Recent scientific evidence points to the origins of childhood obesity as an outcome of the dynamic interplay of genetic, behavioral, and environmental factors throughout early development, with a compelling body of evidence suggesting that both maternal and paternal nutritional and other exposures affect a child's risk of later obesity. The burgeoning field of epigenetics has led researchers to speculate that many of the observed associations between early developmental exposures and later risk of childhood obesity are mediated, at least in part, through epigenetic mechanisms. To explore the body of evolving science that examines the nexus of biology, environment, and developmental stage on risk of childhood obesity, the Institute of Medicine and the National Research Council convened a workshop in February 2015. The workshop focused on the prenatal period, infancy, and early childhood and addressed evidence from both animal and human studies. Workshop objectives were to (1) identify epigenetic-mediated relationships between exposure to risk factors during sensitive periods of development (gestation through age 3) and subsequent obesity-related outcomes; (2) explore the science around periods of plasticity and potential reversibility of obesity risk in the context of early childhood development; and (3) examine the translation of epigenetic science to guide early childhood obesity prevention and intervention to reduce obesity risk. This report summarizes the information presented and discussed at the workshop. Table of Contents Front Matter 1 Introduction 2 Conceptual Overview of the Role of Epigenetics in Childhood Obesity 3 Etiology and Causal Inference 4 Opportunities for Intervention and Prevention 5 Real-World Application 6 Data Gaps and Future Directions References Appendix A: Workshop Agenda Appendix B: Speaker Biographies

Since smallpox eradication, the science of eradication has changed and with it, our definitions of what diseases are possible to eradicate. However, eradication must not beget complacency. As has been learned from past control or eradication attempts with a variety of viral diseases, from yellow fever to influenza, accidental or intentional reintroduction is a real threat-one that could strike anywhere and for which we need to be fully prepared. The criteria for assessing eradicability of polio, measles, and other viral infections have been debated extensively. With the elimination and eradication of several viral diseases on the horizon, issues surrounding the cessation of immunization activities become exceedingly important. In an effort to better understand the dynamics of disease eradication and post-immunization policies, the Institute of Medicine Forum on Emerging Infections hosted a two-day workshop (February 1-2, 2001) on The Consequences of Viral Disease Eradication. This book explores the principles underlying the biological challenges, medical interventions, the continuing research agenda, and operational considerations for post-immunization strategies for vaccine-preventable viral diseases, and highlights important efforts that may facilitate wise decision making. Table of Contents Front Matter 1 Summary and Assessment 2 Major Efforts for Disease Eradication 3 Biological Challenges to Post-Eradication 4 Operational and Institutional Challenges to Post-Eradication 5 Medical Intervention and Technological Solutions 6 The Challenges to Post-Eradication Outbreaks Appendix A Glossary and Acronyms APPENDIX B Workshop Agenda The Consequences of Viral Disease Eradication: Addressing Post-Immunization Challenges APPENDIX C Forum Member and Speaker Biographies

In the wake of September 11th and recent anthrax events, our nationa (TM)s bioterrorism response capability has become an imminent priority for policymakers, researchers, public health officials, academia, and the private sector. In a three-day workshop, convened by the Institute of Medicinea (TM)s Forum on Emerging Infections, experts from each of these communities came together to identify, clarify, and prioritize the next steps that need to be taken in order to prepare and strengthen bioterrorism response capabilities. From the discussions, it became clear that of utmost urgency is the need to cast the issue of a response in an appropriate framework in order to attract the attention of Congress and the public in order to garner sufficient and sustainable support for such initiatives. No matter how the issue is cast, numerous workshop participants agreed that there are many gaps in the public health infrastructure and countermeasure capabilities that must be prioritized and addressed in order to assure a rapid and effective response to another bioterrorist attack.