It began with plutonium, the first element ever manufactured in quantity by humans. Fearing that the Germans would be the first to weaponise the atom, the United States marshalled brilliant minds and seemingly inexhaustible bodies to find a way to create a nuclear chain reaction of inconceivable explosive power. In a matter of months, the Hanford nuclear facility was built to produce the enigmatic and deadly new material that would fuel atomic bombs. In the desert of eastern Washington State, far from prying eyes, scientists Glenn Seaborg, Enrico Fermi and thousands of others-the physicists, engineers, labourers and support staff at the facility-manufactured plutonium for the bomb dropped on Nagasaki, and for the bombs in the current American nuclear arsenal, enabling the construction of weapons with the potential to end human civilisation. With his characteristic blend of scientific clarity and storytelling, Steve Olson asks why Hanford has been largely overlooked in histories of the Manhattan Project and the Cold War. Olson, who grew up just twenty miles from Hanford's B Reactor, recounts how a small Washington town played host to some of the most influential scientists and engineers in American history as they sought to create the substance at the core of the most destructive weapons ever created. The Apocalypse Factory offers a new generation this dramatic story of human achievement and ultimately, of lethal hubris. *2020 marks the 75th anniversary of the United States' detonation of nuclear weapons over the Japanese cities of Hiroshima and Nagasaki on 6 and 9 August 1945.

It began with plutonium, the first element ever manufactured in quantity by humans. Fearing that the Germans would be the first to weaponise the atom, the United States marshalled brilliant minds and seemingly inexhaustible bodies to find a way to create a nuclear chain reaction of inconceivable explosive power. In a matter of months, the Hanford nuclear facility was built to produce the enigmatic and deadly new material that would fuel atomic bombs. In the desert of eastern Washington State, far from prying eyes, scientists Glenn Seaborg, Enrico Fermi and thousands of others-the physicists, engineers, labourers and support staff at the facility-manufactured plutonium for the bomb dropped on Nagasaki, and for the bombs in the current American nuclear arsenal, enabling the construction of weapons with the potential to end human civilisation. With his characteristic blend of scientific clarity and storytelling, Steve Olson asks why Hanford has been largely overlooked in histories of the Manhattan Project and the Cold War. Olson, who grew up just twenty miles from Hanford's B Reactor, recounts how a small Washington town played host to some of the most influential scientists and engineers in American history as they sought to create the substance at the core of the most destructive weapons ever created. The Apocalypse Factory offers a new generation this dramatic story of human achievement and ultimately, of lethal hubris.

"Take one man who rejects authority and religion, and leads a punk band. Take another man who wonders whether vertebrates arose in rivers or in the ocean....Put them together, what do you get? Greg Graffin, and this uniquely fascinating book." --Jared Diamond, author of Guns, Germs, and Steel Anarchy Evolution is a provocative look at the collision between religion and science, by an author with unique authority: UCLA lecturer in Paleontology, and founding member of Bad Religion, Greg Graffin. Alongside science writer Steve Olson (whose Mapping Human History was a National Book Award finalist) Graffin delivers a powerful discussion sure to strike a chord with readers of Richard Dawkins' The God Delusion or Christopher Hitchens God Is Not Great. Bad Religion die-hards, newer fans won over during the band's 30th Anniversary Tour, and anyone interested in this increasingly important debate should check out this treatise on science from the god of punk rock.

What types of instructional experiences help K-8 students learn science with understanding? What do science educators, teachers, teacher leaders, science specialists, professional development staff, curriculum designers, and school administrators need to know to create and support such experiences? Ready, Set, Science! guides the way with an account of the groundbreaking and comprehensive synthesis of research into teaching and learning science in kindergarten through eighth grade. Based on the recently released National Research Council report Taking Science to School: Learning and Teaching Science in Grades K-8, this book summarizes a rich body of findings from the learning sciences and builds detailed cases of science educators at work to make the implications of research clear, accessible, and stimulating for a broad range of science educators. Ready, Set, Science! is filled with classroom case studies that bring to life the research findings and help readers to replicate success. Most of these stories are based on real classroom experiences that illustrate the complexities that teachers grapple with every day. They show how teachers work to select and design rigorous and engaging instructional tasks, manage classrooms, orchestrate productive discussions with culturally and linguistically diverse groups of students, and help students make their thinking visible using a variety of representational tools. This book will be an essential resource for science education practitioners and contains information that will be extremely useful to everyone A-A'A1/2including parents A-A'A1/2directly or indirectly involved in the teaching of science.

Every year, public and private funders spend many billions of dollars on large-scale, complex, multi-national health initiatives. The only way to know whether these initiatives are achieving their objectives is through evaluations that examine the links between program activities and desired outcomes. Investments in such evaluations, which, like the initiatives being evaluated, are carried out in some of the world's most challenging settings, are a relatively new phenomenon. In the last five years, evaluations have been conducted to determine the effects of some of the world's largest and most complex multi-national health initiatives. Evaluation Design for Complex Global Initiatives is the summary of a workshop convened by the Institute of Medicine in January 2014 to explore these recent evaluation experiences and to consider the lessons learned from how these evaluations were designed, carried out, and used. The workshop brought together more than 100 evaluators, researchers in the field of evaluation science, staff involved in implementing large-scale health programs, local stakeholders in the countries where the initiatives are carried out, policy makers involved in the initiatives, representatives of donor organizations, and others to derive lessons learned from past large-scale evaluations and to discuss how to apply these lessons to future evaluations. This report discusses transferable insights gained across the spectrum of choosing the evaluator, framing the evaluation, designing the evaluation, gathering and analyzing data, synthesizing findings and recommendations, and communicating key messages. The report also explores the relative benefits and limitations of different quantitative and qualitative approaches within the mixed methods designs used for these complex and costly evaluations. Table of Contents Front Matter 1 Introduction and Overview of the Workshop 2 Overview Framework for Complex Evaluations 3 Framing the Evaluation 4 Developing the Evaluation Design and Selecting Methods 5 Mapping Data Sources and Gathering and Assessing Data 6 Applying Qualitative Methods to Evaluation on a Large Scale 7 Applying Quantitative Methods to Evaluation on a Large Scale 8 Analysis Through Triangulation and Synthesis to Interpret Data in a Mixed Methods Evaluation 9 Evolving Methods in Evaluation Science 10 Lessons from Large-Scale Program Evaluation on a Not-Quite-as-Large Scale 11 Using Evaluation Findings and Communicating Key Messages 12 Envisioning a Future for Evaluation References Appendix A: Statement of Task Appendix B: Workshop Agenda Appendix C: Participant Biographies Appendix D: Evaluation Information Summary for Core Example Initiatives Appendix E: Evaluation Design Resources Highlighted at the Workshop

Many drug developers have examined new strategies for creating efficiencies in their development processes, including the adoption of genomics-based approaches. Genomic data can identify new drug targets for both common and rare diseases, can predict which patients are likely to respond to a specific treatment, and has the potential to significantly reduce the cost of clinical trials by reducing the number of patients that must be enrolled in order to demonstrate safety and efficacy. A key component of the approval of targeted therapeutics is the ability to identify the population of patients who will benefit from treatment, and this has largely hinged on the co-development and co-submission to the FDA of a companion diagnostic test.The co-development process, or the development of the test and drug for the simultaneous submission to FDA, has led to a major alteration in the way that drugs are being developed, with traditionally separate entities-pharmaceutical and diagnostic companies-now working in close collaboration. Refining Processes for the Co-Development of Genome-Based Therapeutics and Companion Diagnostic Tests is the summary of a workshop held by the Roundtable on Translating Genomic-Based Research for Health on February 27, 2013 to examine and discuss challenges and potential solutions for the codevelopment of targeted therapeutics and companion molecular tests for the prediction of drug response. Prior to the workshop, key stakeholders, including laboratory and medical professional societies, were individually asked to provide possible solutions to resolve the concerns raised about co-development of companion diagnostic tests and therapies. Workshop speakers were charged with addressing these solutions in their presentations by providing insight on (1) whether the proposed solutions address the problems described, (2) whether there are other solutions to propose, and (3) what steps could be taken to effectively implement the proposed solutions. Table of Contents Front Matter 1 Introduction 2 Regulatory Perspectives 3 Perspectives from Patients, Providers, and Laboratory Representatives 4 Perspectives of Diagnostic Test and Pharmaceutical Developers 5 Perspectives of Payers and Regulators 6 Concluding Observations References Appendix A: Workshop Agenda Appendix B: Speaker Biographical Sketches Appendix C: Statement of Task Appendix D: Registered Attendees

The financial crisis that began in 2008 is a stark demonstration that we as a nation take great risks when we build too much of our economy on a base that does not create real value. Relying on vaporous transactions to generate wealth is no substitute for making real products and providing real services. In the 21st century, the United States and the rest of the world will face some of the greatest challenges of the modern age: feeding a growing population, generating adequate energy without destroying the environment, countering chronic and emerging infectious diseases. The first decade of the new century has shown that technological innovation is essential for the United States and other countries to meet these challenges. At the 2009 Annual Meeting of the National Academy of Engineering in Irvine, California, a public forum entitled 'Rebuilding a Real Economy: Unleashing Engineering Innovation' brought together seven prominent leaders of the innovation system to discuss the challenges facing America. The insights of the panel members cut to the heart of what this nation needs to do to remain a global leader in the turbulent world of the 21st century. This summary captures the main points made by the forum participants with the aim of encouraging further reflection and discussion. As the panelists pointed out, no single action can reenergize our innovation system. A portfolio of interconnected and interdependent initiatives must be undertaken to generate new knowledge and technology and move that new knowledge successfully into a competitive world marketplace. But the panelists clarified the goal toward which we must strive and some of the most important steps we need to take to achieve that goal. Table of Contents Front Matter 1 The Ongoing Crisis 2 Key Innovation Sectors 3 Policy Initiatives 4 Prospects A Forum Agenda B Panelists' Biographies

Many measurement systems to monitor the well-being of children and guide services are implemented across the community, state, and national levels in the United States. While great progress has been made in recent years in developing interventions that have been shown to improve the cognitive, affective, and behavioral health of children, many of these tested and effective interventions have yet to be widely implemented. One potential reason for this lag in implementation is a need to further develop and better utilize measures that gauge the success of evidence-based programs as part of a broad effort to prevent negative outcomes and foster children's health and well-being. To address this issue, the Institute of Medicine Forum on Promoting Children's Cognitive, Affective, and Behavioral Health held a workshop in Washington, DC, on November 5-6, 2014. The workshop featured presentations on the use of data linkage and integration to inform research and practice related to children's cognitive, affective, and behavioral health; the use of quality measures to facilitate system change in health care, classroom, and juvenile justice settings; and tools developed to measure implementation of evidence-based prevention programs at scale to support sustainable program delivery, among other topics. Workshop presenters and participants discussed examples of innovative design and utilization of measurement systems, new approaches to build on existing data systems, and new data systems that could support the cognitive, affective, and behavioral health and well-being of children. This report summarizes the presentation and discussions of the event. Table of Contents Front Matter 1 Introduction 2 Maximizing the Value of National, State, and Local Measurement Systems 3 Measurement Systems to Assess Individual- and Population-Level Change 4 Using Quality Measures to Facilitate System Change 5 Toward Efficient and Sustainable Delivery of Interventions 6 Breakout Group Discussions Appendix A: Workshop Agenda Appendix B: Biographies of Workshop Speakers

Multidrug-resistant tuberculosis (TB) is caused by bacteria resistant to isoniazid and rifampicin, the two most effective first-line anti-TB drugs, originally developed and introduced in the 1950 and 1960s. Since 2008, the Forum on Drug Discovery, Development, and Translation of the Institute of Medicine has hosted or co-hosted six domestic and international workshops addressing the global crisis of drug-resistant TB, with special attention to the BRICS countries - Brazil, Russia, India, China, and South Africa. The Global Crisis of Drug-Resistant Tuberculosis and Leadership of China and the BRICS is the summary of a workshop convened to address the current status of drug-resistant TB globally and in China. This report considers lessons learned from high burden countries; highlights global challenges to controlling the spread of drug-resistant strains; and discusses innovative strategies to advance and harmonize local and international efforts to prevent and treat drug-resistant TB. Additionally, the report examines the problem of MDR TB and emergent TB strains that are potentially untreatable with drugs available and considers the critical leadership role of the BRICS countries in addressing the threats and opportunities in drug-resistant TB.

Creating Equal Opportunities for a Healthy Weight is the summary of a workshop convened by the Institute of Medicine's Standing Committee on Childhood Obesity Prevention in June 2013 to examine income, race, and ethnicity, and how these factors intersect with childhood obesity and its prevention. Registered participants, along with viewers of a simultaneous webcast of the workshop, heard a series of presentations by researchers, policy makers, advocates, and other stakeholders focused on health disparities associated with income, race, ethnicity, and other characteristics and on how these factors intersect with obesity and its prevention. The workshop featured invited presentations and discussions concerning physical activity, healthy food access, food marketing and messaging, and the roles of employers, health care professionals, and schools. The IOM 2012 report Accelerating Progress in Obesity Prevention acknowledged that a variety of characteristics linked historically to social exclusion or discrimination, including race, ethnicity, religion, socioeconomic status, gender, age, mental health, disability, sexual orientation or gender identity, geographic location, and immigrant status, can thereby affect opportunities for physical activity, healthy eating, health care, work, and education. In many parts of the United States, certain racial and ethnic groups and low-income individuals and families live, learn, work, and play in places that lack health-promoting resources such as parks, recreational facilities, high-quality grocery stores, and walkable streets. These same neighborhoods may have characteristics such as heavy traffic or other unsafe conditions that discourage people from walking or being physically active outdoors. The combination of unhealthy social and environmental risk factors, including limited access to healthy foods and opportunities for physical activity, can contribute to increased levels of chronic stress among community members, which have been linked to increased levels of sedentary activity and increased calorie consumption. Creating Equal Opportunities for a Healthy Weight focuses on the key obesity prevention goals and recommendations outlined in Accelerating Progress in Obesity Prevention through the lens of health equity. This report explores critical aspects of obesity prevention, while discussing potential future research, policy, and action that could lead to equity in opportunities to achieve a healthy weight. Table of Contents Front Matter 1 Introduction and Themes of the Workshop 2 Building Physical and Social Environments for Physical Activity in High-Risk Communities 3 Combating Disparities in the Food and Beverage Environments of Ethnic Minority and Low-Income Communities 4 Equity-Focused Approaches to Obesity Prevention in Workplaces 5 Pathways to Obesity Prevention for Ethnic Minority and Low-Income Children and Adults in Primary Care 6 Advertising, Promotion, and Education: Bringing Health Equity to the Message Environment 7 Upgrading Food and Physical Activity Options Before, During, and After School in Low-Income Neighborhoods 8 Bringing the Pieces Together References Appendix A: Workshop Agenda Appendix B: Speaker Biographical Sketches Appendix C: Workshop Participants Appendix D: Statements at the Workshop Appendix E: Abbreviations and Acronyms

America's national parks provide a wealth of experiences to millions of people every year. What visitors see-landscapes, wildlife, cultural activities-often lingers in memory for life. And what they hear adds a dimension that sight alone cannot provide. Natural sounds can dramatically enhance visitors' experience of many aspects of park environments. In some settings, such as the expanses of Yellowstone National Park, they can even be the best way to enjoy wildlife, because animals can be heard at much greater distances than they can be seen. Sounds can also be a natural complement to natural scenes, whether the rush of water over a rocky streambed or a ranger's explanation of a park's history. In other settings, such as the New Orleans Jazz National Historical Park, sounds are the main reason for visiting a park. The acoustical environment is also important to the well-being of the parks themselves. Many species of wildlife depend on their hearing to find prey or avoid predators. If they cannot hear, their survival is jeopardized-and the parks where they live may in turn lose part of their natural heritage. For all these reasons it is important to be aware of noise (defined as unwanted sound, and in this case usually generated by humans or machinery), which can degrade the acoustical environment, or soundscape, of parks. Just as smog smudges the visual horizon, noise obscures the listening horizon for both visitors and wildlife. This is especially true in places, such as remote wilderness areas, where extremely low sound levels are common. The National Park Service (NPS) has determined that park facilities, operations, and maintenance activities produce a substantial portion of noise in national parks and thus recognizes the need to provide park managers with guidance for protecting the natural soundscape from such noise. Therefore, the focus of the workshop was to define what park managers can do to control noise from facilities, operations, and maintenance, and not on issues such as the effects of noise on wildlife, noise metrics, and related topics. To aid in this effort, NPS joined with the National Academy of Engineering (NAE) and with the US Department of Transportation's John A. Volpe National Transportation Systems Center to hold a workshop to examine the challenges and opportunities facing the nation's array of parks. Entitled "Protecting National Park Soundscapes: Best Available Technologies and Practices for Reducing Park- Generated Noise," the workshop took place October 3-4, 2012, at NPS's Natural Resource Program Center in Fort Collins, Colorado. Protecting National Park Soundscapes is a summary of the workshop. Table of Contents Front Matter 1 Introduction and Themes of the Workshop 2 Noise in the National Parks 3 Report from the Transportation Breakout Group 4 Report from the Facilities and Maintenance Breakout Group 5 Report from the Construction Breakout Group 6 Reflections on the Workshop References Appendix A: Workshop Steering Committee Biographical Information Appendix B: Workshop Agenda Appendix C: Workshop Attendees

At some point during 2009, more than 17 million households in the United States had difficulty providing enough food for all their members because of a lack of resources. In more than one-third of these households, the food intake of some household members was reduced and normal eating patterns were disrupted due to limited resources. The Workshop on Understanding the Relationship Between Food Insecurity and Obesity was held to explore the biological, economic, psychosocial, and other factors that may influence the relationship between food insecurity, overweight, and obesity in the United States. Hunger and Obesity examines current concepts and research findings in the field. The report identifies information gaps, proposes alternative approaches to analyzing data, recommends new data that should be collected, and addresses the limitations of the available research. Table of Contents Front Matter Overview 1 Goals of the Workshop 2 Setting the Stage for the Coexistence of Food Insecurity and Obesity 3 Socioeconomic Disparities: Food Insecurity and Obesity 4 Sentinel Populations 5 Socioecological Perspectives: The Individual Level 6 Socioecological Perspectives: The Family and Household Level 7 Socioecological Perspectives: The Environmental Level 8 Socioecological Perspectives: The Institutional Level 9 Putting the Levels Together 10 Research Applications 11 Research Gaps from a Disciplinary Perspective 12 Research Methods and Measures 13 Key Elements, Priorities, and Next Steps Appendix A: Workshop Agenda Appendix B: Planning Committee Biographical Sketches Appendix C: Speaker Biographical Sketches Appendix D: Workshop Participants Appendix E: Acronyms Appendix F: Roundtable Discussions Appendix G: Public Comments Appendix H: Brief List of Recurring Workshop Discussions

Since 1965 the foreign-born population of the United States has swelled from 9.6 million or 5 percent of the population to 45 million or 14 percent in 2015. Today, about one-quarter of the U.S. population consists of immigrants or the children of immigrants. Given the sizable representation of immigrants in the U.S. population, their health is a major influence on the health of the population as a whole. On average, immigrants are healthier than native-born Americans. Yet, immigrants also are subject to the systematic marginalization and discrimination that often lead to the creation of health disparities. To explore the link between immigration and health disparities, the Roundtable on the Promotion of Health Equity held a workshop in Oakland, California, on November 28, 2017. This summary of that workshop highlights the presentations and discussions of the workshop. Table of Contents Front Matter 1 Introduction 2 The Past and Present of U.S. Immigration Policy 3 Immigration and the Social Determinants of Health 4 The Voices of Immigrants 5 Reflections on the Workshop References Appendix A: Workshop Agenda Appendix B: Speaker Biographical Sketches Appendix C: World Caf Organizations Appendix D: Statement of Task

Communities provide the context in which programs, principles, and policies are implemented. Their needs dictate the kinds of programs that community organizers and advocates, program developers and implementers, and researchers will bring to bear on a problem. Their characteristics help determine whether a program will succeed or fail. The detailed workings of programs cannot be separated from the communities in which they are embedded. Communities also represent the front line in addressing many behavioral health conditions experienced by children, adolescents, young adults, and their families. Given the importance of communities in shaping the health and well being of young people, the National Academies of Sciences, Engineering, and Medicine held a workshop in June 2016, to examine the implementation of evidence- based prevention by communities. Participants examined questions related to scaling up, managing, and sustaining science in communities. This publication summarizes the presentations and discussions from the workshop. Table of Contents Front Matter 1 Introduction and Overview of the Workshop 2 Transporting Evidence-Based Preventive Interventions into Communities 3 Building Community Capacity for Choosing, Adapting, and Implementing Evidence-Based Programs 4 Taking Advantage of Cutting-Edge Methodologies 5 Programs or Principles? 6 How to Sustain Funding 7 Being Responsive to Communities 8 Reports from the Breakout Groups and Final Discussion References Appendix A: Workshop Statement of Task Appendix B: Workshop Agenda Appendix C: Biosketches of Workshop Speakers and Moderators

More than 2 million Americans below age 24 self-identify as being of American Indian or Alaska Native descent. Many of the serious behavioral, emotional, and physical health concerns facing young people today are especially prevalent with Native youth (e.g., depression, violence, and substance abuse). Adolescent Native Americans have death rates two to five times the rate of whites in the same age group because of higher levels of suicide and a variety of risky behaviors (e.g., drug and alcohol use, inconsistent school attendance). Violence, including intentional injuries, homicide, and suicide, accounts for three-quarters of deaths for Native American youth ages 12 to 20. Suicide is the second leading cause of death?and 2.5 times the national rate?for Native youth ages 15 to 24. Arrayed against these health problems are vital cultural strengths on which Native Americans can draw. At a workshop held in 2012, by the National Academies of Sciences, Engineering, and Medicine, presenters described many of these strengths, including community traditions and beliefs, social support networks, close-knit families, and individual resilience. In May 2014, the Academies held a follow-up workshop titled Advancing Health Equity for Native American Youth. Participants discussed issues related to (1) the visibility of racial and ethnic disparities in health and health care as a national problem, (2) the development of programs and strategies by and for Native and Indigenous communities to reduce disparities and build resilience, and (3) the emergence of supporting Native expertise and leadership. This report summarizes the presentations and discussions from the workshop. Table of Contents Front Matter 1 Introduction and Themes of the Workshop 2 Voices of Native Youth 3 Contributors to Resilience 4 Health and Well-Being 5 Addressing Health Disparities Through Education 6 Concluding Comments References Appendix A: Workshop Agenda Appendix B: Speaker Biographies Appendix C: Resources

Since its creation by the Institute of Medicine (IOM) in 2007, the Roundtable on the Promotion of Health Equity and the Elimination of Health Disparities has been fostering dialogue on racial and ethnic disparities in health and health care, examining the development of programs and strategies to reduce disparities, and encouraging the emergence of new leadership focused on health equity. For the past several years, a prominent topic of discussion within the roundtable has been the Patient Protection and Affordable Care Act (ACA). The ACA has multiple provisions specific to race, ethnicity, and language and other provisions with significant implications for racially and ethnically diverse populations. In April 2013, the roundtable held a workshop to address many issues surrounding the ACA, including expansion of coverage, delivery systems, and access points, service delivery and payment reform, public-private partnerships, and challenges to the safety net. This report summarizes the presentations and discussions from the workshop. Table of Contents Front Matter 1 Introduction and Themes of the Workshop 2 The Potential of the ACA to Reduce Health Disparities 3 The ACA and Health Equity 4 The Patient-Centered Medical Home 5 The Safety Net and Beyond 6 Consumer Engagement References Appendix A: Workshop Agenda Appendix B: Speaker Biographical Sketches

The Patient Protection and Affordable Care Act (ACA), which was signed into law in 2010, has several provisions that could greatly improve the behavioral health of children and adolescents in the United States. It requires that many insurance plans cover mental health and substance use disorder services, rehabilitative services to help support people with behavioral health challenges, and preventive services like behavioral assessments for children and depression screening for adults. These and other provisions provide an opportunity to confront the many behavioral health challenges facing youth in America. To explore how the ACA and other aspects of health care reform can support innovations to improve children's behavioral health and sustain those innovations over time, the Forum on Promoting Children's Cognitive, Affective, and Behavioral Health held a workshop on April 1-2, 2015. The workshop explicitly addressed the behavioral health needs of all children, including those with special health needs. It also took a two-generation approach, looking at the programs and services that support not only children but also parents and families. This report summarizes the presentations and discussions of this workshop. Table of Contents Front Matter 1 Overview and Highlights of the Workshop 2 Responding to the Challenge 3 Funding: Opportunities, Threats, and Potential for Innovation 4 Implementing Innovations at the State and Local Levels 5 Intermediary Groups for Two-Generation Approaches 6 Implementing Innovations in Primary Care 7 Implementing Innovations in Other Settings 8 The Research Landscape for Primary Care and Children's Behavioral Health 9 Looking Forward: Reflections for Public Policy Appendix A: Workshop Statement of Task Appendix B: Workshop Agenda Appendix C: Biographies of Workshop Speakers

The integration and coordination of health, education, nutrition, social protection, and other services have the potential to improve the lives of children and their caregivers around the world. However, integration and coordination of policies and programs affecting early childhood development can create both risks and benefits. In different localities, these services are more or less effective in achieving their objectives. They also are more or less coordinated in delivering services to the same recipients, and in some cases services are delivered by integrated multisectoral organizations. The result is a rich arena for policy analysis and change and a complex challenge for public- and private-sector organizations that are seeking to improve the lives of children. To examine the science and policy issues involved in coordinating investments in children and their caregivers, the Forum on Investing in Young Children Globally held a workshop in Hong Kong on March 14-15, 2015. Held in partnership with the Centre for Health Education and Health Promotion and Wu Yee Sun College of the Chinese University of Hong Kong, the workshop brought together researchers, policy makers, program practitioners, and other experts from 22 countries. This report highlights the presentations and discussions of the event. Table of Contents Front Matter 1 Introduction and Overview 2 Coordinated and Integrated Approaches to Investing in Young Children 3 Integrated and Coordinated Programs in Hong Kong and Chile 4 Coordinating Investments in Children from a Policy Perspective 5 Using Existing Platforms to Integrate Services on the Ground 6 Using Existing Platforms to Reach and Invest in Vulnerable Populations 7 Issues in Program Development, Implementation, and Sustainability 8 Breakout Group Reports and Closing Remarks References Appendix A: Acronyms Appendix B: Workshop Agenda Appendix C: Biographical Sketches of Workshop Speakers

Obesity affects 17 percent of children and adolescents and almost 36 percent of adults in the United States. Conservative estimates suggest that obesity now accounts for almost 20 percent of national health care spending. Until the obesity epidemic is reversed, obesity will continue to drive rates of chronic diseases such as heart disease, stroke, type 2 diabetes, and certain types of cancer. Cross-Sector Responses to Obesity is a summary of a workshop convened by the Institute of Medicine Roundtable on Obesity Solutions in September 2014 to explore models of cross-sector work that may reduce the prevalence and consequences of obesity. This report identifies case studies of cross-sector initiatives that engage partners from diverse fields, and lessons learned from and barriers to established cross-sector initiatives. Table of Contents Front Matter 1 Introduction 2 Health Equity 3 Sustainability 4 Leadership 5 Measurement 6 The National Prevention Council: Bringing Federal Agencies Together to Build Health and Resilience in Americans 7 A Statewide Strategy in the Battle Against Child Obesity in Delaware 8 PLACE MATTERS: Building People Power to Tackle Fundamental Causes of Obesity in Cook County, Illinois 9 PowerUp: Mobilizing Against Obesity in St. Croix Valley, Minnesota, and Wisconsin 10 Community Transformation in the Sault Ste. Marie Tribe of Chippewa Indians in Michigan 11 Concluding Remarks References Appendix A: Workshop Agenda Appendix B: National Prevention Council Cross-Sector Case Study Appendix C: Delaware Cross-Sector Case Study Appendix D: Cook County PLACE MATTERS Case Study Appendix E: PowerUp in the St. Croix Valley (MN/WI) Case Study Appendix F: Sault Ste. Marie Tribe of Chippewa Indians Cross-Sector Case Study Appendix G: Acronyms and Abbreviations Appendix H: Speaker Biographical Sketches

There are many connections between human communities and their surrounding environments that influence community resilience and health in the Gulf of Mexico. The impacts of the Deepwater Horizon oil spill on Gulf communities and ecosystems - coupled with the region's preexisting health challenges and environmental stressors - illustrate the need to better understand these connections. In the future, natural and man-made disasters, climate change impacts, and other environmental stressors will present complex challenges to the physical, mental, and social well-being of communities in the Gulf. Understanding the interrelationships among health, ecological, and economic impacts of disasters and other environmental stressors will be crucial to addressing these challenges. Opportunities for the Gulf Research Program: Community Resilience and Health summarizes a Gulf Research Program workshop held on September 22-23, 2014, in New Orleans, Louisiana. The workshop examined opportunities to improve the health, well-being, and resilience of communities in the Gulf region through discussions with about 50 participants with diverse expertise and experience. These discussions identified perceived needs, challenges, and opportunities that align with the Gulf Research Program's mission and goals - particularly its goal to improve understanding of the connections between human health and the environment to support the development of health and resilient Gulf communities. This workshop is expected to lead to the development of additional Program activities and opportunities for the research community. Table of Contents Front Matter 1 Introduction 2 Human Health, Public Health Practice, and Community Resilience 3 Perspectives on Resilient Communities 4 Reducing Risk and Improving Disaster Recovery 5 Building Resilience in the Gulf Region 6 Capacity to Address Environmental Health Risks 7 Long-term Opportunities 8 Lasting Benefit References A--Workshop Agenda B--Statement of Task C--Speaker Biographies D--Workshop Attendees E--Related Funding Programs

For the first time in decades, promising news has emerged regarding efforts to curb the obesity crisis in the United States. Obesity rates have fallen among low-income children in 18 states, the prevalence of obesity has plateaued among girls, regardless of ethnicity, and targeted efforts in states such as Massachusetts have demonstrably reduced the prevalence of obesity among children. Although the reasons for this turnaround are as complex and multifaceted as the reasons for the dramatic rise in obesity rates in recent decades, interventions to improve nutrition and increase physical activity are almost certainly major contributors. Yet major problems remain. Diseases associated with obesity continue to incur substantial costs and cause widespread human suffering. Moreover, substantial disparities in obesity rates exist among population groups, and in some cases these disparities are widening. Some groups and regions are continuing to experience increases in obesity rates, and the prevalence of severe obesity is continuing to rise. The Current State of Obesity Solutions in the United States is the summary of a workshop convened in January 2014 by the Institute of Medicine Roundtable on Obesity Solutions to foster an ongoing dialogue on critical and emerging implementation, policy, and research issues to accelerate progress in obesity prevention and care. Representatives of public health, health care, government, the food industry, education, philanthropy, the nonprofit sector, and academia met to discuss interventions designed to prevent and treat obesity. The workshop focused on early care and education, schools, worksites, health care institutions, communities and states, the federal government, and business and industry. For each of these groups, this report provides an overview of current efforts to improve nutrition, increase physical activity, and reduce disparities among populations. Table of Contents Front Matter 1 Introduction 2 Current Epidemiology of Obesity in the United States 3 Early Care and Education 4 Schools 5 Worksites 6 Health Care 7 Communities and States 8 The Federal Government 9 Businesses and Industry 10 Closing Remarks References Appendix A: Workshop Agenda Appendix B: Speaker Biographical Sketches

Benefit-cost analyses hold great promise for influencing policies related to children, youth, and families. By comparing the costs of preventive interventions with the long-term benefits of those interventions, benefit-cost analysis provides a tool for determining what kinds of investments have the greatest potential to reduce the physical, mental, and behavioral health problems of young people. More generally, the growth of benefit-cost analysis as a field of research and practice represents an exciting and promising trend in the development and implementation of public policies.
The utility of benefit-cost analyses has been limited by a lack of uniformity in the methods and assumptions underlying these studies. For years, those who perform and those who use benefit-cost analyses have argued that the development and use of theoretical, technical, and reporting standards for benefit-cost analyses would enhance the validity of results, increase comparability across studies, and accelerate the progress of the field.
"Considerations in Applying Benefit-Cost Analysis to Preventive Interventions for Children, Youth, and Families" is the summary of a workshop convened by the Board on Children, Youth, and Families of the Institute of Medicine and the National Research Council in November 2013 as the first phase of a possible two-part effort directed toward guiding future benefit-cost studies and enhancing the relevance of benefit-cost analysis to governments and other organizations wanting to make sound prevention decisions. The workshop brought together leading practitioners in the field, researchers who study the methodological and analytic dimensions of benefit-cost analysis, and representatives of organizations that use the results of benefit-cost analyses to shape and implement public policies. This report discusses a wide range of issues about benefit-cost analysis, including the level of research rigor that should be met before results from an evaluation are used to estimate or predict outcomes in a cost-benefit analysis; best practices and methodologies for costing prevention interventions; prevention outcomes that currently lend themselves to monetization; processes and methodologies that should be used when linking prevention outcomes to avoided costs or increased revenues; and best methods for handling risk and uncertainty in estimates.

Operational systems engineering is a methodology that identifies the important components of a complex system, analyzes the relationships among those components, and creates models of the system to explore its behavior and possible ways of changing that behavior. In this way it offers quantitative and qualitative techniques to support the design, analysis, and governance of systems of diverse scale and complexity for the delivery of products or services. Many peacebuilding interventions function essentially as the provision of services in response to demands elicited from societies in crisis. At its core, operational systems engineering attempts to understand and manage the supply of services and product in response to such demands. Harnessing Operational Systems Engineering to Support Peacebuilding is the summary of a workshop convened in November 2012 by the Roundtable on Science, Technology, and Peacebuilding of the National Academy of Engineering and the United States Institute of Peace to explore the question "When can operational systems engineering, appropriately applied, be a useful tool for improving the elicitation of need, the design, the implementation, and the effectiveness of peacebuilding interventions?" The workshop convened experts in conflict prevention, conflict management, postconflict stabilization, and reconstruction along with experts in various fields of operational systems engineering to identify what additional types of nonnumerical systems methods might be available for application to peacebuilding.

Young adults are at a significant and pivotal time of life. They may seek higher education, launch their work lives, develop personal relationships and healthy habits, and pursue other endeavors that help set them on healthy and productive pathways. However, the transition to adulthood also can be a time of increased vulnerability and risk. Young adults may be unemployed and homeless, lack access to health care, suffer from mental health issues or other chronic health conditions, or engage in binge drinking, illicit drug use, or driving under the influence. Young adults are moving out of the services and systems that supported them as children and adolescents, but adult services and systems--for example, the adult health care system, the labor market, and the justice system--may not be well suited to supporting their needs.
"Improving the Health, Safety, and Well-Being of Young Adults" is the summary of a workshop hosted by the Board on Children, Youth, and Families of the Institute of Medicine (IOM) and the National Research Council (NRC) in May, 2013. More than 250 researchers, practitioners, policy makers, and young adults presented and discussed research on the development, health, safety, and well-being of young adults. This report focuses on the developmental characteristics and attributes of this age group and its placement in the life course; how well young adults function across relevant sectors, including, for example, health and mental health, education, labor, justice, military, and foster care; and how the various sectors that intersect with young adults influence their health and well-being. "Improving the Health, Safety, and Well-Being of Young Adults" provides an overview of existing research and identifies research gaps and issues that deserve more intensive study. It also is meant to start a conversation aimed at a larger IOM/NRC effort to guide research, practices, and policies affecting young adults.

Innovation has been a major engine of American economic and societal progress. It has increased per capita income more than sevenfold since the 19th century, has added three decades to the average lifespan, has revolutionized the way we communicate and share information, and has made the United States the strongest military power in the world. Without its historical leadership in innovation, the United States would be a very different country than it is today. Trends in the Innovation Ecosystem is the summary of two workshops hosted by the Committee on Science, Engineering, and Public Policy (COSEPUP) of the National Academy of Sciences, National Academy of Engineering, and Institute of Medicine in February and May, 2013. Experts from industry, academia, and finance met to discuss the challenges involved in innovation pathways. Both workshops focused on the interactions between research universities and industry and the concept of innovation as a "culture" as opposed to an operational method. The goal was to gain a better understanding of what key factors contributed to successful innovations in the past, how today's environment might necessitate changes in strategy, and what changes are likely to occur in the future in the context of a global innovation ecosystem. This report discusses the state of innovation in America, obstacles to both innovation and to reaping the benefits of innovation, and ways of overcoming those obstacles. Table of Contents Front Matter 1 Introduction 2 The Elements of Success 3 Differences Among Technologies 4 The Roles of Universities 5 The Role of Research Parks 6 Public Policies to Support Innovation Appendixes Appendix A: Workshop Agendas Appendix B: Speakers at the Workshops Appendix C: Speakers Biographies