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Each year, the Gulf Research Program (GRP) produces an annual report to summarize how funds were used. These reports review accomplishments, highlight activities, and, over time, will assess metrics to determine how the program is progressing in accomplishing its goals. The 2016 annual report is the third report in this series. The GRP is an independent, science-based program founded in 2013. Through grants, fellowships, and other activities, it seeks to enhance oil system safety and the protection of human health and the environment in the Gulf of Mexico region and other areas along the U.S. outer continental shelf with offshore oil and gas operations. This report captures key developments and successes in 2016, as the GRP ramped up its grant offerings with five competitions for five different grant types: exploratory, synthesis, capacity building, research-practice, and research and development. The GRP continues to build on its past work and seeks to learn, think about, and plan for how and where it can have the greatest cumulative and lasting impacts.
The 2013-2014 annual report highlights the establishment and first activities of the Gulf Research Program, an independent, science-based program founded in 2013. Through grants, fellowships, and other activities, the Gulf Research Program seeks to enhance oil system safety and the protection of human health and the environment in the Gulf of Mexico and other regions along the U.S. outer continental shelf with offshore oil and gas operations. This report reviews some of the Gulf Research Program's key accomplishments and demonstrates how what was learned throughout the planning process shaped the Program's foundation - from its strategic vision to the initial funding opportunities. The Gulf Research Program will build on this foundation while evolving to meet new challenges during its 30-year duration, 2013-2043. Each year, the Gulf Research Program will produce an annual report to summarize how funds were used. These reports will review accomplishments, highlight activities, and, over time, assess metrics to determine how the Gulf Research Program is progressing in accomplishing its goals. The 2013-2014 annual report is the first report in this series.
Each year, the Gulf Research Program (GRP) produces an annual report to summarize how funds were used. These reports review accomplishments, highlight activities, and, over time, will assess metrics to determine how the program is progressing in accomplishing its goals. The 2017 annual report is the fourth report in this series. The GRP is an independent, science-based program founded in 2013. Through grants, fellowships, and other activities, it seeks to enhance oil system safety and the protection of human health and the environment in the Gulf of Mexico region and other areas along the U.S. outer continental shelf with offshore oil and gas operations. This report captures key developments and successes in 2017. The GRP continues to build on its past work and seeks to learn, think about, and plan for how and where it can have the greatest cumulative and lasting impacts.
Whether the result of an oil well blowout, vessel collision or grounding, leaking pipeline, or other incident at sea, each marine oil spill will present unique circumstances and challenges. The oil type and properties, location, time of year, duration of spill, water depth, environmental conditions, affected biomes, potential human community impact, and available resources may vary significantly. Also, each spill may be governed by policy guidelines, such as those set forth in the National Response Plan, Regional Response Plans, or Area Contingency Plans. To respond effectively to the specific conditions presented during an oil spill, spill responders have used a variety of response optionsâ€"including mechanical recovery of oil using skimmers and booms, in situ burning of oil, monitored natural attenuation of oil, and dispersion of oil by chemical dispersants. Because each response method has advantages and disadvantages, it is important to understand specific scenarios where a net benefit may be achieved by using a particular tool or combination of tools. This report builds on two previous National Research Council reports on dispersant use to provide a current understanding of the state of science and to inform future marine oil spill response operations. The response to the 2010 Deepwater Horizon spill included an unprecedented use of dispersants via both surface application and subsea injection. The magnitude of the spill stimulated interest and funding for research on oil spill response, and dispersant use in particular. This study assesses the effects and efficacy of dispersants as an oil spill response tool and evaluates trade-offs associated with dispersant use.
Each year, the Gulf Research Program (GRP) produces an annual report to summarize how funds were used. These reports review accomplishments, highlight activities, and, over time, will assess metrics to determine how the program is progressing in accomplishing its goals. The 2018 annual report is the fifth report in this series. The GRP is an independent, science-based program founded in 2013. Through grants, fellowships, and other activities, it seeks to enhance oil system safety and the protection of human health and the environment in the Gulf of Mexico region and other areas along the U.S. outer continental shelf with offshore oil and gas operations. This report captures key developments and successes in 2018. The GRP continues to build on its past work and seeks to learn, think about, and plan for how and where it can have the greatest cumulative and lasting impacts.
The frequency and severity of disasters over the last few decades have presented unprecedented challenges for communities across the United States. In 2005, Hurricane Katrina exposed the complexity and breadth of a deadly combination of existing community stressors, aging infrastructure, and a powerful natural hazard. In many ways, the devastation of Hurricane Katrina was a turning point for understanding and managing disasters, as well as related plan making and policy formulation. It brought the phrase "community resilience" into the lexicon of disaster management. Building and Measuring Community Resilience: Actions for Communities and the Gulf Research Program summarizes the existing portfolio of relevant or related resilience measurement efforts and notes gaps and challenges associated with them. It describes how some communities build and measure resilience and offers four key actions that communities could take to build and measure their resilience in order to address gaps identified in current community resilience measurement efforts. This report also provides recommendations to the Gulf Research Program to build and measure resilience in the Gulf of Mexico region.
Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.
Advances in trauma care have accelerated over the past decade, spurred by the significant burden of injury from the wars in Afghanistan and Iraq. Between 2005 and 2013, the case fatality rate for United States service members injured in Afghanistan decreased by nearly 50 percent, despite an increase in the severity of injury among U.S. troops during the same period of time. But as the war in Afghanistan ends, knowledge and advances in trauma care developed by the Department of Defense (DoD) over the past decade from experiences in Afghanistan and Iraq may be lost. This would have implications for the quality of trauma care both within the DoD and in the civilian setting, where adoption of military advances in trauma care has become increasingly common and necessary to improve the response to multiple civilian casualty events. Intentional steps to codify and harvest the lessons learned within the military's trauma system are needed to ensure a ready military medical force for future combat and to prevent death from survivable injuries in both military and civilian systems. This will require partnership across military and civilian sectors and a sustained commitment from trauma system leaders at all levels to assure that the necessary knowledge and tools are not lost. A National Trauma Care System defines the components of a learning health system necessary to enable continued improvement in trauma care in both the civilian and the military sectors. This report provides recommendations to ensure that lessons learned over the past decade from the military's experiences in Afghanistan and Iraq are sustained and built upon for future combat operations and translated into the U.S. civilian system.
The medical research landscape in the United States is supported by a variety of organizations that spend billions of dollars in government and private funds each year to seek answers to complex medical and public health problems. The largest government funder is the National Institutes of Health (NIH), followed by the Department of Defense (DoD). Almost half of DoD's medical research funding is administered by the Congressionally Directed Medical Research Programs (CDMRP). The mission of CDMRP is to foster innovative approaches to medical research in response to the needs of its stakeholdersâ€"the U.S. military, their families, the American public, and Congress. CDMRP funds medical research to be performed by other government and nongovernmental organizations, but it does not conduct research itself. The major focus of CDMRP funded research is the improved prevention, diagnosis, and treatment of diseases, injuries, or conditions that affect service members and their families, and the general public. The hallmarks of CDMRP include reviewing applications for research funding using a two-tiered review process, and involving consumers throughout the process. Evaluation of the Congressionally Directed Medical Research Programs Review Process evaluates the CDMRP two-tiered peer review process, its coordination of research priorities with NIH and the Department of Veterans Affairs, and provides recommendations on how the process for reviewing and selecting studies can be improved.
The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) began 40 years ago as a pilot program and has since grown to serve over 8 million pregnant women, and mothers of and their infants and young children. Today the program serves more than a quarter of the pregnant women and half of the infants in the United States, at an annual cost of about $6.2 billion. Through its contribution to the nutritional needs of pregnant, breastfeeding, and post-partum women; infants; and children under 5 years of age; this federally supported nutrition assistance program is integral to meeting national nutrition policy goals for a significant portion of the U.S. population. To assure the continued success of the WIC, Congress mandated that the Food and Nutrition Service of the U.S. Department of Agriculture (USDA) reevaluate the program's food packages every 10 years. In 2014, the USDA asked the Institute of Medicine to undertake this reevaluation to ensure continued alignment with the goals of the Dietary Guidelines for Americans. This, the second report of this series, provides a summary of the work of phase I of the study, and serves as the analytical underpinning for phase II in which the committee will report its final conclusions and recommendations.