Cardiac arrest often strikes seemingly healthy individuals without warning and without regard to age, gender, race, or health status. Representing the third leading cause of death in the United States, cardiac arrest is defined as "a severe malfunction or cessation of the electrical and mechanical activity of the heart ... [which] results in almost instantaneous loss of consciousness and collapse". Although the exact number of cardiac arrests is unknown, conservative estimates suggest that approximately 600,000 individuals experience a cardiac arrest in the United States each year. In June 2015, the Institute of Medicine (IOM) released its consensus report Strategies to Improve Cardiac Arrest Survival: A Time to Act, which evaluated the factors affecting resuscitation research and outcomes in the United States. Following the release of this report, the National Academies of Sciences, Engineering, and Medicine was asked to hold a workshop to explore the barriers and opportunities for advancing the IOM recommendations. This publication summarizes the presentations and discussions from the workshop. Table of Contents Front Matter 1 Introduction 2 Building a National Cardiac Arrest Surveillance System 3 Advancing Cardiac Arrest Research and Translation 4 Improving Public Awareness and Training 5 Enhancing the Emergency Medical Services Response to Cardiac Arrest 6 Enhancing Hospital Response to Cardiac Arrest 7 Effective Collaboration for Cardiac Arrest Appendix A: Recommendations from the Institute of Medicine Report *Strategies to Improve Cardiac Arrest Survival: A Time to Act* Appendix B: Workshop Agenda

Cardiac arrest can strike a seemingly healthy individual of any age, race, ethnicity, or gender at any time in any location, often without warning. Cardiac arrest is the third leading cause of death in the United States, following cancer and heart disease. Four out of five cardiac arrests occur in the home, and more than 90 percent of individuals with cardiac arrest die before reaching the hospital. First and foremost, cardiac arrest treatment is a community issue - local resources and personnel must provide appropriate, high-quality care to save the life of a community member. Time between onset of arrest and provision of care is fundamental, and shortening this time is one of the best ways to reduce the risk of death and disability from cardiac arrest. Specific actions can be implemented now to decrease this time, and recent advances in science could lead to new discoveries in the causes of, and treatments for, cardiac arrest. However, specific barriers must first be addressed. Strategies to Improve Cardiac Arrest Survival examines the complete system of response to cardiac arrest in the United States and identifies opportunities within existing and new treatments, strategies, and research that promise to improve the survival and recovery of patients. The recommendations of Strategies to Improve Cardiac Arrest Survival provide high-priority actions to advance the field as a whole. This report will help citizens, government agencies, and private industry to improve health outcomes from sudden cardiac arrest across the United States. Table of Contents Front Matter Summary 1 Introduction 2 Understanding the Public Health Burden of Cardiac Arrest: The Need for National Surveillance 3 The Public Experience with Cardiac Arrest 4 Emergency Medical Services Response to Cardiac Arrest 5 In-Hospital Cardiac Arrest and Post-Arrest Care 6 Resuscitation Research and Continuous Quality Improvement 7 Recommendations and Key Opportunities A-- Acronyms B-- Meeting Agendas C-- Committee Biographies D-- Selected Results from Commissioned Analyses E-- Map of U.S. States with CPR Training as a High School Graduation Requirement F-- Utstein Guideline - Endorsed Data Elementsfor Reporting Out-of-Hospital Cardiac Arrest

In 2006 the National Institutes of Health (NIH) established the Clinical and Translational Science Awards (CTSA) Program, recognizing the need for a new impetus to encourage clinical and translational research. At the time it was very difficult to translate basic and clinical research into clinical and community practice; making it difficult for individual patients and communities to receive its benefits. Since its creation the CTSA Program has expanded, with 61 sites spread across the nation's academic health centers and other institutions, hoping to provide catalysts and test beds for policies and practices that can benefit clinical and translation research organizations throughout the country. The NIH contracted with the Institute of Medicine (IOM) in 2012 to conduct a study to assess and provide recommendations on appropriateness of the CTSA Program's mission and strategic goals and whether changes were needed. The study was also address the implementation of the program by the National Center for Advancing Translational Sciences (NCATS) while exploring the CTSA's contributions in the acceleration of the development of new therapeutics. A 13-member committee was established to head this task; the committee had collective expertise in community outreach and engagement, public health and health policy, bioethics, education and training, pharmaceutical research and development, program evaluation, clinical and biomedical research, and child health research. The CTSA Program at NIH: Opportunities for Advancing Clinical and Translational Research is the result of investigations into previous program evaluations and assessments, open-session meetings and conference class, and the review of scientific literature. Overall, the committee believes that the CTSA Program is significant to the advancement of clinical and translational research through its contributions. The Program would benefit from a variety of revisions, however, to make it more efficient and effective. Table of Contents Front Matter Summary 1 Introduction 2 A Vision for the CTSA Program in a Changing Landscape 3 Leadership 4 Crosscutting Topics 5 Conclusion: Opportunities for Action Appendix A: Data Sources and Methods Appendix B: Committee Biographical Sketches

At the request of NASA, an IOM committee reviewed NASA Human Research Program's (HRP's) Scientific Merit Assessment Processes for directed research. Directed research is commissioned or noncompetitively awarded research that is not competitively solicited because of specific reasons, such as time limitations or highly focused or constrained research topics. The scientific merit assessment processes have been developed by NASA to evaluate individual directed research tasks in order to ensure the scientific integrity of the HRP's directed research portfolio. The committee examined the HRP's current scientific merit assessment processes and conducted a public workshop to identify best practices among other federal agencies that use various assessment processes for similar types of directed research. Review of NASA Human Research Program's Scientific Merit Processes: Letter Report finds that the scientific merit assessment process used by the HRP for directed research is scientifically rigorous and is similar to the processes and merit criteria used by many other federal agencies and organizations - including the Department of Defense, National Institutes of Health, and the United States Department of Agriculture - for comparable types of research. This report also makes recommendations on ways to streamline and bolster the accountability and transparency of NASA's current processes. Table of Contents Front Matter Letter Report REFERENCES Appendix A: Workshop Agenda and List of Participants Appendix B: Committee Biosketches

Although epilepsy is one of the nation's most common neurological disorders, public understanding of it is limited. Many people do not know the causes of epilepsy or what they should do if they see someone having a seizure. Epilepsy is a complex spectrum of disorders that affects an estimated 2.2 million Americans in a variety of ways, and is characterized by unpredictable seizures that differ in type, cause, and severity. Yet living with epilepsy is about much more than just seizures; the disorder is often defined in practical terms, such as challenges in school, uncertainties about social situations and employment, limitations on driving, and questions about independent living. The Institute of Medicine was asked to examine the public health dimensions of the epilepsies, focusing on public health surveillance and data collection; population and public health research; health policy, health care, and human services; and education for people with the disorder and their families, health care providers, and the public. In Epilepsy Across the Spectrum, the IOM makes recommendations ranging from the expansion of collaborative epilepsy surveillance efforts, to the coordination of public awareness efforts, to the engagement of people with epilepsy and their families in education, dissemination, and advocacy for improved care and services. Taking action across multiple dimensions will improve the lives of people with epilepsy and their families. The realistic, feasible, and action-oriented recommendations in this report can help enable short- and long-term improvements for people with epilepsy. For all epilepsy organizations and advocates, local, state, and federal agencies, researchers, health care professionals, people with epilepsy, as well as the public, Epilepsy Across the Spectrum is an essential resource. Table of Contents Front Matter Summary 1 Introduction 2 Surveillance, Measurement, and Data Collection 3 Epidemiology and Prevention 4 Health Care: Quality, Access, and Value 5 Health Professional Education 6 Quality of Life and Community Resources 7 Educating People with Epilepsy and Their Families 8 Public Education and Awareness 9 Next Steps and Recommendations Appendix A: Workshop Agendas Appendix B: IOM Data-Gathering Effort Appendix C: Data on Specialized Epilepsy Centers: Report to the Institute of Medicine's Committee on the Public Health Dimensions of the Epilepsies Appendix D: Health Professionals Who Care for People with Epilepsy: Possible Roles and Relevant Boards and Organizations Appendix E: Committee Biographies

Each year in the United States, more than 4,000 occupational fatalities and more than 3 million occupational injuries occur along with more than 160,000 cases of occupational illnesses. Incorporating patients' occupational information into electronic health records (EHRs) could lead to more informed clinical diagnosis and treatment plans as well as more effective policies, interventions, and prevention strategies to improve the overall health of the working population. At the request of the National Institute for Occupational Safety and Health, the IOM appointed a committee to examine the rationale and feasibility of incorporating occupational information in patients' EHRs. The IOM concluded that three data elements - occupation, industry, and work-relatedness - were ready for immediate focus, and made recommendations on moving forward efforts to incorporate these elements into EHRs. Table of Contents Front Matter Incorporating Occupational Information in Electronic Health Records Appendix A: Workshop Agenda Appendix B: Workshop Participants Appendix C: Committee Biographies

The U.S. Department of Health and Human Services (HHS) profoundly affects the lives of all Americans. Its agencies and programs protect against domestic and global health threats, assure the safety of food and drugs, advance the science of preventing and conquering disease, provide safeguards for America's vulnerable populations, and improve health for everyone. However, the department faces serious and complex obstacles, chief among them rising health care costs and a broadening range of health challenges. Over time, additional responsibilities have been layered onto the department, and other responsibilities removed, often without corresponding shifts in positions, procedures, structures, and resources.
At the request of the U.S. House of Representatives Committee on Oversight and Government Reform, HHS in the 21st Century assesses whether HHS is "ideally organized" to meet the enduring and emerging health challenges facing our nation. The committee identifies many factors that affect the department's ability to address its range of responsibilities, including divergence in the missions and goals of the department's agencies, limited flexibility in spending, impending workforce shortages, difficulty in retaining skilled professionals, and challenges in effectively partnering with the private sector.