Author: The National Academies Press

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In 1972 NASA launched the Earth Resources Technology Satellite (ETRS), now known as Landsat 1, and on February 11, 2013 launched Landsat 8. Currently the United States has collected 40 continuous years of satellite records of land remote sensing data from satellites similar to these. Even though this data is valuable to improving many different aspects of the country such as agriculture, homeland security, and disaster mitigation; the availability of this data for planning our nation’s future is at risk.

Thus, the Department of the Interior’s (DOI’s) U.S. Geological Survey (USGS) requested that the National Research Council’s (NRC’s) Committee on Implementation of a Sustained Land Imaging Program review the needs and opportunities necessary for the development of a national space-based operational land imaging capability. The committee was specifically tasked with several objectives including identifying stakeholders and their data needs and providing recommendations to facilitate the transition from NASA’s research-based series of satellites to a sustained USGS land imaging program.

Landsat and Beyond: Sustaining and Enhancing the Nation’s Land Imaging Program is the result of the committee’s investigation. This investigation included meetings with stakeholders such as the DOI, NASA, NOAA, and commercial data providers. The report includes the committee’s recommendations, information about different aspects of the program, and a section dedicated to future opportunities.

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Topics: Earth Sciences | Space and Aeronautics

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The turn of the millennium brought a new research landscape in which the biological sciences are prominent and where technical possibilities once impossible are now attainable. Many disciplines, ranging from engineering to chemistry to social science, have all played important roles in shaping the biology of the 21st century. Biology is also now a global endeavor, with networking technologies enabling new sources of collaboration amongst multidisciplinary teams internationally. But the new century also carried with it new challenges, such as the ever-increasing world population. In the face of climate change, increasing food and energy needs, the dispersion of existing and emerging disease and more, lays a host of unanswered questions about how human and natural systems might offer solutions. Thus, scientists and engineers have looked to a young and potentially transformative field, synthetic biology, which seeks to accelerate improvements on how humans partner with nature to meet needs.

Synthetic biology is an emerging discipline that combines both scientific and engineering approaches to the study and manipulation of biology. By asking different questions, synthetic biologists hope to improve our collective capacity to engineer customized biological systems designed to meet specific human needs and yield a deeper understanding of natural living systems. Although synthetic biology is young, the collective vision for the field is ambitious. As a better understanding of the global synthetic biology landscape could lead to tremendous benefits, six academies—the United Kingdom’s Royal Society (RS) and Royal Academy of Engineering (RAE), the United States’ National Academy of Sciences (NAS) and National Academy of Engineering (NAE), and the Chinese Academy of Science (CAS) and Chinese Academy of engineering (CAE)— organized a series of international symposia on the scientific, technical, and policy issues associated with synthetic biology.

Positioning Synthetic Biology to Meet the Challenges of the 21st Century: Summary Report of a Six Academies Symposium Series offers an overview of the major topics addressed during the symposia, which included the development and potential of synthetic biology; an explanation of synthetic biology; and the agenda for each symposium.

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Topics: Biology and Life Sciences | Engineering and Technology

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In 1991, the Environmental Protection Agency (EPA) and the Agency for Toxic Substances and Disease Registry (ATSDR) asked the National Research Council (NRC) to provide technical guidance for establishing community emergency exposure levels for extremely hazardous substances (EHSs) pursuant to the Superfund Amendments and Reauthorization Act of 1986. As a result the NRC published Guidelines for Developing Community Emergency Exposure Levels for Hazardous Substances in 1993 and Standing Operating Procedures for Developing Acute Exposure Guideline Levels for Hazardous Substances in 2001; providing updated procedures, methods, and other guidelines used by the National Advisory Committee (NAC) on Acute Exposure Guideline Levels (AEGLs) for hazardous substances for assessing acute adverse health effects. Stemming from this report the NAC has developed AEGLs for at least 270 EHSs.

There are currently three AEGLs: AEGL-1, AEGL-2, and AEGL-3. AEGL-1 is the airborne concentration of a substance above which it is predicted that the general population could experience notable discomfort, irritation, or certain asymptomatic nonsensory effects. These effects are not disabling and are transient and reversible once exposure is stopped. AEGL-2 is the airborne concentration (of a substance above which it is predicted that the general population could experience irreversible, long-lasting adverse health effects or an impaired ability to escape. AEGL-3 is the airborne concentration of a substance above which it is predicted that the general population could experience life threatening health effects or death.

On April 22-24 2013, the NRC-established Committee on Acute Exposure Guideline Levels 2013 met to review AEGL documents approved by the NAC. The committee members were selected for their expertise in toxicology, medicine, industrial hygiene, biostatistics, and risk assessment. Twenty-second Interim Report of the Committee on Acute Exposure Guideline Levels presents a review of AEGLs for various chemicals including acrylonitrile, halogen fluorides, tellurium hexafluoride, and thionyl chloride.

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Topics: Environment and Environmental Studies | Health and Medicine

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The Children’s Health Act mandated the National Children’s Study (NCS) in 2000 with one of its purposes being to authorize the National Institute of Child Health and Human Development (NICHD) to study the environmental influences (including physical, chemical, biological, and psychosocial) on children’s health and development. The NCS examines all aspects of the environment including air, water, diet, noise, family dynamics, and genetics, on the growth, development, and health of children across the United States, for a period of 21 years. The purpose of NCS is to improve the health and well-being of children and to contribute to understanding the role of these factors on health and disease.

The research plan for the NCS was developed from 2005 to 2007 in collaboration among the Interagency Coordinating Committee, the NCS Advisory Committee, the NCS Program Office, Westat, the Vanguard Center principal investigators, and federal scientists. The current design of the study, however, uses a separate pilot to assess quality of scientific output, logistics, and operations and a “Main Study” to examine exposure-outcome relationships. The NCS proposed the use of a multilayered cohort approach for the Main Study, which was one of the topics for discussion at the workshop that is the subject of this publication.

In the fall of 2012, NICHD requested that the Committee on National Statistics (CNSTAT) of the NRC and the IOM convene a joint workshop, to be led by CNSTAT. The workshop was to focus on issues related to the overall design (including the framework for implementation) of the NCS. The committee was provided a background paper which it used to select the challenges that were discussed at the workshop. Design of the National Children’s Study: A Workshop Summary presents an overview of the workshop held on January 11, 2013. The publication includes summaries of the four sessions of the workshop, a list of participants, and the agenda.

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Topics: Behavioral and Social Sciences | Health and Medicine

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Obesity poses one of the greatest public health challenges of the 21st century, creating serious health, economic, and social consequences for individuals and society. Despite acceleration in efforts to characterize, comprehend, and act on this problem, including implementation of preventive interventions, further understanding is needed on the progress and effectiveness of these interventions.

Evaluating Obesity Prevention Efforts develops a concise and actionable plan for measuring the nation’s progress in obesity prevention efforts–specifically, the success of policy and environmental strategies recommended in the 2012 IOM report Accelerating Progress in Obesity Prevention: Solving the Weight of the Nation. This book offers a framework that will provide guidance for systematic and routine planning, implementation, and evaluation of the advancement of obesity prevention efforts. This framework is for specific use with the goals and strategies from the 2012 report and can be used to assess the progress made in every community and throughout the country, with the ultimate goal of reducing the obesity epidemic. It offers potentially valuable guidance in improving the quality and effect of the actions being implemented.

The recommendations of Evaluating Obesity Prevention Efforts focus on efforts to increase the likelihood that actions taken to prevent obesity will be evaluated, that their progress in accelerating the prevention of obesity will be monitored, and that the most promising practices will be widely disseminated.

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Topics: Food and Nutrition | Health and Medicine

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The past several decades have been a time of rapid globalization in the development, manufacture, marketing, and distribution of medical products and technologies. Increasingly, research on the safety and effectiveness of new drugs is being conducted in countries with little experience in regulation of medical product development. Demand has been increasing for globally harmonized, science-based standards for the development and evaluation of the safety, quality, and efficacy of medical products. Consistency of such standards could improve the efficiency and clarity of the drug development and evaluation process and, ultimately, promote and enhance product quality and the public health.

To explore the need and prospects for greater international regulatory harmonization for drug development, the IOM Forum on Drug Discovery, Development, and Translation hosted a workshop on February 13-14, 2013. Discussions at the workshop helped identify principles, potential approaches, and strategies to advance the development or evolution of more harmonized regulatory standards. This document summarizes the workshop.

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Topics: Health and Medicine

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The Standing Committee on Defense Materials Manufacturing and Infrastructure (the DMMI standing committee) of the National Materials and Manufacturing Board of the National Research Council (NRC) held a workshop on December 5 and 6, 2012, to discuss new and novel processes in industrial modernization. The participants of the workshop provided their individual opinions but no recommendations were developed as a result of the workshop. The workshop focused on Additive manufacturing, electromagnetic field manipulation of materials, and design of materials.

Additive manufacturing is the process of making three-dimensional objects from a digital description or file. The workshop addresses different aspects of additive manufacturing including surface finish and access to manufacturing capabilities and resources. Electromagnetic field manipulation of materials is the use of electric and/or magnetic fields to change the mechanical or functional properties of a material or for the purposes of sintering. The workshop examined research prioritization in this area as well as other objectives. “Design of materials” refers to the application of computational and analytic methods to materials to obtain a desired material characteristic; the workshop features a discussion on materials genomics in this area and more. Novel Processes for Advanced Manufacture: Summary of a Workshop presents a summarization of the key points of this workshop and includes outlines of the open discussions on each area.

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Topics: Engineering and Technology

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Disasters and public health emergencies can stress health care systems to the breaking point and disrupt delivery of vital medical services. During such crises, hospitals and long-term care facilities may be without power; trained staff, ambulances, medical supplies and beds could be in short supply; and alternate care facilities may need to be used. Planning for these situations is necessary to provide the best possible health care during a crisis and, if needed, equitably allocate scarce resources.

Crisis Standards of Care: A Toolkit for Indicators and Triggers examines indicators and triggers that guide the implementation of crisis standards of care and provides a discussion toolkit to help stakeholders establish indicators and triggers for their own communities. Together, indicators and triggers help guide operational decision making about providing care during public health and medical emergencies and disasters. Indicators and triggers represent the information and actions taken at specific thresholds that guide incident recognition, response, and recovery. This report discusses indicators and triggers for both a slow onset scenario, such as pandemic influenza, and a no-notice scenario, such as an earthquake.

Crisis Standards of Care features discussion toolkits customized to help various stakeholders develop indicators and triggers for their own organizations, agencies, and jurisdictions. The toolkit contains scenarios, key questions, and examples of indicators, triggers, and tactics to help promote discussion. In addition to common elements designed to facilitate integrated planning, the toolkit contains chapters specifically customized for emergency management, public health, emergency medical services, hospital and acute care, and out-of-hospital care.

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Topics: Health and Medicine

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Solar irradiance is a vital source of energy input for the Earth’s climate system and its variability has the potential to mitigate or exacerbate a human-created climate. Maintaining an unbroken record of Total Solar Irradiance (TSI) is critical in resolving ongoing debates regarding the potential role of solar variability in influencing Earth’s climate. Space-borne instruments have acquired TSI data since 1978. Currently, the best calibrated and lowest noise source of TSI measurements is the Total Irradiance Monitor (TIM) onboard NASA’s Solar Radiation and Climate Experiment (SORCE). These TIM-era data are of higher quality than the older data in the full record. Thus, the TSI climate data record (CDR) has two components. There is the shorter, but more accurate record of the TIM era and the full (33+ year) space-based TSI measurement record. Both are important and require preservation.

Review of NOAA Working Group Report on Maintaining the Continuation of Long-Term Satellite Total Irradiance Observations evaluates NOAA’s plan for mitigating the loss of total solar irradiance measurements from space, given the likelihood of losing this capacity from instruments currently on the SORCE satellite in coming years and the short term/experimental nature of the currently identified method of filling the data gap. This report evaluates NOAA’s plan for mitigating the gap in total solar irradiance data.

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Topics: Space and Aeronautics | Earth Sciences

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Within the Federal Aviation Administration (FAA), the Airway Transportation System Specialists ATSS) maintain and certify the equipment in the National Airspace System (NAS).In fiscal year 2012, Technical Operations had a budget of $1.7B. Thus, Technical Operations includes approximately 19 percent of the total FAA employees and less than 12 percent of the $15.9 billion total FAA budget. Technical Operations comprises ATSS workers at five different types of Air Traffic Control (ATC) facilities: (1) Air Route Traffic Control Centers, also known as En Route Centers, track aircraft once they travel beyond the terminal airspace and reach cruising altitude; they include Service Operations Centers that coordinate work and monitor equipment. (2) Terminal Radar Approach Control (TRACON) facilities control air traffic as aircraft ascend from and descend to airports, generally covering a radius of about 40 miles around the primary airport; a TRACON facility also includes a Service Operations Center. (3) Core Airports, also called Operational Evolution Partnership airports, are the nation’s busiest airports. (4) The General National Airspace System (GNAS) includes the facilities located outside the larger airport locations, including rural airports and equipment not based at any airport. (5) Operations Control Centers are the facilities that coordinate maintenance work and monitor equipment for a Service Area in the United States.

At each facility, the ATSS execute both tasks that are scheduled and predictable and tasks that are stochastic and unpredictable in. These tasks are common across the five ATSS disciplines: (1) Communications, maintaining the systems that allow air traffic controllers and pilots to be in contact throughout the flight; (2) Surveillance and Radar, maintaining the systems that allow air traffic controllers to see the specific locations of all the aircraft in the airspace they are monitoring; (3) Automation, maintaining the systems that allow air traffic controllers to track each aircraft’s current and future position, speed, and altitude; (4) Navigation, maintaining the systems that allow pilots to take off, maintain their course, approach, and land their aircraft; and (5) Environmental, maintaining the power, lighting, and heating/air conditioning systems at the ATC facilities. Because the NAS needs to be available and reliable all the time, each of the different equipment systems includes redundancy so an outage can be fixed without disrupting the NAS.

Assessment of Staffing Needs of Systems Specialists in Aviation reviews the available information on: (A) the duties of employees in job series 2101 (Airways Transportation Systems Specialist) in the Technical Operations service unit; (B) the Professional Aviation Safety Specialists (PASS) union of the AFL-CIO; (C) the present-day staffing models employed by the FAA; (D) any materials already produced by the FAA including a recent gap analysis on staffing requirements; (E) current research on best staffing models for safety; and (F) non-US staffing standards for employees in similar roles.

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Topics: Transportation | Industry and Labor

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Health care in the United States is more expensive than in other developed countries, costing $2.7 trillion in 2011, or 17.9 percent of the national gross domestic product. Increasing costs strain budgets at all levels of government and threaten the solvency of Medicare, the nation’s largest health insurer. At the same time, despite advances in biomedical science, medicine, and public health, health care quality remains inconsistent. In fact, underuse, misuse, and overuse of various services often put patients in danger.

Many efforts to improve this situation are focused on Medicare, which mainly pays practitioners on a fee-for-service basis and hospitals on a diagnoses-related group basis, which is a fee for a group of services related to a particular diagnosis. Research has long shown that Medicare spending varies greatly in different regions of the country even when expenditures are adjusted for variation in the costs of doing business, meaning that certain regions have much higher volume and/or intensity of services than others. Further, regions that deliver more services do not appear to achieve better health outcomes than those that deliver less.

Variation in Health Care Spending investigates geographic variation in health care spending and quality for Medicare beneficiaries as well as other populations, and analyzes Medicare payment policies that could encourage high-value care. This report concludes that regional differences in Medicare and commercial health care spending and use are real and persist over time. Furthermore, there is much variation within geographic areas, no matter how broadly or narrowly these areas are defined. The report recommends against adoption of a geographically based value index for Medicare payments, because the majority of health care decisions are made at the provider or health care organization level, not by geographic units. Rather, to promote high value services from all providers, Medicare and Medicaid Services should continue to test payment reforms that offer incentives to providers to share clinical data, coordinate patient care, and assume some financial risk for the care of their patients.

Medicare covers more than 47 million Americans, including 39 million people age 65 and older and 8 million people with disabilities. Medicare payment reform has the potential to improve health, promote efficiency in the U.S. health care system, and reorient competition in the health care market around the value of services rather than the volume of services provided. The recommendations of Variation in Health Care Spending are designed to help Medicare and Medicaid Services encourage providers to efficiently manage the full range of care for their patients, thereby increasing the value of health care in the United States.

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Topics: Health and Medicine

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The Pueblo Chemical Depot (PCD) in Colorado is one of two sites that features U.S. stockpile of chemical weapons that need to be destroyed. The PCD features about 2,600 tons of mustard-including agent. The PCD also features a pilot plant, the Pueblo Chemical Agent Destruction Pilot Plant (PCAPP), which has been set up to destroy the agent and munition bodies using novel processes. The chemical neutralization or hydrolysis of the mustard agent produces a Schedule 2 compound called thiodiglycol (TDG) that must be destroyed. The PCAPP uses a combined water recovery system (WRS) and brine reduction system (BRS) to destroy TDG and make the water used in the chemical neutralization well water again.

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Topics: Conflict and Security Issues

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Much of the ecological research in the past decades has focused on rural or wilderness areas. Today, however, ecological research has been taking place in our cities, where our everyday decisions can have profound effects on our environment. This research, or urban ecology, includes an important element, trees. Trees have had a variety of environmental benefits for our environment including the sequestering carbon, reducing urban heat island effects, providing vital habitat for wildlife, and making nature accessible. These benefits have important impacts on the physical, socio-economic, and mental health of humans as well. Being exposed to trees has been shown to enhance social cohesion, improve health and recreational opportunities, and increase real estate values.

In order to gain more knowledge into this urban forestry, the National Academy of Sciences (NAS) held a workshop February 25-26, 2013. The workshop brought together more than 100 people with various interests in urban forestry research to share information and perspectives, foster communication across specific areas of ecosystem service research, and consider integrated approaches that cut across these realms. The workshop specifically examined current capabilities to characterize and quantify the benefits, key gaps in our understanding, the challenges of planning urban forests in a way that optimizes multiple ecosystem services and more.

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Topics: Earth Sciences

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In 1992 world leaders met at the Earth Summit in Rio de Janeiro to reaffirm the Declaration of the United Nations Conference on the Human Environment that was established on June 16, 1972 in Stockholm. The meeting resulted in the adoption of Agenda 21 by the member states which is a framework for the transition to a more sustainable world. In 2012 the members gathered to assess and reaffirm the importance of progress towards the efforts of Agenda 21.

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Topics: Health and Medicine

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On November 19, 2001 the Transportation Security Administration (TSA) was created as a separate entity within the U.S. Department of Transportation through the Aviation and Transportation Security Act. The act also mandated that all checked baggage on U.S. flights be scanned by explosive detection systems (EDSs) for the presence of threats. These systems needed to be deployed quickly and universally, but could not be made available everywhere. As a result the TSA emphasized the procurement and installation of certified systems where EDSs were not yet available. Computer tomography (CT)-based systems became the certified method or place-holder for EDSs. CT systems cannot detect explosives but instead create images of potential threats that can be compared to criteria to determine if they are real threats. The TSA has placed a great emphasis on high level detections in order to slow false negatives or missed detections. As a result there is abundance in false positives or false alarms.

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Topics: Engineering and Technology

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The National Clinical Trials Network (NCTN) supported by the National Cancer Institute (NCI) has played an integral role in cancer research and in establishing the standard of care for cancer patients for more than 50 years. Formerly known as the NCI Clinical Trials Cooperative Group Program, the NCTN is comprised of more than 2,100 institutions and 14,000 investigators, who enroll more than 20,000 cancer patients in clinical trials each year across the United States and internationally.

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Topics: Health and Medicine

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The childhood obesity epidemic and related health consequences are urgent public health problems. Approximately one-third of America’s young people are overweight or obese. Health problems once seen overwhelmingly in adults, such as type 2 diabetes, cardiovascular disease, and hypertension, are increasingly appearing in youth. Though the health of Americans has improved in many broad areas for decades, increases in obesity could erode these and future improvements. The IOM report Accelerating Progress in Obesity Prevention: Solving the Weight of the Nation recognized the importance of the school environment in addressing the epidemic and recommended making schools a focal point for obesity prevention. The development and implementation of K-12 nutrition benchmarks, guides, or standards (for a discussion of these terms, see the next section of this chapter) would constitute a critical step in achieving this recommendation. National nutrition education curriculum standards could have a variety of benefits, including the following:

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Topics: Food and Nutrition

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The roots of health literacy can be traced back to the national literacy movement in India under Gandhi and to aid groups working in Africa to promote education and health. The term health literacy was first used in 1974 and described as “health education meeting minimal standards for all school grade levels”. From that first use the definition of health literacy evolved during the next 30 years with official definitions promulgated by government agencies and large programs. Despite differences among these definitions, they all hold in common the idea that health literacy involves the need for people to understand information that helps them maintain good health.

Although the United States produces a majority of the research on health literacy, Europe has strong multinational programs as well as research efforts, and health literacy experts in developing countries have created successful programs implemented on a community level. Given these distinct strengths of efforts worldwide, there are many opportunities for collaboration. International collaboration can harness the United States’ research power, Europe’s multilingual and multinational experience, and developing nations’ community-based programs to create robust programs and research that reach people—not based on language or nationality but on need and value.

A workshop on international health literacy efforts that feature presentations and discussion about health literacy interventions from various countries as well as other topics related to international health literacy was held as the basis for this report. Health Literacy: Improving Health, Health Systems, and Health Policy Around the World summarizes the findings and discussions at the workshop.

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Topics: Health and Medicine

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As the Gulf of Mexico recovers from the Deepwater Horizon oil spill, natural resource managers face the challenge of understanding the impacts of the spill and setting priorities for restoration work. The full value of losses resulting from the spill cannot be captured, however, without consideration of changes in ecosystem services–the benefits delivered to society through natural processes.

Approach to Assessing the Impacts of the Deepwater Horizon Oil Spill in the Gulf of Mexico discusses the benefits and challenges associated with using an ecosystem services approach to damage assessment, describing potential impacts of response technologies, exploring the role of resilience, and offering suggestions for areas of future research.

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Topics: Environment and Environmental Studies

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The Institute of Medicine (IOM) Committee on Quality Measures for the Healthy People Leading Health Indicators was charged by the Office of the Assistant Secretary for Health to identify measures of quality for the 12 Leading Health Indicator (LHI) topics and 26 Leading Health Indicators in Healthy People 2020 (HP2020), the current version of the Department of Health and Human Services (HHS) 10-year agenda for improving the nation’s health.

The scope of work for this project is to use the nine aims for improvement of quality in public health (population-centered, equitable, proactive, health promoting, risk reducing, vigilant, transparent, effective, and efficient) as a framework to identify quality measures for the Healthy People Leading Health Indicators (LHIs). The committee reviewed existing literature on the 12 LHI topics and the 26 Leading Health Indicators. Quality measures for the LHIs that are aligned with the nine aims for improvement of quality in public health will be identified. When appropriate, alignments with the six Priority Areas for Improvement of Quality in Public Health will be noted in the Committee’s report. Toward Quality Measures for Population Health and the Leading Health Indicators also address data reporting and analytical capacities that must be available to capture the measures and for demonstrating the value of the measures to improving population health.

Toward Quality Measures for Population Health and the Leading Health Indicators provides recommendations for how the measures can be used across sectors of the public health and health care systems. The six priority areas (also known as drivers) are population health metrics and information technology; evidence-based practices, research, and evaluation; systems thinking; sustainability and stewardship; policy; and workforce and education.

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Topics: Health and Medicine