice systems - for example, reducing the use of juvenile dete

Deals with a workshop that intends to build awareness and demand from patients and families for better care at lower costs and to create a health care system that continuously learns and improves. Thi

The U.S. veterinary medical profession contributes to society in diverse ways, from developing drugs and protecting the food supply to treating companion animals and investigating animal diseases in t

Presents the summary of a workshop convened by the IOM Forum on Neuroscience and Nervous System Disorders to examine opportunities to accelerate early phases of drug development for nervous system dru