High-quality evidence from prospective longitudinal studies in humans is essential to testing hypotheses related to the developmental origins of health and disease. In this paper, the authors draw upon their own experiences leading birth cohorts with longitudinal follow-up into adulthood to describe specific challenges and lessons learned. Challenges are substantial and grow over time. Long-term funding is essential for study operations and critical to retaining study staff, who develop relationships with participants and hold important institutional knowledge and technical skill sets. To maintain contact, we recommend that cohorts apply multiple strategies for tracking and obtain as much high-quality contact information as possible before the child’s 18th birthday. To maximize engagement, we suggest that cohorts offer flexibility in visit timing, length, location, frequency, and type. Data collection may entail multiple modalities, even at a single collection timepoint, including measures that are self-reported, research-measured, and administrative with a mix of remote and in-person collection. Many topics highly relevant for adolescent and young adult health and well-being are considered to be private in nature, and their assessment requires sensitivity. To motivate ongoing participation, cohorts must work to understand participant barriers and motivators, share scientific findings, and provide appropriate compensation for participation. It is essential for cohorts to strive for broad representation including individuals from higher risk populations, not only among the participants but also the staff. Successful longitudinal follow-up of a study population ultimately requires flexibility, adaptability, appropriate incentives, and opportunities for feedback from participants.

During the 2014–2016 Ebola outbreak, health services in Liberia collapsed. Health care facilities could not support effective infection prevention and control (IPC) practices to prevent Ebola virus disease (EVD) transmission necessitating their closure. This report describes the process by which health services and infrastructure were recovered in the public hospital in Monrovia, Liberia. The authors conducted an assessment of the existing capacity for health care provision, including qualitative interviews with community members, record reviews in Ebola treatment units, and phone calls to health facilities. Assessment information was used to determine necessary actions to re-establish services, including building and environmental renovations, acquiring IPC supplies, changing health care practices, hiring additional staff, developing and using an EVD screening tool, and implementing psychosocial supports. On-site monitoring was continued for 2 years to assess what changes were sustained. Described in the report are 2 cases that highlight the challenge of safely re-establishing services with only a symptom-based screening tool and no laboratory tests available on-site. Despite fears among the public, health workers, and the international community, the actions taken enabled basic health care services to be provided during EVD transmission and led to sustainable improvements. This experience suggests that providing routine medical needs helps limit the morbidity and mortality during times of disease outbreak. (Disaster Med Public Health Preparedness. 2018;13:767–773)

At the Savannah River Site (SRS) we are currently finalizing the design for a multi-system vitrification process that will be installed in the F-Canyon Multi-Purpose Process Facility (MPPF), an existing highly shielded, remotely operated facility. Authorization to proceed beyond the preliminary design based on the recommendation of a Formal Design Review Board was requested in May of 1999.

The Savannah River Technology Center (SRTC) Process Development Group has been conducting research and developing a process to identify equipment design bases and process operating parameters since 1996. The goal of the project is to stabilize a tank of ∼11,000 liters of nitric acid solution containing valuable isotopes of americium (Am) and curium (Cm). Vitrification has been selected as the most attractive alternative for stabilization and provides the opportunity for recovery and eventual reuse of the actinides. The final glass form will be placed in interim storage awaiting a disposition by the Department of Energy. This paper presents a brief history of the stabilization program and an overview of the entire Am/Cm stabilization process. This paper also provides details of a specific processing issue related to drain tube pluggage (devitrification) that was encountered during the development of the baseline batch vitrification process, and the remedy employed to reduce the potential for further drain tube pluggage.