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"Neuroinflammation is a burgeoning area of interest in academia and biopharma, with a broadly acknowledged role in many central nervous system (CNS) disorders. However, there is little agreement on the pathophysiological mechanisms that underlie the manifestations of neuroinflammation in the CNS compartment and how neuroinflammation operates as a driver and also as a consequence of disease in the brain. Moreover, another unclear area is how to translate increased understanding of the mechanisms that underlie neuroinflammation and its manifestations in the CNS to therapeutics. To address these gaps in understanding mechanisms and how to translate that understanding into therapeutics, the Forum on Neuroscience and Nervous System Disorders of the National Academies of Sciences, Engineering, and Medicine convened a workshop on March 20-21, 2017, bringing together key leaders in the field from industry, academia, and governmental agencies to explore the role and mechanisms of neuroinflammation in a variety of CNS diseases. The workshop also considered strategies to advance the identification and validation of biomarkers of neuroinflammation that could accelerate development of therapies, bringing much-needed treatments to patients with disorders ranging from neuroinflammatory diseases such as multiple sclerosis (MS) to neuropsychiatric disorders such as depression. This publication summarizes the presentations and discussions from the workshop"--Publisher's description.

"The search for life is one of the most active fields in space science and involves a wide variety of scientific disciplines, including planetary science, astronomy and astrophysics, chemistry, biology, chemistry, and geoscience. In December 2016, the Space Studies Board hosted a workshop to explore the possibility of habitable environments in the solar system and in exoplanets, techniques for detecting life, and the instrumentation used. This publication summarizes the presentations and discussions from the workshop"--

What foods should Americans eat to promote their health, and in what amounts? What is the scientific evidence that supports specific recommendations for dietary intake to reduce the risk of multifactorial chronic disease? These questions are critically important because dietary intake has been recognized to have a role as a key determinant of health. As the primary federal source of consistent, evidence-based information on dietary practices for optimal nutrition, the Dietary Guidelines for Americans (DGA) have the promise to empower Americans to make informed decisions about what and how much they eat to improve health and reduce the risk of chronic disease. The adoption and widespread translation of the DGA requires that they be universally viewed as valid, evidence-based, and free of bias and conflicts of interest to the extent possible. However, this has not routinely been the case. A first short report meant to inform the 2020 review cycle explored how the advisory committee selection process can be improved to provide more transparency, eliminate bias, and include committee members with a range of viewpoints. This second and final report recommends changes to the DGA process to reduce and manage sources of bias and conflicts of interest, improve timely opportunities for engagement by all interested parties, enhance transparency, and strengthen the science base of the process.

Research conducted over the past two decades has shown that poor patient understanding of medication instructions is an important contributor to the more than 1 million medication errors and adverse drug events that lead to office and emergency room visits, hospitalizations, and even death. Patients who have limited literacy skills, who have multiple comorbidities, and who are elderly face the greatest risk, and limited literacy skills are significantly associated with inadequate understanding and use of prescription instructions and precautions. The Agency for Healthcare Research and Quality notes that only 12 percent of U.S. adults have proficient health literacy that allows them to interpret a prescription label correctly. Given the importance of health literacy to the proper use of medications, and the apparent lack of progress in improving medication adherence, the Roundtable on Health Literacy formed an ad hoc committee to plan and conduct a 1-day public workshop that featured invited presentations and discussion of the role and challenges regarding clarity of communication on medication. Participants focused on using health literacy principles to address clarity of materials, decision aids, and other supportive tools and technologies regarding risks, benefits, alternatives, and health plan coverage. This publication summarizes the presentations and discussions from the workshop.

"The Survey of Income and Program Participation (SIPP) is a national, longitudinal household survey conducted by the Census Bureau. SIPP serves as a tool to evaluate the effectiveness of government-sponsored social programs and to analyze the impacts of actual or proposed modifications to those programs. SIPP was designed to fill a need for data that would give policy makers and researchers a much better grasp of how effectively government programs were reaching their target populations, how participation in different programs overlapped, and to what extent and under what circumstances people transitioned into and out of these programs. SIPP was also designed to answer questions about the short-term dynamics of employment, living arrangements, and economic well-being"--Page 1.

"Although ecosystems, humans, and fire have coexisted for millennia, changes in geology, ecology, hydrology, and climate as well as sociocultural, regulatory, and economic factors have converged to make wildland fire management exceptionally challenging for U.S. federal, state, and local authorities. Given the mounting, unsustainable costs and difficulty translating existing wildland fire science into policy, the National Academies of Sciences, Engineering, and Medicine organized a 1-day workshop to focus on how a century of wildland fire research can contribute to improving wildland fire management. This publication summarizes the presentations and discussions from the workshop"--Publisher's description.

"In October 2016, the National Academies of Sciences, Engineering, and Medicine's Roundtable on Population Health Improvement hosted a workshop to explore sustainable financing structures that reflect a recognition of the health and non-health factors that shape the well-being of U.S. communities. The goals of the workshop were to learn from the long-term, sustainable financing strategies used in other sectors, to explore how those approaches could be applied to population health, and to consider structures that work across sectors. This publication summarizes the presentations and discussions from the workshop"--

"Advances in cancer research have led to an improved understanding of the molecular mechanisms underpinning the development of cancer and how the immune system responds to cancer. This influx of research has led to an increasing number and variety of therapies in the drug development pipeline, including targeted therapies and associated biomarker tests that can select which patients are most likely to respond, and immunotherapies that harness the body's immune system to destroy cancer cells. Compared with standard chemotherapies, these new cancer therapies may demonstrate evidence of benefit and clearer distinctions between efficacy and toxicity at an earlier stage of development. However, there is a concern that the traditional processes for cancer drug development, evaluation, and regulatory approval could impede or delay the use of these promising cancer treatments in clinical practice. This has led to a number of efforts--by patient advocates, the pharmaceutical industry, and the Food and Drug Administration (FDA)--to accelerate the review of promising new cancer therapies, especially for cancers that currently lack effective treatments. However, generating the necessary data to confirm safety and efficacy during expedited drug development programs can present a unique set of challenges and opportunities. To explore this new landscape in cancer drug development, the National Academies of Sciences, Engineering, and Medicine developed a workshop held in December 2016. This workshop convened cancer researchers, patient advocates, and representatives from industry, academia, and government to discuss challenges with traditional approaches to drug development, opportunities to improve the efficiency of drug development, and strategies to enhance the information available about a cancer therapy throughout its life cycle in order to improve its use in clinical practice. This publication summarizes the presentations and discussions from the workshop"--

"Millions of people--infants, children, adults, and their families--are currently coping with serious illness in the United States. Efforts are intensifying to improve overall care quality through the delivery of person-centered and family-oriented services, for patients of all ages and across disease stages, care settings, and specialties. While aging Baby Boomers are increasing the proportion of patients in the Medicare population over time, the sickest and most vulnerable patients needing health system support and other services to meet their complex needs can be found across the age spectrum and in a broad range of care settings, from perinatal care to geriatric care. Recognizing the need to thoughtfully consider and address the challenges and opportunities in efforts to improve care quality and value, the Roundtable on Quality Care for People with Serious Illness of the National Academies of Sciences, Engineering, and Medicine held the public workshop Integrating the Patient and Caregiver Voice into Serious Illness Care, on December 15, 2016, in Washington, DC. This workshop was the first in a series planned by the roundtable, and was designed specifically to bring together diverse personal perspectives and experiences about priorities and values that are important to patients and families coping with serious illness, and to consider solutions that support integration of these priorities and values in practice. This publication summarizes the presentations and discussions from the workshop"--

"This proceedings summarizes the presentations and discussions at the 1-day public workshop on Principles and Practices for Federal Program Evaluation, which was in held Washington, DC. in October 2016"--Page 1.

"A consensus study report of The National Academies of Sciences, Engineering, and Medicine."

"A Consensus Study Report of The National Academies of Sciences, Engineering, Medicine."

"Though cancer was once considered to be a problem primarily in wealthy nations, low- and middle-income countries now bear a majority share of the global cancer burden, and cancer often surpasses the burden of infectious diseases in these countries. Effective low-cost cancer control options are available for some malignancies, with the World Health Organization estimating that these interventions could facilitate the prevention of approximately one-third of cancer deaths worldwide. Effective cancer treatment approaches are also available and can reduce the morbidity and mortality due to cancer in low-resource areas. But these interventions remain inaccessible for many people in the world, especially those residing in low-resource communities that are characterized by a lack of funds--on an individual or a societal basis--to cover health infrastructure and care costs. As a result, worse outcomes for patients with cancer are more common in low- and middle-income countries compared with high-income countries. Few guidelines and strategies for cancer control consider the appropriateness and feasibility of interventions in low-resource settings, and this may undermine the effectiveness of care. Recognizing the challenges of providing cancer care in resource constrained settings, the National Academies of Sciences, Engineering, and Medicine developed a two- workshop series examining cancer care in low-resource communities, building on prior work of the National Academies. The first workshop, held in October 2015, focused on cancer prevention and early detection. The second workshop was held in November 2016, and focused on cancer treatment, palliative care, and survivorship care in low-resource areas. This publication summarizes the presentations and discussions of this workshop"--

Accessible and affordable housing can enable community living, maximize independence, and promote health for vulnerable populations. However, the United States faces a shortage of affordable and accessible housing for low-income older adults and individuals living with disabilities. This shortage is expected to grow over the coming years given the population shifts leading to greater numbers of older adults and of individuals living with disabilities. Housing is a social determinant of health and has direct effects on health outcomes, but this relationship has not been thoroughly investigated. In December 2016, the National Academies of Sciences, Engineering, and Medicine convened a public workshop to better understand the importance of affordable and accessible housing for older adults and people with disabilities, the barriers to providing this housing, the design principles for making housing accessible for these individuals, and the features of programs and policies that successfully provide affordable and accessible housing that supports community living for older adults and people with disabilities. This publication summarizes the presentations and discussions from the workshop.

"In September 2016, the National Academies of Sciences, Engineering, and Medicine convened a workshop to examine trends and patterns in aging and factors related to healthy aging in the United States, with a focus on nutrition, and how nutrition can sustain and promote healthy aging, not just in late adulthood, but beginning in pregnancy and early childhood and extending throughout the lifespan. Participants discussed the role of nutrition in the aging process at various stages in life, changes in organ systems over the lifespan and changes that occur with age related to cognitive, brain, and mental health, and explored opportunities to move forward in promoting healthy aging in the United States. This publication summarizes the presentations and discussions from the workshop"--

The U.S. Census Bureau has reported that 56.7 million Americans had some type of disability in 2010, which represents 18.7 percent of the civilian noninstitutionalized population included in the 2010 Survey of Income and Program Participation. The U.S. Social Security Administration (SSA) provides disability benefits through the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. As of December 2015, approximately 11 million individuals were SSDI beneficiaries, and about 8 million were SSI beneficiaries. SSA currently considers assistive devices in the nonmedical and medical areas of its program guidelines. During determinations of substantial gainful activity and income eligibility for SSI benefits, the reasonable cost of items, devices, or services applicants need to enable them to work with their impairment is subtracted from eligible earnings, even if those items or services are used for activities of daily living in addition to work. In addition, SSA considers assistive devices in its medical disability determination process and assessment of work capacity. The Promise of Assistive Technology to Enhance Activity and Work Participation provides an analysis of selected assistive products and technologies, including wheeled and seated mobility devices, upper-extremity prostheses, and products and technologies selected by the committee that pertain to hearing and to communication and speech in adults.

The future security, economic growth, and competitiveness of the United States depend on its capacity to innovate. Major sources of innovative capacity are the new knowledge and trained students generated by U.S. research universities. However, many of the complex technical and societal problems the United States faces cannot be addressed by the traditional model of individual university research groups headed by a single principal investigator. Instead, they can only be solved if researchers from multiple institutions and with diverse expertise combine their efforts. The National Science Foundation (NSF), among other federal agencies, began to explore the potential of such center-scale research programs in the 1970s and 1980s; in many ways, the NSF Engineering Research Center (ERC) program is its flagship program in this regard. The ERCs are "interdisciplinary, multi-institutional centers that join academia, industry, and government in partnership to produce transformational engineered systems and engineering graduates who are adept at innovation and primed for leadership in the global economy. To ensure that the ERCs continue to be a source of innovation, economic development, and educational excellence, A New Vision for Center-Based Engineering Research explores the future of center-based engineering research, the skills needed for effective center leadership, and opportunities to enhance engineering education through the centers.

"The State of the Science in the Field of Regenerative Medicine: Challenges of and Opportunities for Cellular Therapies: a Workshop, October 13, 2016, National Academy of Sciences Building, Room 125. 2101 Constitution Avenue, NW, Washington, DC 20148"--Page 87.

"A report of the National Academies of Sciences, Engineering, Medicine."

The concept of utilizing big data to enable scientific discovery has generated tremendous excitement and investment from both private and public sectors over the past decade, and expectations continue to grow. Using big data analytics to identify complex patterns hidden inside volumes of data that have never been combined could accelerate the rate of scientific discovery and lead to the development of beneficial technologies and products. However, producing actionable scientific knowledge from such large, complex data sets requires statistical models that produce reliable inferences (NRC, 2013). Without careful consideration of the suitability of both available data and the statistical models applied, analysis of big data may result in misleading correlations and false discoveries, which can potentially undermine confidence in scientific research if the results are not reproducible. In June 2016 the National Academies of Sciences, Engineering, and Medicine convened a workshop to examine critical challenges and opportunities in performing scientific inference reliably when working with big data. Participants explored new methodologic developments that hold significant promise and potential research program areas for the future. This publication summarizes the presentations and discussions from the workshop.

"A consensus study report of the National Academies of Sciences, Engineering, Medicine."

The vitality of the innovation economy in the United States depends on the availability of a highly educated technical workforce. A key component of this workforce consists of engineers, engineering technicians, and engineering technologists. However, unlike the much better-known field of engineering, engineering technology (ET) is unfamiliar to most Americans and goes unmentioned in most policy discussions about the US technical workforce. Engineering Technology Education in the United States seeks to shed light on the status, role, and needs of ET education in the United States.

Most countries in the world use the International System of Units (also known as the metric system) for radiation measurements. The United States still uses a mix of SI and conventional units for radiation measurements, which means radiation professionals in the U.S. need to understand and make conversions between the two systems. Participants at this workshop discussed the need for the U.S. to adopt the SI, and, by doing so, standardize internationally the units for radiation measurements.

"A report of the National Academies of Sciences, Engineering, Medicine."

"The volume and complexity of information about individual patients is greatly increasing with use of electronic records and personal devices. Potential effects on medical product development in the context of this wealth of real-world data could be numerous and varied, ranging from the ability to determine both large-scale and patient-specific effects of treatments to the ability to assess how therapeutics affect patients' lives through measurement of lifestyle changes. In October 2016, the National Academies of Sciences, Engineering, and Medicine held a workshop to facilitate dialogue among stakeholders about the opportunities and challenges for incorporating real-world evidence into all stages in the process for the generation and evaluation of therapeutics. Participants explored unmet stakeholder needs and opportunities to generate new kinds of evidence that meet those needs. 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 biennial report summarizes the findings of the ARLTAB from the reviews conducted by the panels in 2015 and 2016 and subsumes the 2015-2016 interim report.

The U.S. Global Change Research Program (USGCRP) is an interagency program, established by the Global Change Research Act (GCRA) of 1990, mandated by Congress to "assist the Nation and the world to understand, assess, predict, and respond to human-induced and natural processes of global change". Since the USGCRP began, scientific understanding of global change has increased and the information needs of the nation have changed dramatically. A better understanding of what is changing and why can help decision makers in the public and private sectors cope with ongoing change. Accomplishments of the U.S. Global Change Research Program highlights the growth of global change science in the quarter century that the USGCRP has been in existence, and documents some of its contributions to that growth through its primary functions of interagency planning and coordination, and of synthesis of research and practice to inform decision making.

Genome editing is a powerful new tool for making precise alterations to an organism's genetic material. Recent scientific advances have made genome editing more efficient, precise, and flexible than ever before. These advances have spurred an explosion of interest from around the globe in the possible ways in which genome editing can improve human health. The speed at which these technologies are being developed and applied has led many policymakers and stakeholders to express concern about whether appropriate systems are in place to govern these technologies and how and when the public should be engaged in these decisions.

Both the Food and Drug Administration (FDA) and the National Institute for Occupational Safety and Health (NIOSH) have responsibilities for evaluating and regulating respiratory protective devices ("respirators") for health care workers. Respirators protect the user from respiratory hazards by either removing contaminants from the air (air-purifying respirators) or by supplying clean air from another source (air-supplying respirators). Respirators that are used in workplaces in the United States must be approved by NIOSH and meet standards and test results specified by regulation. Respirators used by health care workers are air-purifying respirators that generally fall into three types: (1) disposable particulate filtering facepiece respirators (also termed N95s); (2) elastomeric respirators, also known as reusable respirators because they use a replaceable filter; or (3) powered air-purifying air respirators. To provide input to NIOSH and FDA and to discuss potential next steps to integrate the two agencies' processes to certify and approve N95 respirators for use in health care settings, a workshop was held by the National Academies of Sciences, Engineering, and Medicine in August 2016. The workshop was focused on exploring the strengths and limitations of several current test methods for N95 respirators as well as identifying ongoing research and research needs. This publication summarizes the presentations and discussions from the workshop.

Note: This is the French translation of Recent Fertility Trends in Sub-Saharan Africa. Fertility rates and population growth influence economic development. The marked declines in fertility seen in some developing nations have been accompanied by slowing population growth, which in turn provided a window of opportunity for rapid economic growth. For many sub-Saharan African nations, this window has not yet opened because fertility rates have not declined as rapidly there as elsewhere. Fertility rates in many sub-Saharan African countries are high: the total rate for the region is estimated to be 5.1 births per woman, and rates that had begun to decline in many countries in the region have stalled. High rates of fertility in these countries are likely to contribute to continued rapid population growth: the United Nations projects that the region's population will increase by 1.2 billion by 2050, the highest growth among the regions for which there are projections. In June 2015, the Committee on Population organized a workshop to explore fertility trends and the factors that have influenced them. The workshop committee was asked to explore history and trends related to fertility, proximate determinants and other influences, the status and impact of family planning programs, and prospects for further reducing fertility rates. This study will help donors, researchers, and policy makers better understand the factors that may explain the slow pace of fertility decline in this region, and develop methods to improve family planning in sub-Saharan Africa.