Families Caring for an Aging America


Book Description

Family caregiving affects millions of Americans every day, in all walks of life. At least 17.7 million individuals in the United States are caregivers of an older adult with a health or functional limitation. The nation's family caregivers provide the lion's share of long-term care for our older adult population. They are also central to older adults' access to and receipt of health care and community-based social services. Yet the need to recognize and support caregivers is among the least appreciated challenges facing the aging U.S. population. Families Caring for an Aging America examines the prevalence and nature of family caregiving of older adults and the available evidence on the effectiveness of programs, supports, and other interventions designed to support family caregivers. This report also assesses and recommends policies to address the needs of family caregivers and to minimize the barriers that they encounter in trying to meet the needs of older adults.




Gene Drives on the Horizon


Book Description

Research on gene drive systems is rapidly advancing. Many proposed applications of gene drive research aim to solve environmental and public health challenges, including the reduction of poverty and the burden of vector-borne diseases, such as malaria and dengue, which disproportionately impact low and middle income countries. However, due to their intrinsic qualities of rapid spread and irreversibility, gene drive systems raise many questions with respect to their safety relative to public and environmental health. Because gene drive systems are designed to alter the environments we share in ways that will be hard to anticipate and impossible to completely roll back, questions about the ethics surrounding use of this research are complex and will require very careful exploration. Gene Drives on the Horizon outlines the state of knowledge relative to the science, ethics, public engagement, and risk assessment as they pertain to research directions of gene drive systems and governance of the research process. This report offers principles for responsible practices of gene drive research and related applications for use by investigators, their institutions, the research funders, and regulators.




Analysis of Cancer Risks in Populations Near Nuclear Facilities


Book Description

In the late 1980s, the National Cancer Institute initiated an investigation of cancer risks in populations near 52 commercial nuclear power plants and 10 Department of Energy nuclear facilities (including research and nuclear weapons production facilities and one reprocessing plant) in the United States. The results of the NCI investigation were used a primary resource for communicating with the public about the cancer risks near the nuclear facilities. However, this study is now over 20 years old. The U.S. Nuclear Regulatory Commission requested that the National Academy of Sciences provide an updated assessment of cancer risks in populations near USNRC-licensed nuclear facilities that utilize or process uranium for the production of electricity. Analysis of Cancer Risks in Populations near Nuclear Facilities: Phase 1 focuses on identifying scientifically sound approaches for carrying out an assessment of cancer risks associated with living near a nuclear facility, judgments about the strengths and weaknesses of various statistical power, ability to assess potential confounding factors, possible biases, and required effort. The results from this Phase 1 study will be used to inform the design of cancer risk assessment, which will be carried out in Phase 2. This report is beneficial for the general public, communities near nuclear facilities, stakeholders, healthcare providers, policy makers, state and local officials, community leaders, and the media.




Alternatives for Managing the Nation's Complex Contaminated Groundwater Sites


Book Description

Across the United States, thousands of hazardous waste sites are contaminated with chemicals that prevent the underlying groundwater from meeting drinking water standards. These include Superfund sites and other facilities that handle and dispose of hazardous waste, active and inactive dry cleaners, and leaking underground storage tanks; many are at federal facilities such as military installations. While many sites have been closed over the past 30 years through cleanup programs run by the U.S. Department of Defense, the U.S. EPA, and other state and federal agencies, the remaining caseload is much more difficult to address because the nature of the contamination and subsurface conditions make it difficult to achieve drinking water standards in the affected groundwater. Alternatives for Managing the Nation's Complex Contaminated Groundwater Sites estimates that at least 126,000 sites across the U.S. still have contaminated groundwater, and their closure is expected to cost at least $110 billion to $127 billion. About 10 percent of these sites are considered "complex," meaning restoration is unlikely to be achieved in the next 50 to 100 years due to technological limitations. At sites where contaminant concentrations have plateaued at levels above cleanup goals despite active efforts, the report recommends evaluating whether the sites should transition to long-term management, where risks would be monitored and harmful exposures prevented, but at reduced costs.




A Research Review of Interventions to Increase the Persistence and Resilience of Coral Reefs


Book Description

Coral reef declines have been recorded for all major tropical ocean basins since the 1980s, averaging approximately 30-50% reductions in reef cover globally. These losses are a result of numerous problems, including habitat destruction, pollution, overfishing, disease, and climate change. Greenhouse gas emissions and the associated increases in ocean temperature and carbon dioxide (CO2) concentrations have been implicated in increased reports of coral bleaching, disease outbreaks, and ocean acidification (OA). For the hundreds of millions of people who depend on reefs for food or livelihoods, the thousands of communities that depend on reefs for wave protection, the people whose cultural practices are tied to reef resources, and the many economies that depend on reefs for fisheries or tourism, the health and maintenance of this major global ecosystem is crucial. A growing body of research on coral physiology, ecology, molecular biology, and responses to stress has revealed potential tools to increase coral resilience. Some of this knowledge is poised to provide practical interventions in the short-term, whereas other discoveries are poised to facilitate research that may later open the doors to additional interventions. A Research Review of Interventions to Increase the Persistence and Resilience of Coral Reefs reviews the state of science on genetic, ecological, and environmental interventions meant to enhance the persistence and resilience of coral reefs. The complex nature of corals and their associated microbiome lends itself to a wide range of possible approaches. This first report provides a summary of currently available information on the range of interventions present in the scientific literature and provides a basis for the forthcoming final report.




Rights-based Approaches


Book Description




Advancing Oral Health in America


Book Description

Though it is highly preventable, tooth decay is a common chronic disease both in the United States and worldwide. Evidence shows that decay and other oral diseases may be associated with adverse pregnancy outcomes, respiratory disease, cardiovascular disease, and diabetes. However, individuals and many health care professionals remain unaware of the risk factors and preventive approaches for many oral diseases. They do not fully appreciate how oral health affects overall health and well-being. In Advancing Oral Health in America, the Institute of Medicine (IOM) highlights the vital role that the Department of Health and Human Services (HHS) can play in improving oral health and oral health care in the United States. The IOM recommends that HHS design an oral health initiative which has clearly articulated goals, is coordinated effectively, adequately funded and has high-level accountability. In addition, the IOM stresses three key areas needed for successfully maintaining oral health as a priority issue: strong leadership, sustained interest, and the involvement of multiple stakeholders from both the public and private sectors. Advancing Oral Health in America provides practical recommendations that the Department of Health and Human Services can use to improve oral health care in America. The report will serve as a vital resource for federal health agencies, health care professionals, policy makers, researchers, and public and private health organizations.




Strengthening the Safety Culture of the Offshore Oil and Gas Industry


Book Description

"TRB Special Report 321: Strengthening the Safety Culture of the Offshore Oil and Gas Industry offers recommendations to industry and regulators to strengthen and sustain the safety culture of the offshore oil and gas industry. The committee that prepared the report addresses conceptual challenges in defining safety culture and discusses the empirical support for the definition of safety culture offered by the Bureau of Safety and Environmental Enforcement, the nine characteristics or elements of a robust safety culture, methods for assessing company safety culture, and barriers to improving safety culture in the offshore industry. The committee's report also identifies topics on which further research is needed with respect to assessing, improving, and sustaining safety culture"--Provided by publisher.




From the Sierra to the Sea


Book Description

The original report From the Sierra to the Sea: Ecological History of the San Francisco Bay-Delta Watershed was a product of a three-year effort to develop a landscape level overview of the natural ecological structure, function and organization of the watershed, and the way it had changed over the course of the 19th and 20th centuries. Technical review and contributions from government and water agencies helped produce a collaborative document that provided information on the historical ecological baseline in order to assist in what was envisioned at the time as the most ambitious restoration effort ever undertaken in the United States. We are proud of the fact that the original document is still used as an objective reference, and has provided a foundation and inspiration for similar but more intensively researched localized efforts by others in the Bay-Delta watershed. This 20th anniversary edition contains a new Afterword describing changes to the estuary and its watershed since the report was originally published in 1998.




Advancing the Science of Cancer in Latinos


Book Description

This open access book gives an overview of the sessions, panel discussions, and outcomes of the Advancing the Science of Cancer in Latinos conference, held in February 2018 in San Antonio, Texas, USA, and hosted by the Mays Cancer Center and the Institute for Health Promotion Research at UT Health San Antonio. Latinos – the largest, youngest, and fastest-growing minority group in the United States – are expected to face a 142% rise in cancer cases in coming years. Although there has been substantial advancement in cancer prevention, screening, diagnosis, and treatment over the past few decades, addressing Latino cancer health disparities has not nearly kept pace with progress. The diverse and dynamic group of speakers and panelists brought together at the Advancing the Science of Cancer in Latinos conference provided in-depth insights as well as progress and actionable goals for Latino-focused basic science research, clinical best practices, community interventions, and what can be done by way of prevention, screening, diagnosis, and treatment of cancer in Latinos. These insights have been translated into the chapters included in this compendium; the chapters summarize the presentations and include current knowledge in the specific topic areas, identified gaps, and top priority areas for future cancer research in Latinos. Topics included among the chapters: Colorectal cancer disparities in Latinos: Genes vs. Environment Breast cancer risk and mortality in women of Latin American origin Differential cancer risk in Latinos: The role of diet Overcoming barriers for Latinos on cancer clinical trials Es tiempo: Engaging Latinas in cervical cancer research Emerging policies in U.S. health care Advancing the Science of Cancer in Latinos proves to be an indispensable resource offering key insights into actionable targets for basic science research, suggestions for clinical best practices and community interventions, and novel strategies and advocacy opportunities to reduce health disparities in Latino communities. It will find an engaged audience among researchers, academics, physicians and other healthcare professionals, patient advocates, students, and others with an interest in the broad field of Latino cancer.