The medical research landscape in the United States is supported by a variety of organizations that spend billions of dollars in government and private funds each year to seek answers to complex medical and public health problems. The largest government funder is the National Institutes of Health (NIH), followed by the Department of Defense (DoD). Almost half of DoD's medical research funding is administered by the Congressionally Directed Medical Research Programs (CDMRP). The mission of CDMRP is to foster innovative approaches to medical research in response to the needs of its stakeholdersâ€"the U.S. military, their families, the American public, and Congress. CDMRP funds medical research to be performed by other government and nongovernmental organizations, but it does not conduct research itself. The major focus of CDMRP funded research is the improved prevention, diagnosis, and treatment of diseases, injuries, or conditions that affect service members and their families, and the general public. The hallmarks of CDMRP include reviewing applications for research funding using a two-tiered review process, and involving consumers throughout the process. Evaluation of the Congressionally Directed Medical Research Programs Review Process evaluates the CDMRP two-tiered peer review process, its coordination of research priorities with NIH and the Department of Veterans Affairs, and provides recommendations on how the process for reviewing and selecting studies can be improved.

More than 3.7 million U.S. service members have participated in operations taking place in the Southwest Asia Theater of Military Operations since 1990. These operations include the 1990-1991 Persian Gulf War, a post-war stabilization period spanning 1992 through September 2001, and the campaigns undertaken in the wake of the September 11, 2001, attacks. Deployment to Iraq, Kuwait, Saudi Arabia, Bahrain, Gulf of Aden, Gulf of Oman, Oman, Qatar, the United Arab Emirates, and Afghanistan exposed service members to a number of airborne hazards, including oil-well fire smoke, emissions from open burn pits, dust and sand suspended in the air, and exhaust from diesel vehicles. The effects of these were compounded by stressors like excessive heat and noise that are inevitable attributes of service in a combat environment. Respiratory Health Effects of Airborne Hazards Exposures in the Southwest Asia Theater of Military Operations reviews the scientific evidence regarding respiratory health outcomes in veterans of the Southwest Asia conflicts and identifies research that could feasibly be conducted to address outstanding questions and generate answers, newly emerging technologies that could aid in these efforts, and organizations that the Veterans Administration might partner with to accomplish this work.

Since 1992 the Department of Defense (DOD), through the U.S. Army Medical Research and Material Command, has received congressionally earmarked appropriations for programs of biomedical research on prostate, breast, and ovarian cancer; neurofibromatosis; tuberous sclerosis; and other health problems. Appropriations for these Congressionally Directed Medical Research Programs are used to support peer reviewed extramural research project, training, and infrastructure grants. Congress has become concerned about funding increases for these programs given current demands on the military budget. At the request of Congress, the Institute of Medicine (IOM) examined possibilities of augmenting program funding from alternative sources. The resulting IOM book, Strategies to Leverage Research Funding: Guiding DOD's Peer Reviewed Medical Research Programs, focuses on nonfederal and private sector contributions that could extend the appropriated funds without biasing the peer review project selection process.

The National Institute on Disability and Rehabilitation Research (NIDRR) is the principal federal agency supporting applied research, training, and development to improve the lives of individuals with disabilities. NIDRR's mission is to generate new knowledge and promote its effective use in improving the ability of persons with disabilities to perform activities of their choice in the community, as well as to expand society's capacity to provide full opportunities and accommodations for its citizens with disabilities. NIDRR prides itself on being proactive in establishing program performance measures and developing accountability data systems to track the progress of its grantees. An electronic annual reporting system is used to collect data from grantees on many aspects of grant operation and outputs. Various formative and summative evaluation approaches have been used to assess the quality of the performance and results of the agency's research portfolio and its grantees. Prompted by the need to provide more data on its program results, in 2009 NIDRR requested that the National Research Council (NRC) conduct an external evaluation of some of the agency's key processes and assess the quality of outputs produced by NIDRR grantees (National Institute on Disability and Rehabilitation Research, 2009a). Review of Disability and Rehabilitation Research presents the results of that evaluation.

Advances in genetics and genomics are transforming medical practice, resulting in a dramatic growth of genetic testing in the health care system. The rapid development of new technologies, however, has also brought challenges, including the need for rigorous evaluation of the validity and utility of genetic tests, questions regarding the best ways to incorporate them into medical practice, and how to weigh their cost against potential short- and long-term benefits. As the availability of genetic tests increases so do concerns about the achievement of meaningful improvements in clinical outcomes, costs of testing, and the potential for accentuating medical care inequality. Given the rapid pace in the development of genetic tests and new testing technologies, An Evidence Framework for Genetic Testing seeks to advance the development of an adequate evidence base for genetic tests to improve patient care and treatment. Additionally, this report recommends a framework for decision-making regarding the use of genetic tests in clinical care.

Star Gate is the largest funded program in the history of psi research receiving about $19.933 million in funding from 1972 to 1995. Researchers from SRI International, and later at Science Applications International Corporation, in association with various U.S. intelligence agencies participated in this program. Using the remote viewing method, research focused on understanding the applicability and nature of psi in general but mostly upon informational psi. Volume 1: Remote Viewing (1972-1984) and Volume 2: Remote Viewing (1985-1995) include all aspects of RV including laboratory trials and several operational results. Volume 3 focuses on laboratory investigations on psychokinesis. Volume 4: Operational Remote Viewing: Government Memorandums and Reports includes an analysis of the applied remote viewing program and a selection of documents that provide a narrative on the behind the scenes activities of Star Gate. In a total of 504 separate missions from 1972 to 1995, remote viewing produced actionable intelligence prompting 89% of the customers to return with additional missions. The Star Gate data indicate that informational psi is a scientifically valid phenomenon. These data have led to the development of a physics and neuroscience based testable model for the underlying mechanism, which considers informational psi as a normal, albeit atypical, phenomenon. The Star Gate data found insufficient evidence to support the causal psi (psychokinesis) hypothesis.

The past half-century has witnessed a dramatic increase in the scale and complexity of scientific research. The growing scale of science has been accompanied by a shift toward collaborative research, referred to as "team science." Scientific research is increasingly conducted by small teams and larger groups rather than individual investigators, but the challenges of collaboration can slow these teams' progress in achieving their scientific goals. How does a team-based approach work, and how can universities and research institutions support teams? Enhancing the Effectiveness of Team Science synthesizes and integrates the available research to provide guidance on assembling the science team; leadership, education and professional development for science teams and groups. It also examines institutional and organizational structures and policies to support science teams and identifies areas where further research is needed to help science teams and groups achieve their scientific and translational goals. This report offers major public policy recommendations for science research agencies and policymakers, as well as recommendations for individual scientists, disciplinary associations, and research universities. Enhancing the Effectiveness of Team Science will be of interest to university research administrators, team science leaders, science faculty, and graduate and postdoctoral students.