National Academies Press: OpenBook

Assessment of Long-Term Health Effects of Antimalarial Drugs When Used for Prophylaxis (2020)

Chapter: Appendix D: Committee Member and Staff Biographies

« Previous: Appendix C: Epidemiologic Studies That Met the Committee's Inclusion Criteria
Suggested Citation:"Appendix D: Committee Member and Staff Biographies." National Academies of Sciences, Engineering, and Medicine. 2020. Assessment of Long-Term Health Effects of Antimalarial Drugs When Used for Prophylaxis. Washington, DC: The National Academies Press. doi: 10.17226/25688.
×
Page 399
Suggested Citation:"Appendix D: Committee Member and Staff Biographies." National Academies of Sciences, Engineering, and Medicine. 2020. Assessment of Long-Term Health Effects of Antimalarial Drugs When Used for Prophylaxis. Washington, DC: The National Academies Press. doi: 10.17226/25688.
×
Page 400
Suggested Citation:"Appendix D: Committee Member and Staff Biographies." National Academies of Sciences, Engineering, and Medicine. 2020. Assessment of Long-Term Health Effects of Antimalarial Drugs When Used for Prophylaxis. Washington, DC: The National Academies Press. doi: 10.17226/25688.
×
Page 401
Suggested Citation:"Appendix D: Committee Member and Staff Biographies." National Academies of Sciences, Engineering, and Medicine. 2020. Assessment of Long-Term Health Effects of Antimalarial Drugs When Used for Prophylaxis. Washington, DC: The National Academies Press. doi: 10.17226/25688.
×
Page 402
Suggested Citation:"Appendix D: Committee Member and Staff Biographies." National Academies of Sciences, Engineering, and Medicine. 2020. Assessment of Long-Term Health Effects of Antimalarial Drugs When Used for Prophylaxis. Washington, DC: The National Academies Press. doi: 10.17226/25688.
×
Page 403
Suggested Citation:"Appendix D: Committee Member and Staff Biographies." National Academies of Sciences, Engineering, and Medicine. 2020. Assessment of Long-Term Health Effects of Antimalarial Drugs When Used for Prophylaxis. Washington, DC: The National Academies Press. doi: 10.17226/25688.
×
Page 404
Suggested Citation:"Appendix D: Committee Member and Staff Biographies." National Academies of Sciences, Engineering, and Medicine. 2020. Assessment of Long-Term Health Effects of Antimalarial Drugs When Used for Prophylaxis. Washington, DC: The National Academies Press. doi: 10.17226/25688.
×
Page 405
Suggested Citation:"Appendix D: Committee Member and Staff Biographies." National Academies of Sciences, Engineering, and Medicine. 2020. Assessment of Long-Term Health Effects of Antimalarial Drugs When Used for Prophylaxis. Washington, DC: The National Academies Press. doi: 10.17226/25688.
×
Page 406
Suggested Citation:"Appendix D: Committee Member and Staff Biographies." National Academies of Sciences, Engineering, and Medicine. 2020. Assessment of Long-Term Health Effects of Antimalarial Drugs When Used for Prophylaxis. Washington, DC: The National Academies Press. doi: 10.17226/25688.
×
Page 407
Suggested Citation:"Appendix D: Committee Member and Staff Biographies." National Academies of Sciences, Engineering, and Medicine. 2020. Assessment of Long-Term Health Effects of Antimalarial Drugs When Used for Prophylaxis. Washington, DC: The National Academies Press. doi: 10.17226/25688.
×
Page 408

Below is the uncorrected machine-read text of this chapter, intended to provide our own search engines and external engines with highly rich, chapter-representative searchable text of each book. Because it is UNCORRECTED material, please consider the following text as a useful but insufficient proxy for the authoritative book pages.

Appendix D Committee Member and Staff Biographies COMMITTEE MEMBERS David A. Savitz, Ph.D. (Chair), is a professor of epidemiology in the Brown University School of Public Health, where he serves as the interim chair of the Department of Epidemiology and holds joint appointments as a professor of obstetrics and gynecology and pediatrics in the Alpert Medical School. From 2013 to 2017, Dr. Savitz served as the vice president for research at Brown University. He came to Brown in 2010 from the Mount Sinai School of Medi- cine, where he had served as the Charles W. Bluhdorn Professor of Community and Preventive Medicine and the director of the Disease Prevention and Public Health Institute since 2006. Before that appointment, he taught and conducted research at the University of North Carolina School of Public Health and at the Department of Preventive Medicine and Biometrics at the University of Colorado School of Medicine. Dr. Savitz received his undergraduate training in psychol- ogy at Brandeis University, holds a master’s degree in preventive medicine from The Ohio State University, and received his Ph.D. in epidemiology from the University of Pittsburgh Graduate School of Public Health. His epidemiologic research has addressed a wide range of environmental and perinatal health issues, including exposures related to military deployments, the environmental effects of energy development, pesticides and breast cancer, risks from environmental exposures during pregnancy, and drinking water safety. Dr. Savitz has directed 31 doctoral dissertations and 15 master’s theses. He is the author of nearly 350 papers in professional journals and the editor or author of 3 books on environ- mental epidemiology. He has served as the editor at the American Journal of Epi- demiology and Epidemiology and as a member of the Epidemiology and Disease 399

400 LONG-TERM HEALTH EFFECTS OF ANTIMALARIAL DRUGS Control-1 study section of the National Institutes of Health. He has served as the president of the Society for Epidemiologic Research, the Society for Pediatric and Perinatal Epidemiologic Research, and the North American Regional Coun- cilor for the International Epidemiological Association. Dr. Savitz is a member of the National Academy of Medicine and has previously served on 11 National Academies consensus committees, five of which he chaired or was the vice-chair, in addition to serving on several other National Academies convening activities. Sara L. Dolan, Ph.D., is an associate professor of psychology and neurosci- ence and the graduate program director at Baylor University. She completed her Ph.D. in clinical psychology at the University of Iowa and completed her clinical internship in the Division of Substance Abuse at Yale University, and her postdoctoral fellowship at Brown University. Her early research primarily focused on substance use disorders, but more recently her work has focused on neurocognitive function in substance use disorders, posttraumatic stress disorder (PTSD), and traumatic brain injury (TBI). The goal of her research is to improve diagnosis and treatment of substance use disorders, PTSD, and TBI to improve overall functioning and well-being. Dr. Dolan has authored or co-authored more than 40 peer-reviewed journal articles. Marie R. Griffin, M.D., M.P.H., is a professor of health policy and medi- cine, holds the directorship in public health research and education, and directs the master of public health program at Vanderbilt University. She received her M.D. from Georgetown University and her master’s in public health from Johns Hopkins University. Dr. Griffin completed her medical residency at Emory Uni- versity, served as an epidemic intelligence service officer through the Centers for Disease Control and Prevention, and was a clinical epidemiology fellow at Johns Hopkins. She is a general internist and pharmacoepidemiologist whose research focuses on the safety and effectiveness of drugs and vaccines, program evaluation, and methods in pharmacoepidemiology. She has served on Food and Drug Administration committees, including the Nonprescription Drugs Advisory Committee and the Vaccine and Related Products Advisory Committee, and she continues to serve as a member of the Drug Safety and Risk Management Advisory Committee. She also serves as a work group member of the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices for respiratory syncytial virus vaccine. She has worked extensively with administrative data from the Tennessee Medicaid program and the Department of Veterans Affairs to analyze data on the comparative effectiveness and safety of drugs and vaccines. Her work has consistently provided scientific evidence that has been used to drive policy. Dr. Griffin has authored or co-authored more than 350 peer-reviewed journal articles. She has previously served as a member of the National Academies’ Committee to Review the Adverse Consequences of Pertussis and Rubella Vaccines.

APPENDIX D 401 James P. Herman, Ph.D., is the Flor van Maanen professor, the chair of the Department of Pharmacology and Systems Physiology, and the director of the Neurobiology Research Center and the Stress Neurobiology Laboratory at the University of Cincinnati. Dr. Herman’s research examines the relationship be- tween the physiologic actions of central nervous system stress circuits and their place in the central nervous system. His work primarily focuses on two areas. The first area is limbic system regulation of the stress response and, consequently, on the generation of stress-related disorders, ranging from major depressive illness to posttraumatic stress disorder to essential hypertension, to neurodegeneration and aging. The second focus of his research is on defining the role of central adre- nocorticosteroid receptors in transducing stress-related signals in normal physiol- ogy, aging, and disease states. Dr. Herman completed his Ph.D. at the University of Rochester and his postdoctoral training at the Mental Health Research Institute at the University of Michigan. He has received several awards for his research and he has authored or co-authored more than 240 peer-reviewed journal articles. Yuval Neria, Ph.D., is a professor of medical psychology in the Department of Psychiatry and Epidemiology at the Columbia University Medical Center and the director of the PTSD Research Program at the New York State Psychiatric Insti- tute. Dr. Neria completed his doctoral studies at the Haifa University in Israel and has led and collaborated on numerous epidemiologic, clinical, and neuroimaging studies of trauma and PTSD. His research focuses on translational research aim- ing to identify behavioral and neural markers for trauma-related psycho­ athology. p Dr. Neria uses multimodal brain imaging and a number of novel paradigms focus- ing on fear circuitry to probe new biomarkers of PTSD and to identify structural and functional neural markers of clinical response to PTSD treatment. He is primarily interested in clarifying the clinical, behavioral, and neural signatures of trauma and PTSD. He is the recipient of the Medal of Valor for his military service in Israel. Dr. Neria is the author of more than 180 peer-reviewed articles and book chapters and a war novel and co-edited 4 textbooks focusing on the mental health consequences of exposure to trauma. Andy Stergachis, Ph.D., M.S., directs the Global Medicines Program in the De- partment of Global Health at the University of Washington (UW). He is professor of pharmacy and global health and an associate dean in the School of Pharmacy. His research focuses on pharmacoepidemiology, global drug and vaccine safety, and pharmaceutical outcomes research. He is the author of 160 peer-reviewed publications in areas such as pharmacovigilance, pharmaco­ pidemiology, phar- e maceutical outcomes, and clinical epidemiology, and he served as the editor- in-chief of the Journal of the American Pharmacists Association. He presently serves as a co-investigator with the UW Institute for Health Metrics and Evalua- tion for a study on Mapping and Monitoring the Global Burden of Anti­ icrobial m Resistance. He recently directed a study on the safety of antimalarial drugs

402 LONG-TERM HEALTH EFFECTS OF ANTIMALARIAL DRUGS used during pregnancy conducted in three sub-Saharan African countries and has devel­ ped novel approaches for malaria and HIV pharmacovigilance and o strengthening pharmacy services in that region. Through his affiliation with the Northwest Center for Public Health Practice, he works on workforce develop- ment and public health systems research in emergency preparedness with the public health community. He is also affiliated with the UW Comparative Health Outcomes, Policy, and Economics (CHOICE) Institute. He is the chair of the Expert Panel to Review Surveillance and Screening Technologies for the Qual- ity ­ ssurance of Medicines for USP and the chair of the Low-Dose Primaquine A Safety Study Group for the WorldWide Antimalarial Resistance Network, and he has served as a member of the Access and Product Management Advisory Committee for Medicines for Malaria Venture. He is a fellow of the Inter- national Society for Pharmacoepidemiology and of the American Pharmacists Association-Academy of Pharmaceutical Research and Science. Dr. Stergachis is a member of the National Academy of Medicine (elected 2012). He has served on numerous ­ ational Academies committees, including the Committee N on Inter­ ctions of Drugs, Biologics, and Chemicals in U.S. Military Forces and a the Committee on the Assessment of the U.S. Drug Safety System. Dr. Stergachis received his bachelor’s of pharmacy from Washington State University and both his master’s degree in pharmacy administration and his doctorate in social and administrative pharmacy from the University of Minnesota. Elizabeth A. Stuart, Ph.D., is a professor in the Department of Mental Health in the Johns Hopkins Bloomberg School of Public Health (JHSPH) with joint appointments in the departments of biostatistics and of health policy and man- agement, and she is also the associate dean for education at JHSPH. Dr. Stuart has an undergraduate degree in mathematics from Smith College and completed her Ph.D. in statistics at Harvard University. Her research focuses on the use of different design and analysis methods for estimating causal effects, especially in terms of improving the internal validity of non-experimental studies and the external validity of randomized studies. She also researches methods for address- ing missing data and non-compliance. She has made important contributions to collaborative and methodologic research in the area of causal inference applied to mental health, substance use, health care policy, and education. Dr. Stuart is affiliated with several Johns Hopkins centers, including the Center for Drug Safety and Effectiveness, the Center for Mental Health and Addiction Policy Research (which she co-directs), and the Bloomberg American Health Initiative. She is an elected fellow of the American Statistical Association, for which she was a founding member of the Mental Health Statistics Section and has received the Gertrude Cox Award for applied statistics and the Myrto Lefkopoulou award from the Harvard University Department of Biostatistics, and she has been con- sistently recognized for her teaching and mentoring. She is an associate editor and a reviewer for several journals related to statistics, epidemiologic methods,

APPENDIX D 403 and mental health, and she has contributed to more than 200 peer-reviewed pub- lications. Dr. Stuart has previously served as a panel member for the National Academies on an activity related to methodologies for studying commercial mo- tor vehicle driver fatigue. Carol Tamminga, M.D., is a professor, chairman of psychiatry, and chief of translational neuroscience research in schizophrenia at the University of Texas (UT) Southwestern Medical School. She holds the Communities Foundation of Texas Chair in Brain Science along with the Lou and Ellen McGinley Distinguished Chair in Psychiatric Research. She directs clinical and preclini- cal research in schizophrenia focused on identifying disease mechanisms and on improving treatments. Dr. Tamminga graduated from Vanderbilt Medical School and completed a psychiatry residency at the University of Chicago and spent many years at the University of Maryland’s Maryland Psychiatric Research Center, then moved to UT Southwestern Medical School to con- tinue her research. Dr. Tamminga has been the recipient of numerous federal and foundation grants as well as awards in the field. She has served on the National Advisory Mental Health Council of the National Institute of Mental Health and on the Council of the National Institute of Drug Abuse. Dr. Tam- minga was elected to the National Academy of Medicine in 1998 and has served on several Institute of Medicine committees in that capacity. The goal of Dr. Tamminga’s research is to examine and understand the mechanisms underlying schizophrenia, especially its most prominent symptoms, psychosis and memory dysfunction, in order to build rational treatments for the illness. She evaluates the function of the living human brain in individuals with and without schizophrenia using brain imaging techniques. Then, building on this knowledge, she uses human postmortem brain tissue to translate the functional alterations from the living human patient into molecular observations of the illness. Now she is using case-specific neuronal cultures to address molecular and cellular questions. Her ultimate goal is to use the alterations in in vivo imaging, postmortem molecular changes, and cultured neuronal characteristics as biomarkers and targets for identifying animal models of disease and novel active pharmaceuticals for psychosis. Jonathan L. Vennerstrom, Ph.D., is a professor in the Department of Pharma- ceutical Sciences in the College of Pharmacy at the University of Nebraska Medi- cal Center. He received his Ph.D. in medicinal chemistry from the University of Minnesota and completed his postdoctoral training at Walter Reed. Dr. Venner- strom’s work focuses on anti-infective drug discovery, particularly the medicinal chemistry of antiparasitic agents and the investigation of heme as a mechanistic intersection for antimalarial drugs. His work has led to the discovery of new mechanisms of action of chloroquine (and other antimalarial quinolines) and new understanding of mechanisms of how hemozoin is formed in the malaria parasite.

404 LONG-TERM HEALTH EFFECTS OF ANTIMALARIAL DRUGS His research has comprehensively characterized the structural features of chloro- quine associated with its antimalarial properties and shown that peroxide antima- larial activity depends on parasite hemoglobin digestion. Two antimalarial drug candidates were discovered during his work with the Medicines for Malaria Ven- ture; one is now available in India and the other is in phase IIb trials as a potential single-dose malaria treatment. Both of these drugs are outside of the committee’s Statement of Task. Dr. Vennerstrom continues to use the knowledge generated by his research to discover other antimicrobial drug candidates for several infec- tious diseases, including malaria. He is a member of the American Society for Microbiology, the American Society of Tropical Medicine and Hygiene, and the American Chemical Society (ACS) from which he received the ACS Award for Creative Innovation in 2019. He has received several other awards, including the Medicines for Malaria Venture Project of the Year Award twice (2001, 2006), the Alvin M. Earle Outstanding Health Science Educator Award, the University of Nebraska Medical Center Distinguished Scientist Award, the UNeMed Lifetime Achievement Award, and the University of Nebraska Innovation, Development, and Engagement (IDEA) Award. His work continues to drive innovation in the drug discovery field. Dr. Vennerstrom has authored or co-authored more than 130 peer-reviewed journal articles. Christina M. Wolfson, Ph.D., is a professor in the Department of Medicine and the Department of Epidemiology, Biostatistics and Occupational Health at McGill University and a senior scientist in the Brain Repair and Integrative Neuroscience (BRAIN) Program at the Research Institute of the McGill Uni- versity Health Centre. She is an associate member in the departments of neurol- ogy and neurosurgery and mathematics and statistics at McGill University. A neuroepidemiologist, her program of research lies in population-based research in neurodegenerative disorders, including multiple sclerosis (MS), ­ arkinson P disease, and epilepsy. She is a co-principal investigator on the Canadian Lon- gitudinal Study on Aging (CLSA), a 20-year study of 50,338 participants aged 45–85 in which she leads the Neurological Conditions Initiative and the Veter- ans’ Health Initiative and is the director of the CLSA Statistical Analysis Cen- tre. Dr. Wolfson is a co-principal investigator on a five-country MS risk factor study (Environmental Risk Factors in Multiple Sclerosis, EnvIMS) completed in Canada, Italy, Norway, Serbia, and Sweden. She is also the program director of the endMS National Training Program. Dr. Wolfson received her undergradu- ate degree in mathematics, her master’s degree in mathematical statistics, and her Ph.D. in epidemiology and biostatistics from McGill University. She has published more than 220 peer-reviewed journal articles and has previously served as a member on four National Academies’ consensus committees related to health effects in U.S. veterans who served in the 1990–1991 Gulf War and post-9/11 conflicts.

APPENDIX D 405 STAFF Anne N. Styka, M.P.H., study director, is a senior program officer in the Health and Medicine Division of the National Academies. Over her tenure she has worked on more than 10 studies, 5 of which she has directed or co-directed, on a broad range of topics related to the health of military and veteran populations. The subjects of the studies have included mental health treatment offered in the Department of Defense and the Department of Veterans Affairs; designing and evaluating epidemiologic research studies of health outcomes and their associa- tion with deployment-related exposures, including burn pits, herbicides, and other chemicals; and directing a research program that fostered new research studies using data and biospecimens collected as part of the 20-year Air Force Health Study. Before coming to the National Academies, Ms. Styka spent several years working as an epidemiologist for the New Mexico Department of Health and the Albuquerque Area Southwest Tribal Epidemiology Center specializing in survey design and the analysis of behavioral risk factors and injury. She also spent several months in Zambia as the epidemiologist on a study of silicosis and other nonmalignant respiratory diseases among copper miners. She has written several peer-reviewed publications and has contributed to numerous state and national reports. She received her B.S. in cell and tissue bioengineering from the Univer- sity of Illinois at Chicago and has an M.P.H. in epidemiology from the University of Michigan. Ms. Styka was the 2017 recipient of the Division of Earth and Life Sciences Mt. Everest Award, the 2015 recipient of the Institute of Medicine and National Academy of Medicine Multitasker Award, and a member of the 2011 National Academies’ Distinguished Group Award. Kristin E. White is an associate program officer in the Health and Medicine Division of the National Academies. Previously a medical writer and editor, she worked across numerous medical specialties and drug classes to create materials for, and resulting from, continuing medical education programs, international medical symposia, and drug and research advisory board meetings. She worked on programs at the annual meetings of the American Academy of Allergy, Ameri- can College of Cardiology, American College of Gastroenterology, American College of Rheumatology, American Congress of Obstetricians and Gynecolo- gists, American Heart Association, American Diabetes Association, Asthma & Immunology, European College of Cardiology, European Society for Sexual and Impotence Research, Heart Failure Society of America, and International Con- gress of Cardiology. She received an A.B. from Princeton University. Stephanie J. Hanson, M.P.H., is a research associate in the Health and Medicine Division of the National Academies. Before joining the National Academies, Ms. Hanson worked at Save the Children U.S. in the Department of Humani- tarian Response where she assisted on contracts related to food aid in complex

406 LONG-TERM HEALTH EFFECTS OF ANTIMALARIAL DRUGS emergencies. She also worked with the Peace Corps headquarters to conduct a gap analysis on training objectives and outcomes for information given to new Peace Corps volunteers before they begin their roles at post. Her work focused on training materials for malaria, mental health, substance and alcohol use, and HIV/AIDS. Ms. Hanson completed her B.S. in biology at the University of Nebraska–Omaha and has an M.P.H. in global health epidemiology and disease control from The George Washington University. Ms. Hanson has an interest in maternal mental health and has examined existing barriers in low- and middle- income countries surrounding the discussion, diagnosis, or treatment of mental illness, with a focus on postpartum depression, and the exacerbating effects of a complex emergency on these barriers. She plans to pursue her doctoral degree in epidemiology and continue her work on mental illness in low- and middle- income countries. Rebecca F. Chevat is a senior program assistant in the Health and Medicine Division of the National Academies. Ms. Chevat is a graduate of American University where she received her B.A. in public health with concentrations in psychology and political science. During her undergraduate career, she worked in the Office of the Secretary and in the Office of Health Affairs at the Depart- ment of Homeland Security where she examined public–private partnerships and their role on point-of-dispensing models during emergencies. Ms. Chevat also has experience working on Capitol Hill and on a political campaign. She plans to pursue her M.P.H. in global health. Ms. Chevat is a recipient of a 2019 Health and Medicine Division Spot Award. Rose Marie Martinez, Sc.D., has been senior board director of the National Academies’ Board on Population Health and Public Health Practice (BPH) since 1999. BPH has a vibrant portfolio of studies that address high-profile and cut- ting-edge issues that affect population health. It addresses the science base for population health and public health interventions and examines the capacity of the health system, particularly the public health infrastructure, to support disease prevention and health promotion activities, including the education and supply of health professionals necessary for carrying them out. BPH has examined such topics as the safety of childhood vaccines and other drugs; systems for evaluat- ing and ensuring drug safety postmarketing; the health effects of cannabis and cannabinoids; health effects of environmental exposures; population health im- provement strategies; integration of medical care and public health; women’s health services; health disparities; health literacy; tobacco control strategies; and chronic disease prevention, among others. Dr. Martinez was awarded the 2010 Institute of Medicine (IOM) Research Cecil Award for significant contributions to IOM reports of exceptional quality and influence. Prior to joining the National Academies, Dr. Martinez was a senior health researcher at Mathematica Policy Research (1995–1999) where she conducted research on the impact of health

APPENDIX D 407 system change on public health infrastructure, access to care for vulnerable populations, managed care, and the health care workforce. Dr. Martinez is a former assistant director for health financing and policy with the U.S. General Accounting Office, where she directed evaluations and policy analysis in the area of national and public health issues (1988–1995). Her experience also includes 6 years directing research studies for the Regional Health Ministry of Madrid, Spain (1982–1988). Dr. Martinez is a member of the Council on Education for Public Health, the accreditation body for schools of public health and public health programs. She received the degree of doctor of science from the Johns Hopkins School of Hygiene and Public Health.

Assessment of Long-Term Health Effects of Antimalarial Drugs When Used for Prophylaxis Get This Book
×
Buy Paperback | $90.00
MyNAP members save 10% online.
Login or Register to save!
Download Free PDF

Among the many who serve in the United States Armed Forces and who are deployed to distant locations around the world, myriad health threats are encountered. In addition to those associated with the disruption of their home life and potential for combat, they may face distinctive disease threats that are specific to the locations to which they are deployed. U.S. forces have been deployed many times over the years to areas in which malaria is endemic, including in parts of Afghanistan and Iraq. Department of Defense (DoD) policy requires that antimalarial drugs be issued and regimens adhered to for deployments to malaria-endemic areas. Policies directing which should be used as first and as second-line agents have evolved over time based on new data regarding adverse events or precautions for specific underlying health conditions, areas of deployment, and other operational factors

At the request of the Veterans Administration, Assessment of Long-Term Health Effects of Antimalarial Drugs When Used for Prophylaxis assesses the scientific evidence regarding the potential for long-term health effects resulting from the use of antimalarial drugs that were approved by FDA or used by U.S. service members for malaria prophylaxis, with a focus on mefloquine, tafenoquine, and other antimalarial drugs that have been used by DoD in the past 25 years. This report offers conclusions based on available evidence regarding associations of persistent or latent adverse events.

  1. ×

    Welcome to OpenBook!

    You're looking at OpenBook, NAP.edu's online reading room since 1999. Based on feedback from you, our users, we've made some improvements that make it easier than ever to read thousands of publications on our website.

    Do you want to take a quick tour of the OpenBook's features?

    No Thanks Take a Tour »
  2. ×

    Show this book's table of contents, where you can jump to any chapter by name.

    « Back Next »
  3. ×

    ...or use these buttons to go back to the previous chapter or skip to the next one.

    « Back Next »
  4. ×

    Jump up to the previous page or down to the next one. Also, you can type in a page number and press Enter to go directly to that page in the book.

    « Back Next »
  5. ×

    To search the entire text of this book, type in your search term here and press Enter.

    « Back Next »
  6. ×

    Share a link to this book page on your preferred social network or via email.

    « Back Next »
  7. ×

    View our suggested citation for this chapter.

    « Back Next »
  8. ×

    Ready to take your reading offline? Click here to buy this book in print or download it as a free PDF, if available.

    « Back Next »
Stay Connected!