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"Openness and sharing of information are fundamental to the progress of science and to the effective functioning of the research enterprise. The advent of scientific journals in the 17th century helped power the Scientific Revolution by allowing researchers to communicate across time and space, using the technologies of that era to generate reliable knowledge more quickly and efficiently. Harnessing today's stunning, ongoing advances in information technologies, the global research enterprise and its stakeholders are moving toward a new open science ecosystem. Open science aims to ensure the free availability and usability of scholarly publications, the data that result from scholarly research, and the methodologies, including code or algorithms, that were used to generate those data. Open Science by Design is aimed at overcoming barriers and moving toward open science as the default approach across the research enterprise. This report explores specific examples of open science and discusses a range of challenges, focusing on stakeholder perspectives. It is meant to provide guidance to the research enterprise and its stakeholders as they build strategies for achieving open science and take the next steps"--

"The question of whether and under what circumstances terminally ill patients should be able to access life-ending medications with the aid of a physician is receiving increasing attention as a matter of public opinion and of public policy. Ethicists, clinicians, patients, and their families debate whether physician-assisted death ought to be a legal option for patients. While public opinion is divided and public policy debates include moral, ethical, and policy considerations, a demand for physician-assisted death persists among some patients, and the inconsistent legal terrain leaves a number of questions and challenges for health care providers to navigate when presented with patients considering or requesting physician-assisted death. To discuss what is known and not known empirically about the practice of physician-assisted death, the National Academies of Sciences, Engineering, and Medicine convened a 2-day workshop in Washington, DC, on February 12-13, 2018. This publication summarizes the presentations and discussions from the workshop"--Publisher's description.

Beginning in October 2017, the National Academies of Sciences, Engineering, and Medicine organized a set of workshops designed to gather information for the Decadal Survey of Social and Behavioral Sciences for Applications to National Security. The sixth workshop focused on understanding narratives for national security purposes, and this publication summarizes the presentations and discussions from this workshop.

Beginning in October 2017, the National Academies of Sciences, Engineering, and Medicine organized a set of workshops designed to gather information for the Decadal Survey of Social and Behavioral Sciences for Applications to National Security. The fifth workshop focused on workforce development and intelligence analysis, and this publication summarizes the presentations and discussions from this workshop.

Since the end of the Second World War, the United States has developed the world's preeminent system for biomedical research, one that has given rise to revolutionary medical advances as well as a dynamic and innovative business sector generating high-quality jobs and powering economic output and exports for the U.S. economy. However, there is a growing concern that the biomedical research enterprise is beset by several core challenges that undercut its vitality, promise, and productivity and that could diminish its critical role in the nation's health and innovation in the biomedical industry. Among the most salient of these challenges is the gulf between the burgeoning number of scientists qualified to participate in this system as academic researchers and the elusive opportunities to establish long-term research careers in academia. The patchwork of measures to address the challenges facing young scientists that has emerged over the years has allowed the U.S. biomedical enterprise to continue to make significant scientific and medical advances. These measures, however, have not resolved the structural vulnerabilities in the system, and in some cases come at a great opportunity cost for young scientists. These unresolved issues could diminish the nation's ability to recruit the best minds from all sectors of the U.S. population to careers in biomedical research and raise concerns about a system that may favor increasingly conservative research proposals over high-risk, innovative ideas. The Next Generation of Biomedical and Behavioral Sciences Researchers: Breaking Through evaluates the factors that influence transitions into independent research careers in the biomedical and behavioral sciences and offers recommendations to improve those transitions. These recommendations chart a path to a biomedical research enterprise that is competitive, rigorous, fair, dynamic, and can attract the best minds from across the country.

"On September 14, 2017, the Roundtable on Population Health Improvement of the National Academies of Sciences, Engineering, and Medicine convened a workshop to explore the intersection of health and early childhood care and education, two key social determinants of health. This workshop follows a 2014 roundtable workshop that considered the interface between the education and health sectors broadly, from research and metrics to cross-sectoral partnerships and financing. The 2017 workshop continued that discussion, with a deeper focus on early childhood (birth through age 5) as a critical period in human development and an important opportunity for educational and related interventions. This publication summarizes the presentations and discussions from the 2017 workshop"--Publisher's description.

"Black men are increasingly underrepresented in medical schools and in the medical profession. A diverse workforce is a key attribute of quality healthcare and research suggests that a diverse workforce may help to advance cultural competency and increase access to high-quality health care, especially for underserved populations. Conversely, lack of diversity in the health workforce threatens health care quality and access and contributes to health disparities. In this way, the growing absence of Black men in medicine is especially troubling, because their absence in medicine may have adverse consequences for health care access, quality, and outcomes among Black Americans and Americans overall. To better understand the factors that contribute to the low participation of Black men in the medical profession, facilitate discussion of current strategies used to increase their participation in medical education, and explore new strategies along the educational and professional pipeline that may have potential to increase participation in medicine, the National Academies of Sciences, Engineering, and Medicine and the Cobb Institute jointly convened a 2-day workshop in November 2017, in Washington, DC. This publication summarizes the presentations and discussions from the workshop"--

"The review of this proceedings was overseen by Gary LaFree"--Page ix.

The National Academies of Sciences, Engineering, Medicine.

"The increasing diversity of population of the United States presents many challenges to conducting health research that is representative and informative. Dispersion and accessibility issues can increase logistical costs; populations for which it is difficult to obtain adequate sample size are also likely to be expensive to study. Hence, even if it is technically feasible to study a small population, it may not be easy to obtain the funding to do so. In order to address the issues associated with improving health research of small populations, the National Academies of Sciences, Engineering, and Medicine convened a workshop in January 2018. Participants considered ways of addressing the challenges of conducting epidemiological studies or intervention research with small population groups, including alternative study designs, innovative methodologies for data collection, and innovative statistical techniques for analysis"--Publisher's description.

"A pressing challenge in the modern health care system is the gap between education and clinical practice. Emerging technologies have the potential to bridge this gap by creating the kind of team-based learning environments and clinical approaches that are increasingly necessary in the modern health care system both in the United States and around the world. To explore these technologies and their potential for improving education and practice, the National Academies of Sciences, Engineering, and Medicine hosted a workshop in November 2017. Participants explored effective use of technologies as tools for bridging identified gaps within and between health professions education and practice in order to optimize learning, performance and access in high-, middle-, and low-income areas while ensuring the well-being of the formal and informal health workforce. This publication summarizes the presentations and discussions from the workshop"--

The 2006 Institute of Medicine (IOM) consensus study report From Cancer Patient to Cancer Survivor: Lost in Transition made recommendations to improve the quality of care that cancer survivors receive, in recognition that cancer survivors are at risk for significant physical, psychosocial, and financial repercussions from cancer and its treatment. Since then, efforts to recognize and address the unique needs of cancer survivors have increased, including an emphasis on improving the evidence base for cancer survivorship care and identifying best practices in the delivery of high-quality cancer survivorship care. To examine progress in cancer survivorship care since the Lost in Transition report, the National Cancer Policy Forum of the National Academies of Sciences, Engineering, and Medicine held a workshop in July 2017, in Washington, DC. Workshop participants highlighted potential opportunities to improve the planning, management, and delivery of cancer survivorship care. This publication summarizes the presentations and discussions from the workshop.

Solving the world's health challenges requires multidisciplinary collaborations that bring together the talents, experiences, resources, and ideas from multiple sectors. These collaborations in global health frequently occur through public-private partnerships (PPPs) in which public and private parties share risks, responsibilities, and decision-making processes with the objective of collectively and more effectively addressing a common goal. However, these numerous stakeholders bring varying strengths and resources to global health partnerships, but they also bring their own organizational cultures, regulations, and expectations. Managing partnerships among them is complex and requires intentional and thoughtful governance. Over the last several decades, as the number of interested stakeholders, resources invested, and initiatives launched within the global health field has grown, effective governance of global health PPPs has become increasingly critical. To explore the role of governance in PPPs for global health, the Forum on Public-Private Partnerships for Global Health and Safety convened a workshop. Participants explored best practices, common challenges, and lessons learned in the varying approaches to partnership governance. They also highlighted key issues in the governance of PPPs for global health with the goal of increasing their effectiveness in improving health outcomes. This publication summarizes the presentations and discussions from the workshop.

Graduate medical education (GME) is critical to the career development of individual physicians, to the functioning of many teaching institutions, and to the production of our physician workforce. However, recent reports have called for substantial reform of GME. The current lack of established GME outcome measures limits our ability to assess the impact of individual graduates, the performance of residency programs and teaching institutions, and the collective contribution of GME graduates to the physician workforce. To examine the opportunities and challenges in measuring and assessing GME outcomes, the National Academies of Sciences, Engineering, and Medicine held a workshop on October 10-11, 2017, in Washington, DC. Workshop participants discussed: meaningful and measurable outcomes of GME; possible metrics that could be used to track these GME outcomes; possible mechanisms for collecting, collating, analyzing, and reporting these data; and further work to accomplish this ambitious goal. This publication summarizes the presentations and discussions from the workshop.

Genomic applications are being integrated into a broad range of clinical and research activities at health care systems across the United States. This trend can be attributed to a variety of factors, including the declining cost of genome sequencing and the potential for improving health outcomes and cutting the costs of care. The goals of these genomics-based programs may be to identify individuals with clinically actionable variants as a way of preventing disease, providing diagnoses for patients with rare diseases, and advancing research on genetic contributions to health and disease. Of particular interest are genomics- based screening programs, which will, in this publication, be clinical screening programs that examine genes or variants in unselected populations in order to identify individuals who are at an increased risk for a particular health concern (e.g., diseases, adverse drug outcomes) and who might benefit from clinical interventions. On November 1, 2017, the National Academies of Sciences, Engineering, and Medicine hosted a public workshop to explore the challenges and opportunities associated with integrating genomics-based screening programs into health care systems. This workshop was developed as a way to explore the challenges and opportunities associated with integrating genomics-based programs in health care systems in the areas of evidence collection, sustainability, data sharing, infrastructure, and equity of access. This publication summarizes the presentations and discussions from the workshop.

On February 26-27, 2014, the National Academies of Sciences, Engineering, and Medicine's Forum on Global Violence Prevention convened a workshop titled Mental Health and Violence: Opportunities for Prevention and Early Intervention. The workshop brought together advocates and experts in public health and mental health, anthropology, biomedical science, criminal justice, global health and development, and neuroscience to examine experience, evidence, and practice at the intersection of mental health and violence. Participants explored how violence impacts mental health and how mental health influences violence and discussed approaches to improve research and practice in both domains. This publication summarizes the presentations and discussions from the workshop"--

"Rural counties make up about 80 percent of the land area of the United States, but they contain less than 20 percent of the U.S. population. The relative sparseness of the population in rural areas is one of many factors that influence the health and well-being of rural Americans. Rural areas have histories, economies, and cultures that differ from those of cities and from one rural area to another. Understanding these differences is critical to taking steps to improve health and well-being in rural areas and to reduce health disparities among rural populations. To explore the impacts of economic, demographic, and social issues in rural communities and to learn about asset-based approaches to addressing the associated challenges, the National Academies of Sciences, Engineering, and Medicine held a workshop on June 13, 2017. This publication summarizes the presentations and discussions from the workshop"--

"Many different groups of people are subject to stereotypes. Positive stereotypes (e.g., "older and wiser") may provide a benefit to the relevant groups. However, negative stereotypes of aging and of disability continue to persist and, in some cases, remain socially acceptable. Research has shown that when exposed to negative images of aging, older persons demonstrate poor physical and cognitive performance and function, while those who are exposed to positive images of aging (or who have positive self-perceptions of aging) demonstrate better performance and function. Furthermore, an individual's expectations about and perceptions of aging can predict future health outcomes. To better understand how stereotypes affect older adults and individuals with disabilities, the National Academies of Sciences, Engineering, and Medicine, with support from AARP, convened a public workshop on October 10, 2017. This publication summarizes the presentations and discussions from the workshop"--

For the past 17 years, the U.S. National Commission on Mathematics Instruction (USNC/MI) has held workshops with mathematics educators from countries that typically perform well on international assessments and have a history of strong mathematics education programs, such as Japan, China, and South Korea. Finland is among this group. Even though its mathematics education system has some common characteristics with other top-performing nations, such as a great social respect for the teaching profession, it also has unique characteristics. The USNC/MI, a standing committee of the National Academies of Sciences, Engineering, and Medicine, planned a workshop at which U.S. and Finnish mathematics educators could exchange information and ideas about the preparation of new mathematics teachers and the means of providing them with support and professional development throughout their careers. While this is not the first time U.S. and Finnish mathematics educators have discussed educational practices, this workshop focused primarily on teacher development in both nations in the context of mathematics education. This publication summarizes the presentations and discussions from the workshop.

The National Academies of Sciences, Engineering, and Medicine's Army Research Laboratory Technical Assessment Board (ARLTAB) provides biennial assessments of the scientific and technical quality of the research, development, and analysis programs at the Army Research Laboratory (ARL), focusing on ballistics sciences, human sciences, information sciences, materials sciences, and mechanical sciences. This interim report summarizes the findings of the ARLTAB for the first year of this biennial assessment; the current report addresses approximately half the portfolio for each campaign; the remainder will be assessed in 2018.

"The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience"--

Instructional materials are a key means to achieving the goals of science education--an enterprise that yields unique and worthwhile benefits to individuals and society. As states and districts move forward with adoption and implementation of the Next Generation Science Standards (NGSS) or work on improving their instruction to align with A Framework for K-12 Science Education (the Framework), instructional materials that align with this new vision for science education have emerged as one of the key mechanisms for creating high-quality learning experiences for students. In response to the need for more coordination across the ongoing efforts to support the design and implementation of instructional materials for science education, the National Academies of Sciences, Engineering, and Medicine convened a public workshop in June 2017. The workshop focused on the development of instructional materials that reflect the principles of the Framework and the NGSS. This publication summarizes the presentations and discussions from the workshop.

Spacecraft depend on electronic components that must perform reliably over missions measured in years and decades. Space radiation is a primary source of degradation, reliability issues, and potentially failure for these electronic components. Although simulation and modeling are valuable for understanding the radiation risk to microelectronics, there is no substitute for testing, and an increased use of commercial-off-the- shelf parts in spacecraft may actually increase requirements for testing, as opposed to simulation and modeling. Testing at the Speed of Light evaluates the nation's current capabilities and future needs for testing the effects of space radiation on microelectronics to ensure mission success and makes recommendations on how to provide effective stewardship of the necessary radiation test infrastructure for the foreseeable future.

To explore how the use of technology can facilitate progress toward globally recognized health priorities, the Forum on Public-Private Partnerships for Global Health and Safety organized a public workshop. Participants identified and explored the major challenges and opportunities for developing and implementing digital health strategies within the global, country, and local context, and framed the case for cross-sector and cross-industry collaboration, engagement, and investment in digital health strategies. This publication summarizes the presentations and discussions from the workshop.

The Intelligence Community Studies Board of the National Academies of Sciences, Engineering, and Medicine convened a workshop on August 9-10, 2017 to examine challenges in machine generation of analytic products from multi-source data. Workshop speakers and participants discussed research challenges related to machine-based methods for generating analytic products and for automating the evaluation of these products, with special attention to learning from small data, using multi-source data, adversarial learning, and understanding the human-machine relationship. This publication summarizes the presentations and discussions from the workshop.

Continuing education, continuing professional development, and high-value continuing professional development exist along a continuum. Continuing education (CE) often is associated with didactic learning methods, such as lectures and seminars, which take place in auditoriums and classrooms, and is often viewed by health professionals as merely a path to maintaining licensure and certification through the accumulation of credits. Continuing professional development (CPD), in contrast, embraces a wider array of learning formats and methods that are driven by learners. The Global Forum on Innovation in Health Professional Education hosted a workshop in April 2017 to explore the value proposition for CPD. Forum members and workshop participants gathered to learn about innovative CPD programs around the world, to consider the perspectives of those who invest in CPD, and to discuss the business case for CPD. This publication summarizes the presentations and discussions from the workshop.

The increasingly diverse ethnic composition of the United States population has created a profound and ongoing demographic shift, and public health and health care organizations face many challenges as they move to address and adapt to this change. To better understand how the public health and health care communities can meet the challenges of serving an increasingly diverse population, the Roundtable on Health Literacy conducted a public workshop on facilitating health communication with immigrant, refugee, and migrant populations through the use of health literate approaches. The goal of the workshop was to identify approaches that will enable organizations that serve these ethnically and culturally diverse populations in a manner that allows all members of these communities to obtain, process, and understand basic health information and the services needed to make appropriate health and personal decisions. This publication summarizes the presentations and discussions from the workshop--Publishers website.

"Following a series of natural disasters, including Hurricane Katrina, that revealed shortcomings in the nation's ability to effectively alert populations at risk, Congress passed the Warning, Alert, and Response Network (WARN) Act in 2006. Today, new technologies such as smart phones and social media platforms offer new ways to communicate with the public, and the information ecosystem is much broader, including additional official channels, such as government social media accounts, opt-in short message service (SMS)-based alerting systems, and reverse 911 systems; less official channels, such as main stream media outlets and weather applications on connected devices; and unofficial channels, such as first person reports via social media. Traditional media have also taken advantage of these new tools, including their own mobile applications to extend their reach of beyond broadcast radio, television, and cable. Furthermore, private companies have begun to take advantage of the large amounts of data about users they possess to detect events and provide alerts and warnings and other hazard-related information to their users. More than 60 years of research on the public response to alerts and warnings has yielded many insights about how people respond to information that they are at risk and the circumstances under which they are most likely to take appropriate protective action. Some, but not all, of these results have been used to inform the design and operation of alert and warning systems, and new insights continue to emerge. Emergency Alert and Warning Systems reviews the results of past research, considers new possibilities for realizing more effective alert and warning4 systems, explores how a more effective national alert and warning system might be created and some of the gaps in our present knowledge, and sets forth a research agenda to advance the nation's alert and warning capabilities"--Publisher's description.

On March 13, 2017, the Roundtable on Environmental Health Sciences, Research, and Medicine and the Roundtable on Population Health Improvement jointly convened a 1-day public workshop in Washington, DC, to explore potential strategies for public health, environmental health, health care, and related stakeholders to help communities and regions to address and mitigate the health effects of climate change. Participants discussed the perspectives of civic, government, business, and health-sector leaders, and existing research, best practices, and examples that inform stakeholders and practitioners on approaches to support mitigation of and adaptation to climate change and its effects on population health. This publication summarizes the presentations and discussions from the workshop.

Two members of the Committee on Human Rights (CHR), NAS member Mary Jane West-Eberhard and NAS/NAE member Morton Panish, undertook a mission to Guatemala to observe the trial of two high-level Guatemalan military officials who were charged with ordering the murder of Guatemalan anthropologist Myrna Mack. She was stabbed to death in 1990, two days after a report for which she was principal researcher, "Assistance and Control: Policies Toward Internally Displaced Populations in Guatemala," was published by the Georgetown University Press. Ms. Mack had been doing research on and writing about the unjust treatment of the internally displaced people in Guatemala. Thirteen years after Ms. Mack's murder--after the case had gone through dozens of courts and countless delays--a general and colonel in the Guatemalan military intelligence apparatus were brought to trial, and one was convicted. This marked the first time in Guatemalan history that a high-level military official had been brought to justice for atrocities he committed during Guatemala's 30-year civil war. This report summarizes the one-month trial proceedings.