Since fall 2021, the authors of this study have conducted regular enumerations of the unsheltered populations in three Los Angeles neighborhoods known for having high concentrations of people experiencing unsheltered homelessness: Hollywood, Skid Row, and Venice. In addition to counts, the authors have conducted surveys of unsheltered residents in these same neighborhoods to better understand the characteristics, experiences, and needs of these populations. The results of the first year of this study, known as the Los Angeles Longitudinal Enumeration and Demographic Survey (LA LEADS), were presented in a report published by RAND in 2023. The authors continued their enumeration and survey efforts in these three neighborhoods throughout 2023 using an updated survey instrument that includes new questions about employment, income, experiences with service providers, health conditions, and substance use. This study presents their findings from the 2023 data collection period and includes comparisons with the previous year's effort and new information about unsheltered populations' experiences and needs across the same three Los Angeles neighborhoods.
{"title":"Annual Trends Among the Unsheltered in Three Los Angeles Neighborhoods: The Los Angeles Longitudinal Enumeration and Demographic Survey (LA LEADS) 2023 Annual Report.","authors":"Jason M Ward, Rick Garvey, Sarah B Hunter","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Since fall 2021, the authors of this study have conducted regular enumerations of the unsheltered populations in three Los Angeles neighborhoods known for having high concentrations of people experiencing unsheltered homelessness: Hollywood, Skid Row, and Venice. In addition to counts, the authors have conducted surveys of unsheltered residents in these same neighborhoods to better understand the characteristics, experiences, and needs of these populations. The results of the first year of this study, known as the Los Angeles Longitudinal Enumeration and Demographic Survey (LA LEADS), were presented in a report published by RAND in 2023. The authors continued their enumeration and survey efforts in these three neighborhoods throughout 2023 using an updated survey instrument that includes new questions about employment, income, experiences with service providers, health conditions, and substance use. This study presents their findings from the 2023 data collection period and includes comparisons with the previous year's effort and new information about unsheltered populations' experiences and needs across the same three Los Angeles neighborhoods.</p>","PeriodicalId":74637,"journal":{"name":"Rand health quarterly","volume":"12 1","pages":"11"},"PeriodicalIF":0.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11630103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142908081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Julia Rollison, Skye A Miner, Maya Buenaventura, Rachel Holzer, Yoony Lee, Mekdes Shiferaw
The patchwork of laws and regulations that affect abortion access in the United States has become increasingly complex since the 2022 Dobbs v. Jackson Women's Health Organization U.S. Supreme Court decision that gave states the right to enact and enforce policies facilitating or restricting abortion access. The authors examined state, local, and institutional policies in Virginia-which is one of the only remaining states in the South post-Dobbs with legal access to abortion care past 13 weeks gestational age-to better understand how the policy landscape is influencing provision of care in the state. The authors reviewed existing legislation, bills, and sources detailing the policy landscape in Virginia and interviewed a sample of clinicians and nonclinicians working at organizations providing or supporting abortion care. The study principally focused on state laws, local policies and actions, institutional policies, and reported implementation experiences affecting access to abortion care.
{"title":"Understanding the State and Local Policies Affecting Abortion Care Administration, Access, and Delivery: A Case Study in Virginia.","authors":"Julia Rollison, Skye A Miner, Maya Buenaventura, Rachel Holzer, Yoony Lee, Mekdes Shiferaw","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The patchwork of laws and regulations that affect abortion access in the United States has become increasingly complex since the 2022 <i>Dobbs v. Jackson Women's Health Organization</i> U.S. Supreme Court decision that gave states the right to enact and enforce policies facilitating or restricting abortion access. The authors examined state, local, and institutional policies in Virginia-which is one of the only remaining states in the South post-<i>Dobbs</i> with legal access to abortion care past 13 weeks gestational age-to better understand how the policy landscape is influencing provision of care in the state. The authors reviewed existing legislation, bills, and sources detailing the policy landscape in Virginia and interviewed a sample of clinicians and nonclinicians working at organizations providing or supporting abortion care. The study principally focused on state laws, local policies and actions, institutional policies, and reported implementation experiences affecting access to abortion care.</p>","PeriodicalId":74637,"journal":{"name":"Rand health quarterly","volume":"12 1","pages":"5"},"PeriodicalIF":0.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11630096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The authors analyze the relationship between heat events in Los Angeles County and (1) emergency medical services, (2) emergency room visits, (3) deaths investigated by the medical examiner, and (4) bookings for violent offenses. Heat events are classified according to the National Weather Service HeatRisk system. Days classified as moderate, major, and severe HeatRisk days are associated with worse results for all these outcomes.
{"title":"Health and Social Services During Heat Events: Demand for Services in Los Angeles County.","authors":"Roland Sturm, Lawrence Baker, Avery Krovetz","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The authors analyze the relationship between heat events in Los Angeles County and (1) emergency medical services, (2) emergency room visits, (3) deaths investigated by the medical examiner, and (4) bookings for violent offenses. Heat events are classified according to the National Weather Service HeatRisk system. Days classified as moderate, major, and severe HeatRisk days are associated with worse results for all these outcomes.</p>","PeriodicalId":74637,"journal":{"name":"Rand health quarterly","volume":"12 1","pages":"12"},"PeriodicalIF":0.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11630102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Stephanie Brooks Holliday, Elizabeth Marsolais, Samantha Matthews
The Los Angeles County Rapid Diversion Program (RDP) is a pretrial mental health diversion program operating in seven courthouses in Los Angeles County, California. Established in 2019 as a faster approach to pretrial mental health diversion compared with the traditional approach, RDP allows for the diversion of individuals who have a mental health diagnosis or substance use disorder and certain qualifying misdemeanor or felony charges. Individuals who complete the program have their case dismissed. In this study, the authors present findings from a formal assessment of program implementation to date. Using a mixed-methods evaluation, they explore current program operations, characteristics of and case outcomes for individuals who participate in RDP, and strengths and areas for improvement. Lessons learned from this evaluation have the potential to inform efforts to scale the program within Los Angeles County and to other counties interested in implementing a similar pretrial diversion program.
{"title":"Process Evaluation of the Los Angeles County Rapid Diversion Program: A Pretrial Mental Health Diversion Program.","authors":"Stephanie Brooks Holliday, Elizabeth Marsolais, Samantha Matthews","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The Los Angeles County Rapid Diversion Program (RDP) is a pretrial mental health diversion program operating in seven courthouses in Los Angeles County, California. Established in 2019 as a faster approach to pretrial mental health diversion compared with the traditional approach, RDP allows for the diversion of individuals who have a mental health diagnosis or substance use disorder and certain qualifying misdemeanor or felony charges. Individuals who complete the program have their case dismissed. In this study, the authors present findings from a formal assessment of program implementation to date. Using a mixed-methods evaluation, they explore current program operations, characteristics of and case outcomes for individuals who participate in RDP, and strengths and areas for improvement. Lessons learned from this evaluation have the potential to inform efforts to scale the program within Los Angeles County and to other counties interested in implementing a similar pretrial diversion program.</p>","PeriodicalId":74637,"journal":{"name":"Rand health quarterly","volume":"12 1","pages":"6"},"PeriodicalIF":0.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11630099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dana Schultz, Andrea Phillips, Anita Chandra, Emma Bianculli
Healthy child development is a key driver for better health and well-being throughout a person's life, and the early years set that important foundation. Early childhood development programs play a critical role in mitigating risks to the cognitive, social, behavioral, and physical development of children. Increasingly, there is recognition that early intervention to support child development requires more than separate programs and services. Instead, a full system transformation, such as the national Help Me Grow initiative, is necessary. Help Me Grow Western New York (HMG WNY), a regional effort, aims to build and strengthen a comprehensive and coordinated system of early childhood development services and care to support the development and well-being of children in this region. HMG WNY serves eight counties in western New York that form a diverse community whose socioeconomic composition varies but which all share at least some level of need for better coordination and provision of early childhood development programs and services. In this study, the authors assess how HMG WNY addresses this regional need. The authors focus on how HMG WNY is working to strengthen and expand the early childhood network in western New York and provide insights that will inform the next steps for HMG WNY.
健康的儿童发育是一个人一生中更好的健康和福祉的关键驱动力,而幼儿期奠定了这一重要基础。儿童早期发展项目在减轻儿童认知、社会、行为和身体发展风险方面发挥着关键作用。越来越多的人认识到,支持儿童发展的早期干预需要的不仅仅是单独的项目和服务。相反,有必要进行全面的系统转型,比如全国性的“帮助我成长”(Help Me Grow)倡议。“帮助我成长纽约西部”(HMG WNY)是一项区域性努力,旨在建立和加强一个全面和协调的儿童早期发展服务和护理系统,以支持该地区儿童的发展和福祉。HMG WNY服务于纽约西部的八个县,这些县形成了一个多元化的社区,其社会经济构成各不相同,但都至少在一定程度上需要更好的协调和提供早期儿童发展计划和服务。在这项研究中,作者评估了HMG WNY如何满足这一区域需求。作者关注HMG WNY如何努力加强和扩大纽约西部的幼儿网络,并提供将为HMG WNY下一步提供信息的见解。
{"title":"An Assessment of Help Me Grow Western New York's Progress Toward Strengthening Early Childhood Systems.","authors":"Dana Schultz, Andrea Phillips, Anita Chandra, Emma Bianculli","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Healthy child development is a key driver for better health and well-being throughout a person's life, and the early years set that important foundation. Early childhood development programs play a critical role in mitigating risks to the cognitive, social, behavioral, and physical development of children. Increasingly, there is recognition that early intervention to support child development requires more than separate programs and services. Instead, a full system transformation, such as the national Help Me Grow initiative, is necessary. Help Me Grow Western New York (HMG WNY), a regional effort, aims to build and strengthen a comprehensive and coordinated system of early childhood development services and care to support the development and well-being of children in this region. HMG WNY serves eight counties in western New York that form a diverse community whose socioeconomic composition varies but which all share at least some level of need for better coordination and provision of early childhood development programs and services. In this study, the authors assess how HMG WNY addresses this regional need. The authors focus on how HMG WNY is working to strengthen and expand the early childhood network in western New York and provide insights that will inform the next steps for HMG WNY.</p>","PeriodicalId":74637,"journal":{"name":"Rand health quarterly","volume":"12 1","pages":"2"},"PeriodicalIF":0.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11630100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ingrid Estrada-Darley, Gabriela Alvarado, Alejandro Roa Contreras, Cristina Glave, Yoselin Mayoral, Peter Mendel, Nicole K Eberhart
The No More Adverse Childhood Experiences (NACES) pilot project addresses Adverse Childhood Experiences (ACEs) in rural farmworker communities in central California. Informed by engagement of farmworkers, the project included a clinic-based intervention that provided ACE education, screening, and response services during routine health visits with adult and pediatric patients. To understand the impact of the clinic-based intervention, the evaluation team developed a mixed-methods approach that collected and analyzed administrative data on ACE education and screening; clinic readiness for trauma informed health care self-assessments; staff training surveys; and interviews with staff, adult patients, and caregivers of pediatric patients. The evaluation found that clinic staff trained by NACES partners gained confidence in their ability to provide ACE education and screenings to the rural farmworker community they serve. In addition, adult patients and caregivers of pediatric patients said that ACE education was easy to understand and agreed that ACE education and screening was acceptable during routine visits with their or their child's doctor. Overall, results provide early evidence for the feasibility, acceptability, and potential for positive impact of an ACE education, screening, and response model that is informed by farmworker voices.
{"title":"Addressing Adverse Childhood Experiences in Clinics Serving California Farmworker Communities: NACES Pilot Project Evaluation.","authors":"Ingrid Estrada-Darley, Gabriela Alvarado, Alejandro Roa Contreras, Cristina Glave, Yoselin Mayoral, Peter Mendel, Nicole K Eberhart","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The No More Adverse Childhood Experiences (NACES) pilot project addresses Adverse Childhood Experiences (ACEs) in rural farmworker communities in central California. Informed by engagement of farmworkers, the project included a clinic-based intervention that provided ACE education, screening, and response services during routine health visits with adult and pediatric patients. To understand the impact of the clinic-based intervention, the evaluation team developed a mixed-methods approach that collected and analyzed administrative data on ACE education and screening; clinic readiness for trauma informed health care self-assessments; staff training surveys; and interviews with staff, adult patients, and caregivers of pediatric patients. The evaluation found that clinic staff trained by NACES partners gained confidence in their ability to provide ACE education and screenings to the rural farmworker community they serve. In addition, adult patients and caregivers of pediatric patients said that ACE education was easy to understand and agreed that ACE education and screening was acceptable during routine visits with their or their child's doctor. Overall, results provide early evidence for the feasibility, acceptability, and potential for positive impact of an ACE education, screening, and response model that is informed by farmworker voices.</p>","PeriodicalId":74637,"journal":{"name":"Rand health quarterly","volume":"12 1","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11630094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Edward W Chan, Michael G Mattock, Patricia K Tong, Lawrence M Hanser, Christina Panis, Sarah Baker
The Army Medical Corps comprises the physicians of the U.S. Army. In recent years, the Medical Corps' rate of recruitment has not been able to keep up with the pace of separations. Retention is down. A larger-than-expected proportion of Army physicians who have fulfilled their active-duty service obligation are separating rather than extending their careers and, possibly, serving until they are eligible for military retirement. This trend results in positions at military treatment facilities and other units being unfilled, compromising the Medical Corps' ability to fulfill its missions, whether in deployed operations or in caring for service members and other beneficiaries at home. In this study, the authors examine alternative strategies for the Army Medical Corps to ensure that it has access to the personnel it needs to support operational requirements. The authors consulted with subject-matter experts and gathered and analyzed data to help identify five courses of action (COAs) that could increase retention, increase accessions, or reduce the requirement for uniformed physicians.
{"title":"Reimagining the Army Medical Corps: Five Ideas for Raising Recruitment, Restoring Retention, and Restructuring Requirements.","authors":"Edward W Chan, Michael G Mattock, Patricia K Tong, Lawrence M Hanser, Christina Panis, Sarah Baker","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The Army Medical Corps comprises the physicians of the U.S. Army. In recent years, the Medical Corps' rate of recruitment has not been able to keep up with the pace of separations. Retention is down. A larger-than-expected proportion of Army physicians who have fulfilled their active-duty service obligation are separating rather than extending their careers and, possibly, serving until they are eligible for military retirement. This trend results in positions at military treatment facilities and other units being unfilled, compromising the Medical Corps' ability to fulfill its missions, whether in deployed operations or in caring for service members and other beneficiaries at home. In this study, the authors examine alternative strategies for the Army Medical Corps to ensure that it has access to the personnel it needs to support operational requirements. The authors consulted with subject-matter experts and gathered and analyzed data to help identify five courses of action (COAs) that could increase retention, increase accessions, or reduce the requirement for uniformed physicians.</p>","PeriodicalId":74637,"journal":{"name":"Rand health quarterly","volume":"12 1","pages":"9"},"PeriodicalIF":0.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11630097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Many veterans and their advocates are concerned that military service may cause impaired respiratory function resulting from occupational exposures to environmental hazards (e.g., Agent Orange in the Vietnam War, burn pits in the Global War on Terror) or infectious diseases (e.g., pneumonia). Such exposures occurring in service members' young adulthoods may not have immediately discernible effects on lung health; some symptoms may emerge in the immediate months or years after separation from the military, and diagnosable conditions may not manifest until decades later. Health care providers serving veteran populations must consider both the unique combat circumstances surrounding the time of veterans' service and the age-graded nature of health conditions that might result from military service. To characterize lung health across a broad age range of veterans, the authors analyzed data from two nationally representative surveys of health and well-being that include samples of veterans and their civilian peers. With these data, the authors compared respiratory health outcomes observed for the veteran and civilian populations who were of prime age for military service during different periods of national conflict: the Korean War, the Vietnam War, Operation Desert Shield/Storm, and the Global War on Terror. The authors estimated that differences in smoking behaviors-including differences prior to enlistment-account for at least half of the veteran-civilian disparities in respiratory outcomes. This suggests the need for military-based and post-transition smoking cessation efforts and further research into other factors that might contribute to these veteran and civilian disparities, such as environmental exposures during military service.
{"title":"Respiratory Health Among U.S. Veterans Across Age and Over Time.","authors":"Robert Bozick, Roland Neil","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Many veterans and their advocates are concerned that military service may cause impaired respiratory function resulting from occupational exposures to environmental hazards (e.g., Agent Orange in the Vietnam War, burn pits in the Global War on Terror) or infectious diseases (e.g., pneumonia). Such exposures occurring in service members' young adulthoods may not have immediately discernible effects on lung health; some symptoms may emerge in the immediate months or years after separation from the military, and diagnosable conditions may not manifest until decades later. Health care providers serving veteran populations must consider both the unique combat circumstances surrounding the time of veterans' service and the age-graded nature of health conditions that might result from military service. To characterize lung health across a broad age range of veterans, the authors analyzed data from two nationally representative surveys of health and well-being that include samples of veterans and their civilian peers. With these data, the authors compared respiratory health outcomes observed for the veteran and civilian populations who were of prime age for military service during different periods of national conflict: the Korean War, the Vietnam War, Operation Desert Shield/Storm, and the Global War on Terror. The authors estimated that differences in smoking behaviors-including differences prior to enlistment-account for at least half of the veteran-civilian disparities in respiratory outcomes. This suggests the need for military-based and post-transition smoking cessation efforts and further research into other factors that might contribute to these veteran and civilian disparities, such as environmental exposures during military service.</p>","PeriodicalId":74637,"journal":{"name":"Rand health quarterly","volume":"12 1","pages":"10"},"PeriodicalIF":0.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11630092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Forrest W Crawford, Kyle Webster, Gerald L Epstein, Derek Roberts, Joseph Fair, Sella Nevo
On-demand gene synthesis is a growing industry that has democratized access to customized synthetic deoxyribonucleic acid (DNA) and ribonucleic acid (RNA) products used in biological research. However, the increasing availability and decreasing cost of custom synthetic nucleic acids presents a risk of misuse that could allow nefarious actors to obtain sequences of dangerous organisms or novel-engineered pathogens to construct a biological weapon. Securing nucleic acid synthesis is a policy priority for the U.S. government and the synthetic biology industry. But there is currently no legal requirement that gene synthesis providers screen their customers or their orders to ensure that the requested synthetic DNA and RNA constructs are not used for harmful purposes. Many providers screen orders voluntarily, but there is currently no universally accepted standard for screening customers or orders. In this study, the authors review government screening guidelines, industry consortium requirements, legislative proposals, and the scientific literature to assess the current state of commercial gene synthesis screening; summarize proposals for strengthening screening; and contribute recommendations for implementing comprehensive screening policies to secure commercial nucleic acid synthesis. These recommendations expand on and strengthen government communications, industry consortium rules and best practices, and proposals developed by researchers and provider organizations.
{"title":"Securing Commercial Nucleic Acid Synthesis.","authors":"Forrest W Crawford, Kyle Webster, Gerald L Epstein, Derek Roberts, Joseph Fair, Sella Nevo","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>On-demand gene synthesis is a growing industry that has democratized access to customized synthetic deoxyribonucleic acid (DNA) and ribonucleic acid (RNA) products used in biological research. However, the increasing availability and decreasing cost of custom synthetic nucleic acids presents a risk of misuse that could allow nefarious actors to obtain sequences of dangerous organisms or novel-engineered pathogens to construct a biological weapon. Securing nucleic acid synthesis is a policy priority for the U.S. government and the synthetic biology industry. But there is currently no legal requirement that gene synthesis providers screen their customers or their orders to ensure that the requested synthetic DNA and RNA constructs are not used for harmful purposes. Many providers screen orders voluntarily, but there is currently no universally accepted standard for screening customers or orders. In this study, the authors review government screening guidelines, industry consortium requirements, legislative proposals, and the scientific literature to assess the current state of commercial gene synthesis screening; summarize proposals for strengthening screening; and contribute recommendations for implementing comprehensive screening policies to secure commercial nucleic acid synthesis. These recommendations expand on and strengthen government communications, industry consortium rules and best practices, and proposals developed by researchers and provider organizations.</p>","PeriodicalId":74637,"journal":{"name":"Rand health quarterly","volume":"12 1","pages":"4"},"PeriodicalIF":0.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11630105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rosanna Smart, Andrew R Morral, James P Murphy, Rupa Jose, Amanda Charbonneau, Sierra Smucker
In this study, part of RAND's Gun Policy in America initiative, researchers seek objective information about what scientific literature reveals about the likely effects of various gun laws. In the fourth edition of this study, the authors incorporate more-recent research in their synthesis of the available scientific data regarding the effects of 18 state firearm policies on firearm injuries and deaths, violent crime, suicides, the gun industry, defensive gun use, and other outcomes. By highlighting where scientific evidence is accumulating, the authors hope to build consensus around a shared set of facts that have been established through a transparent, nonpartisan, and impartial review process. In so doing, they also illuminate areas in which more and better information could make important contributions to establishing fair and effective gun policies.
{"title":"The Science of Gun Policy: A Critical Synthesis of Research Evidence on the Effects of Gun Policies in the United States, Fourth Edition.","authors":"Rosanna Smart, Andrew R Morral, James P Murphy, Rupa Jose, Amanda Charbonneau, Sierra Smucker","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In this study, part of RAND's Gun Policy in America initiative, researchers seek objective information about what scientific literature reveals about the likely effects of various gun laws. In the fourth edition of this study, the authors incorporate more-recent research in their synthesis of the available scientific data regarding the effects of 18 state firearm policies on firearm injuries and deaths, violent crime, suicides, the gun industry, defensive gun use, and other outcomes. By highlighting where scientific evidence is accumulating, the authors hope to build consensus around a shared set of facts that have been established through a transparent, nonpartisan, and impartial review process. In so doing, they also illuminate areas in which more and better information could make important contributions to establishing fair and effective gun policies.</p>","PeriodicalId":74637,"journal":{"name":"Rand health quarterly","volume":"12 1","pages":"3"},"PeriodicalIF":0.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11630101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}