Mereja

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  • New From NAP 2012-12-24 00:00:00

    Final Book Now Available

    As climate change has pushed climate patterns outside of historic norms, the need for detailed projections is growing across all sectors, including agriculture, insurance, and emergency preparedness planning. A National Strategy for Advancing Climate Modeling emphasizes the needs for climate models to evolve substantially in order to deliver climate projections at the scale and level of detail desired by decision makers, this report finds. Despite much recent progress in developing reliable climate models, there are still efficiencies to be gained across the large and diverse U.S. climate modeling community. Evolving to a more unified climate modeling enterprise-in particular by developing a common software infrastructure shared by all climate researchers and holding an annual climate modeling forum-could help speed progress.

    Throughout this report, several recommendations and guidelines are outlined to accelerate progress in climate modeling. The U.S. supports several climate models, each conceptually similar but with components assembled with slightly different software and data output standards. If all U.S. climate models employed a single software system, it could simplify testing and migration to new computing hardware, and allow scientists to compare and interchange climate model components, such as land surface or ocean models. A National Strategy for Advancing Climate Modeling recommends an annual U.S. climate modeling forum be held to help bring the nation’s diverse modeling communities together with the users of climate data. This would provide climate model data users with an opportunity to learn more about the strengths and limitations of models and provide input to modelers on their needs and provide a venue for discussions of priorities for the national modeling enterprise, and bring disparate climate science communities together to design common modeling experiments.

    In addition, A National Strategy for Advancing Climate Modeling explains that U.S. climate modelers will need to address an expanding breadth of scientific problems while striving to make predictions and projections more accurate. Progress toward this goal can be made through a combination of increasing model resolution, advances in observations, improved model physics, and more complete representations of the Earth system. To address the computing needs of the climate modeling community, the report suggests a two-pronged approach that involves the continued use and upgrading of existing climate-dedicated computing resources at modeling centers, together with research on how to effectively exploit the more complex computer hardware systems expected over the next 10 to 20 years.

    [Read the full report]

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  • Kindergartner undergoes very rare robotic surgery at UCLA

    Leonidas Hill recently made history at Mattel Children’s Hospital UCLA, when the 5-year-old became the first pediatric patient in the western United States to undergo transoral robotic surgery (TORS) — a minimally invasive surgery performed with the help of a robot — to repair a rare congenital condition known as a laryngeal cleft.
     
    Mattel Children’s Hospital UCLA is one of only a handful of medical centers in the country offering this type of surgery, which is rarely done on pediatric patients. The technology allows surgeons to perform the operation through the mouth of the patient, rather than in the traditional manner, which requires external incisions and the splitting of the patient’s voice box.
     
    Hill was born with both a laryngeal cleft and a cleft lip/palate, defects that occur during embryonic development. The cleft is an extremely rare airway defect in the laryngo-tracheal wall, which results in an abnormal opening between the larynx and the esophagus. This allows food to get into the airways and even the lungs.
     
    Hill’s cleft, which was classified as Type 3 (Type 4 is the most severe), extended beyond his voice box and into his trachea, leading to tracheomalacia, a condition that occurs in newborns in which the cartilage of the trachea, or windpipe, has not developed properly. Because of this, the trachea walls, instead of being rigid, are floppy and collapse, resulting in breathing difficulties.
     
    Hill’s breathing difficulties began soon after birth, and he underwent a tracheotomy-tube placement as an infant to help with his airway issues. Due to his chronic aspirating, he also had a gastrostomy tube placed in his stomach to minimize respiratory infections such as pneumonia and bronchitis.
     
    Dr. Nina Shapiro, director of pediatric otolaryngology at Mattel Children’s Hospital UCLA and an associate professor of surgery at the David Geffen School of Medicine at UCLA, diagnosed Hill’s cleft and recommended him for the TORS procedure. 
     
    “The benefit of the surgical robot is that it gives more access to the pediatric airway using minimally invasive techniques,” she said. “For Leonidas, this surgery repaired his cleft, which will greatly improve his airway issues and put him in a better position for removing the tracheotomy tube.”
     
    The Da Vinci robotic surgical system, the state-of-the-art technology used at UCLA, is a minimally invasive procedure in which a surgical robot, under the full control of a specially trained physician, operates with a three-dimensional, high-definition video camera and robotic arms. 
     
    These miniature “arms” can navigate through the small, tight and delicate areas of the mouth without the need for external incisions. A retraction system allows the surgeon to see the entire surgical area at once. While working from an operating console, every movement of the surgeon’s wrists and fingers are transformed into movement of the surgical instruments. 
     
    Dr. Abie Mendelsohn, an assistant professor of surgery at UCLA, developed the TORS program at the UCLA Department of Head and Neck Surgery. Mendelsohn operated on Hill and repaired the cleft in the back of his larynx. 
     
    After examining the cleft, Mendelsohn used a special carbon-dioxide laser-fiber adapter for the robot to destroy the cleft’s inner lining, which allowed for wound-healing of the cleft. Following the laser procedure, Mendelsohn used the robot to transorally place sutures within the larynx and trachea to hold the two ends of the cleft together.
     
    “This type of laryngeal cleft repair traditionally requires open surgery, which entails a very large neck incision, splitting the voice box, and direct suturing of the cleft,” Mendelsohn said. “This approach is highly invasive, has a prolonged surgical time and requires an extensive healing period. Using the TORS method, our approach did not require any skin incisions, there was direct access to the closure site, no visible scars and a faster healing time, so Leonidas was able to go home the next day. The TORS procedure shortens hospital stays for patients, and they can get back to their lives faster and with fewer limitations.”
     
    Hill made a speedy recovery and was back at school within days. His prognosis is good, and Shapiro said that the next step will be to perform additional tests, with the hope of removing Hill’s tracheotomy tube. 
     
    “The ultimate goal is to remove the tracheotomy and gastrostomy tubes so that Leonidas can swallow liquids and solids by mouth,” she said. “This surgery will help him breathe easier and work toward eating and drinking on his own.”
     
    With continuing pediatric adaptations made to the robotic surgical instruments, physicians and surgeons at UCLA will continue to search for appropriate pediatric candidates for robotic surgical procedures.
     
    “The initial robotic surgical instruments had an outer diameter of 8 millimeters, which has now been improved to 5 millimeters,” Mendelsohn said. “Additionally, the initial robotic endoscope had an outer diameter of 15 millimeters, which has now been improved to 8.5 millimeters. These improvements have led to our ability to fit the instrumentation successfully through the mouth of a pediatric patient. In our eyes, this experience was successful, and we believe that with selected pediatric patients, robotics will have a continued use at the Mattel Children’s Hospital UCLA.”
     
    For more news, visit the UCLA Newsroom and follow us on Twitter.

  • Mission Accomplished for Landsat 5

    Today the U.S. Geological Survey announced that Landsat 5 will be decommissioned over the coming months, bringing to a close the longest-operating Earth observing satellite mission in history.  By any measure, the Landsat 5 mission has been an extraordinary success, providing unprecedented contributions to the global record of land change. The USGS has brought the aging satellite back from the brink of failure on several occasions, but the recent failure of a gyroscope has left no option but to end the mission. 

    Now in its 29th year of orbiting the planet, Landsat 5 has long outlived its original three-year design life. Developed by NASA and launched in 1984, Landsat 5 has orbited the planet over 150,000 times while transmitting over 2.5 million images of land surface conditions around the world.  

    “This is the end of an era for a remarkable satellite, and the fact that it flew for almost three decades is a testament to the NASA engineers and the USGS team who launched it and kept it flying well beyond its expected lifetime,” stated Anne Castle, Department of the Interior Assistant Secretary for Water and Science. “The Landsat program is the ‘gold standard” of satellite observation, providing an invaluable public record of our planet that helps us tackle critical land, water, and environmental issues.” 

     “Any major event since 1984 that left a mark on this Earth larger than a football field was likely recorded by Landsat 5, whether it was a hurricane, a tsunami, a wildfire, deforestation, or an oil spill,” said USGS Director Marcia McNutt. “We look forward to a long and productive continuation of the Landsat program, but it is unlikely there will ever be another satellite that matches the outstanding longevity of Landsat 5.” 

    For more than a quarter of a century, Landsat 5 has observed our changing planet. It has recorded the impact of natural hazards, climate variability and change, land use practices, development and urbanization, ecosystem evolution, increasing demand for water and energy resources, and changing agricultural demands worldwide. Vital observations of the Mount Saint Helens eruption, Antarctica, the Kuwaiti oil fires, the Chernobyl disaster, rainforest depletion, major wildfires and floods, urban growth, global crop production, and ice shelf expansion and retreat have helped increase our understanding and awareness of the impact of humans on the land. 

    The USGS Flight Operations Team recently began the process required to safely lower Landsat 5 from its operational orbit. The first series of maneuvers is expected to occur next month.   

    With Landsat 5’s decommissioning, Landsat 7, which was launched in 1999 and has also outlived its five-year design life, will continue to provide information, although an instrument anomaly reduces the amount of data it collects.  The next mission, Landsat 8 — also called the Landsat Data Continuity Mission — is scheduled for launch by NASA in February 2013.   

    The natural resource management and development challenges that the Nation has faced since the beginning of the Landsat program have not diminished; they’ve only accelerated.  Landsat, and the many applications that it has spawned, will be even more critical in the future to keep pace with these challenges.  The Department of the Interior and NASA are working closely with the Administration on options for long-term continuity of the Landsat data stream.

    Since 2008, when the USGS made the Landsat archive accessible to on-line users at no cost, nearly 10 million images, each covering over 12,000 square miles, have been downloaded in 190 countries.  

    For further details and the latest information about the status of Landsat satellites, visit the USGS Landsat Missions website.

     

  • Homeless schooling

    Each day en route to work I pass a perplexing sight – a large single parent family living and learning under a giant fig tree. The hustle and bustle of crowded Dar es Salaam contains a large green space by the coast – like NY’s Central Park. Within it resides Agnes and her six children.

    Lessons under the tree

    Curiosity finally got the better of me and I stopped by to chat this morning and hand out some sweets for the children. As usual, Agnes was spending the morning home schooling her children; aided by a blackboard and a hand drawn map of Africa.

    As I suspected Agnes trained and practiced as a teacher, before running foul of regulations. She’s lived for several years under the tree illustrated and clearly has a low regard for bureaucracy and rules that now no longer apply to her. Despite clearly being homeless and a ‘family in need’, it appeared that her children are relatively well nourished and healthy (I was asked for an anti-malarial bed-net) and that the home (or perhaps homeless) schooling was doing the trick.

    Her children spoke English confidently and I suspect were probably getting a better rounded primary education than many in formal schools – if UWEZO’s child literacy statistics are to be believed. At least the teacher was showing up regularly – which is not always the case according to one recent local survey.

    The lesson to me was I suppose that education comes in all shapes and sizes and formal schooling isn’t always the solution. I spent some time this week discussing how funds from Global Partnership for Education might support Tanzanian children and the relative merits of formal and non-formal delivery.

    Whether Agnes’s approach is a step too far in the non-formal direction must remain to be seen. Something to mull over during the Christmas break..

  • Using Data Sharing to Improve Coordination in Peacebuilding: Report of a Workshop by the National Academy of Engineering and the United States Institute of Peace: Roundtable on Technology, Science, and Peacebuilding

    Cover imageOn May 23, 2012, the Roundtable on Technology, Science, and Peacebuilding convened a workshop at the United States Institute of Peace (USIP) to investigate data sharing as a means of improving coordination among US government and nongovernment stakeholders involved in peacebuilding and conflict management activities. Using Data Sharing to Improve Coordination in Peacebuilding:Report of a Workshop by the National Academy of Engineering and the United States Institute of Peace: Roundtable on Technology, Science, and Peacebuilding addresses the following question: What needs must a data sharing system address to create more effective coordination in conflict zones and to promote the participation of federal agencies and nonfederal organizations in Peacebuilding?

    In addition, the workshop served as a means to obtain feedback on the UNITY system, a data-sharing platform developed by the Department of Defense (DOD) and the United States Agency for International Development (USAID). The Roundtable was established in 2011 as a partnership between USIP and the National Academy of Engineering (NAE) to make a measurable and positive impact on conflict management, peacebuilding, and security capabilities by bringing together leaders from the technical and peacebuilding communities. Its members are senior executives and experts from leading governmental organizations, universities, corporations, and nongovernmental organizations.

    Its principal goals are: 1. To accelerate the application of science and technology to the process of peacebuilding and stabilization; 2. To promote systematic, high-level communication between peacebuilding and technical organizations on the problems faced and the technical capabilities required for successful peacebuilding; and 3. To collaborate in applying new science and technology to the most pressing challenges faced by local and international peacebuilders working in conflict zones. The Roundtable is strongly committed to action-oriented projects, and the long-term goal of each is to demonstrate viability with a successful field trial. The Roundtable has selected a portfolio of high-impact peacebuilding problems on which to focus its efforts: 1. Adapting agricultural extension services to peacebuilding, 2.Using data sharing to improve coordination in peacebuilding, 3. Sensing emerging conflicts, and 4. Harnessing systems methods for delivery of peacebuilding services.

  • Collecting Sexual Orientation and Gender Identity Data in Electronic Health Records: Workshop Summary

    Cover imageCollecting Sexual Orientation and Gender Identity Data in Electronic Health Records: Workshop Summary reviews the statement of task set to the committee which required them to collect sexual orientation and gender identity data in electronic health records. This report summarizes the invited presentations and facilitated discussions about current practices around sexual orientation and gender identity data collection, the challenges in collecting these data, and ways in which these challenges can be overcome.

    Areas of focus for the workshop include the clinical rationale behind collecting these data, standardized questions that can be used to collect these data, mechanisms for supporting providers and patients in the collection of these data, technical specifications involved in creating standards for sexual orientation and gender identity data collection and exchange, and policy considerations related to the health information technology (HIT) Meaningful Use process being overseen by the Department of Health and Human Services. This report summarizes the workshop agenda, select invited speakers and discussants, and moderate the discussions. Invited participants will include lesbian, gay, bisexual, and transgender (LGBT) health care consumer advocates, providers with experience working with LGBT populations, HIT vendors and other HIT specialists, health care administrators, and policy makers.

  • PNNL recognized for transferring innovations to the marketplace

    Pacific Northwest National Laboratory has been recognized for creating technologies or processes that can store large amounts of renewable energy until it’s needed, fight cancer and detect explosives, and then moving the innovations to the marketplace.

    The Federal Laboratory Consortium announced today that the Department of Energy national laboratory in Richland is receiving three 2013 Excellence in Technology Transfer awards.  The consortium is a nationwide network that encourages federal laboratories to transfer laboratory-developed technologies to commercial markets. With these awards, PNNL has been honored by the FLC more than any other federal laboratory, collecting 78 awards since the program began in 1984.

    The 2013 awards will be presented April 25 at the consortium’s annual meeting in Westminster, Colo.

    Renewable energy storage batteries  

    Developing a technology that can smoothly integrate energy from variable and intermittent sources — such as wind and solar power — onto the electricity grid while maintaining grid stability has proven challenging. But PNNL researchers, with funding from DOE’s Office of Electricity, recently made significant progress in improving the performance of “redox flow” batteries, which hold promise for storing large amounts of renewable energy and providing greater stability to the energy grid. 

    First developed in the 1970s, redox flow batteries have shown promise for renewable energy storage but have been limited in their ability to work well in a wide range of temperatures, their relatively high cost and their limited ability to store energy, otherwise known as energy density. The PNNL-developed system incorporates two novel approaches to overcome the limitations of previous generations of redox flow batteries. The result is a dramatically improved operating range, higher energy density and lower cost for vanadium redox flow batteries.

    “Successful commercialization of DOE-sponsored technology development, such as this, is vital for creating the grid of the future, and sustaining U.S. leadership in advanced technology,” said Imre Gyuk, energy storage program manager at DOE’s Office of Electricity.

    License agreements with companies like UniEnergy Technologies LLC in Mukilteo, Wash., are expected to lead to commercial products for utilities, power generators and industry.

    Therapeutic delivery agent for treating cancers

    PNNL researchers created innovative “radiogel” products that allow medical personnel to deliver higher doses of radiation exactly where needed when fighting cancerous tumors that cannot be surgically removed. The treatment is effective, affordable and minimizes exposure to surrounding healthy tissues and organs. 

    The PNNL-developed, injectable radiogels allow for the delivery of insoluble yttrium-90 — a well-established medical radioisotope with many applications in cancer treatment — to a precise location for targeted radiation therapy. The radiogels dissolve and disappear once the yttrium-90 decays. 

    “This new technology will provide doctors with greater flexibility to safely direct radiation therapy to the interior of tumors, as well as to tumor margins following surgical removal,” said Darrell Fisher, who leads PNNL’s Isotope Sciences Program. “Commercialization of the new treatment will help make it readily available to patients.”

    DOE’s Office of Science provided funding to support early studies on radiogel material composition. A license agreement with Advanced Medical Isotope Corp. of Kennewick, Wash., has led to further development of radiogel products that will eventually be used to treat cancers of the liver, pancreas, brain, neck, and kidneys.

    Next-generation microchip — Ion Mobility Spectrometer

    Researchers at PNNL and Owlstone Ltd., in Cambridge, England, collaborated over a period of several years to successfully develop new technology with the potential to dramatically improve the ability to detect and identify very small amounts of chemicals, such as those that are telltale signs of hidden explosives or disease-revealing proteins in blood.

    The Ion Mobility Spectrometer on a Microchip, or IMS Microchip, overcomes limitations of previous sample analytical instruments by shrinking a key component — a channel through which molecules must travel. This advance improves performance by allowing higher electric currents to be effectively utilized in the separations process. The dime-sized chip provides dozens of channels through which ions travel to be separated and identified. 

    Owlstone scientists provided the microfabrication design and methods lying at the foundation of IMS Microchips, while PNNL provided its capabilities in ion mobility spectrometry and mass spectrometry to improve the detection limits and sensitivity of the next generation of analytical microchips. 

    The unique expertise and capabilities contributed by PNNL researchers were critical to Owlstone in its efforts to successfully develop a commercial IMS Microchip tailored to meet the needs of the mass spectrometry research community.

    More information about PNNL innovations available for license can be found online. Business inquiries can be directed to 1-888-375-PNNL or [email protected].

  • New From NAP 2012-12-20 08:45:01

    Prepublication Now Available

    Collecting Sexual Orientation and Gender Identity Data in Electronic Health Records: Workshop Summary reviews the statement of task set to the committee which required them to collect sexual orientation and gender identity data in electronic health records. This report summarizes the invited presentations and facilitated discussions about current practices around sexual orientation and gender identity data collection, the challenges in collecting these data, and ways in which these challenges can be overcome.

    Areas of focus for the workshop include the clinical rationale behind collecting these data, standardized questions that can be used to collect these data, mechanisms for supporting providers and patients in the collection of these data, technical specifications involved in creating standards for sexual orientation and gender identity data collection and exchange, and policy considerations related to the health information technology (HIT) Meaningful Use process being overseen by the Department of Health and Human Services. This report summarizes the workshop agenda, select invited speakers and discussants, and moderate the discussions. Invited participants will include lesbian, gay, bisexual, and transgender (LGBT) health care consumer advocates, providers with experience working with LGBT populations, HIT vendors and other HIT specialists, health care administrators, and policy makers.

    [Read the full report]

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  • Learning the DFID language

    Do you know what a multilateral organisation is? Do you know your GAVI from your GPE? Your AsDB from your AfDB? Your UNDP from your UNFPA? Last July I was happily informed I had obtained a place on the DFID graduate development scheme and would shortly be upping sticks from beautiful Belfast to glorious Glasgow.  Little did I know at the time that in this new role I would be learning an entirely new language.

    It begins with the names of the multilaterals. Multilaterals are organisations that have been established under an international agreement and are jointly funded by multiple countries. Their purpose is to address issues of international concern globally. DFID provides funding to a number of multilateral organisations who undertake a broad range of activities, such as leading the fight against HIV, malaria and TB, responding to natural disasters, providing large scale infrastructure, supporting children and women, and peacekeeping. These multilaterals include well known names such as the World Bank, UNICEF and the World Health Organisation.

    Just as there are lots of multilaterals, there are also lots of acronyms. They range from the obvious ones that you can guess from the letters e.g. UNDP = UN Development Programme – to the ones thay without a knowledge of another language it is impossible to guess e.g. UNITAID = international drug purchasing facility (it’s French).

    Multilateral organisations like GAVI (the Global Alliance for Vaccines and Immunisation, that is) carry out life-saving work. (Photo: C. McNab/The Measles and Rubella Initiative)

    Once you have got your head around the names of the multilaterals themselves, who they are and what function they perform, you then need to understand the terminology that they use to describe their programmes.  Until a few months ago terms such as VfM (Value for money), M&E (Monitoring and Evaluation) and MOU (Memorandum of Understanding) simply did not exist in my vocabulary, yet now it is difficult for a day to pass without me having not used them.

    Some of the multilaterals DFID works with.

    One acronym that my life is now subsumed by is the MAR (Multilateral Aid Review). The MAR was published in March 2011 and is now the benchmark that we measure the effectiveness of multilaterals against.  The MAR assessed the value for money for UK aid of 43 multilateral organisations, with each organisation being assessed against a set of criteria ranging from transparency and accountability to good partnership behaviour. DFID will update the MAR in 2013 to assess the progress being made in those areas which were highlighted as reform priorities in the MAR 2011.

    Throughout this one year graduate placement I will be blogging about multilateralism and showing why multilaterals are key partners in delivering UK development objectives. But don’t worry, acronyms are optional.

     

    This post is part of the Graduate Scheme blog, in which a group of graduates on this year’s DFID training scheme blog regularly on the issues they have encountered in their first year and those they foresee arising over their careers. More from the graduate blog coming soon.

  • Public obsession with obesity may be more dangerous than obesity itself, UCLA author says

    Much has been made about who or what is to blame for the “obesity epidemic” and what can or should be done to stem the tide of rising body mass among the U.S. population.
     
    A new book by a UCLA sociologist turns these concerns on their head by asking two questions. First, how and why has fatness been medicalized as “obesity” in the first place? Second, what are the social costs of this particular way of discussing body size?
     
    In “What’s Wrong With Fat?“, to be published Jan. 3 by Oxford University Press, Abigail Saguy argues that “obesity” is far from a neutral scientific fact. Rather, it is a discrete perspective — what sociologists call a “frame” — that draws attention to certain aspects of a situation while obscuring others.
     
    “The very term ‘obesity’ suggests that weighing over a certain amount is pathological,” says Saguy, an associate professor of sociology. “This perspective shuts out other interpretations of fat as, say, potentially healthy, an aspect of beauty, or even as a basis for civil rights claims resulting from discrimination, which has been well documented.”
     
    In discussing blame and responsibility for the so-called obesity epidemic, scientists, journalists and politicians alike tend to focus on individual responsibility, she argues. And in doing so, they gloss over the ways in which body size is tightly controlled by genetic factors and shaped by social factors, such as socioeconomic status and neighborhood limitations, including poor access to healthy food outlets, a high density of fast food restaurants and a lack of open space for exercise.
     
    “What’s Wrong With Fat?” shows how debates over the best way to discuss body size — including as either a health or civil rights problem — do not take place on an even playing field. Saguy contends that powerful interests benefit from drawing attention to the “crisis,” including the International Obesity Task Force (a lobbying group funded by pharmaceutical companies), obesity researchers and the Centers for Disease Control and Prevention.
     
    On the other hand, fat-acceptance groups, which try to reframe fatness as a civil rights issue, are at a disadvantage because they have considerably less economic power and cultural authority, she says.
     
    Saguy is careful to point out that she doesn’t deny the health risks associated with higher body mass. The clearest case is Type 2 diabetes, which becomes more likely as an individual’s weight goes up. Yet she cites medical research showing that even this association may not be causal.
     
    “It’s not clear whether obesity per se causes diabetes, whether diabetes causes obesity or whether both conditions are caused by a third factor, such as poor nutrition, stress or genetic factors,” she says.
     
    Saguy also points to evidence that obese patients with heart disease or diabetes have been shown to have lower mortality rates than their thinner counterparts, a phenomenon scientists have dubbed the “obesity paradox.” Yet, she says, “To listen to the media, you’d think that there’s unanimity on the need to lose weight.”
     
    In the book, Saguy explains how “confirmation bias” — a term used by sociologists to explain why people tend to give more credence to arguments that are consistent with their existing beliefs — leads scientists, journalists and politicians alike to downplay the complexity and scientific uncertainty surrounding body size and health. 
     
    But beyond the incomplete and misleading information on the issue, America’s obsession with obesity is itself unhealthy, she argues.
     
    Saguy cites studies demonstrating that fat women are reluctant to get medical care for fear of being chided about their weight or treated insensitively by their doctors. In fact, research has shown that obese women are more likely to get cervical cancer because they are less likely than thinner women to get pap smears.
     
    Meanwhile, Saguy’s own research shows that people who read news accounts of the “obesity epidemic” are more likely than people who have not read such reports to perceive fat people as lazy, unmotivated, sloppy, and lacking in self-discipline and competence.
     
    Those attitudes have been shown to play out in a variety of socially damaging ways, Saguy says, including in increasingly widespread weight discrimination. Recent research has shown, for example, that bias against fat people in employment, education, health care and other areas is now comparable in prevalence to reported rates of racial discrimination in the U.S.
     
    Heavier women in particular, Saguy notes, are less likely to be hired and less likely to earn a higher salary, compared with their similarly qualified but thinner peers.
     
    “American attitudes about fat may be more dangerous to public health than obesity itself,” she says.
     
    “What’s Wrong With Fat?” encourages readers to step back from taken-for-granted assumptions of an obesity epidemic and to consider fatness in a new light.
     
    “It’s possible to reframe ‘fat,’ and doing so can have profound implications in people’s lives,” says Saguy.
     
    For more news, visit the UCLA Newsroom and follow us on Twitter.

  • Monitoring HIV Care in the United States: A Strategy for Generating National Estimates of HIV Care and Coverage

    Cover imageIn September 2010, the White House Office of National AIDS Policy commissioned an Institute of Medicine (IOM) committee to respond to a two-part statement of task concerning how to monitor care for people with HIV. The IOM convened a committee of 17 members with expertise in HIV clinical care and supportive services, epidemiology, biostatistics, health policy, and other areas to respond to this task. The committee’s first report, Monitoring HIV Care in the United States: Indicators and Data Systems, was released in March 2012. The report identified 14 core indicators of clinical HIV care and mental health, substance abuse, and supportive services for use by the Department of Health and Human Services (HHS) to monitor the impact of the National HIV/AIDS Strategy (NHAS) and the Patient Protection and Affordable Care Act (ACA) on improvements in HIV care and identified sources of data to estimate the indicators.

    The report also addressed a series of questions related to the collection, analysis, and dissemination of data necessary to estimate the indicators.
    In this second report, Monitoring HIV Care in the United States: A Strategy for Generating National Estimates of HIV Care and Coverage, the committee addresses how to obtain national estimates that characterize the health care of people with HIV within the context of the ACA, both before 2014 and after 2014, when key provisions of the ACA will be implemented. This report focuses on how to monitor the anticipated changes in health care coverage, service utilization, and quality of care for people with HIV within the context of the ACA.

  • Improving Measurement of Productivity in Higher Education

    Cover imageHigher education is a linchpin of the American economy and society: teaching and research at colleges and universities contribute significantly to the nation’s economic activity, both directly and through their impact on future growth; federal and state governments support teaching and research with billions of taxpayers’ dollars; and individuals, communities, and the nation gain from the learning and innovation that occur in higher education.

    In the current environment of increasing tuition and shrinking public funds, a sense of urgency has emerged to better track the performance of colleges and universities in the hope that their costs can be contained without compromising quality or accessibility. Improving Measurement of Productivity in Higher Education presents an analytically well-defined concept of productivity in higher education and recommends empirically valid and operationally practical guidelines for measuring it. In addition to its obvious policy and research value, improved measures of productivity may generate insights that potentially lead to enhanced departmental, institutional, or system educational processes.

    Improving Measurement of Productivity in Higher Education constructs valid productivity measures to supplement the body of information used to guide resource allocation decisions at the system, state, and national levels and to assist policymakers who must assess investments in higher education against other compelling demands on scarce resources. By portraying the productive process in detail, this report will allow stakeholders to better understand the complexities of–and potential approaches to–measuring institution, system and national-level performance in higher education.

  • Sustainable Development of Algal Biofuels

    Cover imageBiofuels made from algae are gaining attention as a domestic source of renewable fuel. However, with current technologies, scaling up production of algal biofuels to meet even 5 percent of U.S. transportation fuel needs could create unsustainable demands for energy, water, and nutrient resources. Continued research and development could yield innovations to address these challenges, but determining if algal biofuel is a viable fuel alternative will involve comparing the environmental, economic and social impacts of algal biofuel production and use to those associated with petroleum-based fuels and other fuel sources. Sustainable Development of Algal Biofuels was produced at the request of the U.S. Department of Energy.

  • New From NAP 2012-12-19 16:23:34

    Final Book Now Available

    On May 23, 2012, the Roundtable on Technology, Science, and Peacebuilding convened a workshop at the United States Institute of Peace (USIP) to investigate data sharing as a means of improving coordination among US government and nongovernment stakeholders involved in peacebuilding and conflict management activities. Using Data Sharing to Improve Coordination in Peacebuilding:Report of a Workshop by the National Academy of Engineering and the United States Institute of Peace: Roundtable on Technology, Science, and Peacebuilding addresses the following question: What needs must a data sharing system address to create more effective coordination in conflict zones and to promote the participation of federal agencies and nonfederal organizations in Peacebuilding?

    In addition, the workshop served as a means to obtain feedback on the UNITY system, a data-sharing platform developed by the Department of Defense (DOD) and the United States Agency for International Development (USAID). The Roundtable was established in 2011 as a partnership between USIP and the National Academy of Engineering (NAE) to make a measurable and positive impact on conflict management, peacebuilding, and security capabilities by bringing together leaders from the technical and peacebuilding communities. Its members are senior executives and experts from leading governmental organizations, universities, corporations, and nongovernmental organizations.

    Its principal goals are: 1. To accelerate the application of science and technology to the process of peacebuilding and stabilization; 2. To promote systematic, high-level communication between peacebuilding and technical organizations on the problems faced and the technical capabilities required for successful peacebuilding; and 3. To collaborate in applying new science and technology to the most pressing challenges faced by local and international peacebuilders working in conflict zones. The Roundtable is strongly committed to action-oriented projects, and the long-term goal of each is to demonstrate viability with a successful field trial. The Roundtable has selected a portfolio of high-impact peacebuilding problems on which to focus its efforts: 1. Adapting agricultural extension services to peacebuilding, 2.Using data sharing to improve coordination in peacebuilding, 3. Sensing emerging conflicts, and 4. Harnessing systems methods for delivery of peacebuilding services.

    [Read the full report]

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  • ‘Study partners’ play critical role in clinical trials for Alzheimer’s disease

    For Alzheimer’s disease researchers who conduct clinical trials, enrolling enough patients to make a trial meaningful is always a challenge. To enroll a single patient in a study requires not one but two participants — the patient and what’s known as a study partner. Study partners provide the patient with support and update researchers about the patient’s progress.
     
    A new UCLA study has assessed the prevalence of the various types of study partners in Alzheimer’s clinical trials — a patient’s spouse or “other” partners, like a patient’s adult child — and has discovered that who the study partner is can actually impact the results of the trials and the interpretations of those results.
     
    The study appears in the Dec. 19 online issue of the journal Neurology.
     
    “The role of the study partner is vital to the success of Alzheimer’s disease clinical trials,” said the study’s first author, Joshua D. Grill, an assistant professor of neurology at UCLA and a member of the UCLA Mary S. Easton Center for Alzheimer’s Disease Research. “We count on them to ensure that the patient is taking their medications, drive them to appointments and, in general, report back how things are going.”
     
    In their analysis of 2,041 Alzheimer’s patients who had participated in six clinical trials, Grill and his colleagues found that 67 percent of these patients had a spouse as their study partner. Yet in the general population, more than two-thirds of all unpaid Alzheimer’s disease caregivers are patients’ children, children-in-law or grandchildren, and half of unpaid caregivers are under the age of 50.
     
    And importantly, the researchers said, as many as 90 percent of Alzheimer’s sufferers don’t have spouses.
     
    “But two-thirds of clinical trial participants do have spouses,” Grill said. “That confirms we are missing a huge population of people we are not enrolling. They’re out there, and we need to do a better job of recruiting them in order to expedite study of promising drugs for Alzheimer’s.”
     
    The team also found that, after controlling for confounding factors, the risk of dropout for the “other” study partner group — the group including adult children — was 70 percent higher than for the spouse study partner group.
    Grill added that factors such as race of the patient and the attitudes of caregivers can also impact recruitment for clinical trials.
     
    For example, only 5 percent of participants in the clinical trials the researchers looked at were Hispanic, and only 6 percent were African American. Those trial participants who had an adult child as their study partner were twice as likely as those with spouse partners to be Hispanic and nearly three times as likely to be African American.
     
    “Typically in Alzheimer’s disease trials, we don’t know if there are differences between minority patients and Caucasians in terms of a drug’s possible effectiveness,” Grill said. “But if we can do a better job with enrolling Alzheimer’s patients who have non-spousal study partners, we may get better with recruiting minorities as well, so that we can answer that type of question.”
     
    The current study doesn’t explain why clinical trial participants with non-spouse study partners were underrepresented. Adult-child study partners were more likely to be working and living apart from the patient, Grill said, “so it might simply be a question of logistics. But this will require further study.”
     
    Other authors of the study included Rema Raman, Karin Ernstrom and Paul Aisen from the Alzheimer’s Disease Cooperative Study at UC San Diego and Jason Karlawish of the University of Pennsylvania.
     
    The study was supported by the National Institute on Aging (AG016570, P30-AG01024, UO1-AG10483), the Sidell-Kagan Foundation, and the Marian S. Ware Alzheimer Program. Please see the full paper for author disclosures.
     
    The Mary S. Easton Center for Alzheimer’s Disease Research at UCLA is part of the UCLA Department of Neurology, which encompasses more than 20 disease-related research programs, along with large clinical and teaching programs. These programs cover brain mapping and neuroimaging, movement disorders, Alzheimer’s disease, multiple sclerosis, neurogenetics, nerve and muscle disorders, epilepsy, neuro-oncology, neurotology, neuropsychology, headaches and migraines, neurorehabilitation, and neurovascular disorders. The department ranked first among its peers nationwide in National Institutes of Health funding (2002–09). 
     
    For more news, visit the UCLA Newsroom and follow us on Twitter.

  • More than half a million California adults think seriously about committing suicide

    More than half a million adults in California seriously thought about committing suicide during the previous year, according to a new study from the UCLA Center for Health Policy Research.
     
    The study, which uses data from the 2009 California Health Interview Survey (CHIS), is the first by the center to focus on suicide ideation.
     
    In California, suicide is the 10th leading cause of death, the researchers noted. An average of nine deaths by suicide occur each day in the state.
     
    “Suicide is complex and always devastating,” said David Grant, the report’s lead author and director of CHIS. “Our research identifies some populations that are at high risk of suicidal behavior, and our findings may help target prevention efforts and, hopefully, save lives.”
     
    Among the study’s findings:
     
    Gays, lesbians, bisexuals at greatest risk
    Gay, lesbian and bisexual Californians were more than three times as likely (6.5 percent) as all adults (1.8 percent) to have seriously thought about suicide during the previous year.
     
    Suicidal thoughts high for Americans Indians, Alaska Natives
    Among all ethnic groups, American Indians and Alaska Natives had the highest level of suicidal thoughts (6.2 percent).
     
    People with disabilities, smokers also at risk
    Adults who reported a disability due to a physical, mental or emotional condition were four times as likely (4.2 percent) as all adults to report having suicidal thoughts. Nearly 5 percent of smokers also had suicidal thoughts.
     
    Differences in married, non-married adults
    Those adults who said they were married reported lower rates of suicidal thoughts (1.1 percent) than those who were not married (2.6 percent.)
     
    At-risk adults not receiving treatment they need
    Sixty-five percent of adults who need mental health services for serious psychological distress and who had recent suicidal thoughts received little or no treatment.
     
    Higher rates of suicide in northern and Sierra counties
    About 2.1 percent of adults in California’s northern and Sierra counties had seriously thought about suicide in the past year, a finding consistent with reported deaths by suicide based on 2009 vital statistics data. The Sacramento area and Los Angeles reported similar rates of suicidal thoughts, but their suicide rates were lower.
     
     
     
    The UCLA Center for Health Policy Research is one of the nation’s leading health policy research centers and the premier source of health-related information on Californians. 
     
    For more news, visit the UCLA Newsroom and follow us on Twitter.

  • New From NAP 2012-12-19 00:00:00

    Final Book Now Available

    In September 2010, the White House Office of National AIDS Policy commissioned an Institute of Medicine (IOM) committee to respond to a two-part statement of task concerning how to monitor care for people with HIV. The IOM convened a committee of 17 members with expertise in HIV clinical care and supportive services, epidemiology, biostatistics, health policy, and other areas to respond to this task. The committee’s first report, Monitoring HIV Care in the United States: Indicators and Data Systems, was released in March 2012. The report identified 14 core indicators of clinical HIV care and mental health, substance abuse, and supportive services for use by the Department of Health and Human Services (HHS) to monitor the impact of the National HIV/AIDS Strategy (NHAS) and the Patient Protection and Affordable Care Act (ACA) on improvements in HIV care and identified sources of data to estimate the indicators.

    The report also addressed a series of questions related to the collection, analysis, and dissemination of data necessary to estimate the indicators.
    In this second report, Monitoring HIV Care in the United States: A Strategy for Generating National Estimates of HIV Care and Coverage, the committee addresses how to obtain national estimates that characterize the health care of people with HIV within the context of the ACA, both before 2014 and after 2014, when key provisions of the ACA will be implemented. This report focuses on how to monitor the anticipated changes in health care coverage, service utilization, and quality of care for people with HIV within the context of the ACA.

    [Read the full report]

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  • Education for Life and Work: Developing Transferable Knowledge and Skills in the 21st Century

    Cover imageAmericans have long recognized that investments in public education contribute to the common good, enhancing national prosperity and supporting stable families, neighborhoods, and communities. Education is even more critical today, in the face of economic, environmental, and social challenges. Today’s children can meet future challenges if their schooling and informal learning activities prepare them for adult roles as citizens, employees, managers, parents, volunteers, and entrepreneurs. To achieve their full potential as adults, young people need to develop a range of skills and knowledge that facilitate mastery and application of English, mathematics, and other school subjects. At the same time, business and political leaders are increasingly asking schools to develop skills such as problem solving, critical thinking, communication, collaboration, and self-management – often referred to as “21st century skills.”

    Education for Life and Work: Developing Transferable Knowledge and Skills in the 21st Century describes this important set of key skills that increase deeper learning, college and career readiness, student-centered learning, and higher order thinking. These labels include both cognitive and non-cognitive skills- such as critical thinking, problem solving, collaboration, effective communication, motivation, persistence, and learning to learn. 21st century skills also include creativity, innovation, and ethics that are important to later success and may be developed in formal or informal learning environments.

    This report also describes how these skills relate to each other and to more traditional academic skills and content in the key disciplines of reading, mathematics, and science. Education for Life and Work: Developing Transferable Knowledge and Skills in the 21st Century summarizes the findings of the research that investigates the importance of such skills to success in education, work, and other areas of adult responsibility and that demonstrates the importance of developing these skills in K-16 education. In this report, features related to learning these skills are identified, which include teacher professional development, curriculum, assessment, after-school and out-of-school programs, and informal learning centers such as exhibits and museums.

  • Building the Arkansas Innovation Economy: Summary of a Symposium

    Cover imageA committee under the auspices of the Board on Science, Technology, and Economic Policy (STEP), is conducting a study of selected state and regional programs in order to identify best practices with regard to their goals, structures, instruments, modes of operation, synergies across private and public programs, funding mechanisms and levels, and evaluation efforts. The committee is reviewing selected state and regional efforts to capitalize on federal and state investments in areas of critical national needs. Building the Arkansas Innovation Economy: Summary of a Symposium includes both efforts to strengthen existing industries as well as specific new technology focus areas such as nanotechnology, stem cells, and energy in order to better understand program goals, challenges, and accomplishments. As a part of this review, the committee is convening a series of public workshops and symposia involving responsible local, state, and federal officials and other stakeholders. These meetings and symposia will enable an exchange of views, information, experience, and analysis to identify best practice in the range of programs and incentives adopted. Drawing from discussions at these symposia, fact-finding meetings, and commissioned analyses of existing state and regional programs and technology focus areas, the committee will subsequently produce a final report with findings and recommendations focused on lessons, issues, and opportunities for complementary U.S. policies created by these state and regional initiatives.

    Since 1991, the National Research Council, under the auspices of the Board on Science, Technology, and Economic Policy, has undertaken a program of activities to improve policymakers’ understandings of the interconnections of science, technology, and economic policy and their importance for the American economy and its international competitive position. The Board’s activities have corresponded with increased policy recognition of the importance of knowledge and technology to economic growth. One important element of STEP’s analysis concerns the growth and impact of foreign technology programs.1 U.S. competitors have launched substantial programs to support new technologies, small firm development, and consortia among large and small firms to strengthen national and regional positions in strategic sectors. Some governments overseas have chosen to provide public support to innovation to overcome the market imperfections apparent in their national innovation systems. They believe that the rising costs and risks associated with new potentially high-payoff technologies, and the growing global dispersal of technical expertise, underscore the need for national R&D programs to support new and existing high-technology firms within their borders.

  • Developing and Strengthening the Global Supply Chain for Second-Line Drugs for Multidrug-Resistant Tuberculosis: Workshop Summary

    Cover imageTo effectively treat patients diagnosed with drug-resistant (DR) tuberculosis (TB) and protect the population from further transmission of this infectious disease, an uninterrupted supply of quality-assured (QA), second-line anti-TB drugs (SLDs) is necessary. Patients diagnosed with multidrug-resistant tuberculosis (MDR TB)—a disease caused by strains of Mycobacterium tuberculosis (M.tb.) resistant to two primary TB drugs (isoniazid and rifampicin)—face lengthy treatment regimens of 2 years or more with daily, directly observed treatment (DOT) with SLDs that are less potent, more toxic, and more expensive than those used to treat drug-susceptible TB. From 2000 to 2009, only 0.2-0.5 percent of the estimated 5 million MDR TB cases globally were treated with drugs of known quality and in programs capable of delivering appropriate care (Keshavjee, 2012). The vast majority of MDR TB patients either died from lack of treatment or contributed to the spread of MDR TB in their communities. A strengthened global supply chain for SLDs could save lives by consistently delivering high quality medicines to more of the people who need them.

    This public workshop explored innovative solutions to the problem of how to get the right SLDs for MDR TB to people who critically need them. More specifically, the workshop examined current problems and potential opportunities for coordinated international efforts to ensure that a reliable and affordable supply of high-quality SLDs is available. Developing and Strengthening the Global Supply Chain for Second-Line Drugs for Multidrug-Resistant Tuberculosis: Workshop Summary covers the objectives of the workshop, which were to review:

    -To what extent and in what ways current mechanisms are or are not effectively accomplishing what is needed, including consideration of bottlenecks.
    -The advantages and disadvantages of centralization in the management of the global drug supply chain, and potential decentralized approaches to improve operations of the supply chain.
    -What can be learned from case studies and examples from other diseases (e.g., the Affordable Medicines Facility-malaria (AMFm) and the U.S. President’s Emergency Plan for AIDS Relief [PEPFAR])
    – The current allocation of responsibilities and roles of the private (including industry and nonprofit public health organizations) and public sectors, and examination of opportunities for enhancing and optimizing collaboration
    -Identification of potential innovative solutions to the problem