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As the nation’s economic activities, security concerns, and stewardship of natural resources become increasingly complex and globally interrelated, they become ever more sensitive to adverse impacts from weather, climate, and other natural phenomena. For several decades, forecasts with lead times of a few days for weather and other environmental phenomena have yielded valuable information to improve decision-making across all sectors of society. Developing the capability to forecast environmental conditions and disruptive events several weeks and months in advance could dramatically increase t
Electricity is the lifeblood of modern society, and for the vast majority of people that electricity is obtained from large, interconnected power grids. However, the grid that was developed in the 20th century, and the incremental improvements made since then, including its underlying analytic foundations, is no longer adequate to completely meet the needs of the 21st century. The next-generation electric grid must be more flexible and resilient. While fossil fuels will have their place for decades to come, the grid of the future will need to accommodate a wider mix of more intermittent genera
From 1962 to 1971, the US military sprayed herbicides over Vietnam to strip the thick jungle canopy that could conceal opposition forces, to destroy crops that those forces might depend on, and to clear tall grasses and bushes from the perimeters of US base camps and outlying fire-support bases. Mixtures of 2,4-dichlorophenoxyacetic acid (2,4-D), 2,4,5-trichlorophenoxyacetic acid (2,4,5-T), picloram, and cacodylic acid made up the bulk of the herbicides sprayed. The main chemical mixture sprayed was Agent Orange, a 50:50 mixture of 2,4-D and 2,4,5-T. At the time of the spraying, 2,3,7,8-tetrac
Science, engineering, and technology permeate nearly every facet of modern life and hold the key to solving many of humanity's most pressing current and future challenges. The United States' position in the global economy is declining, in part because U.S. workers lack fundamental knowledge in these fields. To address the critical issues of U.S. competitiveness and to better prepare the workforce, A Framework for K-12 Science Education proposes a new approach to K-12 science education that will capture students' interest and provide them with the necessary foundational knowledge in th
The Future of Nursing explores how nurses' roles, responsibilities, and education should change significantly to meet the increased demand for care that will be created by health care reform and to advance improvements in America's increasingly complex health system.
At more than 3 million in number, nurses make up the single largest segment of the health care work force. They also spend the greatest amount of time in delivering patient care as a profession. Nurses therefore have valuable insights and unique abilities to contribute as partners with other health care p
As climate has warmed over recent years, a new pattern of more frequent and more intense weather events has unfolded across the globe. Climate models simulate such changes in extreme events, and some of the reasons for the changes are well understood. Warming increases the likelihood of extremely hot days and nights, favors increased atmospheric moisture that may result in more frequent heavy rainfall and snowfall, and leads to evaporation that can exacerbate droughts. Even with evidence of these broad trends, scientists cautioned in the past that individual weather events couldn't be attribut
The Centers for Medicare & Medicaid Services (CMS) have been moving from volume-based, fee-for-service payment to value-based payment (VBP), which aims to improve health care quality, health outcomes, and patient care experiences, while also controlling costs. Since the passage of the Patient Protection and Affordable Care Act of 2010, CMS has implemented a variety of VBP strategies, including incentive programs and risk-based alternative payment models. Early evidence from these programs raised concerns about potential unintended consequences for health equity. Specifically, emerging evidence
First released in the Spring of 1999, How People Learn has been expanded to show how the theories and insights from the original book can translate into actions and practice, now making a real connection between classroom activities and learning behavior. This edition includes far-reaching suggestions for research that could increase the impact that classroom teaching has on actual learning.
Like the original edition, this book offers exciting new research about the mind and the brain that provides answers to a number of compelling questions. When do infants begin to lear
The Physical Measurement Laboratory (PML) at the National Institute of Standards and Technology (NIST) is dedicated to three fundamental and complementary tasks: (1) increase the accuracy of our knowledge of the physical parameters that are the foundation of our technology-driven society; (2) disseminate technologies by which these physical parameters can be accessed in a standardized way by the stakeholders; and (3) conduct research at both fundamental and applied levels to provide knowledge that may eventually lead to advances in measurement approaches and standards. This report assesses the
Pathogens transmitted among humans, animals, or plants by insects and arthropod vectors have been responsible for significant morbidity and mortality throughout recorded history. Such vector-borne diseases – including malaria, dengue, yellow fever, and plague – together accounted for more human disease and death in the 17th through early 20th centuries than all other causes combined. Over the past three decades, previously controlled vector-borne diseases have resurged or reemerged in new geographic locations, and several newly identified pathogens and vectors have triggered disease outbreaks
The workshop summarized in this report was organized as part of a study sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Office of the Assistant Secretary for Planning and Evaluation of the U.S. Department of Health and Human Services, with the goal of assisting SAMHSA in its responsibilities of expanding the collection of behavioral health data in several areas. The workshop brought together experts in mental health, psychiatric epidemiology and survey methods to facilitate discussion of the most suitable measures and mechanisms for producing estimat
Factoring health and related costs into decision making is essential to confronting the nation's health problems and enhancing public well-being. Some policies and programs historically not recognized as relating to health are believed or known to have important health consequences. For example, public health has been linked to an array of policies that determine the quality and location of housing, availability of public transportation, land use and street connectivity, agricultural practices and the availability of various types of food, and development and location of businesses and indust
Second in a series of publications from the Institute of Medicine's Quality of Health Care in America project
Today's health care providers have more research findings and more technology available to them than ever before. Yet recent reports have raised serious doubts about the quality of health care in America.
Crossing the Quality Chasm makes an urgent call for fundamental change to close the quality gap. This book recommends a sweeping redesign of the American health care system and provides overarching principles for specific direction for policymakers,
The past half-century has witnessed a dramatic increase in the scale and complexity of scientific research. The growing scale of science has been accompanied by a shift toward collaborative research, referred to as "team science." Scientific research is increasingly conducted by small teams and larger groups rather than individual investigators, but the challenges of collaboration can slow these teams' progress in achieving their scientific goals. How does a team-based approach work, and how can universities and research institutions support teams? Enhancing the Effectiveness of Team Scien
The World Health Organization defines the social determinants of health as “the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life.” These forces and systems include economic policies, development agendas, cultural and social norms, social policies, and political systems. In an era of pronounced human migration, changing demographics, and growing financial gaps between rich and poor, a fundamental understanding of how the conditions and circumstances in which individuals and populations exist affect menta
Experts estimate that as many as 98,000 people die in any given year from medical errors that occur in hospitals. That's more than die from motor vehicle accidents, breast cancer, or AIDS--three causes that receive far more public attention. Indeed, more people die annually from medication errors than from workplace injuries. Add the financial cost to the human tragedy, and medical error easily rises to the top ranks of urgent, widespread public problems.
To Err Is Human breaks the silence that has surrounded medical errors and their consequence--but not by pointing fingers at
The scientific research enterprise is built on a foundation of trust. Scientists trust that the results reported by others are valid. Society trusts that the results of research reflect an honest attempt by scientists to describe the world accurately and without bias. But this trust will endure only if the scientific community devotes itself to exemplifying and transmitting the values associated with ethical scientific conduct.
On Being a Scientist was designed to supplement the informal lessons in ethics provided by research supervisors and mentors. The book describes the
Adding It Up explores how students in pre-K through 8th grade learn mathematics and recommends how teaching, curricula, and teacher education should change to improve mathematics learning during these critical years.
The committee identifies five interdependent components of mathematical proficiency and describes how students develop this proficiency. With examples and illustrations, the book presents a portrait of mathematics learning:
Research findings on what children know about numbers by the time they arrive in pre-K and the implications f
Intrinsic variability across the human population is associated with variable responses to environmental stressors. Understanding both the sources and the magnitude of the variability is a key challenge for scientists and for decision makers. Understanding such variations has long been a key consideration for those tasked with risk-based decisions. The National Academies of Sciences, Engineering, and Medicine, sponsored by the National Institute for Environmental Health Sciences, held its second workshop on interindividual variability on September 30 and October 1, 2015 in Washington, DC. The
For patients and their loved ones, no care decisions are more profound than those made near the end of life. Unfortunately, the experience of dying in the United States is often characterized by fragmented care, inadequate treatment of distressing symptoms, frequent transitions among care settings, and enormous care responsibilities for families. According to this report, the current health care system of rendering more intensive services than are necessary and desired by patients, and the lack of coordination among programs increases risks to patients and creates avoidable burdens on them and