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In recent years much has happened to justify an examination of biological research in light of national security concerns. The destructive application of biotechnology research includes activities such as spreading common pathogens or transforming them into even more lethal forms. Policymakers and the scientific community at large must put forth a vigorous and immediate response to this challenge. This new book by the National Research Council recommends that the government expand existing regulations and rely on self-governance by scientists rather than adopt intrusive new policies. One key recommendation of the report is that the government should not attempt to regulate scientific publishing but should trust scientists and journals to screen their papers for security risks, a task some journals have already taken up. With biological information and tools widely distributed, regulating only U.S. researchers would have little effect. A new International Forum on Biosecurity should encourage the adoption of similar measures around the world. Seven types of risky studies would require approval by the Institutional Biosafety Committees that already oversee recombinant DNA research at some 400 U.S. institutions. These "experiments of concern" include making an infectious agent more lethal and rendering vaccines powerless.
During an influenza pandemic, healthcare workers will be on the front lines delivering care to patients and preventing further spread of the disease. As the nation prepares for pandemic influenza, multiple avenues for protecting the health of the public are being carefully considered, ranging from rapid development of appropriate vaccines to quarantine plans should the need arise for their implementation. One vital aspect of pandemic influenza planning is the use of personal protective equipment (PPE)-the respirators, gowns, gloves, face shields, eye protection, and other equipment that will be used by healthcare workers and others in their day-to-day patient care responsibilities. However, efforts to appropriately protect healthcare workers from illness or from infecting their families and their patients are greatly hindered by the paucity of data on the transmission of influenza and the challenges associated with training and equipping healthcare workers with effective personal protective equipment. Due to this lack of knowledge on influenza transmission, it is not possible at the present time to definitively inform healthcare workers about what PPE is critical and what level of protection this equipment will provide in a pandemic. The outbreaks of severe acute respiratory syndrome (SARS) in 2003 have underscored the importance of protecting healthcare workers from infectious agents. The surge capacity that will be required to reduce mortality from a pandemic cannot be met if healthcare workers are themselves ill or are absent due to concerns about PPE efficacy. The IOM committee determined that there is an urgent need to address the lack of preparedness regarding effective PPE for use in an influenza pandemic. Preparing for an Influenza Pandemic : Personal Protective Equipment for Healthcare Workers identifies that require expeditious research and policy action: (1) Influenza transmission research should become an immediate and short-term research priority so that effective prevention and control strategies can be developed and refined. The current paucity of knowledge significantly hinders prevention efforts. (2) Employer and employee commitment to worker safety and appropriate use of PPE should be strengthened. Healthcare facilities should establish and promote a culture of safety. (3) An integrated effort is needed to understand the PPE requirements of the worker and to develop and utilize innovative materials and technologies to create the next generation of PPE capable of meeting these needs.
Who Goes There?: Authentication Through the Lens of Privacy explores authentication technologies (passwords, PKI, biometrics, etc.) and their implications for the privacy of the individuals being authenticated. As authentication becomes ever more ubiquitous, understanding its interplay with privacy is vital. The report examines numerous concepts, including authentication, authorization, identification, privacy, and security. It provides a framework to guide thinking about these issues when deciding whether and how to use authentication in a particular context. The book explains how privacy is affected by system design decisions. It also describes government's unique role in authentication and what this means for how government can use authentication with minimal invasions of privacy. In addition, Who Goes There? outlines usability and security considerations and provides a primer on privacy law and policy.
The twentieth century witnessed an era of unprecedented, large-scale, anthropogenic changes to the natural environment. Understanding how environmental factors directly and indirectly affect the emergence and spread of infectious disease has assumed global importance for life on this planet. While the causal links between environmental change and disease emergence are complex, progress in understanding these links, as well as how their impacts may vary across space and time, will require transdisciplinary, transnational, collaborative research. This research may draw upon the expertise, tools, and approaches from a variety of disciplines. Such research may inform improvements in global readiness and capacity for surveillance, detection, and response to emerging microbial threats to plant, animal, and human health. The Influence of Global Environmental Change on Infectious Disease Dynamics is the summary of a workshop hosted by the Institute of Medicine Forum on Microbial Threats in September 2013 to explore the scientific and policy implications of the impacts of global environmental change on infectious disease emergence, establishment, and spread. This report examines the observed and potential influence of environmental factors, acting both individually and in synergy, on infectious disease dynamics. The report considers a range of approaches to improve global readiness and capacity for surveillance, detection, and response to emerging microbial threats to plant, animal, and human health in the face of ongoing global environmental change.
Once ice-bound, difficult to access, and largely ignored by the rest of the world, the Arctic is now front and center in the midst of many important questions facing the world today. Our daily weather, what we eat, and coastal flooding are all interconnected with the future of the Arctic. The year 2012 was an astounding year for Arctic change. The summer sea ice volume smashed previous records, losing approximately 75 percent of its value since 1980 and half of its areal coverage. Multiple records were also broken when 97 percent of Greenland's surface experienced melt conditions in 2012, the largest melt extent in the satellite era. Receding ice caps in Arctic Canada are now exposing land surfaces that have been continuously ice covered for more than 40,000 years. What happens in the Arctic has far-reaching implications around the world. Loss of snow and ice exacerbates climate change and is the largest contributor to expected global sea level rise during the next century. Ten percent of the world's fish catches comes from Arctic and sub-Arctic waters. The U.S. Geological Survey estimated that up to 13 percent of the world's remaining oil reserves are in the Arctic. The geologic history of the Arctic may hold vital clues about massive volcanic eruptions and the consequent release of massive amount of coal fly ash that is thought to have caused mass extinctions in the distant past. How will these changes affect the rest of Earth? What research should we invest in to best understand this previously hidden land, manage impacts of change on Arctic communities, and cooperate with researchers from other nations? The Arctic in the Anthropocene reviews research questions previously identified by Arctic researchers, and then highlights the new questions that have emerged in the wake of and expectation of further rapid Arctic change, as well as new capabilities to address them. This report is meant to guide future directions in U.S. Arctic research so that research is targeted on critical scientific and societal questions and conducted as effectively as possible. The Arctic in the Anthropocene identifies both a disciplinary and a cross-cutting research strategy for the next 10 to 20 years, and evaluates infrastructure needs and collaboration opportunities. The climate, biology, and society in the Arctic are changing in rapid, complex, and interactive ways. Understanding the Arctic system has never been more critical; thus, Arctic research has never been more important. This report will be a resource for institutions, funders, policy makers, and students. Written in an engaging style, The Arctic in the Anthropocene paints a picture of one of the last unknown places on this planet, and communicates the excitement and importance of the discoveries and challenges that lie ahead.
There are over 20 million young people of color in the United States whose representation in STEM education pathways and in the STEM workforce is still far below their numbers in the general population. Their participation could help re-establish the United States' preeminence in STEM innovation and productivity, while also increasing the number of well-educated STEM workers. There are nearly 700 minority-serving institutions (MSIs) that provide pathways to STEM educational success and workforce readiness for millions of students of colorâ€"and do so in a mission-driven and intentional manner. They vary substantially in their origins, missions, student demographics, and levels of institutional selectivity. But in general, their service to the nation provides a gateway to higher education and the workforce, particularly for underrepresented students of color and those from low-income and first-generation to college backgrounds. The challenge for the nation is how to capitalize on the unique strengths and attributes of these institutions and to equip them with the resources, exceptional faculty talent, and vital infrastructure needed to educate and train an increasingly critical portion of current and future generations of scientists, engineers, and health professionals. Minority Serving Institutions examines the nation's MSIs and identifies promising programs and effective strategies that have the highest potential return on investment for the nation by increasing the quantity and quality MSI STEM graduates. This study also provides critical information and perspective about the importance of MSIs to other stakeholders in the nation's system of higher education and the organizations that support them.
As the first of the nation's 78 million baby boomers begin reaching age 65 in 2011, they will face a health care workforce that is too small and woefully unprepared to meet their specific health needs. Retooling for an Aging America calls for bold initiatives starting immediately to train all health care providers in the basics of geriatric care and to prepare family members and other informal caregivers, who currently receive little or no training in how to tend to their aging loved ones. The book also recommends that Medicare, Medicaid, and other health plans pay higher rates to boost recruitment and retention of geriatric specialists and care aides. Educators and health professional groups can use Retooling for an Aging America to institute or increase formal education and training in geriatrics. Consumer groups can use the book to advocate for improving the care for older adults. Health care professional and occupational groups can use it to improve the quality of health care jobs.
Advances in medical, biomedical and health services research have reduced the level of uncertainty in clinical practice. Clinical practice guidelines (CPGs) complement this progress by establishing standards of care backed by strong scientific evidence. CPGs are statements that include recommendations intended to optimize patient care. These statements are informed by a systematic review of evidence and an assessment of the benefits and costs of alternative care options. Clinical Practice Guidelines We Can Trust examines the current state of clinical practice guidelines and how they can be improved to enhance healthcare quality and patient outcomes. Clinical practice guidelines now are ubiquitous in our healthcare system. The Guidelines International Network (GIN) database currently lists more than 3,700 guidelines from 39 countries. Developing guidelines presents a number of challenges including lack of transparent methodological practices, difficulty reconciling conflicting guidelines, and conflicts of interest. Clinical Practice Guidelines We Can Trust explores questions surrounding the quality of CPG development processes and the establishment of standards. It proposes eight standards for developing trustworthy clinical practice guidelines emphasizing transparency; management of conflict of interest ; systematic review-guideline development intersection; establishing evidence foundations for and rating strength of guideline recommendations; articulation of recommendations; external review; and updating. Clinical Practice Guidelines We Can Trust shows how clinical practice guidelines can enhance clinician and patient decision-making by translating complex scientific research findings into recommendations for clinical practice that are relevant to the individual patient encounter, instead of implementing a one size fits all approach to patient care. This book contains information directly related to the work of the Agency for Healthcare Research and Quality (AHRQ), as well as various Congressional staff and policymakers. It is a vital resource for medical specialty societies, disease advocacy groups, health professionals, private and international organizations that develop or use clinical practice guidelines, consumers, clinicians, and payers.