Edward W Chan

This report examines climate adaptation strategies for 25 National Critical Functions (NCFs) at risk of disruption from climate change. The focus is on impact pathways, each of which is a combination of climate drivers (such as drought and flooding) and impact mechanisms (such as physical damage and workforce shortages) affecting a given NCF. The emphasis is on strategies that owner-operators of critical functions might implement.

The Transportation Worker Identification Credential (TWIC) is designed to enhance security at U.S. ports. It demonstrates that the holder has passed a Transportation Security Administration security threat assessment and is required of anyone with unescorted access to a secure area at a regulated facility. This report provides the findings from an assessment of the TWIC program, along with the assessors' recommendations.

The authors describe Puerto Rico's communities in terms of population characteristics, community and individual preparedness, and economic pressures leading up to Hurricanes Irma and Maria. They detail the storms' impact in terms of damage, community stress, and migration. The researchers developed courses of action to improve capacity for emergency preparedness, coordination, communication, recovery planning, and research and training.

Making aviation security more cost-effective is hampered by a lack of understanding of the costs and benefits of security interventions. Moreover, there will always be considerable uncertainty about terrorists' capabilities and decision making, security system performance, and the tangible and intangible costs of security measures. This volume focuses on exploring ways to use cost-benefit and other types of analysis to improve aviation security decision making in spite of such uncertainties. The authors present a set of analyses that discuss how historical data on aviation security can inform security planning; examine ways to address uncertainty about the costs of security measures; discuss the ways in which different layers of a security system interact; offer a method for incorporating deterrence into the assessment of security measures via the concept of a risk-reduction threshold, using the Federal Air Marshal Service as an example; examine tradeoffs between intended and unintended consequences of security measures, using a trusted traveler program as an example; and discuss the merits of high- versus low-resolution models of aviation terrorism for informing policy.These analyses contribute to filling some of the current gaps in the assessment of the costs, benefits, and efficiency of aviation security measures and strategies.

Most U.S. Air Force (USAF) medical personnel care for patients with ailments far less complex or urgent than the trauma-related injuries they would see in war, and the USAF must ensure that these personnel receive the training and experience they need for high-casualty environments. The authors present findings, recommendations, and a prototype framework to suggest readiness activities and policies that could be employed to prepare personnel for war.

Hurricane Maria magnified Puerto Rico's fragile system for delivering social, behavioral, and environmental health services, which were evidenced by chronic disease burdens, demographic transitions, and unmet health needs. The recovery plan outlines action strategies for building a robust health infrastructure, strengthening the health care workforce, expanding social service capacity, and investing in healthy communities.

The U.S. Army Medical Department's missions are to care for the war wounded during conflict and to operate medical treatment facilities (MTFs) that care for service members, their beneficiaries, and military retirees. Because the injuries that require treatment during wartime can be very different from the case mix seen in MTFs, the Army sought to identify ways to help providers prepare for wartime missions while they are stationed at home.

The Cities Readiness Initiative (CRI) aims to improve communities' ability to rapidly provide life-saving medications during public health emergencies. The authors examine (1) the status of communities' operational capability to meet the goal of delivering medical countermeasures within 48 hours of a federal decision to deploy assets and (2) whether there is evidence that CRI has improved communities' capability to meet that goal.

The Air Force Medical Service (AFMS) currently runs three in-theater hospitals for severely injured or wounded personnel. Part of the practioners' preparation was treating DoD beneficiaries for a broad range of injuries and illnesses. Opportunities for this preparation are not as numerous in house as they once were, and AFMS does not always get proper credit for those gained elsewhere. Proper credit for that work is important for funding.

A new metric for measuring expeditionary medical support (EMEDS) and a construct for applying it across three Air Force medical missions: deployed military support, humanitarian relief, and defense support to civil authorities. The new metric focuses on the rate at which each component of the deployment system can evaluate, stabilize, triage, treat, and evacuate patients, or the medical STEP rate, to replace the current inadequate measure, beds.

Presents an analysis of Air Force combat support experiences associated with Operation Enduring Freedom and compares these experiences with those associated with Operation Allied Force (OAF) to determine similarities and applicability of lessons across experiences. An analysis of combat support experiences associated with Operation Enduring Freedom that compares these experiences with those associated with Operation Allied Force (OAF). Its objectives were to indicate the performance of U.S. Air Force combat support in OEF, examine how Agile Combat Support concepts were implemented in OEF and compare OAF and OEF experiences to determine similarities and applicability of lessons across experiences, and to determine whether some experiences are unique to particular scenarios.