>> GOOD MORNING AND WELCOME TO THE JOINT NATIONAL ADVISORY COUNCIL MEETING WITH THE NATIONAL INSTITUTE OF ALCOHOL ABUSE AND ALCOHOLISM AT THE NATIONAL CANCER INSTITUTE. SO I'M GEORGE KOOB AND I'M THE DIRECTOR. >> I'M [INDISCERNIBLE] >> WILSON [INDISCERNIBLE] JAPANESE DIRECTOR AT THE NATIONAL INSTITUTE ON ALCOHOL. >> SUSAN WANG DIRECTOR OF EPIDEMIOLOGY RESEARCH ON NATIONAL ININSTITUTE OF ALCOHOL. >> [INDISCERNIBLE]. >> [INDISCERNIBLE]. [INDISCERNIBLE]--NIAAA COUNCIL. >> MIKE [INDISCERNIBLE] IN NIADA. >> [INDISCERNIBLE] BOB WITH UNIVERSITY OF TEXAS AT AUSTIN. >> [INDISCERNIBLE] UNIVERSITY OF GOOGLE NIAAA COUNCIL. [LAUGHTER] >> SARAH [INDISCERNIBLE] SAN DIEGO STATE UNIVERSITY. >> PAUL [INDISCERNIBLE]. >> [INDISCERNIBLE]. >> [INDISCERNIBLE]--KNOTTING HAM. >> [INDISCERNIBLE]. KD--SALLY. >> [INDISCERNIBLE]. >> [INDISCERNIBLE]. >> [INDISCERNIBLE]--BROWN UNIVERSITY [INDISCERNIBLE]. >> [INDISCERNIBLE]. >> CAROL [INDISCERNIBLE] NEBRASKA--[INDISCERNIBLE] >> [INDISCERNIBLE]. NIADA COUNCIL. >> DIRECTOR OF OFFICE OF EXTRAMURAL ACTIVITIES AT NIAAA. >> [INDISCERNIBLE]. >> WE ALSO HAVE REPRESENTATIVES FROM THE NATIONAL ADVISORY COUNCIL OF NCI AND THEY'RE IMPORTANT SO PLEASE INTRODUCE YOURSELFOT TELEPHONE. >> THIS IS RICHARD THOMAS FROM THE DEPARTMENT OF LABOR. >> ANYMORE MEMBERS? >> YEAH THIS, IS BOB LENNOX NIADA COUNCIL, UNIVERSITY OF ENGLAND. >> TWO MORE? THEY'RE PROBABLY MUTED. >> OKAY I WANT YOU TO KNOW THERE'S NOT BEEN A REVERSAL OF THE MERGE, IT'S JUST THAT I AM GETTING OVER A HEAD COLD AND SENSITIVE TO VIRUSES, SO I DON'T WANT ANYONE TO READ INTO THIS LIKE A MAYDAY SQUARE, WE STILL LOVE EACH OTHER, OUR VIRUSES NEED TO KEEP THEMSELVES SEPARATE. ALL RIGHT. SO, I THINK IT'S MY TURN TO DO A PRESENTATION, I WANT TO UPDATE YOU ON WHAT WE'RE DOING AT NIAAA OR AT LEAST PART OF IT. AND I DO WANT TO THANK EVERYONE COMING TO THIS MEETING, I KNOW IT'S A LOT OF TRAVEL TO SOME OF YOU AND IT'S GREAT TO SEE OLD FRIENDS AND COLLEAGUES. SO AS YOU KNOW OUR CHARGE AT THE NATIONAL INSTITUTE OF ALCOHOL ABUSE ALCOHOLISM IS TO STUDY ALCOHOL ACROSS THE LIFETIME AND THE LIFE SPAN, IT'S A CENTRAL POINT THAT KEN MADE, THE STAFF OVER THE YEARS AND I THINK IT FITS VERY WELL WITH OUR GOALS AND ENTERPRISES, WE DO EVERYTHING FROM NEUROBIOLOGY, METABOLISM, GENETICS EPIGENETICS, EPIDEMIOLOGY AND HEALTH SERVICES RESEARCH AND WE ADDRESS THIS--THESE QUESTIONS AT ALL STAGES OF THE LIFE SPAN. SO TODAY I'LL FOCUS TO A GOOD EXTENT ON THE ADOLESCENT WORK WE'RE DOING BECAUSE I WOULD LIKE TO USE THAT FOR NORA TO ALSO DISCUSS SOME OF THE JOINT ISSUES THAT WE'RE WORKING ON IN THIS REGARD. JUST SO YOU KNOW, WE DO HAVE A SLIDE SIMILAR TO THIS FOR NIAAA, I KNOW TOM AS ONE FOR NIH, WE'RE IN SIMILAR FUNDING SITUATION, WE HAVE A STEADY INCREASE IN APPLICATIONS AND HAVE A FLAT LINE OF THE NUMBER OF APPLICATIONS WHICH ARE ACTUALLY FUND ASKED WHICH TURNS INTO THE RED LINE WHICH IS THE NEAR DECREASE IN THE SUCCESS RATE AND I THINK WE'RE ALL AWARE OF THAT. WE KNOW THAT EVERYONE AT NIH IS DOG EVERYTHING THEY CAN TO REVERSE THIS TREND AND WE'LL JUST HAVE TO BEAR WITH OUR CLIENT BUDGETS AT THE MOMENT BUT IT DOES GIVE US AN OPPORTUNITY TO LOOK AT OUR PORTFOLIOS MORE CAREFULLY AND DECIDE WHERE WE WANT TO PUT OUR EMPHASIS AND NECESSITY IN GENDERS IN THIS CASE, THAN WE HAVE TO DO SOMETHING WHERE ISSUES THAT WE COVERED EXTENSIVELY CANNOT BE FUNDED. SO SOME OF THE KEY NIAAA INITIATIVES AND PROGRAMS AND MANY OF YOU HEARD ME TALK ABOUT THIS BEFORE BUT I WANT TO FOCUS ON NEW FINDINGS IN THESE DOMAINS BUT REALLY DIAGNOSIS OF THE SPECTRUM DILLS ORDER, WE HAVE A BIG PROGRAM ON--IN PRECLINICALOT NEUROBIOLOGY OF ADOLESCENT DRINKING WITH THE NADIA CONSORTIUM. WE HAVE A PRECLINICAL GROUP ON THE WAY FROM THE ADOLESCENT BRAIN AND COGNITIVE DEVELOPMENT NATIONAL LONGITUDINAL STUDY AND NORA WILL EXPLAIN MORE ABOUT THAT. WE HAVE A COLLEGE ALCOHOL INTERVENTION MATRIX AS A PREVENTION PROGRAM, IT'S ABOUT TO BE LUNCHED AND WE START LAUNCH OUR BIOSENSOR INITIATIVE AND WE ARE ENGAGED RIGHT NOW IN WORKING ACROSS NIH AND EVEN WITH C. O. D. TO SEE IF WE CAN GET A PROGRAM ON CO MORBIDITY AND PTSD, SO WE'RE TRYING TO GIVE YOU MORE. SO CAN WE SEE THE SLIDE OF RECENT WORK BY COLLEAGUES AND BASICALLY WHAT THIS ARGUES IS THAT WE CAN MAKE PREDICTIONS ON FACIAL MEASURES OF WHAT'S ACTUALLY HAPPENING IN THE BRAIN. SO IT GIVES US A WINDOW TO THE BRAIN IN SEVERE FETAL ALCOHOL SYNDROME, BOTH LIPOMETER AND AT THE BOTTOM THERE AND IT'S A SCALE AND YOU SEE THE CHANGE IN THE UPPER LEFT AND NUMBER FOUR IS FIVE IS THE INDICATION USUALLY OF THE FETAL ALCOHOL SYNDROME AND CHANGES IN BRAIN VOLUME WHEN YOU SEE THAT ILLUSTRATED APPROXIMATE WITH THE BLUE BOXS ON THE RIGHT HAND SIDE, THE THALAMUS, [INDISCERNIBLE] AND SOME [INDISCERNIBLE] SUGGESTED THIS IS A WINDOW ON THE BRAIN AND SUGGESTED ABOUT MEASURES OF DIAGNOSIS WILL BE VERY USEFUL, MORE HOPEFULLY INTERVENTION WITH THESE CHILDREN. CONSEQUENCES OF BINGE DRINKING AND THE NEGATIVE CONSEQUENCES OF BINGE DRINKING ARE PROFOUND IN SOCIETY. MEANTALLY YOU HEARD ME SAY THIS BEFORE, WHAT WE FIND IN OUR--ON OUR SURVEY HAVE LESS AND EXPLAIN [INDISCERNIBLE] A ACTUALLY A DECREASE IN THE PERCENTAGE OF INDIVIDUALS IN THE ADOLESCENT A-FRAME IN BINGE DRINKING, THERE'S ACTUALLY A DECREASE FOR SOME BUT WHAT IT SAYS IS THERE'S AN INCREASE OF THE BINGE DRINKING OF THOSE WHO ENGAGE IN BINGE DRINKING AND YOU REMEMBER THAT BINGE DRINKING IS FOUR DRINKS IN FEMALES AND FIVE DRINKS IN FEMALES IN A TWO HOUR PERIOD THAT WAS DEFINED BY NIAAA, I WOULD LIKE TO COMMEND THEM, THEY FOUND THAT QUITE SOMETIME AGO AND CONTRIBUTING TO OUR RESEARCH IN THIS DOMAIN AND I DON'T HAVE TO GO THROUGH THE SLIDE BUT THE RANGES FROM MANY BEHAVIORIAL PROBLEMS LIKE DRIVING WHILE DRINKING, STILL WITH COUNCIL BUT 30% OF THE TRAFFIC ACCIDENTS IN THE UNITED STATES ARE [INDISCERNIBLE] AND TO USING MARIJUANA AND COCAINE IN CONJUNCTION WITH THE ALCOHOL AND THIS IS ALSO WHAT I WAS TALKING ABOUT WITH HOSPITAL-RELATED INCIDENT FOR WHOLE RELATED OVERDOSES AND THERE'S MORE MET WICKS COMING OUT THAT INDICATES THIS HAS BEEN SUBITANTIATED. A LEVEL OF HIGH BINGING IS INCREASED IN THIS GROUP AND ALSO IN MIDDLE AGE, THE DANGERS OF [INDISCERNIBLE] GENERATING RIGHT NOW AND PROBABLY [INDISCERNIBLE] VACCINE AND DOES SUGGEST THAT THERE IS HIGH IRB INTENSITY OF DRINKING IN THIS AGE GROUP WHEN THEY DRINK AND THE TOXICITY ASSOCIATE WIDE THIS IS ALSO PRONOUNCED AND ALSO THE DATA I GOT FROM THE UNITED KINGDOM WHICH INDICATES THAT IT'S UNDER 30 YEAR-OLD IN THE U. K. THERE'S BEEN [INDISCERNIBLE] OF ALCOHOL SCLEROSIS DIAGNOSING IN THE LAST 10 YEARS. AND WE KNOW THAT THERE'S A MAJOR BINGE DRINKING PROBLEM IN THE [INDISCERNIBLE] SO MUCH SO THAT YOU PROBABLY READ, THEY STARTED TO USE THE [INDISCERNIBLE] FOR REPEATED OFFENDERS FOR PUBLIC INTOXICATION. SO WHY IS THIS IMPORTANT? WELL, I ALWAYS LIKE TO CHANNEL ICE THE TERM NEUROPREVENTION AND DURING ADOLESCENT OUR FRONT AT CORTEX IS NOT DEVELOPED IT DOESN'T FULLY DEVELOP UNTIL ABOUT AGE 25. SO WE HAVE ALREADY SUBSTANTIAL DATA TO SUGGEST THAT THE CORTEX IS ADVERSELY EFFECTED BY ADOLESCENT DRINKING AND POSSIBLY MORE SO THAN IN ADULTS ALTHOUGH THAT HASN'T REALLY BEEN PROVEN IN CHAPTER AND VERSE YET. BUT WE KNOW THAT THE FRONTAL CORTEX IS ILLUSTRATED IN THIS SLIDE, PLAYS AN INCREDIBLY IMPORTANT ROLE IN CONTROLLING TWO ASPECTS OF THE ADDICTION PROCESS. ONE IS THE IMPULSIVITY THAT'S GENERATED FROM DISREGULATION OF THE BASAL GANGLIA BUT THE OTHER IS IN THE SENSITIVITY DISSTRESS WHICH IS ENGAGED BY DISINHIBITION OF THE AMYGDALA AND THE ASCENDED, AND I COULD BORE YOU WITH STORIES ABOUT THIS AND SO COULD NORA BUT ONE OF THE MAIN REASONS WE'RE CONCERNED ABOUT ADOLESCENT DRINKING AND DRUG TAKE SUGGEST BECAUSE OF THIS VERY DELICATE BALANCE THAT IS ENGAGED AS ADOLESCENTS MATURE. AND I'M PROUD TO ILLUSTRATE THIS ONE FINDING THAT COMES FROM ACTUALLY TWO OF MY FORMER POST DOCS, SO NICK GILPIN WHO'S AT LSU IN NEW ORLEANS AND HEATHER RICHARDSON WHO'S AT UNIVERSITY OF MASSACHUSETTS, WERE BOTH POSTDOCTORAL STUDENTURAL FELLOWS IN MY LAB, AND THEY DID THIS ON THEIR OWN, THEY USED AN ANIMAL MODEL IN BINGE DRINKING IN ADOLESCENCE AND THESE RODENTS WERE DRINKING SWEETENED ALCOHOL SOLUTIONS FOR THE 14 DACE OF ADOLESCENCE, THOSE WHO ARE NOT RODENT SCIENTISTS MAY NOT REALIZE THAT ADOLESCENCE IN A RAT IS 14 DAYS. PERIOD, THAT'S IT. AND WHAT'S REMARKABLE WAS THAT THE ACTUAL DRINKING OF ALCOHOL LED TO A REDUCED DENSITY OF MILENNATED AXONS IN THE MEDE YACHTIAL PREFRONTAL CORTEX AND WOTHERAPIST IS ONE OF THE FIRST, I NEVER LIKE TO SAY ANYTHING, THE FIRST OF ANYTHING, BUT THIS IS CERTAINLY AN IMPORTANT OBSERVATION THAT EVEN IN ANIMAL MODELS WE CAN BEGIN TO SEE, THE DISREGULATION OF THE FRONTAL CORTEX AND THIS LEADS US WITH ENTERPRISES LIKE OUR CONSORTIUM, TO BE ABLE TO DIVE IN AND UNDERSTAND WHAT THE MOLECULAR MECHANISM IS FOR THESE CHANGES. WE ALSO AS A MENTIONED HAVE A NATIONAL CONSORTIUM ON ALCOHOL AND NEURAL DEVELOPMENT ON ADOLESCENCE AND I WOULD LIKE TO SAY THAT OUR LAUNCHING OF THIS AND DISCUSSIONS WE HAD LAST YEAR ARE JOINT COUNCIL HAVE LED TO THE HYPOTHESIS ON A MUCH LARGER SCALE ASK WE'LL BOTH TALK ABOUT THAT A LITTLE LATER, AND THIS CONSORTIUM WHICH IS TO STUDY EFFECTS OF ALCOHOL EXPOSUREOT TRAJECTORY OF ADOLESCENT BRAIN DEVELOPMENT IN THE CONTEXT OF DEVELOPMENT IS UNDERWAY. AND WHAT'S REALLY INTERESTING ABOUT THIS STUDY IS THIS IS A GROUP OF PEOPLE THAT ARE ENGAGED AND WE'RE HOPING THEY WILL JOIN US FOR THE ABCD STUDY, BUT THESE ARE GROUPS THAT HAVE BEEN ESTABLISHED IN IMAGING AND THERE ARE CHALLENGES THERE, BUT WE WANT TO SHOW YOU THAT IN ACTUAL FACT, THIS IS A CROSS SECTIONAL, THIS IS A CROSS, CROSS SECTIONAL LONGITUDINAL DESIGN ON THE LEFT HAND TOP CHANNEL, CAN YOU SEE THAT THEY ALREADY UNSCREENED AND TWO YEAR PERIOD OF 788, THEY IMAGE 788 SUBJECT, AND THEY'RE IN THE PROCESS OF DOING THE ONE YEAR FOLLOW UP. THEY'VE GOTTEN REASONABLY HARMONIOUS AND GENIUS DATA, THERE ARE DIFFERENCES AND WELL ESTABLISHED AND TOTAL BRAIN MATTER AND IN THE PART, BUT YOU LOOK AT TOTAL CORTICAL DATA YOU SEE THAT THEY'RE VERY SIMILAR AND IF YOU LOOKOT RIGHT HAND SIDE, CAN YOU SEE THAT THE ADULT [INDISCERNIBLE] AND HIS INFORMAT CLINICAL COMMUNITYS GROUP HAVE MANAGED TO FIND A WAY TO HARMONIZE ACROSS DIFFERENT SCANNERS, THE DATA FOR FRACTIONAL ANISTROPEY AND YOU CAN SEE HOW THEY APPLY THE DIRECTIONS ACROSS THE SCANNERS THEY GET A MUCH MORE HARMONIOUS DATA AND IT SHOWS THAT THE WHITE MATTER IS GOING UP OVER TIME, AGE AND THE GRAY MATTER IS GOING DOWN OVER AGE WHICH IS CLASSIC IN THE LITERATURE, KNOWN FOR OVER 15 YEARS. AND THEN WHAT'S MORE COMPELLING IS THEY COULD MEASURE CHANGES--WHILE THE RATS--BUT THEY WERE PEOPLE WHILE THE PEOPLE WERE IN THE SCANNER DOING A STRIP TEST WHICH IS A CHALLENGING TEST OF IMPULSIVITY BECAUSE YOU KNOW THEY SHOW YOU A WORD, AND YOU CAN SEE THAT ADOLESCENCE IMPROVE IN THEIR STRIP TESTING AND CORRELATES WELL, WITH THEIR AGE GROUP AND THE MATURATION OF THE BRAIN. SO I THINK THAT SO IT'S REALLY A TAKE HOME MESSAGE HERE IS NOT SO MUCH THE DATA BUT THAT WE CAN DO THIS, AND SO, I THINK IT'S REALLY EXCITING SO THAT--I JUST WANT TO MENTION THAT NORA AND SUSAN WEISS IS TAKING THE LEAD ON THIS AND WE'RE ALL VERY GRATEFUL TO HER, WE'RE PLANNING THIS LARGE STUDY, 10,000 USE WHICH WE HOPE TO IMAGE IN A PURELY LONG--LONGITUDINAL STUDY, AND WHERE WE'RE AT THE CURRENT TIME. WE HAD A COLLEGE INITIATIVE, AND I WANT TO REPORTING EMPHASIZE IT BECAUSE I'M HOPING THERE WILL BE A WEDGE IN THE DOOR OF WORKING WITH THE COLLEGE PRESIDENT'S GROUPS AT NIAAA, AND THERE'S AT LEAST ONE COLLEGE THAT'S NOW CHARTING WHERE--HOW MANY STUDENTS ARE ENDING UP IN THE EMERGENCY ROOM AND WE WOULD--I REALLY LIKE THE WEDGE IN THIS COLLEGE AIM AND PREVENTION, AND TRYING TO GET OTHER COLLEGES TO ENGAGE IN THESE KIND OF ACTIVITIES. WE REALLY NEED THIS INFORMATION IF WE'RE GOING TO FIGURE OUT WHERE THIS PARTICULAR APPROACH IS GOING TO BE SUCCESSFUL AND WE NEED A METRIC OF KNOWING WHETHER WE SUCCEEDED, AS YOU KNOW WE WERE IN THE ELEVATOR WITH LARRY TABAK, AND ONE OF THE ACD MEETINGS AND HE INTRODUCED ME TO ONE OF THE MEMBERS OF THE ADVISORY COUNCIL FOR THE DIRECTOR IN THE ELEVATOR AND HE SAID THIS IS ONE OF OUR--THIS IS AROUND CHRISTMAS AND I SAID THIS IS ONE OF OUR BUSIEST TIMES AT NIAAA, BUT, OF ONE OF OUR TWO BUSIEST TIMES AT NIAAA, AND THE GENTLEMAN WHOM I DON'T REMEMBER HIS NAME WHO WAS ON THE ACD, SAID WHAT'S THE OTHER TIME? AND LARRY, I WAS VERY PROUD, LARRY TABAK SAID, WHEN THE KIDS GO BACK TO SCHOOL. SO--SO HE GOT IT. AND I DIDN'T EVEN HAVE TO SAY ANYTHING, I JUST STOOD THERE SO I WAS REALLY PLEASED. BUT WHAT THIS WILL DO IS--I WILL NOT READ THROUGH THE SLIDE, YOU CAN LOOK AT THIS MENU AND DECIDE WHAT FITS THEIR STUDENT BODY BEST, THEIR DEMOGRAPHICS BEST, AND ACTUALLY UNDER THE STIMULATION OF JUDGE [INDISCERNIBLE] COUNCIL MEETING WE'RE NOW ENGAGED AND TRYING TO PUT TOGETHER A SIMILAR PORTFOLIO FOR THE NATIVE AMERICAN POPULATIONS AND SITES IN THE UNITED STATES WHERE WE HAVE DATA AND WE'LL PROBABLY BE TALKING ABOUT WHAT NIDA, IN THE FUTURE BECAUSE ALCOHOL ABUSE, MISUSE AND DRUG MISUSE IS A BIG PROBLEM [INDISCERNIBLE]. SO I WANT TO SUMMARIZE WHY WE THINK THIS ADOLESCENT EXPOSURE TO ALCOHOL AND DRUG SYSTEM IMPORTANT, WELL AS I MENTIONED THE ADOLESCENT BRAIN DOESN'T DEVELOP REALLY UNTIL 25, AND I LIKE IT IS TAKE AWAY AUDIENCES IF YOU RATE THE BEHAVIOR TO KNOW WHAT I'M TALKING ABOUT, OUR SHORT-TERM [INDISCERNIBLE] AND ADOLESCENTS ACTIVATING SYSTEM AND LOCKS IN CHANCES ASSOCIATED WITH DRINKING AND WE COULD TALK ABOUT THAT IN THE PAST, SHORT-TERM ALCOHOL USE AND INTERRUPTS THE FRONT LOBE DECISION MAKING CONTROL, AND THE AMYGDALA, FEAR AND ANXIETY, BRAIN STEM, VITAL REFLEXES, LONG-TERM, ALCOHOL MISUSE AND CAN ALTER THE SPHRA JECTORY OF ADOLESCENT BRAIN DEVELOPMENT AND CAUSE LINGERING COGNITIVE DEFICITS, NIAAA STUDIES UNDERWAY TO UNDERSTAND VULNERABILITY AND RESILIENCE FACTORS IN ADOLESCENT BRAIN DEVELOPMENT. I MIGHT ADD THAT OTHER INSTITUTES ADDED SINCE I MADE THIS SLIDE SO NINDF AND NIH HAVE JOINED US AND NIAAA SIGNIFICANTLY INVEST INDEED THE PREVENTION OF UNDERAGE DRINKING AND WE WILL BE PURSUING THIS WITH VIGOR IN THE COMING YEAR. I WANT TO MENTION OTHER EXCITING AREA FIST ARE ME AT LEAST, WE'RE PLANNING ON DEVELOPING A ALCOHOL BIOSENSOR, THEY KNOW IT'S A LARGE CLUNKY THING THAT GOES AROUND YOUR ANKLE, THANK YOU LINDE LOHAN AND THE MAGAZINES BUT WE WANT TO MAKE IT SMALLER AND PUT IT ON YOUR WRIST, WE NEED TO DO MICRO-INIZING AND WE NEED TO WORK ON T. AND ONCE WE GET OUR ACT TOGETHER, WE WANT TO JOIN NIDA IN NIMH, BUT POST-TRAUMATIC STRESS DISORDER IS A BIG PROBLEM IN OUR CURRENT WORLD. IT'S CERTAINLY VERY PREVALENT AS WELL AS YOU KNOW AND MILITARY VETERANS AND INCLUDING SEXUAL ASSAULT AND A DAY DOESN'T G BY WHEN THERE'S SOMETHINGOT TELEVISION OF SOME HORRIBLE THING GOING DOWN AND NOW WITH MODERN COMMUNICATION, WE GET TO SEE IT IN OUR OWN LIVING ROOM. WE KNOW THAT ALCOHOL USE DISORDERS FREQUENTLY CAN-CURS WITH POST-TRAUMATIC STRESS DISORDER AND THEIR CO CURRENCE COMPLICATES BOTH FOR DISORDERS, I WOULD ARGUE THAT 30-50% OF INDIVIDUALS WITH POST-TRAUMATIC STRESS DISORDER GO ON TO DEPRIVATION A ALCOHOL USE DISORDER AND I'LL GO FURGT OR A LIMB AND ARGUE TO A LARGE EXTENT THAT'S LARGELY SELF-MEDICATION. PTSD INCREASES THE RISK FOR ALCOHOL USE DISORDERS AND AND DIAGRAMS OVER LAP IN ONE OF MY FAVORITE BRAIN AREAS WHICH IS OF COURSE THE CENTRAL COURSE OF THE AMYGDALA AND THE ACTIVATION OF THE BRAIN STRESS SYSTEM AND THE KEY ROLE FOR THE FRONTAL CORTEX AS I ILLUSTRATE INDEED THAT ONE SLIDE. SO WE WILL EXPLAINING OUR RESEARCH ON THE NEUROBIOLOGICAL MECHANISMS FOR POST-TRAUMATIC STRESS DISORDER AND ALCOHOL ABUSE DISORDERS HOPEFULLY TO IMPROVE THE TREATMENT IN INDIVIDUALS. AND WE HAD A WORKSHOP ON THIS BEFORE SOCIETY FOR NEUROSCIENCE AND WE'RE STILL DIGESTING SOME OF THE THINGS WE LEARN FRIDAY THAT BUT HOPEFULLY WE WILL BE MOVING FORWARD WITH THIS EFFORT IN THE NEAR FUTURE. AND LINDSAY GRANISON IS OUR LEAD BURN ON POST-TRAUMATIC STRESS DISORDER AND ANTONIO NEURONAL DIVISION. SO I WANT TO THANK ALL OF MY COLLEAGUES AND ESPECIALLY ONE WHO IS I STOLE SLIDES FROM WHO ARE ILLUSTRATED ON THIS AND WE DO HAVE QUITE A FEW PUBLICATIONS OUT THERE, I WOULD SAY NOT A WEEK GOES BY THAT I DON'T HAVE A COLLEAGUE SOMEWHERE EITHER WITHIN NIH OR IN THE EXTRAMURAL WHO CALLS ME UP AND WANTS HELP WITH SOME LOVED ONEe#w THAT'S ACTUALLY SUFFERING FROM AN ALCOHOL USE DISORDER. WE DO HAVE AN ALCOHOL SCREENING BRIEF INTERVENTION GUIDE, WE HAVE A NEW TREATMENT GUIDE AND PARTICULARLY IMPORTANT, ANY INTERVIEW I DO AT THE PRESS, I DO INTERVIEWING ABOUT RETHINKING DRINKING WHICH IS A WEB SITE THAT IS VERY USEFUL AND RANGES FROM TELLING YOU HOW MUCH YOUR ALCOHOL IS IN YOUR COCKTAIL TO HOW MANY COLORYS ARE IN THEIR COCKTAIL TO GIVING GUIDELINE OF WHAT IS PINCH DRINKING AND ISSUES SURROUNDING THE MISUSE OF ALCOHOL SO THANK YOU VERY MUCH. [ APPLAUSE ] [ APPLAUSE ] >> I JUST WANT TO COMMEND YOU FOR THIS IMPORTANT WORK THAT YOU ARE DOING IN PARTICULAR TO THE EFFORT TO TRANSLATE THE RESEARCH SO THAT WE AS PARENTS AND STUDENTS CAN UNDERSTAND WHAT YOU KNOW ABOUT THE EFFECTS OF ALCOHOL ON YOUNG BRAINS. WE DO PRESENTATIONS TO PARENTS AND STUDENTS OF MIDDLE SCHOOLS AND IN THE HIGH SCHOOLS AND ONE OF YOUR SCIENTISTS DR. MARISSA AS YOU KNOW THIS IS A VERY COMPLICATED AREA SO HOW DO YOU ENGAGE MIDDLE SCHOOL STUDENTS AND HIGH SCHOOL OPPORTUNITIES IN SOME OF THE INFORMATION THAT YOU JUST DISCUSSED, SO DR. SALVERY, HELPED US TO PUT TOGETHER AN INTERESTING POWER POINT WHICH IS CALLED THE SCIENCE OF DECISION MAKING SO IT TAKES A COMPLICATED SUBJECT AND MAKE ITS MEMORABLE AND IT GIVES KIDS AND PARENTS OF A BASIC UNDERSTANDING OF THE COMPLEXITY RELATING TO THE EFFECTS OF ALCOHOL ON THE BRAIN AND THEN WHAT DOES THAT MEAN IF THE ALCOHOL, YOU KNOW HOW DOES THAT EFFECT YOUR LIFE AND AFFECT YOUR ABILITY TO MAKE DECISIONS AS THE IMPULSIVITY OF--WHICH IS REGULATED BY THE PREFRONTAL CORTEX IS IMPACTED? SO I JUST CAN'T THANK YOU ENOUGH FOR ALL OF YOUR WORK AND PARTICULARLY YOU DR. KOOB AS THE LEADER OF THE INSTITUTE, THANK YOU. >> I LOVE PRAISE, SO THANK YOU. [LAUGHTER] IT RELEASES DOPAMINE, I'M SURE. >> I'M NOT YOUR CHEERLEADER BUT I REALLY--MY BASIS POINT IS THAT THE TRANSLATIONAL NATURE OF WHAT YOU'RE LEARNING HAS CAUGHT THE ATTENTION OF THE PARENTS IN THE KIDS AND HELP THEM INTERNALIZE REASONS FOR NOT WANTING TO DRINK. >> WELL, ACTUALLY ON A SERIOUS NOTE, WE HAVE BIG CHALLENGES AHEAD OF US, ONE OF WHICH IS OF COURSE THAT WE REALLY NEED TO BE ABLE TO GET THIS INFORMATION OUT AS YOU KNOW WHEN WE DISCUSS THIS MANY TIMES TO MIDDLE SCHOOLS TO HIGH SCHOOLS THAT EVEN IN AN APPROPRIATE WAY THAT THAT IS ACCEPTABLE TO PARENTS AND DOESN'T EXACERBATE THE PROBLEM AND I WAS AT [INDISCERNIBLE] YESTERDAY AND SOMEONE SPOKE UP AND WAS TALKING ABOUT GROUP THERAPY AND ADOLESCENTS AND THERE GROUP THERAPY WAS THAT IT ACTUALLY BACK FIRED SO THE ADOLESCENTS GOT EXCITED HEARING ABOUT THE DRUGS THAT OTHER PEOPLE WERE USING SO I THINK IT REALLY--IT REALLY IS, THERE ARE CHALLENGES WE HAVEN'T MET YET, THE OTHER ONE WE'RE WELL AWARE OF IN THE ALCOHOL FIELD IS EDUCATING PRIMARY CARE PHYSICIANS ABOUT ALCOHOLISM IS ADDICTION IN GENERAL. SO WE'RE--BOTH OF OUR INSTITUTES ARE WORKING WITH [INDISCERNIBLE] AND AMERICAN BOARD OF ADDICTION MEDICINE AND THE AMERICAN SOCIETY OF ADDICTION ON THESE ISSUES BUT THERE'S STILL A WEDGE THAT'S WOO HAVE TO GET INTO TO GET PIECES OF ADDICTION EDUCATIONOT MEDICAL BOARD EXAMS AND HOPEFULLY INTO THE CURRICULUM, SO THIS IS A--I POINT THIS OUT TO EVERYBODY BECAUSE IF YOU EVER HAVE INSIGHT ON HOW TO DO THAT, WE'RE READY TO GO. >> I THINK EMPHASIZING ADOLESCENCE AND ALCOHOL IS INCREDIBLY COMPELLING AND I APPLAUD YOUR EMPHASIS ON THAT, I THINK IT WILL CHANGE THE LIFE COURSE OF MANY PEOPLE AND I THINK UNDERAGE DRINKING CHANGES THEIR COURSE. I'M REALLY HAPPY YOU'RE DOING THIS. >> AND YOU'RE NOT PAROCHIAL, BECAUSE YOU'VE ONLY BEEN WORKING ON THIS FOR 20 YEARS BUT THAT'S--[LAUGHTER] >> [INDISCERNIBLE]. >> [LAUGHTER] >> THANK YOU THAT WAS A REALLY FABULOUS PRESENTATION, I WANT TO FOLLOW SOMETHING, COLLEGE INIT T ISHIAATIVES AND ONE IS, IT MAKES SENSE TO ME IN COLLEGE INITIATIVES COULD BE COMBINED WITH COLLEGE INITIATIVES AROUND [INDISCERNIBLE] AND IT DOESN'T SEEM LIKE THOSE AND THAT COULD BE THE [INDISCERNIBLE]. THE OTHER PIECE OF IT, RELATED TO THAT WAS THAT NORA WAS [INDISCERNIBLE] INITIATIVE AT NYU, ABOUT A YEAR AGO, WAS IT? WITH BILL CLINTON AND JOHN SEXTON AND THE [INDISCERNIBLE] YOUTH COMMISSION AND I'M CURIOUS BUT AS A KICKOFF OF THE INITIATIVE, VERY MUCH OF BOTH OF THAT, AND I'M CURIOUS FROM BOTH OF YOU, FOR CLINTON FOUNDATION [INDISCERNIBLE] AND HOW THIS CAN HAPPEN TO THE [INDISCERNIBLE]. >> THAT WAS TRIGGERED BY CLINTON BECOMING SENSITIZED FOR THE [INDISCERNIBLE] FROM OVERDOSES FROM [INDISCERNIBLE] MEDICATION SO FROM THE PERSPECTIVE OF DRUG TAKING IT HAD THAT MAIN TARGET BUT I DO NOT KNOW THE DETAILS OF HOW THEY ARE GOING TO BE ADDRESSING IT WITH ALCOHOL BECAUSE I WAS LOOKING AT THE SLIDE, GEORGE WAS SHOWINGOT INCREASES AND THE ALCOHOL OVERDOSE, OF COURSE THE THOUGHT CROSSED MY BRAIN THAT AS THESE DRUGS ARE [INDISCERNIBLE] THESE ARE USE INDEED COMBINATION AND TO WHAT EXTENT SOME OF THESE OVERDOSES MAY BE DRIVEN BY THE INTERACTIVE RESPECTS OF OPIATES AND ALCOHOL. SO THAT'S WHERE MAYBE [INDISCERNIBLE]. WITH VERY SPECIFIC DISCUSSION IN TERMS OF INITIATIVE AND THE FOUNDATION IS GOING IN GENERAL AND COLLEGES, I DO NOT KNOW WHAT WE CAN GET INFORMATION AND WHAT DO I KNOW IS THAT THEY'RE FOCUSING ON [INDISCERNIBLE] THAT THAT WAS THE MAIN DRIVER. BUT YOU MAY HAVE SOME MORE INFORMATION. >> NO, I DON'T. BUT I DO KNOW AS YOU DO THAT IF THERE'S--IS IT'S A LETHAL COMBINATION AND THERE'S A LOT OF CONCERN THAT CAME UP AT [INDISCERNIBLE] YESTERDAY AS WELL AND THERE'S A LOT OF CONCERN WITH PRESCRIPTION OPIATE USE AND IT TURNS INTO HEROIN USE AND THEY WERE ARGUING YESTERDAY THAT SOME OF THESE ADOLESCENTS WHO'VE GOTTEN ENGAGED THAT WAY, PRESCRIPTION OPIATES AND THEN HEROIN, THEIR LIVES ARE RUINED THE WAY WE WERE DISCUSSING IT AND WE HAD A LOT OF TROUBLE GETTING THEM INTO TREATMENT AND SO FORTH, SO I THINK IT'S A REAL CHALLENGE TO ADDRESS, I MEAN I--I SUSPECT THAT ULTIMATELY, AND YOUR EFFORTS ARE SUCCESSFUL IN THIS AREA, THE PRESCRIPTION OPIATE USE WILL DECLINE, BUT THERE'S ALWAYS STILL THE ILLEGAL OPIATES OUT THERE AND THE INTERACTION WITH ALCOHOL IS SOMETHING WE SHOULD LOOK AT. YOU KNOW I THINK YOU'LL PROBABLY FIND IT AT ANY OF THOSE PARTIES WHERE THEY THROW THE PILLS INTO A BUCKET AND TAKE THEM THAT ALCOHOL'S INVOLVED AND I WOULD ALMOST BE WILLING TO BET MONEY ON IT. >> DO I RESONATE WITH YOUR SUGGESTION ON THAT, IT IS REALLY AN OPPORTUNITY FOR A GROUND INITIATIVES BECAUSE THESE DRUGS ARE TAKEN IN COMBINATION AND WE HAVE THAT FORCE PREDOMINANTLY IN HIGH SCHOOL AND THAT TRANSITION WOULD IDENTIFY THAT TRANSITION FROM HIGH SCHOOL TO COLLEGE AND ONE OF GREAT, GREAT, OVER ALL SO WE STRIVE TO EXPAND OUR AREA OF RESEARCH THAT THIS WOULD MAKE SENSE BECAUSE THIS IS IN COMBINATION AND NOT JUST ABOUT OPIATES AND [INDISCERNIBLE] WE KNOW THAT THE BENZO DRIAPENES ARE [INDISCERNIBLE] ARE [INDISCERNIBLE] COMBINATION OF ALCOHOL ENHANCES THE RISK FOR OVERDOSES SO I THINK IT'S A SUGGESTION FOR HOW WE CAN SHOW AN EFFORT AND AVOID REPLICATIONS AND EXPAND [INDISCERNIBLE] CASE. >> THE ANSWER IS DULY NOTED. >> I WOULD LIKE-- >> THANK YOU VERY MUCH FOR THE PRESENTATION, I THINK IT'S RIGHT ON AND I WANT TO--I HAVE KIND OF COMMENT. BUT THE MAIN ISSUE IS THE WE NEED TO LOOK OW HOW DO WE DO SOCIAL CHANGE. BECAUSE ALCOHOL IS A LEGAL SUBSTANCE AND WHAT ARE THE IMPLICATIONS FOR THIS LEGAL SUBSTANCE, HOW DO WE USE IT AND WE KNOW THERE ARE HEALTH BENEFITS FOR SOME PEOPLE AS LOW ALCOHOL USE HAS BEEN DOCUMENTED. BUT THE, LOOKING BACK AT THE STORY ABOUT SMOKING AND MULTIPLE CIGARETTES THAT IS AN EASIER SOCIAL METHOD BECAUSE I KNOW OF NO BENEFIT WITH SMOKING, WHERE IT'S MUCH MORE NUANCED WITH ALCOHOL, SO I THINK IT'S REALLY IMPORTANT FOR US TO HELP US STUDY SOCIAL CHANGE, MESSAGING THOSE ASPECTS BECAUSE YOU KNOW REALLY WE'RE IN THIS AREA WHERE WE HAVE A LEGAL SUBSTANCE, PEOPLE ARE GOING TO USE IT, IT IS AVAILABLE, AND HOW DO WE USE IT WELL. AND AS A MOTHER OF COLLEGE-AGED STUDENTS, THE MESSAGE THAT I'M HEARING FROM MY CHILDREN IS, WE'RE GETTING THE IDEA THAT ALCOHOL IS BAD AND MARIJUANA IS GOOD BECAUSE WITH ALCOHOL--I JUST WANT TO MAKE THIS STATEMENT SO YOU FIGHT WHEN YOU USE ALCOHOL, YOU DRINK AND DRIVE WHEN YOU USE ALCOHOL, YOU DIE WHEN YOU USE ALCOHOL BUT WHEN YOU USE MARIJUANA YOU SIT ON A COUCH AND YOU EAT. [LAUGHTER] SO I THINK WE HAVE TO BE VERY CAREFUL ABOUT THE SOCIAL CHANGE AND WHERE WE MOVE THE SUMMIT IN THE ADOLESCENTS. >> I WOULD LOAMACYIC TO RESPOND TO THAT BECAUSE I THINK WHAT YOU'RE SAY SUGGEST ONE THAT IS VERY, VERY IMPORTANT, HOW THE SOCIAL MESSAGES INFLUENCES BEHAVIOR AND HOW WE CAN PRESENT THEM IN DIFFERENT WAYS AND I THINK THAT THAT AN AREA OF [INDISCERNIBLE] YEARS AGO WAS TAKING ADVANTAGE OF IMAGE IN ORDER TO ACTUAL INVESTIGATE HOW MESSAGES INFLUENCE THE BRAIN AND WATCH SIGNATURES WHERE PEOPLE ARE CHANGING BUT WHAT YOU'RE SAYING, IS ONE STEP FURTHER BECAUSE IT'S TAKING IT FROM MESSAGES TO SOCIAL INTERACTION AND THAT IS AN AREA THAT I THINK THAT'S VERY, VERY PEOPLE WILL WORK ON, AND ONE THAT IS VERY RELEVANT [INDISCERNIBLE]. WE THEY'D TO THINK ABOUT HOW TO--NEED TO THINK ABOUT HOW TO GET IT TO STEP UP. IN PARTICULAR AS WE HAVE FACEBOOK, TWITTER AND ALL THESE DIFFERENT WAYS THAT THE INTERIMS, THE NETWORKS HAVE GREATLY EXPANDED FOR THE KIDS IN YOUR DORM ROOM TO REALLY [INDISCERNIBLE] FRIENDS. >> BOTH OF OUR INSTITUTE VS A NUMBER OF GRANTS THAT ARE FUNDED TO LOOK AT THESE KIND OF INTERACTIONS BUT YOU RAISE AN IMPORTANT ISSUE WHICH IS THAT WE PROBABLY AT NIAAA NEED TO GET AN OVERLOOK OF WHERE WE'RE GOING WITH THAT. SO I MEAN THESE ARE THE KINDS OF THINGS THAT START AND THEY'RE REALLY GOOD AND THEN THEY GO LIKE THIS AND WE NEED TO CORRAL THEM INTO MAKING THE TRANSLATIONAL PART THAT [INDISCERNIBLE] WAS TALKING ABOUT AND THAT'S WHAT WE TRY TO DO AT THE COLLEGE A. I. M. STUDIES AND WE WILL NEED TO DO THAT WITH SOCIAL MEDIA PIECES. I HAVE A TEENAGE SON AS MOST OF YOU KNOW AS WELL AND WHAT I HEAR FROM HIM IS THAT THE MESSAGING COMING THROUGH ALL KINDS OF MEDIA, SONGS AND MUSIC AND FOR ALCOHOL. AND IT REALLY DID SENSITIZE ME TO SOME OF THE--SOME OF THE ISSUES AROUND EXACTLY WHAT YOU'RE TALKING ABOUT WHICH IS THE WAY YOUNG PEOPLE PERCEIVE DRINKING AND I WAS TALKING TO MICHAEL [INDISCERNIBLE] AND HE SAID IT'S EVEN WORSE THAT THAT, IN BOSTON THEY LOAD UP ON ALCOHOL AT HOME AND THEN THEY GO TO THE BAR TO SAVE MONEY WHEN THEY GET TO THE BAR, SO THESE ARE ALL CULTURAL, SOCIAL, MEDIA PROBABLY--I DON'T WANT TO SAY FUEL BUT THE INFORMATION SPREADS LIKE WILDFIRE AND I THINK IT CONTRIBUTES TO THIS--WE NEED TO CHANGE THE PRECEPT. >> THIS SUBJECT MY EXPERTISE NECESSARILY BUT--ISN'T MY EXPERTISE NECESSARILY BUT I HAVE BEEN STUDYING ADOLESCENTS FOR A WHILE AND MAYBE WE WANT OTHER COMMENTS BUT MY EXPERIENCE IS THAT THE COMMUNICATION HAS TO BE PARENT TO YOUNG ADOLESCENTS, THAT THE GROUPS OF ADOLESCENTS THEMSELVES WILL COMMUNICATE A MESSAGE OF PROTECTION AND IT IS A MISTAKE THAT ADOLESCENTS ARE DIFFERENT BUT PARENTS STILL HAVE A HUGE IMPACT. THAT MOST KID WHO IS GET ALCOHOL GET IT FROM THEIR PARENT, BECAUSE THEIR PARENTS SAID YOU'LL BE SAFE AS LONG YOU DON'T DRIVE, GO DOWN IN A BASEMENT AND DRINK, OR THE PARENTS LEAVE TOWN AND THERE'S ACCESS, THAT THE ACCESS OFTEN COMES FROM PARENTS NOT PAYING ATTENTION. AND I THINK IN PREVENTION, AND SO IN THERAPY, FAMILY THERAPY, WHERE THE PARENTS ARE INVOLVED SEEMS TO WORK BETTER FOR STUDENTS IS MY UNDERSTANDING, SO ONE THING IS TO CONSIDER IS THAT ADOLESCENTS AREN'T REALLY ADULTS, YOU ACTUAL SLEY HAVE GREATER CONTROL, BUT YOU CAN CONTROL IT THROUGH A NAMELY STRUCTURE THAN YOU CAN WITH ADULTS WHO ARE INDEPENDENT AND YOU SHOULD CONSIDER THAT AND TRYING TO STRUCTURE ADOLESCENT PREVENTION BECAUSE I THINK THE FAMILIES THAT THERE'S DATA SUGGESTING DATA STRUCTURES AND CREATE DYNAMICS THAT INFORM ADOLESCENCE BETTER THAN TRYING TO IMPACT ADOLESCENT GROUPS THEMSELVES. >> I WANT TO FOLLOW UP ON JORDAN'S COMMENT THAT SOMETIMES THESE INITIATIVES TAKE PLACE, THEY BOOM AND THEN IT'S HARD TO CORRAL THEM BACK, AND FOLLOWING UP ON THE COMMENT THAT WE'RE GOING TO HAVE TO BE VERY CAREFUL WITH A MESSAGE THAT IS BEING SENT OUT RATHER THAN REENFORCING NOTION THAT ALCOHOL AND BAD AND MARIJUANA WILL BE OKAY. WE'RE TALKING A LOT ABOUT ADOLESCENCE AND I AGREE IT'S DEFINITELY A VERY VULNERABLE PERIOD FOR THESE PROCESSES, BUT I ALSO WOULD NOT WANT US TO FORGET THE AGING POPULATION, AND THE PEOPLE FACT THAT PEOPLE ARE LIVING WAY LONGER, THAT PEOPLE WITH CHRONIC DISEASES ARE LIVING WAY LONGER AND ONE OF THE--TO ME FASCINATING THINGS WE'RE STARTING TO SEE IS ADULTS, PARTICULARLY ADULTS WITH HIV THAT THINK THAT DRINK SUGGEST OKAY, BECAUSE, YOU KNOW THE RISK FACTOR IS NO LONGER THERE. THEY'RE GOING TO BE OKAY, THEY'RE GOING TO LIVE LONGER AND IT SEEMS TO ME THAT THAT IS GOING TO BE A PROBLEM THAT IS GOING TO HAVE SIGNIFICANT BIOMEDICAL CONSEQUENCES, IF WE FORGET THE FACT THAT PEOPLE ARE AGING. SO MAYBE BECAUSE MY KIDS ARE LEAVING THE ADOLESCENT STATE BUT ADOLESCENTS ARE IMPORTANT BUT THE AGING POPULATION IS ALSO VERY, VERY VULNERABLE, PARTICULARLY [INDISCERNIBLE]. >> IT'S NOT THE FIRST TIME THAT PEOPLE RAISE THAT ISSUE TO ME SO I AM INTERESTED IN THAT, WE HAVEN'T REALLY ENGAGED IN IT SO FAR BUT ONE OF THE THINGS I NOTICED IS ACTUALLY THE BINGE--EXCESSIVE BINGE DRINK SUGGEST EXTENDING INTO MIDDLE AGE AS WELL AS ADOLESCENT GROUP. >> THANK YOU. I WOULD LIKE TO FOLLOW UP ON TWO COMMENTS ALSO. THE FIRST ONE DR. CRUZ COMMENT ABOUT THE COMMUNICATION, THE FACT THAT FAMILY, THE DYNAMIC OF A FAMILY IS SO IMPORTANT FOR THE KIDS. IN RELATION TO CONTROL PREVENTION. WE ACTUALLY FOUND THE SAME THING AND WHAT WE HAVE IS A PROGRAM THAT WE CALL CONVERSATIONS THAT COUNT WHERE WE BRING TOGETHER THE PARENTS AND THE STUDENTS SO THEY BOTH GET THE SCIENCE AND THEY HAVE DIALOGUE ABOUT REAL LIFE SITUATIONS RELATING TO ALCOHOL AND OTHER DRUG USE AT THEIR TABLES. SO THEY'RE CONDUCTED AT SCHOOL CAFETERIAS AND THE IDEA IS TO DRIVE HOME OR DRIVE DOWN, RATHER THE UNDERSTANDING THAT YOU CAN SHOW PEOPLE HOW TO HAVE CONVERSATIONS ABOUT THESE DIFFICULT SUBJECTS, DEMONSTRATED HERE OR IN THE SCHOOLS WITH A RANDOM GROUP OF PARENTS AND STUDENTS SEATED AT EACH TABLE AND DRIVE DOWN THAT ABILITY SO THEY CAN HAVE THE SAME SORTS OF CONVERSATIONS AROUND THE DINNER TABLE, SO THE PARENT PART OF THIS IS EXTREMELY IMPORTANT. BUT ALSO IT'S EXTREMELY IMPORTANT FOR THE STUDENTS AND PARENTS TO BE ABLE TO COMMUNICATE, THAT'S WAWE FOUND. AND SECONDLY, IN RELATION TO YOUR COMMENT DR. KOOB, ABOUT GETTING YOUR INFORMATION, THE SCREENING GUIDES, THE RETHINKING DRINKING ALL THESE WONDERFUL RESOURCES THAT YOU ARE PUTTING TOGETHER HERE AT NIAAA, THE WAY OUR BOOKLET WORK SYSTEM THAT PIECES OF THE BOOKLET IS SCIENCE, BUT THE COVERS CHANGE SO WE'RE WORKING WITH SOME OF YOUR STAFF TO DEVELOP A COVER THAT WILL BE SPECIFICALLY HIGHLIGHTING THE RESOURCES THAT ARE AVAILABLE THROUGH NIAAA AND THE GOAL IS TO DISTRIBUTE THOSE BOOKLETS WORKING WITH THE ADDICTION, TREATMENT, DIRECTOR OF OUR LOCAL HOSPITAL HERE, SUBURBAN HOSPITAL AND GET THEM INTO PEDIATRICIANS OFFICES AND COUNCILORS OFFICES AND OFFICES SO THAT WE CAN, YOU KNOW HELP YOU MAKE SURE THAT AS MANY PEOPLE AS POSSIBLE ARE AWARE OF IT AND USE IT. SO THANK YOU FOR THAT. >> AMOUNT OF EXPERIENCE JUST--[INDISCERNIBLE] COMMENT ABOUT FAMILY, FAMILY IS CERTAINLY IMPORTANT BUT NOT ALL [INDISCERNIBLE] ARE THE SAME IN THE SITUATION THAT THEY HAVE WITH ALCOHOL AND DRUG USE AND THE FAMILIES, AND THE FAMILIES OF THESE ADOLESCENTS HAVE THEIR OWN SUBSTANCES, PROBLEMS AND THERE'S A GROUP OF ADOLESCENTS OUT THERE THAT YOU MAY JUST HAVE TO WORK WITH THEM ALONE. AND BECAUSE FAMILY IS NOT GOING TO BE THAT HELP SO WE WILL OFFER--WELL, BECAUSE SOMETIME YOU KNOW THERE'S CERTAIN BIAS IN TERMS OF THE FAMILY THAT STARTED BETTER BECAUSE THOSE FAMILIES WERE IN THE SITUATION THAT WAS VERY DIFFERENT TO [INDISCERNIBLE]. SO THERE'S THE RISK OF JUST FORGETTING THAT GROUP OF ADOLESCENTS. >> I MET A MAN YESTERDAY WHO NEVER HAD A DRINK OF ALCOHOL, NEVER USED A DRUG, NEVER SMOKED TOBACCO. WHEN HE WAS SEVEN HIS UNCLE WHO KILLED A MAN IN A BAR ROOM BRAWL, AND WHEN HE WAS LET OUT, THEY HAD TO SHARED A BEDROOM, AND THE THE PARENTS GAVE UP ON HIM AND PUT HIM BUT AT TIME MAN DECIDED HE WOULD NEVER DRINK AND HE LIVED HIS LIFE NEVER HAVING CONSUMED ANYTHING, THAT HAPPENS IN FAMILIES WHERE THERE'S ALCOHOLISM BUT WHAT I SEE MORE OFTEN THAN THAT IS THE GRANDFATHER IN AA WHO IS CELEBRATING THE FACT THAT HIS GRANDSON GOT THERE. AND THERE'S SOMETHING TERRIBLY WRONG IN MY MIND WHEN, IF YOU GET TO AA AND YOUR SON GETS TO AA YOUR SONS AND YOUR NEPHEWS AND THEIR CHILDREN GET TO AA, THERE'S SOMETHING THAT WE HAVE MISSED IN BEING ABLE TO COMMUNICATE TO PEOPLE WHO HAVE DISEASE, BUT WHAT THEY NEED TO DO IS PROTECT THE NEXT GENERATION; WE CELEBRATE IN AA, WE CELEBRATE, THE GUY WHO GETS HOME FROM JAIL MORE THAN THE ONE WHO IS GRADUATE FROM HIGH SCHOOL AND THERE'S SOMETHING THAT WE NEED TO DO TO BE ABLE TO COMMUNICATE A VALUE. YOU KNOW I HEAR THE MESSAGE ABOUT, WELL THOSE WHO CAN DRINK FOR HEALTH BENEFIT, I NEVER RECOMMENDED THAT ANYBODY WITH OBESITY AND CORDIAC DISEASE DRINK WINE AS A FIRST LINE OF DEFENSE FOR THEIR HEALTH. MOST PEOPLE DON'T IN THE MEDICAL PRACTICE, AND YOU KNOW THAT IS A REASONABLE CONSIDERATION. YOU HAVE PEOPLE WHO ARE PROMOTING THE USE OF MARIJUANA FOR HEALTH BENEFITS, TOO. I DON'T THINK THAT THESE ARE THE THINGS THAT, YOU KNOW WE AS SCIENTISTS NEED TO RELY FOCUS ON, I THINK WE NEED TO FOCUS ON HOW DOES THE STRUCTURE OF THIS BIGGEST RECOVERY, PATHWAY IN THIS COUNTRY AND THIS WORLD IS OF AA HOW DID IT WORK WITH--HOW DO WE GET TO PEOPLE WHO HAD TO FIND THAT PATHWAY TO MAKE SURE THEIR FAMILIES DON'T CONTINUE TO EXPERIENCE THE THEN GENERATION OF THESE AND WE DON'T KNOW THAT WE ARE DOING ENOUGH WITH THEM. >> I THINK YOU RAISE UP A REALLY IMPORTANT POINT AND THERE IS THE BEGINNING OF EVIDENCE TO SUGGEST THAT EPIGENETIC PHENOMENON CAN CROSS GENERATIONS, SO ANOTHER SCENARIO THAT YOU DIDN'T OUTLINE IS THAT THE SONS OF ALCOHOLICS DON'T DRINK BECAUSE THEY'VE SEEN WHAT HAVOC AS BEEN REACHED IN THE FAMILY BUT THEIR CHILDREN STILL HAVE THE VULNERABILITY BECAUSE OF EITHER ENVIRONMENTAL OR GENOMIC INTERACTIONS AND I THINK WE DO HAVE AND INTERACTION BETWEEN THE GENES, EXPRESSION OF GENES AND ENVIRONMENTAL INTERACT AND HOPEFULLY THIS BASIC RESEARCH WILL ULTIMATELY GET INFORMATION ON BIOMARKERS, THEY'RE GOING TO SAY, OKAY, YOU KNOW, IT'S LIKE YOU GO TO YOUR DOCTOR AND HE KNOWS THAT YOUR HISTORY OF YOUR FAMILY, THERE'S HEART DISEASE, SO YOU TAKE THE STEPS TO PREVENT THE HEART DISEASE, HOPEFULLY WE WILL BE THERE EVENTUALLY FOR ADDICTION AND ALCOHOLISM. SO WE HAVE TIME FOR JUST A COUPLE MORE QUESTIONS. >> YEAH, I JUST WANT TO THANK YOU FOR YOUR PRESENTATION AND JUST UNDERSCORE THE ONE THING I THINK WE HAVEN'T PICKED UP ON WAS IN YOUR TALK ABOUT THE PTSD, AND ALCOHOLISM AND REALLY TAKING A STEP BACK, YOU KNOW TO BROADEN THAT TO LOOK AT [INDISCERNIBLE] THAT MAY NOT LEAD TO PTSD, IMMEDIATELY BUT HIGHLY STRESSFUL EVENTS IN A FAMILY AND AIN'TS CHILDREN BEING VICTIMS OF VIOLENCE AND THEY WILL GO TO ALCOHOL EACH PRIOR TO THE MANIFESTATION OF PTSD SYMPTOMS AND I DO KNOW VERY WELL THAT IN FACT THEY'RE USING THAT TO PERHAPS REGULATE SOME OF THE HYPER AROUSAL, I THINK--I THINK WE NEED TO PAY ATTENTION TO THAT, AND AGAIN, YOU, I THINK KNOW THIS REALLY WELL, THE CIRCUITRY IS HIGHLY OVERLAPPING AND WE TALK ABOUT DECISION MAKING AND THE FRONTAL CORTEX AND AMYGDALA AND THAT'S THE TRAUMA AND STRESS, SO IT WOULD BE IMPORTANT I THINK TO THINK BROADLY AROUND TRAUMA IMMEDIATE--IMMEDIATE RECENT TRAUMA AND STRESSES, I KNOW IT IS NIMH IS DOING WORK WITH EMERGENCY ROOM TRAUMA SHOWING UP AND THEY'RE DISCOVERING, MY GOSH IT'S THOSE FOLKS ARE ACTUALLY SHOWING UP IN THE E. R. NOT JUST THE TRAUMA BUT BECAUSE OF ALCOHOLISM AND THOSE THINGS BEING PRESENTED SO PERHAPS CLEARLY LOOKING AT THAT MORE CAREFULLY, I THINK IT SPEAKS RIGHT INTO THE SOCIAL CHANGE POINTS THAT HAVE BEEN BROUGHT UP AROUND--ARE PARENTS AVAILABLE TO HELP ADOLESCENTS BUILD THIS KIND OF INTERVENTION WE'RE TALKING ABOUT. >> AND POINT WELL TAKEN AND I WAS TALKING TO WALTER, THE ACTING DIRECTOR OF NINDS, ABOUT BRAIN TRAUMA, PHYSICAL BRAIN TRAUMA WHICH INTERACTS WITH PTSD AND ALCOHOLISM AS WELL PROBABLY BECAUSE A LOTS OF TIME AND FRONTAL CORTEX THAT'S EFFECTED. SO ARE THERE ANY OTHER--I THINK I HAVE TIME FOR ONE MORE QUESTION, OTHERWISE I THINK WE WILL MOVE ON? >> FIRST OF ALL JUST EXCUSE ME, FOR THOSE ON THE TELEPHONE PLEASE MUTE OUR COMPUTER BECAUSE THE CIT IS HAVING DIFFICULTY RECORDING THE PROCEEDINGS, WE HAVE A LOT OF INTERFERENCE SO PLEASE MUTE THE PHONES. >> JOE? >> FIRST OF ALL THANKS FOR THE EFFORTS FOR THE TRIBAL INDIGIOUS PEOPLE, WELL NEEDED--INDIGINNOUS PEOPLE, AND THE NEUROLOGIST WILL GET A KICK OUT OF WHAT I AM GOING TO SAY AND I TAKE ADDER OLDER PEOPLE AND SIX YEARS AGO I DECIDED TO TAKE IT, I WAS DIAGNOSED WITH SEVERE ADHD AND LAST WEEK ON A TRIP, AND I E-MAILED THE DOCTOR, BECAUSE YOU HAVE TO GO EVERY 30 DAYS AND THEY'RE USUALLY PRETTY GOOD, YOU KNOW E-MAIL THE PHARMACIST, BUT THEY DIDN'T DO IT SO I AS OF SATURDAY, I HAVEN'T HAD ANY SO I'M HAVING A VERY DIFFICULT TIME JUST THINKING, BUT THERE'S A LOT OF PEOPLE LIKE THAT, WELL I THINK NOT JUST NATIVE PEOPLE BUT SOME PEOPLE HAVE THIS LEVEL OF THIS BRAIN ISSUE AND I CAN REALLY JUST TELL THE DIFFERENCE, YOU KNOW IF YOU WEREN'T INTERESTING PEOPLE, I WOULD BE SPINNING IN NIGH CHAIR. BECAUSE IT'S REALLY HARD. [LAUGHTER] , AND AFTER THREE DAYS, I'LL BECOME SAD, I GET SADDER INTO A DEPRESSION BECAUSE I CAN'T HOLD ON TO TO [INDISCERNIBLE] SO I WILL HAVE A HARD TIME--I JUST WANT YOU TO KNOW, YOU KNOW I HADN'T--I'M JUST NOT FOCUSING BUT ABOUT THE BRAIN PART, I'M WONDERING WHY IS IT THAT IT ISN'T JUST A REGULAR PRACTICE, THAT EVERYBODY GETS A BRAIN SCAN. SO IF THEY'RE GOING TO GIVE YOU DRUGS, YOU KNOW ALL THESE STUDIES AND HAVE YOU 10,000 KIDS GOING TO GET IT WHY DOESN'T EVERY HUMAN BEING AS THEY GROW UP, GET BRAIN SCANS AND WHAT'S THAT COST? AND WHY ISN'T A RECOMMENDATION. I WANT A BRAIN SCAN AND I WANT TO SEE WHAT'S GOING ON HERE AND NO ONE CAN GET IT UNLESS THEY'RE DYING BECAUSE THAT'S WHAT HAPPENS. AND THERE'S A LOT OF ISSUES WITH THE BRAIN, AND I HIT MY HEAD, IN COLLEGE, COLLEGE-AGE DRINKING BUT THE ADHD MADE IT WORSE, I GUESS BUT THERE'S A LOT OF PEOPLE I KNOW WITH THE DUAL DISORDERS TO [INDISCERNIBLE] ISSUES BUT IT SEEMS THAT THE BRAIN SCAN STUFF WOULD PROBABLY HELP BUT MAYBE THE SCIENTISTS HAS SOMETHING TO SAY ABOUT THAT, THAT WAS JUST A QUESTION HERE. BUT ALSO TO FOLLOW UP THE DOCTOR OVER HERE, IN COURT, WE DEAL WITH GENERATIONS OF—[ ALCOHOLICS AND GRANT PANDERS, THE PARENTS AND GRANDKIDS WERE ALL IN THERE, ALL DRINKING TOGETHER, HAVE YOU TO THINK OF THE PARENTS ARE YET TO HAVE THEM ALL [INDISCERNIBLE] AND SENT THEM SOME KIND OF FAMILY THERAPY AND I KNOW THERE'S FAMILY RELATED TO THOSE THINGS THERE ARE FAMILY GRANTS WE'RE DOING WHICH I LIKE THAT AND TRIBAL PEOPLE WITH A WHOLE GENERATION AND MAYBE EVEN FOUR, AND GRAND PARENTS AND THEY APPRECIATE THAT. THAT THINKING. THERE'S A LOT INTO THAT, BUT I WANTED TO SAY THAT, JUST ALSO THE FIRST THING I SAID ABOUT THE CONCENTRATION BECAUSE THAT--IT'S HARD FOR ME, AND I'M--YOU KNOW MAYBE HAVE YOU WITHDRAWAL OR SOMETHING, I WOULD NOT [INDISCERNIBLE] BUT I'M UPSITE WITH MY IHS DOCTOR FOR NOT FILLING MY PRESCRIPTION BEFORE A CAME, THANK YOU. >> THAT WAS A ELEGANT WAY OF DESCRIBING THE REAL WORLD AND I ENJOY IT. YOU KNOW I THINK THE PROBLEM RIGHT NOW IS WE DON'T KNOW ENOUGH TO SCAN EVERYONE AND I THINK THAT THE HYPOTHESIS, AND IT WOULD BE PROHIBITIVELY EXPENSIVE AND WE DON'T HAVE A CAPACITY TO IT AND THE REAL ISSUE IS THAT LIKE THE ABCD STUDY, THAT WILL ULTIMATELY COME UP WITH NEUROCOGNITIVE TESTS, MAYBE EVEN ELECTROENCEPHALOGRAPHY, NOT AS DIFFICULT TO EMPLOY THAT WOULD THEN SAY, WELL, MAYBE THAT SOUTH AMERICAN RECEIVE A BRAIN SCAN TO FURTHER DIAGNOSE A POTENTIAL PROBLEM, SO I THINK THAT'S WHERE I WOULD LOOK AT IT. I DON'T KNOW [INDISCERNIBLE]. >> I AGREE, COMPLETELY AND THAT'S EXACTLY WHY WE WANT AND THE [INDISCERNIBLE] STORY SO THAT WE CAN DEVELOP STANDARDS BECAUSE WITHOUT THOSE STANDARDS, IF YOU HAVE A BRAIN THAT LOOKS LIKE A DIFFERENCE, HOW DO WE KNOW THE NORM AND THE VARIABILITY AS OPPOSE TO BEING OUTSIDE AND JUST LIKE WHEN YOU'RE A CHILD AND THEY MEASURE HEIGHT AND WEIGHT, MAYBE NICELY FOLLOW YOUR IN VIVO TRAJECTORY TO DO THIS IMAGING TO GENERATE DATABASE SO THAT INDEED, IF YOU HAVE A CHILD THAT'S HAVING PROBLEMS, VERY EFFICIENTLY CAN YOU DERM IF IT'S DEVELOPMENTAL BRAIN TRAJECTORIES ARE NORMAL. SO WE WILL SEE IT, WE WILL SEE IT IN THE FUTURE BUT I AGREE ALSO WITH GEORGE, ONE OF THE THINGS WE WOULD LIKE TO SEE, ABCD TO DO IS HELP US IDENTIFY BIOMARKERS THAT ARE CLINICALLY ACCESSIBLE THAT CAN GIVE YOU FORMATION ABOUT THOSE TRAJECTORIES AND THAT'S WHY I'M EXERCISING THE COLLEAGUES AND I'LL SPEAK ABOUT IT LATER. >> SO I THINK WE WILL KEEP THE TRAINS RUNNING ON TIME AND IT'S A PLEASURE FOR ME TO INTRODUCE DR. SALLY ROCKEY, WHO LEADS THE NIH AND THE BIOMEDICAL WORKFORCE. HER ROLE AT NIH IS TO OVERSEE THE DEVELOPMENT AND THE IMPLEMENTATION OF CRITICAL POLICIES AND GUIDELINES CENTRAL TO THE SUCCESSFUL CONDUCT OF NIH SUPPORTED BIOMEDICAL RESEARCH. DR. ROCKEY HAS A Ph.D. IN ENTOMOLOGY, WHICH I FOUND--BECAUSE I LOVE BUGS--FROM THE OHIO STATE UNIVERSITY AND SHE SPENT THE MAJORITY OF HER CAREER IN THE RESEARCH AND INFORMATION TECHNOLOGY IN 1986, SHE JOINED THE U.S. DEPARTMENT OF AGRICULTURE AND SOON BECAME DEPUTY ADMINISTRATOR OF THE STATE RESEARCH EDUCATOR AND TENSION SERVICE WHERE SHE OVERSAW THE USDA EXTRAMURAL COMPETITIVE GRANT AND THEN SHE SERVA AS THE AGENCIES CHIEF INFORMATION OFFICER, IN 2005 SHE MOVED TO NIH'S DEPRIVATIONUTE TOW THE CURRENT POSITION AND BECAME DIRECTOR FOR EXTRAMURAL RESEARCH IN 2008. SHE--DR. ROCKEY CAN LEAVE ON A NUMBER OF FEDERAL RELATED ACTIVITIES AND ELECTRONIC GOVERNMENT, SHE WORKS MOST CLOSELY WITH THE OTHER FEDERAL SCIENCE AND ADMINISTRATORS AND PROFESSIONAL SOCIETIES AND SCIENTIST COMMUNITIES HERE AROUND THE WORLD. SHE CO CHAIRS THE COMMITTEE ON THE SCIENCE RESEARCH BUSINESS MODEL AND SERVES AS VICE PRESIDENT OF THE HUMAN FRONTIERS OF SCIENCE PROGRAM AND INTERNATIONAL PROGRAM FOR LIFE SCIENCE RESEARCH SUPPORT IN 2012. DR. ROCKEY WORKS ON A GROUND BREAKING BIOMEDICAL WORKFORCE. SHE'S A SKILLED PUBLIC SPEAKER ON WORKFORCES AND POLICIES AND SHE'S THE AUTHOR OF A LIVELY READ, [INDISCERNIBLE] BLOG AND RECOGNIZED FOR NUMEROUS PROFESSIONAL ACCOMPLISHMENTS INCLUDING RECEIVING THE PRESIDENTIAL [INDISCERNIBLE] AWARD AND [INDISCERNIBLE] AWARD IN 2013 AND THE ARI PUBLIC SERVICE AWARD IN 2014. SO LET'S WELCOME DR. ROCKEY TO OUR CONSISTENCY ILLEGALS. >> THANK YOU. >> [LAUGHTER] >> IS THIS ON? I DON'T IF THIS IS GOING TO WORK. >> IT'S ON, IF I'M TALKING UP HERE, SO WHY IN THE WORLD WITH NIH HIRE AN ENTOMOLOGYST TO LEAD THE EXTRAMURAL RESEARCH PROGRAM AND I SAID I'M HERE, THEY HIRED ME TO BUG YOU. IT'S THE BEST I HAVE, YOU HAVE TO LAUGH LOUD BECAUSE IT DOESN'T GET MUCH BETTER THAN THAT. SO, GEORGE JUST MENTIONED THE WORKFORCE REPORT AND ACTIVITIES THAT WE DID A NUMBER OF YEARS AGO AND I WANT TO TELL YOU ABOUT WHAT WE FOUND AND DISCOVERED ABOUT THE BIOMEDICAL WORKFORCE AND SOME OF THE IMPLICATIONS IT HAS FOR PRODUCING THE NEXT GENERATION OF SCIENTISTS AS WELL AFOR THE ENTIRE WORKFORCE AND I WANT TO TELL YOU A LITTLE BIT WHAT WE LEARNED AND THE SOME OF THE THINGS WE IMPLEMENTED AND I WOULD LOVE TO HEAR YOUR COMMENTS AND HAVE A DISCUSSION WITH YOU ABOUT IT. SO OUR WORKFORCE WAS PUT TOGETHER TO REALLY DEVELOP A MODEL FOR THE BIOMEDICAL WORKFORCE AND THE FIRST THING WE DID WAS WE CHANGED OUR CHARGE BECAUSE WE REALIZED WITHIN A YEAR WE WERE NOT GOING TO BE ABLE TO MAKE A PLUG AND PLAY MODEL THAT SAID IF THIS HAPPENS WITH THE ECONOMY YOU SHOULD RECRUIT FEWER Ph.D. STUDENTS, ET CETERA, ET CETERA. WE HAD TO LEARN THE LAY OF THE LAND, WE DID NOT UNDERSTAND ALL OF THE IMPLICATIONS FOR THE WORKFORCE BASED ON NIH FUNDING BASED ON WHAT THE CONSTRUCT WAS, THE UNIVERSITIES, ET CETERA. SO WHAT WE DID OVER A YEAR'S TIME WAS TO LEARN ABOUT THE WORKFORCE AND MAKE SOME RECOMMENDATIONS THAT NIH COULD LIMP IMPLEMENT. SO I INCAPSULATE THIS DOWN INTO A SMALL LITTLE TALK BECAUSE I CAN NORMALLY TALK ABOUT ON THE FIRST COUPLE SLIDES FOR AN HOUR, LET ME TELL YOU WHAT WE LEARNED. SO FIRST OF ALL, INDIVIDUALS ARE RECEIVING--I'M GOING TO CONCENTRATE ON PH Ds AND WE HAD A FOLLOW UP STUDY ON PHYSICIAN SCIENTISTS AND WE'VE LEARNED MANY OF THE SAME THINGS THAT ARE HAPPENING WITH THE Ph.D., WORKFORCE SUCH AS THE AGING OF THE WORKFORCE, ALSO HAPPENING IN THE PHYSICIAN SCIENTIST, SO WHAT'S APPLICABLE HERE AND ALSO APPLICABLE THERE. BUT WHEN YOU--70% OF OUR PIs AT NIH, ARE PDs SO WE CONCENTRATEOT PART OF THE WORKFORCE, SO THE FIRST OF ALL THE MEDIAN AGE IS AROUND 31, IT TAKES ON AVERAGE ABOUT SEVEN YEARS FOR AN INDIVIDUAL TO RECEIVE A Ph.D., THAT IS NOT ACTUALLY A LENGTHY Ph.D., AND MANY OTHER AREAS OF SCIENCE IT CAN BE SHORTER THAN THAT. LONGER THAN THAT. BUT NONETHELESS, IT'S ABOUT SEVEN YEARS AND THIS IS BASICALLY UNCHANGED. BUT YOU SEE ALSO AT THE AGE AT WHICH OUR Ph.D. IS UNCHANGED BUT WHAT HAS CHANGED OVER TIME IS THAT A PERSON RECEIVED AN INDEPENDENT POSITION. SO WHAT HAPPENS NOW AS A PERSON COMES TO A Ph.D. INTO A POST DOC, THEY'VE LEAPTENNED, THE AVERAGE LENGTH OF TIME FOR A POST DOC IS FIVE-SEX YEARS FOR NHIERARCHIES H SUPPORTED POTE DOCS OR THOSE POTE DOCS IN THE MEDICAL WORLD AND THE AGE ABOUT GETTING YOUR FIRST INDEPENDENT JOB, AT ABOUT 38 OR 39, SO FOR US THIS IS CONCERNING BECAUSE THE IDEA THAT YOU ARE APPROACHING 40 OR APPROACHING WHAT MANY WOULD CALL MIDDLE AGED, ALTHOUGH I ACTUALLY THINK MIDDLE AGE IS 56 YEARS AND 11 MONTHS BUT MOST PEOPLE WILL THINK ABOUT--ABOUT 40 YEARS OF AGE AND YOU KNOWE OF THINGS HAPPENING IN YOUR LIVES AT THAT POINT PLUS WE KNOW PEOPLE ARE PRODUCTIVE AND HAVE CREATIVE IDEAS AND IT SEEMS LIKE THE 30S IS WHERE WE SHOULD HIT PEOPLE TO BECOME TRULY INDEPENDENT SCIENTISTS BECAUSE IT WILL LEAD TO ALL OUR ENTIRE WORKFORCE AND NOT ONLY OPPORTUNITY FOR JOBS BUT CREATIVITY THAT COMES WITH INDIVIDUALS THAT ARE STARTING OUT IN THEIR CAREERS. SO THIS WAS OUR CONCERN, WE COMPARE IT TO CHEMISTRY, AND THIS IS OUR CONCERN THAT THIS IS REALLY THE AGE, ROUND 39 THAT YOU'RE BECOMING INDEPENDENT, THE OTHER THING THAT SURPRISES THEM AND WE LEARN INDEED IN REPORT, WHERE DO PEOPLE GO TO GET Ph.D.s BECAUSE OUR TRAINING PROGRAMSA THE NIH WERE DESIGNED TO HAVE INDIVIDUAL SAYS MAKE A B-LINE TO ACADEMIA, WE TRAIN PEOPLE TO LOOK LIKE US, WE WANT THEM TO GO INTO CAREERS IN ACADEMIA AND WE MEASURED YOUR SUCCESS IN A TRAINING PROGRAM OF HOW MANY OF YOUR STUDENTS END UP IN ACADEMIA, BUT WHAT WAS FOUND OUT IS THAT ONLY 43 OR SO PERCENT OF ALL PH Ds TRAINED IN THIS COUNTRY ARE IN THE ACADEMIA, SO THESE ARE THOSE TRAINS IN THE COUNTRY, DOESN'T SAY ANYTHING ABOUT YOUR NATION ALEXANDERRITY AND RECEIVED YOUR Ph.D. HERE IN THE UNITED STATES, WHERE CO YOU END UP VERY LITTLE EMPLOYMENT, NONRESEARCH RELATED, THIS MEANS THAT IF I'M A SCIENCE TEACHER, GIVING--YOU ON I GET A Ph.D., BECOME A SCIENCE TEACHER, I END UP IN THIS BOX HERE, DOESN'T MEAN IT'S NOT A MEANINGFUL CAREER, IT'S NOT IMPORTANT, IT'S FABULOUS TO THINK ABOUT PEOPLE THAT KNOW ABOUT SCIENCE AND EVERY SECTOR OF OUR SOCIETY, BUT WE HERE ARE PAYING FOR YOU TO GET A, Ph.D. IN THE AREA AND WHAT WE'RE INTERESTED HERE IS HOW MANY GO WHERE IN RESEARCH AND RESEARCH RELATED AREAS. SO TO INDUSTRIAL RESEARCH AT THE BENCH IS ABOUT 16.4%. OUR GOVERNMENT 23 YOU'RE AT NIH YOU'RE HERE, FIVE PUBLICITY 2 PERCENT RESEARCH RELATED PEOPLE ARE PEOPLE LIKE ME, PEOPLE THAT ARE WORKING IN RELATED AREAS THAT ARE WANTING TO SUPPORT THE ENTIRE APPARATUS OF THE RESEARCH ENTERPRISE. IT ALSO HAS A LARGE COMPONENT OF THESE OR THOSE IN INDUSTRY THAT MANAGE RESEARCH PROGRAMS AND NOT AT THE BENCH BUT THEY'RE MANAGING THE LARGE RESEARCH PROGRAMS OF THE PRIVATE SECTOR. SO HERE WE ARE IN ACADEMIC RESEARCH. NOW THIS ALSO INCLUDES PEOPLE THAT AREN'T DOING RESEARCH, SO IF YOU END UP IN AMDEEMIA AS A LECTURER OR TEACHER, YOU END UP IN THIS SPOT. SO YOU CAN SEE THAT ONLY LESS THAN HALF OF OUR PH Ds ARE ENDING UP IN ACADEMIA AND AS YOU KNOW THE WORLD OF TENURE CHANGES IN ACADEMIA AND MANY OF THESE ARE IN SOFT MONEY POSITIONS IN ACADEMIA, AND NOT NECESSARILY IN TENURE AND TENURE TRACK, SO WE CALCULATED FOR THE ENTIRE WORKFORCE, ONLY ABOUT 22 OR 23% END UP IN TENURE OR TENURE TRACK POSITION SO THAT'S PRETTY INCREDIBLE. SO THE IF I HAVE THING WE SAID WAS THERE'S A LARGE UPSURGE IN Ph.D.s, THERE'S AGING WHICH I'M GOING TO TALK ABOUT AT THE WORKFORCE, IT BECOMES MORE DIFFICULT TO LAUNCH A TRADITIONAL ACADEMIC CAREER AND OUR TRAINING PROGRAMS ARE NOT PREPARING INDIVIDUALS FOR THE TYPES OF JOBS THAT THEY ULTIMATELY MIGHT HAVE. SO WE MADE A LOT OF INITIATIVES, FIRST OF OF ALL WE WANTED PEOPLE TO TALK ABOUT TRAINING AT AN EARLY STAGE SO WE NOW HAVE AN EXPECTATION THAT WHETHER OR NOT YOU'RE SUPPORT OFFICE OF DIVERSITY A TRAINING GRANT OR RESEARCH GRANT IF YOU'RE A Ph.D., STUDENT OR A POST DOC OR ANOTHER TRAINEE ON A GRANT, YOU WILL RECEIVE AN IPA, WHICH IS AN INDIVIDUAL DEVELOPMENT PLAN SO WHAT THAT MEANS IS THAT WE WANT TO GET PEOPLE ON TRAJECTORIES AND HELP THEM ALONG THE WAY FROM THE VERY BEGINNING OF THEIR TRAINING PERIOD. IT WASN'T SO DIFFICULT FOR INDIVIDUALS TO THINK ABOUT TALKING TO THEIR GRADUATE STUDENTS ABOUT THE CAREER PLANS BUT I TELL YOU, WE HAD A LOT OF SHOCKED PEOPLE IN THE ROOM WHEN WE SAID, YOU NEED TO TALK TO YOUR POST DOCS ABOUT THEIR PLANS FOR RESEARCH, A LOT OF THEM HIRE POST DOCS FOR EXPERTISE, AND THE THOUGHT OF TALKING WITH POST DOCS ABOUT THEIR CAREERS WAS A BIT SURPRISING. HOWEVER, POST DOCS REALLY ARE CENTRAL TO ALL OF OUR WORKFORCE ISSUES. IT ALWAYS SEEMS TO COME BACK TO A POST DOC, SO IF WE CAN HELP THE POST DOC ALONG TO GET THEM TO WHERE THEY WANT TO GO IT WOULD BE HELPFUL. WE'VE DONE A COUPLE OTHER THINGS I DON'T HAVE TIME TO GO INTO BUT ONE OF THE MAJOR CENTERPIECES OF OUR PROGRAM WAS THE BEST PROGRAM, THE COMPETITION IS OVER, WE HAD TWO COMPETITIONS IN 2014. IT WAS THE BEST WAY TO EXPAND THE TRAINING OF INDIVIDUALS RECEIVED SO THEY WOULD BE BETTER PREPARED FOR THE MYRIAD OF OUTCOMES THEY HAVE IN THEIR CAREERS SO WE GAVE 20 INSTITUTIONS AND WE HAD TO HAVE INSTITUTIONS OF DEGREE GRANTS OF PH Ds AND THESE WILL EXPERIMENT WITH PROGRAMS THAT WILL HELP GRADUATE STUDENTS AND POST DOCS ACQUIRE THE SKILLS THEY NEED TO GO INTO ANY OF THOSE POSITIONS THAT YOU SAW IN THE PREVIOUS SLIDE. AND IT'S BEEN REALLY WONDERFULLY RECEIVED. WE'VE GOT DYNAMITE PROJECTS THAT WE'RE SUPPORTING, VERY CREATIVE THINKING OUTSIDE THE BOX, GIVING PEOPLE OPPORTUNITIES AND INDUSTRY, GIVING PEOPLE OPPORTUNITIES TO DEVELOP AN ENTREPRENEURIAL SKILL, ET CETERA, ET CETERA. SO THIS WAS BEYOND GOING FOR ABOUT FIVE YEARS, WE ARE GOING TO BE INTERESTED IN THE OUTCOME BECAUSE WHAT WE HOPE ARE THE BEST PRACTICES THAT ARE GENERATED BY THE PROGRAM CAN BE IMPLEMENTED ACROSS ALL OF OUR TRAINING PROGRAMS HERE IN THE COUNTRY. SO,--SO THAT'S THE FIRST STEP, THAT'S TRAINING, THAT Ph.D. POST DOC, THE SECOND STEP IS NEW INVESTIGATORS, SO LET'S SAY YOU GET IN, WHAT IS HAPPENING TO YOU. WE'VE HAD A LOT OF CONCERN ABOUT THE AGE OF OUR WORKFORCE, I WILL SHOW YOU A SLIDE IN A FEW MINUTES BUT SO THERE'S BEEN A LOT OF INTEREST BY CONGRESS, BY OTHERS, AND A LOT OF IT CENTERS AROUND THIS NEW INVESTIGATOR, AND PERHAPS WE SHOULD JUST BE SUPPORTING MORE NEW INVESTIGATORS, AS A WAY TO REDUCE THE AGE AT WHICH PEOPLE BECOME INDEPENDENT BUT IT'S MUCH MORE COMPLICATED THAN THAT BECAUSE WE ACTUALLY HAVE BEEN MAKING A VERY SERIOUS EFFORT OVER THE COURSE OF THE LAST--AROUND SEVEN OR EIGHT YEARS TO TARGET NEW INVESTIGATORS FOR SUPPORT ASK TO ASSURE THAT THEY ARE SUCCESSFUL ALONG THE WAY. SO HERE'S THE AGE OF OUR NEW INVESTIGATORS, AND FOR PH Ds, THIS IS NEW INVESTIGATORS WHO ARE SEEING THEIR FIRST RO-1. BY MANY PEOPLE'S DEFINITION, RECEIVING TRUE INDEPENDENT AT RO-1, THAT STANDARD GRANT THAT WE GET, A LOT OF INSTITUTIONS GET IT--AS A DETERMINANT OF WHETHER OR NOT YOU GET TENURE BUT THAT IDEA THAT IF I GET AN RO-1, I'M TRULY AN INDEPENDENT SCIENTIST. SO IN OUR CASE FOR Ph.D.s THEY'RE NOT RECEIVING THE FIRST RO-1 UNTIL ABOUT THE AGE OF 42, BUT NOTICE HERE THAT THAT ACTUALLY STARTED BEFORE THE DOUBLING OF THE NIH BUDGET, WE HAVEN'T GONE UP MUCH, WE'VE BEEN STABLE AT 42 YEARS SO WE TRY TO BRING THAT DOWN BY SUPPORTING NEW INVESTIGATORS SO BEGINNING IN 2007, WE STARTED HAVING SPECIAL CONSIDERATION FOR NEW INVESTIGATORS IN OUR FUNDING DECISION PROCESS, AND YET, EVEN WITH THAT, WE HAVE NOT CHANGED THE AGE OF NEW INVESTIGATORS. IF YOU LOOK AT PH DASKS MDs, MDPH Ds AND MDs, IT'S HIGHER WHERE THEY GET THEIR FIRST RO-1. SO OUR POLICY IN 2007 IS WE WILL MAKE COMPARABLE SUCCESS RATES FOR NEW INVESTIGATORS AND ESTABLISH INVESTIGATORS SO REALLY THAT'S WHAT WE'VE BEEN TRYING TO DO AND WE WILL CONCENTRATE ON THOSE INDIVIDUALS FOR WITHIN 10 YEARS OF THEIR TERMINAL DEGREE. SO THAT'S WHAT WE CALL AN EARLY STAGE INVESTIGATOR. SO WE'VE DONE THAT. SOME INSTITUTE VS PAY LINES THAT ARE MORE GENEROUS FOR NEW INVESTIGATORS, OTHERS INSTITUTES ACTUALLY HAVE AN ESTABLISHED PAY LINE AND GO BEYOND THE PAY LINE TO PICK UP NEW INVESTIGATORS, IT DEPENDS ON THE INSTITUTE AT WHICH APPROACH AT A HAVE. WE ALSO HAVE ALL SORTS OF OTHER WAYS, WE HAVE THE KANGAROO AWARDS WHICH ARE THOSE THAT GIVE YOU THOSE LAST TWO YEARS OF A POST DOC AND THEN AN R-GRANT, AND YOU GET TO GO OUT, AND THEY HAVE BECOME EXCEEDINGLY POPULAR, SO POPULAR THAT MOST POST DOCS NOW BELIEVE THAT IF YOU DON'T HAVE A KANGAROO AWARD, YOU CANNOT GET A FACULTY POSITION, AND IT MAKES THOSE INDIVIDUAL WHO IS HAVE THIS BECAUSE THEY COME WITH THE RESEARCH GRANT, ALREADY IN THEIR HANDS, WHEN THEY COME TO THE INSTITUTION, VERY ATTRACTIVE FOR AN INTUITION TO HIRE. SO ONE OF THE THINGS WE TAUGHT ABOUT, WE PUT MORE INTO INVESTING IN KANGAROO AWARDS BUT WE'VE DONE OTHER THINGS AS WELL. WE HAVE THIS AWARD THAT IS REALLY AN INTERESTING AWARD. WE ONLY GIVE 10 OR 12 OF THESE A YEAR. IT'S ACTUALLY A SKIP A POST DOC SO IN YOUR Ph.D. PROGRAM, YOU APPLY, YOU ACTUALLY SKIP A POST DOC AND BECOME A JUNIOR FACULTY MEMBER FOR A PERIOD OF TIME, THERE'S REQUIREMENTS THAT THEY CANNOT DO A LOT OF TEACHING AND OUTSIDE ACTIVITIES, THEY HAVE TO CONCENTRATE ON RESEARCH, AND WE'RE SEEING HOW SUCCESSFUL THAT IS. IT TAKES A BIG COMMITMENT ON THE PART OF A UNIVERSITY, TO TAKE THESE INDIVIDUALS ON, STRAIGHT FROM THE Ph.D., SO YOU CAN IMAGINE THE CALIBER OF THOSE INDIVIDUALS THAT ARE COMING OUT AND GETTING THESE AWARDS. SO HERE TO DEMONSTRATE THAT WE REALLY HAVE INCREASED OUR PROPORTION OF INVESTIGATORS THIS, IS THE PROPORTION THAT OUR ENTIRE RO-1 POOL AND CAN YOU SEE WHEN WE STARTED OUR NEW PROGRAM, OUR PROPORTION OF NEW INVESTIGATORS ACTUALLY ROSE TO ABOUT 30%, 33%, IT'S NOW ABOUT 28% AND IT HAD HISTORICALLY BEEN ABOUT 23%, SO ONE QUESTION, WHAT IS THE RIGHT PROPORTION. IT'S HARD TO KNOW WHAT IS THE RIGHT PROPORTION BECAUSE REMEMBER RIGHT NOW WITH OUR FLAT BUDGET THIS IS A ZERO-SOMETHING GAIN. SO IF YOU PUT MORE MONEY INTO NEW INVESTIGATORS, IT HAS TO COME FROM SOMEWHERE, RIGHT? THE SECOND THING IS, ARE YOU SETTING UP NEW INVESTIGATORS WITH THESE REALLY LOW SUCK SESSION RATES RIGHT NOW FOR ALL OF NIH FOR FAILURE BECAUSE YOU BRING THEM IN, YOU GET THEM IN THE SYSTEM AND THEN THEY HAVE TO--I AILS SAY, A NEW INVESTIGATOR FOR A NANO SECOND. THE MINUTE YOUR INSTITUTION DRIVES DOWN THAT FIRST PENNY OF FUNDS, YOU'RE IN WITH THE SHARKS, RIGHT? YOU'RE NOW AN ESTABLISHED INVESTIGATOR. SO ARE WE SETTING THEM UP FOR FAILURE BECAUSE THEY NOW HAVE TO COME BACK AND COMPETE, WITH ALL THE ESTABLISHED INVESTIGATORS AND IN FACT YOU'RE GOING TO SEE IN A MOMENT THAT THAT'S WHERE WE SEE OUR BIGGEST DROP OFF IS RIGHT AFTER THE FIRST AWARD. SO LET ME TALK ABOUT THIS, ONE OF THE THINGS WE'RE INTERESTED IN IS WHAT HAPPENS TO NEW INVESTIGATORS? SO I DID A BLOG ON THIS. I WILL GO THROUGH WHAT WE FOUND. THIS IS ABOUT RETENTION RATES, ONCE WE GET YOU IN THE SYSTEM, WHAT HAPPENS. SO WE SAID THAT WE KNOW THAT A LOT OF PEOPLE ARE DROPPING OUT OF THE SYSTEM, AND ANECDOTEALLY WE'RE HEARING THAT PEOPLE ARE DROPPING OUT RIGHT AND LEFT AND PEOPLE ARE CHANGING THE CAREER PATH ALTHOUGH WE DON'T HAVE A LOT OF DATA WANT TO IS THAT SO WE DID WAS WE LOOKED AT THREE COHORTS BECAUSE WE WANT TO FOLLOW THESE COHORTS OVER TIME. SO WE LOOKED AT COHORTS IN 89, 97 AND 2003, SO THIS IS SOME OF THE DATA. YOU DON'T HAVE TO READ THIS REAL CLOSELY, I WILL JUST SHOW YOU, WE USE THIS CAP LANMEYER STATISTIC, WE USE THE STATISTIC THAT SAYS, WHAT IS THE LIKELIHOOD THAT SOMETHING'S GOING TO HAPPEN, A SPECIFIC EVENT WILL HAPPEN AND IN THIS CASE WHAT WE'RE TALK ABOUT IS WHETHER OR NOT WE WILL CONTINUE THE EVENT, WILL THEY CONTINUE TO RECEIVE AWARDS AFTER THEY GET THEIR INITIAL NIH AWARD, WE FOUND SOMETHING ACTUALLY QUITE SURPRISING, THIS IS THE 89 COHORT, AND IF YOU SEE HERE, AFTER YEARS SINCE THE FIRST RO-1, IN ALL THREE OF THESE COHORTS, YOU SEE THE BIG DROP, SO THAT MEANS THAT AFTER YOU GET YOUR FIRST RO-1, WE SEE A LOT OF PEOPLE COMING OUT OF THE SYSTEM. AND THAT'S AGAIN BECAUSE NOW THEY'RE COMPETING FOR THEIR SECOND, THEY MAY OR MAY NOT COMPETE, WE'VE GOT A LITTLE BIT OF INFORMATION ON ABOUT THAT IN A MOMENT. BUT WHAT WE FOUND IS THAT ACTUALLY THE GROUP THAT DROPPED OUT THE MOST OFTEN WAS BACK IN 1989. IN 1997 IS THE LEAST AMOUNT OF DROP OFF AND THAT MAKES A LOT OF SENSE BECAUSE THOSE PEOPLE WERE COMING BACK AND COMPETING DURING THE DOUBLING AND THERE WAS A LOT OF MONEY GOING TO NIH AND THEY--THEY WERE ABLE TO COMPETE SUCCESSFULLY. AND HERE IS 2003. SO THERE'S MORE DROP OFF THAN 97 BUT LESS OF THEY DROP OFF IN 89. HOW IN THE WORLD DO WE EXPLAIN THIS WE WOULD THINK THAT 89 WOULD BE HIGHER THAN WHAT WE'RE SEEING TODAY, WE HAD ANTICIPATED TODAY THERE WOULD BE THE LARGEST DROP OFF AND OF COURSE, WHAT WE'RE TRYING TO CORMIZE WAWHY THAT IS, IF YOU LOOK AT STABILITY OF FUNDING IT MIGHT EXPLAIN SOME OF THE VERYS. SO BACK IN 89, NO ONE REALLY KNEW WHAT WAS HAPPENING WITH NIH, WE WERE IN THE SWIRL, WE WERE AT ABOUT 13 OR 11 BILLION DOLLARS, AND I THINK THERE WAS A LOT OF UNCERTAINTY ABOUT WHAT HAPPENED, WHAT'S GOING TO HAPPEN WITH THE BUDGET OF NIH AND THAT IMPACTS WHETHER OR NOT INDIVIDUALS ARE ABLE TO COMPETE AND WILL COMPETE. IN 97 THERE WAS GREAT ANTICIPATION, RIGHT? THERE WAS GREAT ANTICIPATION BECAUSE WE KNEW THE DOUBLING WAS COMING AND IN FACT, IT WAS A LOT OF TALK ABOUT IT AT THE TIME AND PEOPLE WERE REWARDED BECAUSE OF THE DOUBLING. THEY WERE ABLE TO COME BACK AND COMPETE. NOW WHY ABOUT TODAY? WELL, I WOULD CONTEND THAT WHILE THERE'S A VERY TIGHT BUDGET SITUATION BECAUSE IT IS NOW 11 YEARS OF FLAT FUNDING, ACTUALLY GIVES YOU SOME STABILITY ABOUT PRODICKING THE BUDGET, RIGHT? WE KNOW THAT RIGHT NOW, WE'RE ON A PRETTY FLAT BUDGET FOR PROBABLY A LONG-TERM, EVEN WITH OUR VERY GENEROUS 2016 BUDGET FROM THE PRESIDENT THIS WEEK TAKEN--THEY INCREASED THE BUDGET BY 3.3% OF A BILLION DOLLARS OF INCREASED PROPOSED BY THE PRESIDENT, THAT STILL IS NOT ON THE LEVEL OF DOUBLING, THAT STILL DOESN'T REALLY EVEN KEEP UP WITH THE COST OF INFLATION. SO EVEN THOUGH WE'RE AT A VERY TOUGH TIME NOW, AT LEAST CAN YOU PREDICT IT, SO WHEN YOU'RE MAKING PLANS ABOUT YOUR FUTURE, YOU KNOW GOING THERE, YOU WILL HAVE A REALLY TOUGH TIME IN THE FUTURE. THIS IS JUST ABOUT APPLICATIONS AND AGAIN WE SAW THE SAME THING, THIS IS HOW--YOU KNOW IF PEOPLE WERE COMING BACK, IF PEOPLE WERE COMPETING DID THEY ACTUALLY COME BACK, AND WE FIND AGAIN THAT THE 87 COHORT WAS LESS LIKELY TO COME BACK AND COMPETE COMPARED TO THE--TO TODAY'S COHORT AND INTERESTINGLY ENOUGH, TODAY'S CO HORDE COMES BACK MORE OFTEN TO COMPETE; WE'RE ALWAYS HOPEFUL AND HERE'S THE 97 IN HERE. SO THE OTHER THING THAT'S HAPPENING IS WE KNOW THERE'S A LOT OF CONTRIBUTING FACTORS TO THE AGE OF THE FIRST AWARD THAT WORKFORCE IS AGING OVERALL AND WHILE I USUALLY HAVE A MOVIE THAT I SHOW YOU THAT'S ALL REALLY FORDRAMA, IT SHOWS THIS--THIS MOVEMENT OF THE AGE OF THE WORKFORCE, THIS IS THE AGE AT WHICH YOU--THE AVERAGE AGE OF OUR INVESTIGATORS WHO HAVE RPGs, THOSE ARE ALL OF OUR RESEARCH BANDS AND HERE WE ARE IN 1980, THE AVERAGE AGE OF OUR INVESTIGATORS WAS 37, THE AVERAGE AGE OF OUR INVESTIGATORS NOW IS ABOUT 52, 53 YEARS OF AGE. SO THERE'S DEFINITELY BEEN A HUGE MOVEMENT ON THIS SCALE TO THE RIGHT. 10% OF OUR INVESTIGATORS, 12% OF OUR INVESTIGATORS ARE NOW AGE 66 AND OLDER, AND SO WHEN THAT HAPPENS, IF YOU'RE A PERSON THAT'S TRY TOKING TO BREAK IN AT THIS END IT BECOMES MORE DIFFICULT BECAUSE PEOPLE STAY IN PLACE LONGER, THE WORKFORCE IS AGING, NOT A LOT OF FACULTY POSITIONS OPENING UP. SO WE'RE TAKING THAT INTO ACCOUNT WE SAW MY BLOG YESTERDAY, WE ANNOUNCED THE IDEA OF AN EMERITUS AWARD AND THAT ALLOWED THOSE THAT HAVE HAD SUPPORT FROM NIH TO TRANSITION FROM NIH RESEARCH SUPPORT INTO OTHER ACTIVITIES, SO, THE IDEA IS TO ALLOW A VERY WELL ESTABLISHED INVESTIGATOR TRANSITION AND THEIR PROGRAM TO A NEW INVESTIGATOR TO ALSO ALLOW THEM TO ACCUMULATE SKILLS THAT THEY MIGHT NEED TO GO TO THE NEXT PHASE OF THEIR CAREER, WHETHER IT'S TEACHING, MENTORING, ET CETERA. SO WE WOULD LOVE TO HEAR YOUR COMMENTS ON THAT. THAT AGAIN IS ALL ABOUT THE CHURN SO A LARGE BIT OF THIS IS ABOUT THE CHURN OF THE WORKFORCE, WHO'S COME NOTHING, WHO'S GOING OUT, HOW DO WE PICK UP THIS CHURN, HOW DO WE MAKE IT MORE STABLE SO WE CAN HAVE PREDICTIONS THAT FOLLOW THESE PREDICTIONS. SO THERE'S THE NOTED NOTE. PLEASE GIVE US COMMENTS IF YOU CAN, WE WOULD LOVE TO HEAR FROM YOU TO TALK ABOUT THIS AND THINK ABOUT THIS AWARD BEFORE WE WOULD LAUNCH ANYTHING. AND THERE'S ANOTHER THING THAT WE'RE TRYING TO DO, IS WE'RE TRYING TO REALLY FOCUS ON IF WE ARE GOING TO DECREASE, SO IMAGINE ONE OF THE REASONS THAT THE IDEA OF PUTTING MORE MONEY IN NEW INVESTIGATORS, DOES NOT NECESSARILY DECREASE THE AGE IS BECAUSE YOU KNOW THAT YOU HAVE TO BE A FACULTY POSITION IN ORDER TO APPLY FOR AN RO-1 AND MOST INSTITUTIONS WILL NOT ALLOW, POST DOCS TO APPLY FOR AN RO-1. SO WE CAN PUT ALL THE MONEY WE WANT TO IN NEW INVESTIGATORS, BUT IF YOU'RE NOT A NEW INVESTIGATOR, A FACULTY MEMBER BY AN EARLIER AGE, YOU'RE NOT GOING TO BE IN A POSITION TO APPLY FOR AN RO-1. SO THE IDEA IS HOW DO WE SHRINK THIS TIME SO THAT PEOPLE ARE IN A POSITION TO BECOME FACULTY MEMBERS AT AN EARLIER AGE AND THINK BEING ALL DIFFERENT WAYS, INCLUDING THE AWARD THAT WILL HELP WITH THE TURN BUT OTHER WAYS AND WE WOULD LOVE TO HAVE COMMENTS ON THOSE AS WELL. SO THEN WE HAVE ANOTHER GROUP THAT'S LOOKING AT HOW DO WE DISTRIBUTE FUNDS, SO I'LL JUST END ON THIS. IF WE'RE IN THE BUSINESS OF CREATING IDEAS, JOHN LORSCH LIKES TO SAY SHOULD WE INVEST IN BLUE CHIPS OR DIVERSIFY OUR PORTFOLIOS. SO IF YOU'RE IN THE BUSINESS, WE'RE BUYING IDEA, WE'RE BUYING IDEAS. SO IF WE'RE BUYING IDEAS WE HAVE A LARGE CADRE OF INVESTIGATORS AND INSTITUTIONS THAT GET THE MAJORITY OF FUNDS. SO SHOULD WE THINK ABOUT WAYS TO INTRIEWBT THE FUNDS ACROSS A MORE DIVERSE GROUP OF INDIVIDUALS AND THEREFORE COLLECT MORE IDEAS? WHAT JON AND LORSCH AND OTHER VS FOUND, AND LOOK AT JEREMY BURKE WHO IS THE HEAD OF OUR GM INSTITUTE FOUND THAT LABORATORIES THAT FUNDED BY GM IF YOU MEASURE THEIR PRODUCTIVITY BASED ON PUBLICATIONS THAT THEY--THEY ACTUALLY AT THEIR FIRST AWARD ARE HIGHLY PRODUCTIVE AND AS YOU PUT MORE MONEY INTO THAT LABORATORY SO THERE'S MORE AWARDS TO THAT LABORATORY, YOU GO UP IN PRODUCTIVITY AND REACH CARE CAPACITY AND THEN FALL. SO THE QUESTION AGAIN IS HOW DO WE DISTRIBUTE THESE FUNDS THAT WILL ALLOW US TO BE EFFICIENT AND EFFECTIVE AND NOT ONLY IN THE FUNDING OF RESEARCH ACROSS THE COUNTRY BUT OF COURSE, IN GENERATING THE MOST IDEAS WE CAN HAVE. SO THAT'S A SECOND GROUP THAT WE'RE WORKING ON. AND WE'RE PROBABLY GOING TO PUT OUT A REQUEST FOR INFORMATION. THEY'LL BE LOOKING FOR THAT ON THIS DISTRIBUTION OF FUNDS. AND THERE'S MY BLOG, THIS WAS ACTUALLY A COUPLE YEARS AGO, THEY DID A FEATURE, IN NATURE ON THE BLOGGING, THE BLOG HAS BEEN AN INEDIBLE EXPERIENCE BUT I HAD TO GO INTO IT KICKING AND SCREAMING AND BECAUSE IT'S ONE OF THE FEW GOVERNMENT BLOGS THAT ALLOWS COMMENTS AND BECAUSE WE ACTUALLY ARE VERY OPEN IN TRYING TO ALLOW PEOPLE INTO THE BACK ROOMS OF NIH TO UNDERSTAND WHY WE MAKE THE DECISIONS WE MAKE BASED ON DATA, OR SCIENCE AGENCY SO WE WANT TO HAVE INFORMED DECISIONS, POLICY DECISIONSY, SO WE PUT OUT A LOT OF DATA ON THAT BLOG, PUT OUT ALL OF OUR POLICY, NEW POLICIES ON THE BLOG AND WE ACCEPT COMMENTS AND IT'S BEEN AMAZING ACCEPTING COMMENTS BECAUSE WE REALLY USE THOSE COMMENTS. AND WE'RE ONE OF THE FEW GOVERNMENT BLOGS THAT,A LOWS THEM TO COME IN BUT WE WANT THEM TO COME IN, WE PUT THEM UP UNEDITED UNLESS THERE'S SOMETHING A LITTLE DEROGATORY IN THEM, NOW. WHEN YOU WRITE A BLOG, YOU HAVE TO HAVE A HARD OUTER SHELL, BEING AN ENTOMOLOGYST THAT'S EASY TO ENVISION ABOUT ME, BECAUSE THERE'S COMMENTYOU PERSONALLY, OR YOUR ORGANIZATION OR NIH BUT NONETHELESS, THE COMMENTS ARE SO VALUABLE THAT WE DO ACCEPT ALMOST ALL COMMENTS THAT WE GET ON THE BLOG. SO TAKE A LOOK AT THAT. PAY ATTENTION TO TIT AM CANS OUT ONCE A --PAY ATTENTION TO IT, IT COMES OUT ONCE A WEEK AND PAY ATTENTION TO IT. OKAY, THAT'S IT AND I'LL BE HAPPY TO TAKE A FEW QUESTIONS. I MADE IT. I MADE IT! ALMOST 20 MINUTES. >> THIS IS GREAT AND APPLAUD ALL YOUR EFFORTS. SO I FEW THINGS I WANT TO MENTION, I LOVE THE IDEA OF THE EMERITUS AWARD, AND WE WERE TALKING ABOUT SOMETHING LIKE THIS FOR PEOPLE WHO ARE OLDER AND WANT TO STAY INVOLVED AND THE MECHANISM BY WHICH TO DO THAT, IT IS WONDERFUL SO I DECIDED TO SEE WHERE THIS GOES. I ALSO WANT TO POINT OUT A COUPLE OTHER THINGS AND THE INDIVIDUALS DEVELOPMENT PLANS AS A DIRECTOR OF THE T32, I CAN TELL YOU FIRST HAND THAT THIS IS A WONDERFUL THING. AND THIS KEEPS EVERYBODY HAPPY AND STRAY JECTORY JECTORY WELL DEFINED AND EVERYONE AS EVIDENCE, ONE THING I WILL SAY, [INDISCERNIBLE] ABOUT AND WE TALK ABOUT THIS QUITE A BIT IS THE DECREASE FROM FIVE YEARS TO [INDISCERNIBLE] AWARDS FOUR YEAR, THAT HAS CREATED A LOT OF PROBLEMS. FOR EXAMPLE WITH MINORITIES WITH WOMEN WHO ARE DURING THAT TIME HAVING CHILDREN DURING THAT PERIOD AND I CAN JUST TELL YOU FOR MY OWN EXPERIENCE, I HAVE SEVERAL STUDENT WHO IS HAVE GOTTEN THESE AWARDS AND THEY ARE ABSOLUTELY INCREDIBLY USEFUL IN GETTING JOBS. BUT I THINK IT'S A HUGE PROBLEM TAKING UP ONE EXTRA YEAR OFF, I THINK IT CERTAINLY HAS BEEN A BIG HELP IN MY EXPERIENCE AND [INDISCERNIBLE]. >> RIGHT, OKAY, THANKS. >> SO THANKS FOR YOUR TALK, IT WAS QUITE LIVELY. I HAD A FEW COMMENTS. FIRST YOU HAVE TO CONSIDER THE FACT THAT PEOPLE GO INTO AGENCY PROGRAMS ARE NOT THE SAME TODAY AS THEY WERE IN 1997, THEY GO IN WITH THE OBJECTIVE OF NOT GOING INTO SCIENCE OR NOT GOING INTO ACADEMIA, I THINK THEY'RE VERY FORWARD AND SAYING I WANT TO BECOME AN AGENT OR I WANT TO DO THIS ... AND IN MY SCHOOL, I DON'T KNOW IF ANYBODY ELSE'S SCHOOL IT'S ENCOURAGED TO THINK OF OPPORTUNITIES IN THE Ph.D., BECAUSE THE FUNDING IS QUIETER LIMITED. SO I THINK YOU'RE GOING--THERE'S A GUYS WHO ARE GRADUATING ALREADY HAVE MADE THEIR MINDS UP TO NOT DO WHAT YOU'RE ASKING. AND THEN ANOTHER POINT IS THAT, IN TERMS OF THE NEEDS OF THE WORKFORCE, WHAT IS YOUR--WHAT'S THE GOAL. THERE ARE SEVERAL LEVELS OF FUNCTIONS THAT ARE NEEDED, THERE ARE POTENTIAL POST DOCS AS I CALL THEM AND ALL OF US LOVE THEM BECAUSE THEY KEEP THE LAB RUNS AND IN EUROPE THEY USE THIS KIND IF IT'S NOT CALLED THAT BUT THEY USE THIS KIND OF SUPPORT STRUCTURE WHICH PROVIDES SOLID SUPPORT FOR THE PERSON, THEY DON'T HAVE THE STRESS OF [INDISCERNIBLE] BUT THEY LOVE THE SCIENCE AND PARTICIPATE. I MEAN FOR ME I ACCOUNTEDN'T SURVIVE--I DON'T CALL THEM THAT, RESEARCH ASSOCIATES OR WHATEVER AND THEY'RE EDUCATED, Ph.D.s ET CETERA AND I THINK YOU NOT OVER LOOK THIS VALUE BECAUSE THAT DRIVES SCIENCE IN MANY, MANY LABORATORIES, PARTICULARLY THE PHYSICIANS SCIENTISTS AND SO, THE OTHER THING IS ABOUT CREATIVITY. I HAVE NO IDEA, WHERE IT COMES FROM, AND WHEN PEOPLE HAVE IT, THEY HAVE IT AND IT NEEDS TO BE CULTIVATED AND I DONE KNOW WHEN YOU DECIDE THEY HAVE IT AND HOW CAN YOU GET THEM FROM THE POINT OF BEING SCRAMBLED ALL OVER THE PLACE, AND THEY GET A K99 AND THEY FLOP OR A KANGAROO GRANT AND THEY FLOP BECAUSE THEY DON'T KNOW HOW TO FOCUS. THE DURATION OF TRAINING, IF YOU SAY IT'S SEVEN-10 YEARS, MY GOSH, I MEAN PEOPLE CAN AFFORD BABIES IN THAT TIME, AND YET, OR MORE, AND YET--[LAUGHTER] --AND YET, HOW CAN THEY POSSIBLY FINISH AND NOT GET TIRED OF DOING THE SAME THING AND JUST SAY OH, I'M JUST SO TIRED OF THIS AND THEY WANT A JOB ASK THEY'RE NOT EVEN READY FOR IT. THEY JUST FINISHED THEIR Ph.D. AND IT'S JUST EXHAUSTION THAT COMES IN AND I THINK THAT'S WHAT BRINGS ME BACK TO THE MULTITIERED GOAL OF WHEN WE MAKE A WORKFORCE AND THIS MAY HAVE PARTICULAR APPLICATION TO MINORITY EDUCATED PEOPLE BECAUSE THEY CAN FIT IN AT MULTIPLE LEVELS AND MAYBE THAT'S--YOU KNOW THAT GETS THE NEXT GROUP GOING. YOU KNOW? I THINK THAT'S PERFECTLY--SO THAT'S EXACTLY--[INDISCERNIBLE] THIS IS SO MULTITEARED AND COMPLICATED AND IT'S NOT SOMETHING THAT NIH ALONE WILL DO. IT HAS TO DID WITH THE PARTNERSHIP WITH THE UNIVERSITIES AND WITH THE OTHER ORGANIZATIONS THAT SUPPORT TRAINEES AND POST DOC. IT REALLY CANNOT BE ALL DRIVING IT. IT'S BASICALLY ABOUT THE CONSTRUCT OF THE WHOLE WORKFORCE. ON YOUR FIRST POINT I'M SURPRISED BY THAT BECAUSE I'VE BEEN TO AT LEAST 10 DIFFERENT UNIVERSITIES IN THE PAST THREE MONTHS AND I'VE ASKED EVERY GROUP OF POST DOCS AND GRADUATE STUDENT WHAT IS THEY WANT TO DO AND ALMOST WITHOUT A HAND EVERYONE WANTS TO GO INTO ACADEMIA. THAT MIGHT BE AT YOUR INSTITUTION, AND IT'S CHANGING BUT IT'S STILL NOT REALLY THE--WHAT I BELIEVE WHAT MOST STUDENTS THINK. [SPEAKING AT ONCE ] >> WHICH MAY ARE WAY ARE YOU SAYING? >> WELL THE QUESTION IS, HOW MANY PEOPLE THINK THE STUDENTS ARE GOING IN WITH THE IDEA THAT THEY WILL NOT NECESSARILY BE RESEARCHERS AND THAT IS NOT NECESSARILY A PRIMARY GOAL. >> YOU MEAN RESEARCHERS? >> OR ACADEMICS? >> OH. >> IT'S >> INCREASING. >> [INDISCERNIBLE] OF TRAIN OUR Ph.D.. >> RIGHT THAT'S THE ABOUT THE BEST PROGRAM, IT WAS TO CODIFY THE ONE-OFF PROGRAMS THAT ARE GOING ON AT INSTITUTIONS, A MORE SYSTEMATIC APPROACH TO GIVE THEM THIS BROADENING OF TRAINING AND THEN THE OTHER ISSUE YOU HAD THE POST DOC, THE POST DOC HAS BECOME A HOLDING POSITION, RIGHT? BECAUSE THEY'RE WAITING FOR THE ACADEMIC JOBS, NOW WE SEE OFTEN TIMES THAT POST DOCS THAT ARE POST DOCS FOR A WHILE GET THEIR NAME CHANGED. THEY BECOME ASSISTANT ASSOCIATE, ADJUNCT, WHATEVER IT'S GOING TO BE FACULTY MEMBER AND IN WE DID A ENUMERATION STUDY TO LOOK AT WHAT PEOPLE--HOW MANY PEOPLE ARE IN THE BIOMEDICAL WORKFORCE, AND WE HAD 1200 CATEGORIES OF PEOPLE. 1200 CATEGORIES OF PEOPLE. AND THAT POST DOC PROFESSOR, HAD LIKE 700 DIFFERENT NAMES SOCKED WITH THAT. IT WAS UNBELIEVABLE, SO IT DOES HAPPEN, YOU KNOW PEOPLE CHANGE. NOW ONE ISSUE WE'RE LOOKING AT IN OUR EARLY EARLY INDEPENDENT IS ABOUT STAFF SCIENTIST, BECAUSE AT NIH, NIH HAS A LARGE CADRE OF STAFF SCIENTISTS, THEY'RE INDIVIDUALS WHO ARE NOT PIs IN LABS, THER NOT TENURED OR TENURED TRACK BUT THEY CAN COME IN AND MAKE A HUGE DIFFERENCE, WE HAVE MORE STAFF SCIENTIST THAN WE HAVE TENURE OR TENURE TRACK POSITIONS AND WE INTERVIEW THEM IN OUR BIOMEDICAL WORKFORCE AND THEY'RE WANT HAPPIEST PEOPLE ON EARTH AND AT A LOVE THEIR JOB, FEEL ACCOMPLISHED. LOUD INDEPENDENTS, ET CETERA, ET CETERA, IN THE UNIVERSITY SYSTEM WE SEE SCIENTISTS ESTABLISHED WITH CORE AND CENTERS AND PLACES WHERE THERE'S STABLE FUNDING SO IF YOU'RE GOING TO THINK ABOUT A NEW CATEGORY OF PEOPLE THAT YOU MIGHT BE ABLE TO SUPPORT, IN THIS STAFF SCIENTIST REALM HOW DO YOU SUPPORT THEM BECAUSE IT DEPENDS ON MORE PERM NANCY INFRASTRUCTURE AND SUPPORT, YOU WE DID MAKE MENTION OF THIS IN OUR REPORT AND WE CHANGED OUR REVIEW CRITERIA TO ASSURE REVIEWERS WERE NOT SAYING HEY, YOU'RE PAY FIGURE A COSTLY CAST SCIENTIST, YOU COULD BAY --BUY TWO POST DOCS AND A STUDENT, OR TWO STUDENTS AND A POST DOC, AND WOO THAT'S WEIGH WANT IS THEM TO THINK ABOUT THE INFRASTRUCTURE. AND THE GOALS. WHAT ARE THE GOAL? S ONE OF OUR GOAL SYSTEM THAT WE WANT TO SEE PEOPLE TO INDEPENDENCE EARLIER. WE KNOW THAT. HOW WE GET THERE, THAT'S THE BIG QUESTION. >> I'M GOING TO LET YOU MODERATE PEOPLE BECAUSE I DON'T KNOW HOW MUCH TIME WE HAVE. >> I'M INTERESTED IN THE FALL OUT, HOW MUCH TIME WE HAVE LEFT. HAVE WE STUDIED THAT POPULATION, SO THE DAT A THINK WE SHOWED WERE PEOPLE WHO FELL OUT OF THE WORKFORCE, AND THE FIRST WAS AWARD AND THE SECOND WAS THE APPLICANT. WHEN YOU COMPARE THOSE TWO POOLS DO HAVE YOU ANY INFORMATION YOU'VE BEEN ABLE TO OR STUDIED THE DETAIL TO TRY AND FIGURE OUT WHY THOSE PEOPLE WERE FALLING OFF? NYEAH, I MEAN I THINK NOW PEOPLE ARE FALLING OFF SIMPLY BECAUSE OF THE LOW SUCCESS RATE, THE CHANCES ARE GETTING FUNDING BECAUSE YOU SEE THEY APPLY AT A HIGHER RATE THAN THEY DID IN 89 SO THEY COME BACK NTHERE ARE FEWER GRANTS TO BE MADE. NOW IF YOU REALIZE WE MADE THE NUMBER NOW THAN BEFORE THE DOUBLING BECAUSE WE TO MAKE LARGER GRANTS BECAUSE OF THE COST OF RESEARCH, I THINK THAT'S PART TELEVISION. DIFFERENT PEOPLE FALL IN DIFFERENT PLACES NOW WHEN WE STUDY THE WORKFORCE AS A WHOLE, WE SEE THAT MEMBERS OF UNDERREPRESENTED GROUPS FALL OFF BETWEEN THE UNDERGRADUATE AND THE Ph.D. PROGRAM, BUT WE INTEND TO FALL OF INTO THE PPh.D. INTO THE FACULTY AND THEN EVERYBODY FALLS OFF AFTER THE FIRST GRANT. I MEAN IT JUST HAPPENS, SO WE'RE TRYING TO UNDERSTAND THAT. WE'RE LOOKING ALSO, WHAT'S CRITICAL HERE AND A LOT OF OUR I.T. DIRECTORS AND OTHERS HAVE BEEN TALKING ABOUT IS HOW WE GET SUPPORT FOR THE SECOND GRANT. IF YOU THINK ABOUT IT THEY GET TO THE FIRST GRANT AND SECOND GRANT THAT CAN TAKE THEM ON THE TRACK TO SUCCESS. SO WE'RE LOOKING AT HOW THESE INDIVIDUALS DO COMING BACK AND COMPETING, WE SEE THAT NEW INVESTIGATORS COMPETE ALMOST THE SAME AS ESTABLISHED INVESTIGATORS COMING BACK FOR RENEWAL, NOT QUITE AS HIGH BUT THEY DO COMPETE FOR THAT SECOND GROUND. >> I WOULD STATE THAT IF YOU LOOK AT ECONOMICS FOR HIRING THAT WORKFORCE, THOSE ARE THE PEOPLE THAT HAVE GOTTEN MAJOR INVESTMENTS. AND--- >> RIGHT. >> --IT WOULD BE NICE TO COME UP WITH STRATEGIES ALSO IF FIGURE OUT IF THE BEST OUT OF THAT POOL CAN BE-- >> NOW IN ONE OF OUR INSTITUTES HERE WE ACTUALLY HAVE A PROGRAM RAB THEY GIVE ADDITIONAL CREDIT TO YOUR SECOND AWARD. THEY GIVE YOU A DIFFERENT PAY LINE FOR THOSE COMING BACK FROM THEIR FIRST AWARD TO THEIR SECOND. THERE'S WAYS TO DO T. I KNOW WE'RE RUNNING OUT OF TIME. THERE'S SO MANY GREAT QUESTIONS AND COMMENTS. >> ONE MORE AND THEN WE'RE GOING TO TAKE A BREAK. >> I'LL GET YOU IN THE HALL. >> [LAUGHTER] >> I DID WANT TO COMMENT THAT I THINK THAT THAT INCREASE IN PRODUCTIVITY IN THE RO-1 IS AN EQUIVALENT AND SO THE WAY IT'S SET UP IS LIKE NEW INVESTIGATORS VERSES ESTABLISHED INVESTIGATORS AND ONE OF MY WORRYTHE PROLIFERATION OF U-ONES AND LARGE GRANTS WHERE WE DO DATA COLLECTION BUT IT HAS TO TAKE AWAY FROM THE RO-1 POOL, SO THINK BEING THOSE GRANTS AND HOW THEY'RE DEVELOPED AND KEEPING THAT IN CONTACT IS A VERY IMPORTANT ASPECT AND FUNCTION OF THE RON ONE AND WE NEED TO KEEP IN MIND AS L. >> I WON'T TELL YOU OUR PROPORTION OF RO-1S OR RPGs STAYED CONSTANT. ACTUALLY THERE'S QUITE A FEW INTUITYS HERE THAT ARE GIVING UP ON THE Ps, BECAUSE THEY FIND THAT THERE'S MORE VALUE IN JUST SUPPORTING Rs ON THEIR OWN THAN THE COMPILATION TOGETHER INTO A P. THIS YEAR WAS THE FIRST YEAR THAT WE REALLY SAW CHANGE AND THIS YEAR WHERE WE HAD A LOT OF INITIATIVES, THE BRAIN INITIATIVE, ET CETERA WHERE WE MIGHT HAVE HAD MORE Us, BUT IN GENERAL, THE PROPORTION HAVE HAD OF OUR RPGs REMAINED CONSTANT FOR NIH. >> SO I KNOW YOU GUYS HAVE ALL OF--ALL OF HAVE YOU A LOT OF QUESTIONS FOR SALLY BUT THERE'S A GREAT URGE FOR PEOPLE TO GO TO THE BATHROOM. SO WE'RE GOING TO TAKE A 10 MINUTE BREAK, COME BACK AT FIVE OF. WE'LL HAVE ENOUGH TIME FOR DISCUSSION WITH NORA, AND YOU'RE MOST WELCOME TO TALK TO SALLY AND BLOG HER. . >> GOOD MORNING EVERYBODY, THANK YOU FOR HOSTING US HERE. IT'S WONDERFUL TO SEE HOW THERE'S BEEN AN INCREASE IN THE DIRECTIONS OF BOTH OF OUR INSTITUTES AND THE MORE I SEE ABOUT IT, IN TERMS OF WHERE SCIENCE GOING IS BECOME INCREASINGLY CLEAR THAT OUR ABILITY TO INTEGRATE ACROSS DISCIPLINE SYSTEM INDISPENSABLE FOR THE SUCCESS OF SCIENCE AND KNOWLEDGE AND WHAT BETTER WAY OF KNOWLEDGE AND START TAG INTERACTION THAT ECSEATING BETWEEN THE SUBSTANCE USE DISORDERS AND ALCOHOL ABUSE DISORDERS, ALL OF WHICH BASICALLY SHARE MANY COMMON ELEMENTS. I DO ALSOMENT TO RECOGNIZE THE CONTRIBUTIONS FROM THE CANCER INSTITUTE WHO HAS ALSO FOR TOBACCO AND PRODUCTS UNFORTUNATELY, IT COULD NOT BE HERE WITH US, BUT HE HAS REPRESENTATIVES FROM AND IT'S QUITE REMARKABLE AND I WOULD HOPE THAT IN GENERAL AS WE GO FORWARD WE WOULD SLEEP APNEA AND OBESITY MORE OF THE INLET GREATED EFFORTS AND THE ENTERPRISE. I'M NOT GOING TO BE VERY MORE SPECIFICALLY DISCUSSING ON INITIATIVES THAT RELATE TO NIDA, BECAUSE I WANT TO FOCUS BASICALLY ON THE OPPORTUNITIES WE HAVE HERE ON WORKING TOGETHER IN WHAT I THINK MAY BE ONE OF THE MOST TRANSFORMATIVE PROJECT WE CAN DO TOGETHER. BUT I FIRST DO WANT TO SHOW THIS SLIDE BECAUSE GEORGE TOLD YOU I WOULD HAVE A SIMILAR SLIDE AND I DON'T WANT TO DISAPPOINT HIM BECAUSE WHEN YOU DISAPPOINT, THE DOPAMINE CELLS STOP FIRING AND THEY ACTIVATE THE [INDISCERNIBLE] THAT'S DYSPHOR GENIC BUT THE DATA HERE IS NOT VERY--WITH THE INFLATION, THE AMOUNT OF DOLLARS YOU ACQUIRE IS NOT THE SAME WHAT ALLOWS TO YOU BUY WHAT YOU WERE ABLE TO BUY IN THE PAST. SO WHAT THIS SLIDE SHOWS IN THE RED LINE, IS THE PURCHASING POWER, NORMALIZED TO 1998. AND WHAT YOU'VE SEEN IS THAT BASICALLY RIGHT NOW, FOR 2013,-2014 OUR VERSION OF IS WHAT IT WAS IN 1998. THAT MEANS THAT THE DOUBLING OF THE NIH PROJECT, WHICH ACTUALLY YOU CAN SEE, WAS BASICALLY TERMINATED IN THIS 2003, IT HAS LED US TO WHERE WE WERE IN 1998. NOW IN THE MEAN TIME THE ENTERPRISE RESEARCH HAS GROWN SIGNIFICANTLY AND AS A RESULT OF THAT, AS YOU WOULD EXPECT, SIMPLE MATHEMATICS VERY PREDICTABLE, HAVE YOU MANY MORE INVESTIGATORS APPLYING FOR GRANTS AND SINCE HAVE YOU THE SAME PURCHASING POWER THAT MEANS OF COURSE THAT YOUR SUCCESS RATE IS GOING TO GO DOWN AND UNDERSTANDING THESE DYNAMIC SYSTEM ONE OF THE THINGS THAT KEEP US ALL AWAKE AT INSTITUTES BECAUSE WE HATE THE NOTION OF LOSING CREATIVE THINKERS OR CREATIVE PROJECTS BECAUSE WE CANNOT AFFORD THEM. SO HOW ARE WE WITH OUR SUCCESS RATE AND THAT'S ACTUALLY DETERMINES WHO WILL BE GETTING A GRANT AND AS YOU CAN SEE THE SUCCESS RATES HAVE BEEN GOING DOWN AND LOOK AT THE GREATER SUCCESS RATES WE HAVE IN 201,999 AND 2000 TABOO THOUSAND ONE WHERE YOU HAD ACTUALLY THE DOUBLING OF THE NIH, SO THE NUMBER OF INVESTIGATORS AND GRANTS AND APPLICATIONS WE HAVE. THERE WERE MUCH LOWER THAN WHAT WE CURRENTLY HAVE AND THIS IS EXACTLY WHY THESE ARE LOW SUCCESS RATE, AND I THINK SOME OF THE QUESTIONS THAT [INDISCERNIBLE] BY SALLY ROCKEY IN TERMS OF WHEN WE'RE TRAINING NEW SCIENTISTS WHAT IS IT THAT WE'RE OFFERING? WHAT CAN THEY ANTICIPATE, BUT I THINK THAT THE OTHER REALITY OF WHAT WE ARE OBSERVING IS OF COURSE THE WAY WE ARE DOING SCIENCE IS CHANGING QUITE DRAMATICALLY. THAT IN THE PAST, WE WOULD BASICALLY CONCEIVE OF SCIENCE IN A LABORATORY WITH CERTAIN RESOURCES BY YOURSELF IS BECOMING EVIDENT AND IT WOULD BE LARGE DATABASES THAT ARE OPEN, SO CAN YOU EXTRACT INFORMATION AND KNOWLEDGE, IT'S DIFFERENT, IT'S NOT JUST ONE MODEL AND GENERATE THE INFRASTRUCTURE THAT WILL ALLOW US TO MAXIMIZE THE NEW WAYS IN SCIENCE IS EVOLVING AND AGAIN THIS IS WHY WE HAVE COUNCIL AND WE UP FOROT INFORMATION FOR MANY PEOPLE OUTSIDE IN THE COMMUNITY TO HELP ANTICIPATE AND BE READY BY PREPARING THE SCIENTIFIC AND NOW SCIENTISTS TO TAKE ADVANTAGE OVER THESE ADVANCES. NOW BECAUSE WE ARE IN [INDISCERNIBLE] IT'S CONTROL, TOBACCO ELICIT DRUGS, I WANTED TO SHOW THESE SLIDES BECAUSE IT'S SLIDES THAT EVEN THOUGH IT DOESN'T SHOW ALL OF THE PANNOR RAM AFRONS PRODUCING OUR COUNTRY IT SHOWS A VERY IMPORTANT PANORAMA WHICH IS THE RATE OF USE OF DRUGS AND IN THIS CASE, THE INDIVIDUALS THAT ARE ON THE 12th GRADE, AND THIS IS MONITORING FUTURE FOR 5000 KIDS THAT ARE SURVEYED IN SCHOOL EVERY SINGLE YEAR AND I'M HIGHLIGHTING THE THREE DRUGS THAT HAVE THE GREATEST IMPACT DURING THESE DEVELOPMENTAL STAGE AND AGAIN, YOU MAY SEE A SLIGHTLY DIFFERENT LANDSCAPE WHEN YOU LOOK AT OTHER AGE GROUPS BUT THIS IS AN AGE GROUP THAT S&P VERY, VERY RELEVANT AS WE KNOW ABOUT BECAUSE THIS IS WHEN YOU'RE BRAIN IS CHANGING VERY DRAMATICALLY, YOU ARE ACTUALLY BUILDING UP THE INFRASTRUCTURE OF YOUR OWN RESOURCES, THAT WILL ENABLE THEM OFTEN TO SUCCEED OR FAIL. BUT IT WILL DETERMINE MANY, TOO, OUTCOMES THAT WILL BE SOME AS YOU GROW OLDER AND YOU AGE. THE VERY GOOD NEWS, ACTUALLY I THINK THAT THESE MONITORING THE FUTURE [INDISCERNIBLE]. EXTREMELY GOOD NEWS INTO 2014 IS THAT YOU CAN SEE THE DRAMATIC DECREASES YOU SEE IN CIGARETTE SMOKING AND THAT IS ONE OF THE LARGEST CLASSES THAT WE BOTH SERVE IN THE BEHAVIOR THAT WAS THOUGHT WOULD BE VERY DIFFICULT TO CHANGE. AND WE HAVE DONE SIGNIFICANT ADVANCES ON DECREASING SMOKING AMONG THE ADULTS IN THE 60S BUT THAT TOOK MANY YEARS, LOOK AT WHAT WE'VE DONE WITH THE ADOLESCENTS WE'VE DONE MORE THAN 50% REDUCTION OF CIGARETTE SMOKING OVER A PERIOD OF 10 YEARS AND I HIGHLIGHT THIS AGAIN AND AGAIN AND AGAIN BECAUSE IT WAS NOT AUTOMATICALLY REFLECTED VERY AGGRESSIVE PREVENTION CAMPAIGN BUT IT ALSO SHOWS THAT PREVENTION CAMPAIGNS WERE WE SEE GOOD NEWS IN TERMS OF THE PREVALENCE, THIS IS A INDICATOR OF ALCOHOL USE AMONG 12th GRADER AND WE SEE THIS AND THE INDICATORS WE'VE BEEN SEEING ALL TEND TO GO IN THE RIGHT DIRECTION, NOW I DO WANT TO HIGHLIGHT WHAT GEORGE SAID IN TERMS OF THOSE DATA THEY ARE OBSERVING THAT THE AMOUNT THAT'S CONSUMED IN BINGING IS GOING ON UP AND BENGING BEHAVIOR IS ONE OF THESE MATERIALS, AND THESE PATTERNS OF VERY HEAVY DRUG USE ARE ALSO THE ONES THAT ARE ASSOCIATED WITH DROPPING OUT OF SCHOOL AND THIS IS A SURVEY THAT'S DONE IN HIGH SCHOOL STUDENTS. SO THIS SLIDE ITSELF MAY TELL US THE WHOLE STORY BUT IT DOES TELL YOU THAT A SIGNIFICANT NUMBER OF KIDS ARE NOT CONSUMING CONTROL ON A MONTHLY BASIS AND THAT THAT'S GOING DOWN, WHICH IS THE GOOD DIRECTION. OT OTHER HAND YOU CAN SEE NOW FOR ONE, TWORKS THREE, FOUR, YEARS WE'VE SEEN THIS PHENOMENA WITH THE USE OF MARIJUANA WAS MORE PREVALENT THAN CIGARETTES AND SAYS--THIS SEEMS TO HAVE STABILIZED WHETHER IT'S GOING TO GO DOWN OR UP, I MEAN IT'S WITHIN THE ERRORS OF THE MEASUREMENT BUT CERTAINLY WE'RE NOT SEEING INCREASES WE WERE PREDICTING SO THESE ARE GOOD NEWS WITH RESPECTS TO THE TWO LEGAL DRUGS THIS, IS NOT SO GOOD NEWS WITH RESPECT TO A DRUG THAT IS TRANSITIONED INTO LEGALITY. BUT THIS IS THE SCENARIO WHERE WE'RE IN THE UNITED STATES AND AGAIN IT'S AN IMPORTANT ONE FOR BOTH OF OUR INSTITUTES BECAUSE IN MARIJUANA THE OTHER THING WE'RE OBSERVING IS THAT THEY FREQUENTLY COMBINE IT WITH ALCOHOL. SO THE COMBINATION OF ALCOHOL AND MARIJUANA WE'RE SEEING THAT MULTIPLE SURVEYS THAT PREVALENCE IS GOING UP BUT I'M SURE THE MAP OF THE UNITED STATES TO ACTUALLY SHOW YOU WHERE WE ARE WITH RESPECT TO THE LOSS OF MARIJUANA IN OUR COUNTRY ASK IT'S EXTRAORDINARY DIVERSE AND THEY GO FROM THE EXTREME OF BEING FULLY LEGAL WHERE YOU CAN BUY IT AND YOU GO INTO THE STORES AND YOU SEE A WHOLE VARIETY OF PROBLEMS THAT THAT ARE DEVELOPING AND MOST OF THE DATA WE CURRENTLY HAVE IS FROM COLORADO BECAUSE IT IS THE INSTITUTE THAT COMPLETE LEGALIZATION, LONGER HISTORY OF COMPLETE LEGALIZATION, BUT ALSO PROCEEDED BY LEGALIZATION OF MEDICAL MARIJUANA. AND WHAT'S INTERESTING WHEN YOU START TO COMPARE THE STAGES OF MEDICAL MARIJUANA THERE ARE SIGNIFICANT DIFFERENCES BETWEEN THEM SO THE MEDICAL MARIJUANA LAWS IN COLORADO WERE EXTREMELY OPEN SO LIKE THEY ARE, THE MEDICAL MARIJUANA LAWS IN CALIFORNIA ARE EXTREMELY OPEN. YOU CAN GO TO [INDISCERNIBLE] WITH THOSE IDEAS AND THEN CAN YOU GET A PRESCRIPTION FOR MEDICAL MARIJUANA, FOR $40, I DIDN'T DO THAT I JUST TOOK THE PICTURE AND THEY THROUGH HE OUT. THEY WERE UPSET THAT I WAS TAKING PICTURES OF THIS ADVERTISEMENT FOR MARIJUANA FOR $40 BUT YOU CAN SEE THESE ARE NOW ASSOCIATED WITH RESEARCHERS ARE LOOKING TO HAVE THESE DIFFERENCES IN HOW YOU IMPLEMENT THESE POLICIES EFFECT COMSUMPTION. AS OPPOSE TO OTHER STATE WHERE IS LEGALIZATION OF MEDICAL MARIJUANA MAY BE ASSOCIATED TO HAVE BEEN STUDIED REGISTERED PRESCRIPTION AND AS YOU CAN SEE THAT THE RATE OF USE OF MARIJUANA IS ACTUALLY GOING DOWN. SO IT'S AN INTERESTING PHENOM THAT BECAUSE WE'RE NOT SEEING A HOMOGENIUS RESPONSE IN TERMS OF HOW FAR GOOD THESE INFLUENCE THE PREVALENCE RATE OF MARIJUANA CONSUMPLEGZ IN THAT PARTICULAR STATE AND DO THEY INFLUENCE THE PREVALENCE OF MARIJUANA USE AMONG TEENAGERS, WHICH ACTUALLY OF COURSE WERE THE ONES THAT WE'RE MOST CONCERNED BECAUSE THEY ARE THE ONES THAT ARE MORE LIKELY TO SUFFER FROM ADVERSE EFFECTS OF DRUG SAFETY. AND SO NOT EVERYTHING IS THE SAME AND AGAIN, HIGHLIGHTING THE IMPORTANT TO UNDERSTAND HOW THESE LAWS ARE GOING TO BE INFERENCING PATTERNS OF DRUG COMSUMPTION AND A NORMAL PATTERN THAT AGAIN, WHY SO IMPORTANT TO INTEGRATE THE EFFORTS ARE THAT IF YOU ARE IF YOU LEGALIZE AND MARIJUANA IS ONE OF THE QUESTIONS AND THEY SAY OH WE SHOULD LEGALIZE, LEGALIZE BECAUSE THEN DRINKING BEHAVIOR WILL GO DOWN. NOW, AGAIN, WHAT WILL HAPPEN IS SOMETHING THAT THE DATA WILL TELL, THE DATA FROM COLORADO AND IT'S TELLING US THAT THE INDICATORS ARE NOT GOING IN A GOOD DIRECTION. WE'RE SEEING AN INCREASE BY VERY SIGNIFICANT ACTUALLY LETHALITY AND ASSOCIATE WIDE MARIJUANA OR COMBINATION OF MARIJUANA WITH ALCOHOL. WE'RE SEEING SIGNIFICANT DROP OUTS FROM SCHOOL ASSOCIATED WITH MARIJUANA AND WE'RE SEEING ALSO CRIME GOING UP. NOW, THESE MAY REFLECT THE FACT THAT THIS IS A STATE THAT WAS NOT PREPARED, YOU CAN MAKE WHICHEVER ARGUMENT YOU CAN MAKE BUT WE NEED TO BE PREPARED AS SCIENTIFIC RESEARCH ORGANIZATIONS TO UNDERSTAND THEM, SO WE CAN EXTRACT THE CONSEQUENCES OF ONE POLICY VERSES THE OTHER THAT CAN BE OBJECTIVELY MEASURED IN A WAY THAT HOPEFULLY THAT WILL GUIDE IN THE FUTURE POLICY AND NOT JUST IN THE UNITED STATES, BUT THESE MOVEMENT ABOUT LEGALIZATION OF THE UNITED STATES IS DISPURSING GLOBALLY AND YOU NOW SEE MANY, MANY COUNTRY FACING THIS DIALOGUE ABOUT WHETHER THEY SHOULD LEGALIZE MARIJUANA OR NOT. NOW WHAT HAVE WE BEEN OBSERVING AND WE OF COURSE NORM INFLUENCE ENORMOUSLY THE LIKELIHOOD YOU WILL TAKE DRUGS NOR THE AND IN TEENAGERS FOR EXAMPLE, ONE OF THE PREDICTORS IS NOT JUST HOW EASY AVAILABLE THAT DRUG IS BUT WHETHER YOU HAVE THE PERCEPTION, THE OTHER KIDS IN SCHOOLS ARE TAKING THE DRUG, SO IF YOU BELIEVE THAT OTHERS ARE TAKING THE DRUG AND THIS IS ALSO TRUE, THEY'RE MUCH MORE LIKELY TO TAKE THEM SO IF YOU BELIEVE THAT MARIJUANA IS GOOD AND GROOVY AND IMPROVES WITH EVERYTHING WITH MARIJUANA THEN YOU'RE LIKELY TO TAKE IT. NOW WE HAVE SEEN IPT GREATER CREASES IN MARIJUANA BUT I WANT TO KNOW SOMETHING, I'M SHOWING YOU DATA ON REGULAR MARIJUANA USE, REGULAR MARIJUANA USE, BASICALLY ALMOST EVERY DAY MARIJUANA USE AND IT'S THE ONE THAT'S MOST CONCERNED. BASED ON THE MONITORING THE FUTURE WHICH IS DAT ATHESE DATA HERE, DAILY USE IS APPROXIMATELY SIX%. AND THESE ARE KIDS IN SCHOOL. NOW FROM THE HIGH SCHOOL SURVEY, THE SAMSA SURVEY, YOU ARE SIGHING HIGHER NUMBERS BECAUSE WE'RE--SEEING HIGHER NUMBERS BECAUSE YOU'RE SEEING AGE 12 AND OLDER AND THEY RELATE TO EVERY DAY USE, SO THE NUMBERS ARE VERY HIGH, WE SEE EXACTLY THE SAME PHENOMENA AS MORE--AS LESS KIDS PERCEIVE THAT THERE'S A RISK OF REGULAR MARIJUANA, MORE KIDS UTILIZE SO RISK OF EFFECT AND INFLUENCE BEHAVIORS ARE TAKING. SO AMIDST ALL THESE CHANGES THAT ARE HAPPENING IN TERMS OF LAWS REGARDING DRUGS. PEOPLE COME TO US ANDYeSAY IS MARIJUANA HARMFUL? JUST LIKE IS ALCOHOL HARMFUL? IS TOBACCO HARMFUL? WELL WE KNOW THEY'RE GENERALLY HARMFUL IN MEDICAL TURNS AND ACCIDENTS AND DEATH AND MORTALITY. WE KNOW THAT. WE KNOW THAT BASICALLY, THE NUMBER ONE REASON OF MORTALITY AMONG DRUNK PEOPLE RELATES TO DRUG USE, NOT FOR ADDICTION NECESSARILY BUT THEY GET INTOXICATED AND THEY DRIVE AND THEY DRIVE INTOXICATED AND THEY GET IN AN ACCIDENT, SO ACCIDENTS DRIVE THE MORTALITY OF TEENAGERS. WHAT ABOUT THE BRAIN? SO THAT IS NOT TELEVISION TO CONVINCE WHY WE NEED BETTER STRATEGY TO PREVENT USE OF THESE DRUGS AMONG TEENAGERS IS THE EFFECT OF THE BRAIN FUNCTION AND HAS THIS BEEN A LOT OF WORK OF COURSE WITH ALCOHOL, THERE'S BEEN VERY LITTLE WORK WITH RESPECT TO TO BACK O, SURPRISINGLY THERE'S VERY, VERY LITTLE WORK IN TERMS OF THOSE TOBACCO NEGATIVELY INFLUENCE THE BRAIN DEVELOPMENT AND THERE'S ALSO LIMITED WORK WITH RESPECT TO MARIJUANA INFLUENCE, THE TRAJECTORY OF BRAIN DEVELOPMENT AND THAT PUTS US IN A VERY, VERY AWKWARD POSITION BECAUSE WE NEED TO ACTUALLY GO AND SAY, I BELIEVE THAT IT'S HARMFUL TO SHOWING OBJECTIVE DATA ABOUT HOW THESE DRUGS CAN BE HARMFUL. NOW THIS IS A PAPER THAT I WANT TO HIGHLIGHT BECAUSE IT ACTUALLY PUTS THOSE EXACTLY IN THE BIND THAT WE ARE. WE DO HAVE MANY STUDIES THAT SHOW THAT EXPOSURE TO MARIJUANA AND I WILL FOCUS ON ADOLESCENCE AND IT'S HARMFUL AND MANY OF THEM RELATE ON NEUROPSYCHOLOGICAL PATHS AND COGNITION, MANY OF THEM RELATE TO--AS YOU KNOW, THERE'S BEEN STORIES THAT HAVE SHOWN A SIGNIFICANT DECLINE IN O GENICNITIVE FUNCTION AND MARIJUANA EVEN AFTER CONTROLLING FOR BASELINE PREEXPOSURE MEASURES. BUT THERE'S ALSO STUDIES THAT SHOW NO CHANGES. NOW THE SAME THING IS HAPPENING WHEN IT COMES TO BRAIN IMAGING AND BRAIN IMAGING HAS OPENED UP A NEW WAY OF MORE DIRECTLY AND PERHAPS WITH GREATER SENSITIVITY, TRY TO UNDERSTAND HOW DRUGS INFLUENCE THE SYSTEM OR ALL THESE STUDIES RESPONSIBLE FOR OUR BEHAVIORS AND WHO WE ARE. SO THIS IS A DATA, IT'S A PAPER THAT WAS JUST PUBLISHED ONE OR WOWEEKS AGO AT THE JOURNAL OF NEUROSCIENCE IN WHICH THEY ACTUALLY ARE MEASURING THE MORPH LOGICAL CHANGES OF BRAIN [INDISCERNIBLE] CHANGES OR AN AREA THAT HAVE BEEN MOST FREQUENTLY ASSOCIATE WIDE CHANGE WHEN IS PEOPLE TAKE MARIJUANA AND THOSE RELATE TO THE AMYGDALA, THE HYPEY CAMPUS, AND TO A LESSER EXTENT, IN TERMS OF MONITORROLOGY, THE NUCLEUS SER CUMBENT AND THE CEREBELLUM SO THERE'S A HIGH DENSITY OF CANNABINOIDS IN THE CEREBELLUM AND THE HYPOCAMPUS WHICH MAKES THEM TARGET FOR THE NEGATIVE EFFECTS AND OVER ALL STORIES HAVE SHOWN THAT CHRONIC EXPOSURE TO MARIJUANA RESULT IN DECREASED VOLUMES IN AMYGDALA AND HYPOCAMPUS AND ABNORMALITIES IN CEREBELLUM FUNCTION. THIS IS A WELL KNOWN STUDY IN TERMS OF MET BULGES AND RELATE TO STRUCTURES--BUT THEY ALSO STORIES OF ADOLESCENCES NEVER EXPOSE INDEED ADOLESCENCES THAT ARE REGULARLY EXPOOEDED SO WHAT YOU SEE IS THE CURRENT STORY, SO THEY ACTUALLY, THE SEROEFFECT AND SO FOR ALL OF THE BRAIN STRUCTURES THEY WERE UNABLE TO SEE DIFFERENCES IN BRAIN MORPHOLOGY, BETWEEN THOSE THAT WERE REGULAR MARIJUANA USERS AND NOT, AND THEN THEY BASICALLY DISDISPLAYED THE DATA FOR OTHER STORIES AND ILLUSTRATE THAT SOME STUDIES SHOW BIG CHANGES AND DECREASE IN VOLUME WHERE OTHERS SHOW INCREASE IN VOLUME INDICATING REALLY IF YOU LOOK AT THE DATA IN A CRITICAL WAY, THAT AT THIS POINT WE DON'T HAVE A CLEAR ANSWER IF SOMEONE WERE TO ASK ME IN TERMS OF METABIOLOGY, WHAT WOULD YOU SAY? I SAY FIRST OF ALL IT TELLS ME THERE'S TREMENDOUS VARIABILITY IN THE EFFECTS OF MARIJUANA, THIS INDEPENDENT LABORATORY BUT ALSO LIKE TEE TO REFLECT IN FACT THE TREMENDOUS DIVERSITY I THINK WITH WE FIND TO EVALUATE THE EFFECTS OF DRUGS IN TEENAGERS, AND LIKE WE HAVE SEEN FOR CANCER, SOME WILL BE MUCH MORE SENSITIVE TO THAT DISRUPTIVE EFFECTS OF THAT DRUG DURING ADOLESCENT THAN THIS OTHERS. AND I WAS THINK BEING WHAT GEORGE WAS PRESENTING WITH RESPECT TO THE EVIDENCE THAT EVIDENCE OF ALCOHOL EXPOSURE WAS INTERFERING WITH MALINNATION OF THE WHITE MATTER IN THE HUMAN BRAIN AND THE RECOGNITION FOR EXAMPLE THAT THERE ARE CERTAIN GENES WHO POLYMORPHISMS IS ASSOCIATE WIDE DIFFERENT SENSITIVITY TO THE ALIENATION AS WE GROW OLDER AND AGAIN JUST TO ILLUSTRATE HOW DIFFERENCES IN GENETIC BACKGROUNDS ARE LIVELY TO UNDERLINE THOSE CHANGEs AS WELL AS THE COMBINATION OF DRUGS BECAUSE WHAT THIS PARTICULAR STUDY THAT SHOW NO EFFECT ON DRUG REGULAR MARIJUANA USE THAT IN A MORE CONTROL FASHION THAN THE OTHER STUDIES WAS TO CONTROL FOR CONTROL COMSUMPTION, INDKAYING THAT IT SUGGESTED HAD OF--SUGGESTING THAT THE INTERACTION OF ALCOHOL WITH MARIJUANA MAY BE [INDISCERNIBLE] A LOT OF PRIOR FINDINGS OF DECREASES IN VOLUMES AMYGDALA HYPEY CAMPUS AGAIN HIGHLIGHTING WHY WE CANNOT LOOK AT THIS DRUGS IN ISOLATION. AND JUST HIGHLIGHTING THESE CONSORTIUM DATA THAT INDICATES THE DEVELOPMENTAL TRAJECTORIES, THIS CROSS OVER DESIGN, BUT I'M ACTUALLY SHOWING THAT THEY SEE DEFICIENCYS ON NICKEE TEEN EXPOSURE BETWEEN MALES AND FEMALES, THEY'RE ONLY SEEING A DIFFERENCE IN FEMALES IF IT RELATES TO THE GLOBAL VOLUME, NOW I'M NOT SHOWINGS YOU FOR A FINDING LIKE THAT, I THINK THAT ONE OF THE THINGS THAT WE NEED TO RECOGNIZE IN JUST SHOWING YOU THIS SLIDE BEFORE, IS A I REPRODUCIBILITY AND ROBUSTNESS OF FINDING, WHAT I SHOW IN THESE SLIDE SYSTEM FOR YOU TO SLEY THE TREMENDOUS VARIABILITY THAT WE ARE OBSERVING ACROSS INDIVIDUALS WHICH AGAIN HIGHLIGHTS THE POINT THAT WAS ASKED BEFORE, SHOULD WE BE GETTING BRAIN IMAGING SCAN TO DETERMINE IF SOMEONE HAS AN ABNORMALITY OR NOT, SO WE NEED TO UNDERSTAND WHAT IS DRIVING THIS TREMENDOUSLY ENDENDOUS VARIABILITY AND ALSO NOTICING THAT THE DATA THAT WAS GEORGE WAS PRESENT NOTHING TERMS OF DEVELOPMENTAL STRAY JECTORY JECTORIES THAT THERE WERE SOME INDIVIDUALS THAT HAD BASICALLY VERY, VERY POOR DEVELOPMENT REGARDLESS OF AGE AND BASICALLY NORMAL INDIVIDUALS IN WHOM ACTUALLY THE PREFRONTAL CORTEX, THE CONNECTIVITY REMAINS ACTUALLY AT A MUCH LOWER DEVELOPMENT OF STAGE THAN OTHERS. THIS IS ABNORMAL OR PART OF THIS VARIABILITY AND WITHOUT UNDERSTANDING THAT, WE MAY BE SMART SOG IMPROPERTILY CATEGORIZE THE INDIVIDUALS WHICH OF COURSE BASICALLY LIVING IN A VERY GENTLE WAY TO THE NOTION ABOUT WHY THIS STORY IS ONE THAT WE HAVE UP ASAUR MAIN INITIATIVE AS OUR ACTIVITIES AND THE ABILITY TO CONSULT THE PERSPECTIVE STORY AND EVALUATE THE INDIVIDUAL WEP DEVELOPMENT OF AND IN TRANSITION FROM CHILDHOOD TO ADULTHOOD WHICH IS A TRANSITION THAT IS ONE OF GREAT DEGREE OF SUBSTANCES, IT'S ALSO A TRANSITION WHERE MANY OF THE MENTAL ILLNESSES EMERGE GIVING THE OPPORTUNITY IF THEY'RE DOING BY SUCH A PROSPECTIVE STUDY AND SEEING THE STATE-OF-THE-ART IMAGING TECHNOLOGY TO BE ABLE TO FINDALLY UNDERSTAND BETTER WHAT'S AN INTERACTION BETWEEN DRUG TAKING AND THE EMERGENCE OF MENTAL ILINESS, WHAT IS THE INTERACTION BETWEEN THE USE OF MULTIPLE DRUGS? AND WHAT IS ULTIMATELY THOSE TRAJECTORIES TELLING US ABOUT HOW ULTIMATELY OUR BRAIN WILL WORK, HOW DO GENES INFLUENCE THOSE TRAJECTORIES. SO THIS IS PART OF A LARGE PROPOSAL THAT WE ARE REQUESTING? AND RECENTLY ALAN GUTMACHER SAID COUNT ME IN THIS IS IMPORTANT FOR OUR INSTITUTE SO THE FIRST DEVELOPMENT OF THE PROJECT WAS DONE JOINTLY BETWEEN THE THREE INSTITUTES THAT ARE PART OF THE [INDISCERNIBLE] AT NICHD, AND THEN [INDISCERNIBLE], GEORGE WAS MENTIONING, BOTH THE NATIONAL INSTITUTES OF MENTAL HEALTH, NATIONAL INSTITUTE EVER NEUROLOGICAL DISEASES AND STROKE HAVE JOINED IN AND IN ADDITION, NIMHD, WHICH IS THE NATIONAL INSTITUTE ON MINORITY AND HEALTH DISPARITIES AND THE OFFICE OF OBSSR CHRKS DEALS WITH BEHAVIORIAL AND SOCIAL SCIENCES RESEARCH HAS ALSO BEEN INTERESTED IN JOINING AND THE NATIONAL INSTITUTE ON ENVIRONMENTAL SCIENCES THAT EXPRESS INTEREST IN JOINING IN THIS PARTICULAR STORY. SO WHAT IS IT PRO POSING AND HOW HAVE WE GONE ABOUT IT. SO I'VE GIVEN PRELIMINARY UPDATES SO I THINK IT'S IMPORTANT THAT YOU GET [INDISCERNIBLE] WHERE WE ARE. WE HAD OUR FIRST SCIENTIFIC ADVISORY MEETING ON PAY 27th-28 TO HELP US DELINEATE THE MAIN ISSUES THAT SUCH A STUDY WOULD NEED TOO ADDRESS OR JUST POWERICIZE OR EMERGING METHODOLOGIES. VERY SUCCESSFUL MEETING AND BASED ON THAT WE RELEASE IT TO SOLICIT INPUT FROM THE SCIENTIFIC COMMUNITYOT PROPOSED STUDY AND THE MEASURES AND WE GO MANY, MANY VERY GOOD SUGGESTIONS, BOTH FROM INDIVIDUALS AS WELL AS ORGANIZATION AND THIS WAS RUN BETWEEN JUNE AND AUGUST. AND THEN, WE SUMMARIZE THOSE FINDINGS AND WE HAVE SATELLITES SYMPOSIUM AS PART OF THE SOCIETY FOR NEUROSCIENCE AND SO I ALLOW THE MEMBERS TO COMMEND THEM ON THIS ISSUE AND BASED ON THAT WE HAD AN INTENT TO PUBLISH ON WHICH WAS JANUARY 2015 AND YOU HAVE THE UPDATE WHERE IS YOU CAN GO AND LOOK AT WHERE WE ARE. SO WHAT IS THE BASIC SKELETON OF SUCH A STORY? TO ACTUALLY FOLLOW 10,000 KIDS BEGINNING AGE NINE OR 10. ONE OF THE VERY CONSISTENT MESSAGES THAT WE GO FROM THE SCIENTIFIC ADVISORY GROUPS AND THEN TO COMMENCE AND INITIATE BETWEEN PUBERTY IF POSSIBLE AT ALL AND WE WANT TO DO IT IN A COHORT THAT IS RECRUITED OVER A RELATIVELY SHORT PERIOD OF TIME, SAY TWO YEARS, AT THE MOST THREE YEARS. AND THEN TO FOLLOW THEM AT LEAST FOR 10 YEARS, PERIODICALLY, EXACTLY WHAT THE TIME OF THE IMAGING COMPONENT SHOULD BE, WELL IS A LITTLE BIT OF DISAGREEMENT AS YOU MAY IMAGINE, BUT IT IS MORE OR LESS SAYING, EVERY TWO YEARS, VERY SPECIFIC IN TERMS OF IMAGING PROTOCOL RELATE TO THOSE--THOSE STRATEGIES THAT CAN BE REPRODUCED BY INDEPENDENT LABORATORIES THAT ARE VERY SOLID SO THAT MEANS MORPHOLOGY STRUCTURE, DEFICIENT IMAGING WHICH WILL ALLOW TO YOU LOOK AT AN ATOMICAL CONNECTIVITY OF BRAIN, VERY IMPORTANT DURING THIS TRANSITION AND FINALLY RESTING FUNCTIONAL CONNECTIVITY WHICH WILL GIVE YOU THE FUNCTIONAL CONNECTIVITY OF HOW THE BRAIN ESTABLISHES A DIALOGUE BETWEEN ONE AREA AND THE OTHER. THEY ALSO VERY MUCH ENCOURAGE US TO LEAVE US FLEXIBILITY FOR A NEW ADVANCES TO BE INCORPORATED AS THE PROJECT GOES ON. 10 YEAR SYSTEM A LONG TIME AND DEVELOPED TECHNOLOGIES ARE DEVELOPING VERY, VERY RAPIDLY SO WE DON'T WANT TO BE GENERATING A STORY THAT'S ITSELF WILL [INDISCERNIBLE]. SO THAT WAS ONE OF THE THINGS THAT THEY WERE VERY ADAM ANT ABOUT, ALSO THE OTHER VERY IMPORTANT--AGAIN THE PHENOTYPICAL CHARACTERIZATION, AND PHENOTYPICAL CHARACTERIZATION, CAN YOU DO AN ELEGANT STUDY, ON THE EPIDEGENETIC AND YOU DO NOT HAVE AN PHENOTYPICAL CHARACTERIZATION, YOU WILL HAVE A DIFFICULTY UNDERSTAND WAG THE SIGNIFICANCE OF THESE CHANGES HAVE IN TERMS OFY HAIR AND THAT IS ANOTHER ASPECT, AND MANY OPPORTUNITIES OF DOING RESEARCH AND NOT JUST IN TERMS OF UNDERSTANDING WHAT GENES ARE INVOLVED IN THE INDIVIDUAL BRAIN DEVELOPMENT BUT ALSO ON EPIGENETIC MODIFICATIONS. AND WHAT WE ARE IN, AT THE END OF THE DAY BEING ABLE TO ANSWER THESE QUESTIONS. HOW DO DRUGS BY THEMSELVES AND INTERACTIONS INFLUENCE THESE TRAJECTORIES IN A REAL SETTING. KIDS ARE GOING TO BE KIDS, THEY'RE GOING TO GET INTO SITUATIONS OF DANGER AND THEY'RE GOING TO BE EXPOSED TO MULTIPLE DRUGS, SOME OF THEM MAY HAVE CONFUSION, AND WE WILL BE ABLE TO FOLLOW THEM THROUGH AND UNDERSTAND BETTER WITH TECHNOLOGY THAT ARE NOW ACCESSIBLE AND QUITE REPRODUCIBLE TO UNDERSTAND BETTER HEALTH INFLUENCES AND HOW THAT INFLUENCES THE HUMAN BRAIN. THESE ARE DETAILS IN TERMS OF THE NOTICE INTENT TO PUBLISH A FUNDING OPPORTUNITY. WE HAVE BEEN XREAMLY AGGRESSIVE AND I DO WANT TO THANK--EXTREMELY AGGRESSIVE AND I WANT TO THANK SUSAN WISE WHO'S BEEN RELENTLESS AND I HAVE TO GIVE HER PSYCHOTHERAPY ALMOST ON A DAILY BASIS BECAUSE SHE'S REALLY PUSHING AND SWIMMING AGAINST THE CURRENT TO TRY TO MOVE THESE AS RAPIDLY AS POSSIBLE. [INDISCERNIBLE] BURWELL WHEN SHE CAME TO THE NIH AND SHE MADE SOME COMMENTS, AND ONE STUCK IN MY BRAIN AND WHEN THEY ASKED HER WHAT ARE SOME OF THE CHALLENGES AND SHE SAID: WE HAVE VERY LITTLE TIME. I COUNT THE DAYS, ONE YEAR, ONE MONTH. WE HAVE VERY LITTLE TIME. SO THERE'S AN URIGENCE TOW GET THIS DATA OUT AND THAT'S WHY I COME AND I KEEP ON--SUSAN DOESN'T NEED ANY PRESSURE. BUT WHY I GIVE HER PSYCHOTHERAPY. WE NEED TO MOVE. THERE IS AN URGENCY TO UNDERSTAND BETTER. WE CANNOT STOP IN TERMS OF OH, THE NECKATOLOGYS WILL BE BETTER FIVE YEARS FOR NOW. THEY WILL BE BETTER FIVE YEARS FROM YOU NOW BUT WE HAVE VERY, VERY GOOD TOOLS RIGHT NOW AND IT'S OUR RESPONSIBILITY TO PROVIDE THIS INFORMATION. THIS INFORMATION VALUABLE FOR SCIENCE IN GENERAL, FOR ADVANCING KNOWLEDGE AND PROVIDE FOR INFORMATION THAT WILL HELP AND PREVENTION AND PREVENTION MESSAGES THAT ARE BASED ON DATA AND NOT SUBJECTIVE PERCEPTIONS. AND THE FINAL STATEMENT THAT I WANT TO MAKE IS I DO WANT TO INVOLVE EVERYONE IN SORT OF [INDISCERNIBLE] TO THE COUNCIL OF NIDA, BUT THE CERTAINLY THE COUNCIL OF THE ALCOHOL, IS WE'RE WORKING ON THE NIDA STRATEGIC PLAN. WE HAVE THE URGENCY OF THE LIMITED TIME THAT WE HAVE IN ORDER TO MOVE THINGS BUT WE ALSO HAVE A FAST MOVING SCIENTIFIC LANDSCAPE, TECHNOLOGIES, ADVANCES, KNOWLEDGE, WE DO THINGS AND CHANGING RAPIDLY. AND OUR RESPONSIBILITY AS AGENCY IS THORS INSURE THAT WE INVEST TAE MONEY IN WAYS THAT ARE NOT WASTED. INVEST THE MONEY TO MAXIMIZE OUTPUT, KNOWLEDGE AND ON THE ONE SIDE, PROCURE KNOWLEDGE BASIS BECAUSE THAT WILL PROVIDE A SOLUTION THAT WE CANNOT EVEN THINK ABOUT BUT ALSO THE OPPORTUNITY TO GET TRANSLATION INTO PRODUCTS THAT CAN HELP THOSE THAT ARE AFFLICTED IN OUR CASE BY SUBSTANTIAL DISORDER AND THEN THE ONES THAT WILL COME OUT OF THAT INTERACTION BETWEEN KNOWLEDGE BY CELL AND THE OPPORTUNITY THAT COME AROUND FOR THEIR OBLIGATION. HOW DO WE DO THAT? AND WE'RE IN THE PROCESS OF COMING UP WITH THAT PLAN, THIS IS A LIST OF MECHANISMS AND THIS KEEPS ME AWAKE AT NIGHT AND IT'S NOT GOOD TO NOT HAVE YOUR BRAIN SLEEP BECAUSE THEN YOU CANNOT [INDISCERNIBLE] AND NOW IT'S ASSOCIATE WIDE DEMENTIA. I DON'T LIKE TO BE KEPT AWAKE AT NIGHT BUT THESE ARE THE THINGS, LEVERAGING NEW TECHNOLOGIES, WE HAVE MAJOR BRAIN INITIATIVE AND THE BRAIN INITIATIVE IS DEVELOPING TOOLS AND IT BEHOOVES US TO TAKE ADVANTAGE OF THOSE TO APPLY THEM AND IN THE TOX USE COMMUNITY AND JOBS RELEASED BY OBAMA AND ALSO WHO SAYS TO TAKE ADVANTAGE OF THAT TECHNOLOGY, YOU WANT TO CALL TECHNOLOGIES AND CHANGING THE WAY THAT OBSTRUCT YEVERGZ AND WE NEED TO MAKE SURE WE TAKEAD ANTAGE OF THAT AND ACCESS TO DATA SETS THAT ARE OPEN AND ACCESSIBLE TO EVERYBODY THAT'S ACTUALLY MAKING ASK CHANGING THE WAY THAT WE EXTRACT KNOWLEDGE, BUT THAT WILL REQUIRE NEW SCIENTISTS THAT ARE TRAINED IN DIFFERENT WAYS. THAT'S CHANGING LANDSCAPE OF SUBSTANTIAL DISORDERS, NOT JUST MY ONE APOLOGIES THAT ARE TURNING US UP SIDE DOWN BUT ALSO ABOUT HEALTHCARE REFORM, WE HAVE THE OPPORTUNITY HEALTHCARE REFORM TO ADDRESS PROBLEM OF SUBSTANTIAL DISORDERS, BOTH FOR PREVENTION AND TREATMENT, CIGARETTES AS DRUG DELIVERIES THIS IS A NEW TECHNOLOGY, THIS IS--WE DON'T UNDERSTAND IT POSITIVELY WE LOSE TAKING ADVANTAGE OF THAT, BUT WE MAY ALSO LOSE THE DEMONSTRATION OF OTHER DRUGS IN WAYS THAT COULD BE BENEFICIAL. SO HOW DO WE TAKE THIS KNOWLEDGE? HOW DO WE TRANSLATE? HOW DO WE TRAIN THE NEXT GENERATION OF SCIENTIST? S AND THESE ARE THE SAME QUESTIONS WHETHER IT IS NIDA, ALCOHOL, NIMH, NINDS, THESE ARE ALL THE QUESTIONS THAT WE AS SCIENTISTS ARE FACING SO SO AGAIN, HOW DO WE ANTICIPATE AND PREDICT WHEN WE'RE GETTING INTO A FIELD AND ARENA WHERE THERE'S NOT A PRECEDENT. WE'RE GOING INTO NEW ARENA SO WE THEY'D TO BE VERY OPEN, CREATE AND I HAVE USUALLY FLEXIBLE BY HOW WE MOVE FORWARD. AND AS A RESULT OF THAT, WHAT WE'RE DOING FOR OUR STRATEGIC PLAN IS OPENING IT UP AS BROADLY AS POSSIBLE TO GET IT. AND NEITHER STAFF ADVISORY COUNCILS AND I'M BRINGING IT UP ABOUT THE 96 NIAA, ADVISORY COUNCIL, CONSUMER GROUPS AND OTHERS, WE'RE TRYING TO BE AS CREATIVE AS WE CAN IN ORDER TO GET INPUT, ALSO FROM THOSE THAT MAY NOT NECESSARILY BE STATISTICIAN BUT COULD BRING CONCEPT BISE USING CHALLENGING [INDISCERNIBLE] WE'RE USING RFIs, WE'RE CREATING GROUPS OUR GOOD Y SIDE TO HAVE THE PLAN BY THE FALL OF 2015 AND WE CAN OBVIOUSLY UNDERSTAND THAT THESE WILL BE ALLEVING DOCUMENTS THAT WHERE THE COUNCIL WHO EXPECT THE COUNCIL TO BE VERY ACTIVELY INVOLVED AS WE MOVE FORWARD WITH THIS. THIS IS THE JUST THE DATES AND WE WANT TO USE IT TO END MY PRESENTATION BUT I WANT TO MAKE A COMMENT BECAUSE I WAS THINKING ABOUT WHAT GEORGE WAS SAYING AND SAY, I SAY FOR THOSE OF YOU THAT ARE NOT [INDISCERNIBLE] EXPERTS, HE SAID--AT EXPERTS AND IT'S TWO WEEKS AND I THOUGHT COULD YOU IMAGINE WHAT IT WOULD BE IF OUR KIDS ADOLESCENCE OF TWO WEEKS, MAYBE OUR PROBLEMS WOULD BE SOLVED, FOR THOSE RISKY ABOUT HAIRS, PATTERNS OF--BEHAVIORS AND PATTEDERNS OF DRUGS AND KIDS ARE GOING TO TAKE RISKS AND HAVE CONSEQUENCES AND DEVELOP AN INTERVENTION THAT WILL BE GOOD FOR DOING SO AND THE BEST TOOLS WE HAVE IS SCIENCE AND KNOWLEDGE AND THAT'S WHAT WE'RE HERE FOR SO THANKS IT ARE MUCH FOR YOUR ATTENTION. DID. >> SO WE'RE NOW OPEN FOR QUESTIONS. >> I WANT TO APPLAUD YOUR LONGITUDIAL ADOLESCENT STUDY BECAUSE REALLY ADOLESCENCE IS POORLY DEFINED AND AND SOME PEOPLE THINK THAT RAT ADOLESCENCE MIGHT BE THREE WEEKS, YOU KNOW? AND DID YOU LOOK AT RATS IN THE FIRST WEEKS OF LIFE, WE CAN MAP THEM TO THE HUMAN BRAIN STRUCTURE AND THEN SAY AT THE AGE OF RAT IS THIS AND THIS AGE OF THE FETAL HUMAN BY THE STRUCTURE OF THE BRAIN AFTER THE FIRST SEVEN POSTNATAL DAYS OF A RAT, WE DON'T HAVE A MARKER AND IF YOU THINK ABOUT IT, THE MARKERS, I MEAN MOST OF US COULD RECOGNIZE AN ADOLESCENT IN THE ROOM, BUT MANY OF THOSE WOULD SAY NO I'M NOT AN ADOLESCENT, I'M AN ADULT, RIGHT? SO REALLY THEY HAVE MARKERS OF AGE, DIFFERENT FROM AGE, IN FACT BECAUSE PUBERTY IS IN A DIFFERENT AGE AND DIFFERENT PLACES, ALL KINDS OF THINGS ARE CHANGING TO LONGITUDINALLY BE ABLE TO MAP HOW THINGS CHANGE TOGETHER WOULD ALLOW US TO SAY IN HUMANS WHY CAN SEE THESE THINGS WHAT AGES OF ANIMALS CAN WE USE FOR MODELS, THESE ARE REALLY, REALLY VALUABLE TO CREATE THE--TO BETTER DEFINE TO DEVELOPMENTAL STAGE OF ADOLESCENCE. >> [INDISCERNIBLE]--JUST WATCHING IT ON THE POLL EXACTLY HOW IMPORTANT IT IS AND AGAIN, YEAH, ABILITY TO ASK QUESTIONS THAT WE REALLY HAVEN'T ASKED BEFORE AND JUST THE BRAINS ARE ASSOCIATED ALL THE TIME BUT ASKED WHAT IS THE ONE TIME AND ALSO TO THE FACT, YOU KNOW I WAS BORN IN MEXICO AND I WENT TO SCHOOL THERE AND I DID MY INTERNSHIP IN THE GUNG AND HE WILL WHAT WAS INTERESTING TO ME WAS THAT KIDS IN THE JUNGLE ACTUALLY GET MARRIED WHEN THEY'RE 13 OR 14 YEARS OF AGE. AND THEY REALLY DON'T HAVE ALL OF THE ASSOCIATED BEHAVIORS THAT ARE CLASSICALLY BEING WITH ADOLESCENCE BECAUSE THEY GET MARRIED VERY, VERY YOUNG THEY'RE MUCH MORE IN COMCOMPLIANT AND YOU HAVE [INDISCERNIBLE] IN HOW THEY'RE RAISED UP BUT THEY'RE SOCIAL AND CULTURAL CONSTRUCTS THAT ARE ALSO GOING TO BE INFLUENCING HOW OUR BRAIN DEVELOPS. THE BRAIN IS CLASSICAL AND NOT KNOW SOMETHING THAT ANYONE TO MY KNOWLEDGE HAS FABULOUS, HOW CULTURE AS A SOCIAL IS GOING TO BE INFLUENCING THOSE BRAIN DEVELOPMENT TRAJECTORY AND IT'S GOING TO OPEN UP THE POSSIBILITY FOR STUFF TO LOOK AT THAT SIDE OF THE QUESTIONS. I WOULD LIKE TO CONGRATULATE BOTH DIRECTORS ON THE TALKS AND THE DIRECTION THAT THE INSTITUTES ARE GOING. NOW I KNOW ALL OF YOU SCIENCE AND INSTITUTE DIRECTORS IN A SENSE ARE REMOVED FROM THE GROUND AND IN THE IVORY TOWERS OF DOING THE RESEARCH BUT I WANT TO HIGHLIGHT SOMEONE HERE WHO HAS HAD A TREMENDOUS INFLUENCE JUST LAST WEEK AND THAT WOULD BE DR. SUSAN WEISS, WHO SPOKE AT THE CHEVY ESTIMATE THAD --CHEVY CHASE HIGH SCHOOL LAST YEAR AND SPOKE TO PARENTS TO PLAN A SERIES OF PROGRAMS DURING NATIONAL DRUG AWARENESS WEEK WHICH WAS LAST WEEK WHICH WAS LED BY A NEUROSCIENTIST FROM BRITAIN DR. CATHERINE WOOD AND I THINK THAT MY EXPERIENCE WITH DR. WEISS WHEN I REACHED OUT FOR HELP HAS BEEN ONE THAT SHE'S ALWAYS AVAILABLE, SHE IS SHARING SCIENCE WITH SLIDES, CITATIONS AND HELPING HOW TO COMMUNICATE WITH YOUR RESEARCH TO THE POPULATION OF PARENTS AND STUDENTS THAT ARE SO INVOLVED IN AND IT'S SO INTERESTING THAT AT THE END OF THE WEEK, THERE ARE FIVE PROGRAMS DURING THE DAY FOR KIDS CULMINATE NOTHING THE DRUG CHAT, FOUR PROGRAMSA THE NIGHT WITH THE PARENTS WHY WERE PART OF THE EVENTS PRESENTATIONS FOR THE PAINTS, TWO INCIDENTS OCCURRED ON FRIDAY. AND THE REPORT THAT HAY PUT OUT HAD SAID THAT THE, BOTH EVER THE INCIDENTS, THE ADMINISTRATION OF THE SCHOOL AND PRINCIPALS AND VICE PRINCIPALS FEEL THEY WERE DIRECTLY ASSOCIATED WITH THE PROGRAM. THE FIRST PART OF AN ANON NOWS CALL MADE TO THE STUDENT TO REPORT THE EXACT WHEREBYS OF DRUG DEALS UNDERWAY ON THE SCHOOL PROPERTY SO THE DRUG DEALER IS KNOWN TO THE SCHOOL AND LAW ENFORCEMENT, THE STUDENTS PURCHASING WERE APPLICATIONS PREHENNEDDED AND BROUGHT INTO THE SCHOOL AND NOW DIRECTED TO SCREENING AND INTERVENTION BUT WHAT I WAS THOUGHT WAS INTERESTING IS ONE OF THE PARENTS OF ONE OF THE KIDS WHO WAS BUYING THE DRUGS HER REACTION TO THE SCHOOLS WAS ONE OF IMMEDIATE ACTION TO GET SPECIFICALLY TO GET HELP SPECIFICALLY OF WHAT SHE LEARNED IN THE DRUG WEEK AND SECOND WAS THAT FRIENDS OF A FRIEND WHO HAD BEEN DRINKING HEAVILY BEFORE THE SCHOOL FRIDAY MORNING BROUGHT HIM TO THE SCHOOL NURSE INSTEAD OF ALLOWING HIM TO TRAVEL TO THE [INDISCERNIBLE] CHESAPEAKE BAY BY SPECIAL OLYMPICS SO TWO PEOPLE WHO YOU KNOW FOR THE FIRST ONE GETS A GROUP OF PEOPLE, BUT IN THE SECOND ONE A YOUNG MAN AND AND I WAS SO AMAZING AND I'M SURE THERE'S LOTS OF OTHER THINGS WITH THE ATTENTION OF THE ADMINISTRATION AND THE RESULTS OF LAST WEEK'S PROGRAM BUT I GUESS MY QUESTION, FIRST OF ALL, THANK YOU ALL ALL FOR--AND THE DOCTOR FOR START THANKSGIVING OUTREACH FIVE YEARS AGO, BUT--STARTING THIS OUTREACH FIVE YEARS AGO BUT ALCOHOL AND DRUGS SO IS THERE AN OPERATION FOR COLLABORATION BETWEEN THE TWO INSTITUTES FOR CONTROL AND DRUG WEEK. >> FIRST OF ALL THANK YOU FOR THE FEEDBACK AND THIS PROGRAM HAS BEEN VERY SUCCESSFUL AND BROUGHT OUR COMMUNITY TOGETHER NOW FOR SEVERAL YEARS, THE MEMBERS FROM THE ALCOHOL INSTITUTES HAVE BEEN VERY ACTIVE PARTICIPANTS AND SO, AND NOW WE ALSO HAVE PARTIC PACTS FROM THE NIMH AND SO THE ISSUE MAY BE--MAYBE MAKING IT EVEN MORE SO, BY ALL MEANS, I THINK ANY OPPORTUNITY THAT WE HAVE SOPHISTICATED INTEGRATE EFFORTS, THAT WOULD HAVE A GREATER IMPACT AND A NONBRAINER THE WAY I VIEW IS SO THANKS --THANK YOU FOR YOUR COMMENTS. >> NO BRAINER? >> NO BRAINER, YES [LAUGHTER] >> LOVELY PRESENTATION AND FOCUS ON THE OBCD STUDY SYSTEM ENLIGHTENING. YOU KNOW YOUR SLIDE SHOWING THE SMOKING DECREASE IS DRAMATIC AND YOU TALKED ABOUT THE LARGE SCALE SOCIAL IRPT EVICTIONS THAT HAVE GONE ON. OBVIOUSLY--SOCIAL INTERVENTIONS THAT HAVE GONE ON AND IT TOOK POLITICAL FORCES TO GET THAT GOING, AGAINST THE WORRY I HAVE AND SOMEBODY HAD SAID NICOTINE DOESN'T HAVE BENEFITS AND SO MAYBE THAT WASSA AN EASIER SELL AS WE GET INTO THE MARIJUANA ISSUE, IT'S SORT OF WORRYING A LITTLE BIT LIKE THE OUTFIELD ALCOHOL DEBATE, THAT THE BENEFIT OF ALCOHOL, THERE'S NOT, NOW WE HAVE MARIJUANA GETTING LEGALIZED AND I GUESS THE WORRY IS THAT WHEN WE DON'T HAVE A CLEAR CUT, WAY OF DESCRIBING THE PROBLEM WITH THE DRUGS DO WE HAVE A BIGGER PROBLEM IN SORT OF PRESENTING THE SCIENCE BEHIND IT AND THEREFORE GETTING YOU KNOW LARGE SCALE SOCIAL INTERVENTIONS UNDERWAY. SO FOR EXAMPLE, WITH ALCOHOL THERE WAS A NEW STUDY AND I'M SURE GEORGE HAS SEEN THIS AND WAS SUBMITTED NIAA AND SHOWS THAT THERE WAS A DIRECT EPIDEMIO LODGE CAKE STUDY SHOWING A VERY BEAUTIFULLY LOOKED AND ASSESSED THE IMPACT OF ADVERTISING, ALCOHOL ADVERTISING ON INCREASED DRINK NOTHING ADOLESCENCES, AND ALSO HAD A NICE CONTROL GROUP OF FOOD AND SHOWED THERE WAS A DIRECT EFFECT AND ALL OF US KNOW THAT BEFORE 2003 ALCOHOL WAS NOT, THERE WERE LIMITS ON IT. SO JUST THAT CHANGE ITSELF IS HAVING AN IMPACT AND NOW WE'RE SORT OF THINK BEING HOW DO YOU HANDLE BINGE LEVELS AND MAYBE MARIJUANA THAT WILL BECOME AN ISSUE AS LMAYBE LITTLE BIT IS OKAY, AND LARGER NUMBERS ALL OF THAT HAS TO BE DATA FOR THAT, BUT AS ALCOHOL WE KNOW THIS, AND SO THE WORRY IS OF COURSE YOU HO DO YOU TURN THE TIDE WHEN YOU'VE GOT SCIENCE DATA THAT MAY NOT BE ADDED BLACK AND WHITE AND WHAT IS OUR RESPONSIBILITY AS SCIENTISTS AND AS THE LEAD INSTITUTE, CLARIFYING THAT PLAYING FIELD AND MOVING FORWARD FORWARD TO BRING SOCIAL INTERFERON-GAMMA --SOCIAL INTERVENTION TO BEAR. >> MY SUGGESTION HAS BEEN TO UTILIZE THE DATA AND I SHOW THE DAT FOR THE BRAIN DATA BECAUSE IT'S NOT BLACK AND WHITE AND NOT WHAT PEOPLE WOULD LIKE IT TO BE BUT IT WASN'T JUST IN BLACK AND WHITE OF CIGARETTE SMOKING BECAUSE NOT EVERYBODY WHO SMOKES GET CANCER SO IT IS DOCUMENTED SO EVEN THOUGH THERE IS SIGNIFICANT STORIES ON EVIDENCE THAT IF YOU GET EXPOSED TO MARIJUANA DOG ADOLESCENCE YOUR OUTCOMES WILL MUCH WORSE AND SO YOUR EDUCATIONAL ACHIEVEMENT, SUCCESS AND YOUR [INDISCERNIBLE] THAT CAN BE NEED BECAUSE PEOPLE SAY YOU'VE EVEN CONTROLLED FOR A, B, C, D, SO THAT'S WHY IN MY VIEW, THIS STORY IS SO EXTREMELY IMPORTANT. WHY WE NEED TO GENERATE IN SUCH A WAY THAT WHEN WE HAVE THE DATA, THE METHODOLOGY WILL NOT ALLOW FOR PEOPLE TO SAY CONTROL FOR ABCD, SO WHEN HAVE YOU DIVERSITY, YOU WILL ALTS GET SAMPLE WHERE YOU DON'T SEE ANY [INDISCERNIBLE]. AND WE NOW HAVE THE TOOLS AND THAT'S WHY I SAY TO ME, IT'S ALMOST IKE A RESPONSIBILITY TO SHOW T. LET'S SEE WHAT HAPPENS: AND WE TOOK A THOUSAND KIDS AND WE FIND THERE'S NO ADVERSE EFFECTS, WELL, WE'LL KNOW BUT IF WE DO FIND THERE ARE ADVERSE EFFECTS, THEN WE'LL ALL HAVE A BETTER UNDERSTANDING OF ABOUT WHAT TYPE OF PATHOLOGY AND THAT CAN PRODUCE VERY OBJECTIVE AND LIKE YOU SHOW WITH CANCER, BUT WE NEED TO DO IT, YOU KNOW OBJECTIVE AND NOT SUBJECTIVE WAY CANS THIS STORY WE'RE WILL ENABLE US TO DO THAT AND IT WILL ALSO HIGHLIGHT THE OTHER ASPECT OF IT, WHICH IS THAT OF EFFECTS OF ALCOHOL DRINKING AND EFFECTS OF TAKEN--THEY CONTROLLER OF BANK O, WE DONE BE IF NICKEE TEEN EFFECTS BRAIN DEVELOPMENT, WE HAVE DATA AND HAVE STUDIES BUT HOW DOES THAT INTERACT WITH TRAUMA TO THE BRAIN? SO WE HAVE THE TOOLS TO DO IT NOW AND WE CAN DO. WE CAN DO IT. >> I WOULD ALSO LIKE TO ADD MY APLOWED TO THIS INITIATIVE AND FOLLOWING UP ON WHAT YOU'RE SAYING, ONE OF THE--ONE OF THE DIFFICULTIES HERE IS THAT WE'RE REALLY JUST BEGINNING TO UNDERSTAND THE BASIC COMPLEX PROCESS OF DEVELOPING BRAIN PERIOD AND SO WE KNOW ALREADY THAT THERE IS ENORM AUSDIVERSITY AND INDIVIDUAL DIFFERENCES, AND INDIVIDUAL DIFFERENCES BUT ALSO MANY, MANY INTERACTING PROCESSES, WITH THE FACES AND TRAJECTORIES AND SO, I THINK--ALTHOUGH THIS STUDY IS EXTREMELY IMPORTANT BECAUSE OF THE POOR AIMS WE'VE BEEN TALKING ABOUT IT'S EXTREMELY IMPORTANT BECAUSE IT MOVES IN THE DIRECTION AND HAVING AN ADEQUATE OBSERVATIONAL DATA SET THAT MAKE ITS POSSIBLE, TRACTABLE TO HAVE SOPHISTICATED MODEL OF THE DEVELOPING BRAIN THROUGH THIS AGE EXPRAINCH THROUGH ADOLESCENCE AND OF COURSE, THIS INSTITUTE SPECIAL CERTAINLY OTHERS IN IN ROOM HAVE BEEN PURNANANDAMMING THIS AND THEY'RE ON THE VAN GUARD OF THIS AND IT'S VERY NICE TO SO SO MANY INSTITUTES COMING ON BOARD AND UNDERSTANDING THE SIGNIFICANCE OF THIS. SO I THINK THAT APPROACH THANKSGIVING DATABASE THAT WE CAN ALL SHARE AND AVAILABLE TO EVERYONE TO EXPLOIT IS A REALLY IMPORTANT ACCOMPLISHMENT OF THIS STUDY AND I JUST LIKE TO MAKE ONE OTHER POINT WHICH IS THAT--IT KIND OF MAKES CONTACT WITH THE BIOMEDICAL WORKFORCE, YOU KNOW THE OTHER KIND OF DIVERSITY THAT I THINK WE HAVE IS WE ALL KNOW IS THAT AMONG SCIENTISTS, YOU KNOW THERE ARE DIFFERENT PHENOTYPES AND SO, SOME PEOPLE EVEN THOUGH THEY'RE PRODUCTIVE SCIENTISTS SOME PEOPLE--PRODUCTIVITY IS MORE RELATED TO GREAT ORGANIZATIONAL SKILLS AND ENERGY AND MAKE THESE HAPPENS AND SOME PEOPLE BECAUSE THEY HAVE EXTREMELY CREATIVE OUT OF THE BOX IDEAS AND COME TO AND PROBLEMS WITH AND SOME PEOPLE BECAUSE THEY HAVE POWERFUL COMP TUEITATIONAL SKILLS AND THEY CAN IMPLEMENT--COMPUTATIONAL SKILLS AND THEY CAN IMP LEMENT THINGS AND SO ON AND I THINK WITH THESE LARGE INITIATIVES IT'S EXTREMELY IMPORTANT THAT WE RECOGNIZE THAT WE HAVE AN OPPORTUNITY HERE BECAUSE OF THE SHARING OF THE DATA AND THE AGGREGATION OF THE DATA TO ACTUALLY HAVE THOSE KINDS OF PEOPLE WORK NOTHING AN INTEGRATIVE WAY SO I THINK ANOTHER CHALLENGE AS WE MOVE TOWARDS THESE LARGE BIG DATA SORT OF INITIATIVES IS TO MAKE SURE THAT CONTINUING INNOVATION AS WELL IN TERMINGS OF HOW YOU SUPPORT THOSE KEY PEOPLE--AND HOW PEOPLE WHO HAVE THOSE COMPUTATIONAL AND MODELING SKILLS DO AND HAVE THEM SUPPORT EVEN IF THEIR MAIN ROLE MAY BECOME SIMPLY EXTRACT THE MOST INTERESTING EFFECTS FROM THESE DATABASES, I THINK, YOU KNOW THIS IS A GREAT INITIATIVE AND CONTINUING AGILITY IN FIGURING OUT HOW TO STAFF SUCH INITIATIVES AND FRANCHISE AS MANY CREATIVE PEOPLE WITH DIFFERENT--DIFFERENT SORT OF SCIENTIFIC RESEARCH PHENOTYPES IN THESE INITIATIVES. THEY'LL ALSO ACCELERATE THE PROGRESS. >> --70% ARE OKAY WITH STOPPING DRINKING BEHAVIORS AND THEY DON'T SEEM TO HAVE LONG-TERM ADVERSE EFFECTS AND I'M WONDERING WHETHER THE INFORMATION ALREADY AVAILABLE BECAUSE THEY'RE CLEAR PAPERS SHOWING ADVERSE EFFECTS OF MARIJUANA AND OTHERS DON'T BUT SOME OF THE DATA CAN BE MINED NOW TO FIND OUT WHAT ARE THE PROTECTIVE THINGS. I MEAN THIS PLASTICITY GOING ON AND ARE THERE PEOPLE WHO ARE NOT PROTECTED AND THEY'RE DISPARATE PROCESSES OF PEOPLE. COULD THAT THAT DATA BE SOMEHOW MADE YOU BETTER USE OF WHILE WE'RE WAITING FOR THE 10 YEAR FOLLOW UP? >> YOU'RE ABSOLUTELY RIGHT AND THERE IS AN URGENCY OF TRYING TO GET THE INFORMATION FOR PEOPLE WHO ARE MAKING QUALITY OF WHETHER THEY LEGALIZE OR NOT. AND WHAT WE ARE DOING BECAUSE THERE ARE BARRIERS, AND LARGE DATABASES THAT ARE ON IMAGING THAT YOU KNOW IN THE UNITED STATES AND THEY ALSO WERE, WE'VE ACTUALLY SUPPLEMENTED RESEARCHERS AND PIs SO THAT CAN LOOK PRELIMINARILY FROM THEIR DATA TESTS EVEN THOUGH IT MAY BE RETROSPECTIVELY, THE EXTENT TO WHICH WE CAN START EXTRACTING IT AND TARGETING EXPOSURES TO MARIJUANA. SO BY ALL MEANS, THIS WILL NOT BE THE ONLY EMERGING STORY THAT COMES THROUGH BECAUSE THERE'S ALWAYS VALUE TO IN TAKE THANKSGIVING INFORMATION, THIS INFORMATION THAT'S GOING TO START TO EMERGE AND WE WANT THE DATA TO COME OUT AS SOON AS POSSIBLE. WE'RE NOT GOING TO WAIT IN HERE. SO THERE W84@ BE--THERE WILL BE INFORMATION THAT WILL BE FOR THE SCIENTIFIC COMMUNITY TO WORK WITH. ONE OF THE THINGS OF THE DATA CAN BE USED TO POWER A RESEARCHER TO LOOK MORE SPECIFICALLY FOR SOMEONE WHO ASSOCIATE MECHANISTIC RELATIONSHIP THAT FOR EXAMPLE, WE [INDISCERNIBLE] SO THEN EXTRACT THAT INFORMATION AND DO LABORATORY EXPERIMENTS TO SEE WHAT MAY BE THE MECHANISM, SO WE SEE THESE LIKE A SKELETON WHERE RESEARCHERS CAN USE IN ORDER TO HELP THEM WHERE THEY ARE GOING TO BE BUT TELL NOT BE THE ONLY [INDISCERNIBLE] FOR [INDISCERNIBLE] AND WE ARE EMPHASIZING THE IMPORTANCE OF RELEASING THE DATA AND MAKING IT OPEN ACCESS AS SOON AS [INDISCERNIBLE] READY TO BE WITH IT. >> I WAS ALSO WONDER NOTHING THE LAST TWO COMMENTS IT'S NOT JUST BIG DATA, IT'S BIG SCIENCE. SO PART TELEVISION IS HOW MUCH ATTENTION YOU GIVE TO HAVE IT ORGANIZED THE SCIENTISTS AND HOW MUCH AUTONOMY THEY HAVE, HOW MUCH INPUT THEY HAVE, HOW THEY CAN REALLY COORDINATE THE WORK. I'VE BEEN PART OF SEVERAL LARGER GROUPS, SOME WORK REALLY WELL AND OTHERS DON'T AND I WONDERED HOW MUCH ATTENTION IS KIND OF BEING GIVEN AND LOOKING AT HOW TO MANAGE THIS AS A GIANT PROJECT OVER A NUMBER OF YEARS WILL BE PEOPLE MOVING IN AND OUT OF THAT PROJECT, HOW TO ACTUALLY MANAGE AND COORDINATE AND ORGANIZE THAT. SO WE'VE HAD A LOT OF EXPERIENCE MANAGING LARGE PROJECTS AND THE ALCOHOL INSTITUTE HAS BEEN DOING IT NOT AS LARGE BUT THEIR PROJECT AND BRAIN IMAGING NOW LESSONS SO GEORGE MAY WANT TO COMMENT ON THAT BECAUSE WE--WE ARE GOING TO ACTUALLY BASE ON ONE WORK, WE ARE GOING TO INFLUENCE A WAY THAT WE'RE GOING TO BE ABLE TO MANAGE THE LARGER [INDISCERNIBLE]. >> YEAH, I THINK THE PROJECT INDICATES ON A SCALE OFON 10th OF WHAT WE ENVISION FOR THE ABCD STUDY, IT'S DOABLE BUT WE HAVE ARE GOING TO NEED STRONG LEADERSHIP, NORA AND I TALKED ABOUT THAT SUSAN WILL NEED ADDITIONAL PSYCHOTHERAPY. [LAUGHTER] BUT YOU RAISE AN IMPORTANT POINT. WE ARE GOING TO HAVE TO HAVE A COORDINATING GROUP THAT WORKS WELL TOGETHER BUT THAT'S WHY WE CHOSE THE U-MECHANISM IN THIS CASE AND GETS US MORE FLEXIBILITY BECAUSE WITH THE U-MECHANISM THE NIH STAFF HAS A MORE PROMINENT ROLE SO TELL BE NECESSARY TO COORDINATE THIS ACTIVITY. >> WE HAVE A COUPLE MORE MINUTES IF ANYONE HAS QUESTIONS FOR NORA, WE HAVE ONE MORE PRESENTATIONOT CRAN ACTIVITIES AND SUMMARY AND ANY FURTHER DISCUSSION. THIS IS YOUR CHANCE TO ASK NORA THE HARD QUESTIONS. I DIDN'T KNOW ALASKA HAS LEGALIZED MARIJUANA. ? >> UNFORTUNATELY NEGATIVELY EFFECT [INDISCERNIBLE]. >> SO IN THAT CASE, PEG SCHESUSAN--THERE WILL BE TIME FOR OTHER QUESTIONS, IF YOU THINK ABOUT OTHER QUESTIONS WE WILL TALK ABOUT THOSE AT THE END AND I GUESS PEGGY WILL LEAD OFF. SO PEGGIA GOING TO DO IT AND--PEGGY'S GOING TO DO IT AND GIVE US AN UPDATE ON CRAN ACTIVITY. >> FIRST OF ALL I WANT TO SAY UP HERE AS A MEMBER OF A TEAM OF WHICH YOU KNOW SUSAN IS PART OF BUT ALSO MICHELLE BLACK WITH THE NATIONAL CANCER INSTITUTE AND IT CAN BE WARNED SINCE THE BEGINNING SO I WAS SELECTED TO SPEAK BUT I HAVE TO SAY THAT IT'S A WHOLE GROUP OF US AND YOU KNOW IT'S THE WAY WE WORKED TOGETHER ON THESE INITIATIVES, ANY INDICATION OF HOW IT FEELS TO WORK ON THE ABCD STUDY, THERE I THINK THERE'S HOPE FOR IT. ALL RIGHT? SO SINCE THE LAST COUNCIL WE'VE DONE A NUMBER OF THINGS I'M GOING TO GO THROUGH THEM, SORT OF BRIEFLY ALL OF THIS INFORMATION IS AVAILABLE ON THE CRAN WEB SITE, GOOGLE CRAN NIH AND YOU WILL GET CORRECTLY TO IT AND I WANT TO TAKE THIS OPPORTUNITY TO ACKNOWLEDGE GREG ROWA BUT GREG WORKS 24/SEVEN KEEPING THE CRAN WEB SITE UP TO DATE WITH EVERYTHING SO CAN YOU FIND SYNOPSIS OF THE FUNDED APPLICATIONS AS WELL AS INFORMATION ABOUT THE DEVELOPMENT OF THE FUNDING ANNOUNCEMENTS. BUT WE'VE FUNDED ADMINISTRATIVE SUPPLEMENTS RESEARCH TRAINING SUPPLEMENTS, AND RFA WE HAD ON USING SOCIAL MEDIA, TO ADDRESS SUBSTANCE USE AND ADDICTION. WE NOW HAVE CURRENTLY TWO PROGRAM ANNOUNCEMENTS THAT ARE LOOKING AT NOVEL TARGETS FOR PREVENTION AND TREATMENT. SO 25 ADMINISTRATIVE AND TWO COMPETITIVE SUPSUMMITS ARE FUNDED AND THEY'RE A COVER A RANGE OF SCIENTIFIC AREAS AND BASIC SCIENCE MEDICATION, DEVELOPMENT AND CLINICAL TRIALS AND SERVICES RESEARCH. GRANTEE WORKSHOP WILL BE HELD MAY 11th AND 12th. WE SOLD THE APPLICANTS FOR THIS SUPPLEMENT, SO THE FUNDS TO TRAVEL TO THIS WORKSHOP, THE PURPOSE WHICH WILL BE TO ENCOURAGE COLLABORATION, IDENTIFY RESEARCH PRIORITIES AND NEEDS AND TO DISCUSS OBSTACLES THAT ARE OCCURRING AND HOW TO ADDRESS THEM. WE ALSO FUNDED 14 SUPPLEMENTS TO T32 PROGRAMS AND THESE HAD A DUAL PURPOSE TO TRAINEES TO CROSS CUTTING RESEARCHIARYS OF TOBACCO ALCOHOL AND OTHER SUBSTANCE USE AS AS WELL AS CONDUCT CROSS CUTTING RESEARCH IN THOSE AREAS, THE IMMEDIATE USE OF RFAs FOR SUBSTANCE RESTRICTIONS, THERE WAS ENORMOUS RFA, WE COULDN'T FUND AS MANY AS WE WOULD HAVE LIKED BUT I THINK WE HAD 100 APPLICATIONS BUT IT FOCUSED ON TWO TYPES OF OBSERVATIONAL STUDIES AND WE USE SOCIAL MEDIA INTERACTIONS AS SURVEILLANCE TOOLS TO UNDERSTAND EPIDEMIOLOGY OF RISK FACTORS AND ATTITUDES AND BEHAVIORS ASSOCIATE WIDE ALCOHOL, TOBACCO AND OTHER DRUG USE AND THEN ALSO WE FUNDED OR WE WERE LOOKING FOR APPLICATIONS THAT WOULD LOOK AT INTERVENTION RESEARCH MEASURING THE REACH, ENGAGEMENT AND BEHAVIORIAL IMPACT OF SOCIAL MEDIA INTERVENTIONS FOR SCREENING PREVENTION AND TREATMENT. WE DID MAKE 11 AWARDS IN SEPTEMBER, SEVEN RO-1S AND FOUR R21S. I CHOSE TWO TO SORT OF HIGHLIGHT HERE. THE FIRST IS A STUDY AT WASHINGTON UNIVERSITY WHICH WILL DELINEATE THE NATURE, EXTENT AND ENGAGEMENT PATTERNS OF MARIJUANA AND ALCOHOL-RELATED CONTENT TO WHICH YOUNG PEOPLE ARE EXPOSED VIA SOCIAL MEDIA. I THINK THAT'S WHAT YOU WERE TALKING ABOUT EARLY. THERE'S SO MUCH OF SOCIAL MEDIA THAT'S CHANGING THE CULTURE OF ALCOHOL AND DRUG USE THAT'S IMPORTANT TO FOCUS RESEARCH ON IT AND THEN HOW THAT EXPOSURE ASSOCIATES WITH CONTROL USE BEHAVIORS AND NORMING AND MARIJUANA BEHAVIORS AND NORMS. THE SECOND STUDY THAT I HIGHLIGHTED IS ONE INTERVENTION STUDY THAT'S LOOKING AT--IT'S THE AMERICAN LEGACY FOUNDATION AND THEY'RE LOOKING AT HOW ONLINE SOCIAL NETWORKS THAT ARE USED BY LOTS OF PEOPLE. MILLIONS OF PEOPLE TO STOP SMOKING, HOW THEY ACTUALLY INFLUENCE SMOKING CESSATION. THE NOVEL TARGET'S PROGRAM CAME OUT RECENTLY, ALMOST A MONTH AGO TODAY, OR TOMORROW. IT'S AIMED AT BEDDING THE MECHANISM AS WELL AS DEVELOPMENT OF NOVEL TREATMENT ASKS INTERVENTIONS THAT DIRECTORY TARGET AND MODULATE BEHAVIORIAL MECHANISMS. SO WE'RE LOOKING AT BOTH THE BIOMEDICAL SIDE AS WELL AS THE INTERVENTION SIDE, AND IT'S--IT'S ACTUALLY, I THINK A NICE EXAMPLE OF TRANSLATIONAL RESEARCH. THE TARGETS WE'RE LOOKING AT, THEY'RE NOT EXCLUSIVELY, BUT ARE LIKELY GOING TO BE THINGS SUCH AS IMPULSIVITY, RISK TAKING PROPENSITY, SENSATION SEEKING, STRESS TOLERANCE, SELF-REGULATION AND STRESS REACTIVITY. SO WE HAD BOTH AN R34 DEVELOPMENTAL PROGRAM ANNOUNCEMENT AS WELL AS REGULAR RO-1 AND THESE WILL BE OPEN FOR THE NEXT THREE YEARS. IT'LL BE--YOU'LL BE HEARING AT FUTURE COUNCILS HOW WELL THE ACTIVITY IS UNDER THESE TWO ANNOUNCEMENTS. NORA TALKED ABOUT THE ABCD STUDY, SO I JUST WANT TO SAY ONE THING, IF YOU LOOK AT PLANNING, THE FOURTH BULLET DOWN WHICH IS BI-WEEKLY MEETINGS OF NIH STAFF, A TREMENDOUS AMOUNT OF WORK HAS GONE INTO THE DEVELOPMENT OF THIS RFA, AND SUSAN HAS LED IT, BUT I ALSO WANT TO ACKNOWLEDGE JOHN FROM NIAAA AND KEVIN CONWAY FROM NIDA WHO HAVE BEEN PART OF THIS TEAM THAT HAVE DONE THE LATE NIGHT REWRITES AND REWORKING OF THE RFA TO GET IT OUT AS SOON AS WE KTHERE'S A WHOLE TEEM OF PEOPLE THAT REPRESENT THE LIST OF PEOPLE WHO ARE SUPPORTING IT BUT KEV AND I KNOW JOHN HAD BEEN PART OF THE CENTRAL EFFORT THAT'S DONE A LOT OF WORK. YOU ALREADY HEARD ABOUT THE COLLABORATION AND THE FUNDING OPPORTUNITY ANNOUNCEMENT WILL BE COMING OUT SOON. THERE WILL BE THREE COMPONENTS TO IT, A RESEARCH, THE RESEARCH SITES, THE COORDINATING CENTER SITES AND THEN DATA ANALYSIS AND INFORMATIC CENTER, EACH OF THOSE WILL HAVE A SEPARATE RFA. ONCE THE FA IS RELEASED THERE WILL BE--FOA IS RELEASED THERE WILL BE A PLANNED WEBINAR THAT WILL HAVE MEMBERS OF THE NIH STAFF AVAILABLE TO ANSWER QUESTIONS FOR PEOPLE WHO ARE INTERESTED IN APPLYING. TAKEN--THEY'S ALL I CAN SAY ABOUT THAT. I WANT TO THANK THE CRAN COMMITTEE AGAIN, I MENTIONED GREG ROWA IS NOW WE'RE OPEN TO QUESTIONS AND SUSAN AND MICHELLE UPON HOPEFULLY HELP ME ANSWER SOME OF THEM. DRNCHL. >> I'M INTERESTED IN THE PROGRAM ANNOUNCEMENTS FOR THE INTERVENTIONS FOR THE NOVEL TARPGETS AND SUBSTANCE ABUSE TREATMENTS? SO YOUR SUMMARY STATEMENT IN THE BEGINNING, THE TOP PART, YOU KNOW A LOT OF THOSE ARE RELEVANT TO YOUNG ADULTHOOD AS WELL. >> YES, SO I GUESS THE WORRY HAVE IS THAT THE PA TALKS ABOUT ADOLESCENT AND WE KNOW THE BRAIN IS STILL DEVELOPING TILL 25. WE ALL KNOW ABOUT THE ISSUES GOING ON IN COLLEGE AND I JUST WONDER IF IT WOULD HELP TO CLARIFY THAT AT LEAST TRANSITION TO INCLUDE THE WORD TRANSITION PERIOD AS WELL AND I KNOW YOU CAN'T--PERHAPS YOU CAN'T CHANGE IT BUT TO HELP A REVIEW COMMITTEE NOT SORT OF IGNORE OR UNDERMINE THE HUGE IMPACT OF AND THE NEED FOR NOVEL TARGETS IN THAT TRANSITION PERIOD MOVING RIGHT INTO YOUNG ADULTHOOD. >> ACTUALLY I THINK THERE IS A WAY WE CAN DO THAT, SUSAN, AM I RIGHT IN TERMS OF ISSUE--AS LONG AS WE ISSUE A PUBLIC NOTICE? IS THAT-- >> [INDISCERNIBLE]. >> THAT WOULD EXTENT INTO A PERIOD OF YOUNG ADULTS AND ADOLESCENTS IS THAT AREN'T CLEAR TREATMENTS AVAILABLE AND WE CERTAINLY DO UNDERSTAND A LOT ABOUT THE NECKANISMS INVOLVED SO THAT WAS REALLY AND THIS IS ACTUALLY--WILL IS HERE BUT HE'S KIND OF THE PERSON WHO INITIATED THIS IDEA AND WORK WIDE COLLEAGUES AND NIAAA AND BUT I THINK THAT WE CAN CERTAINLY DO SOMETHING LIKE THAT. >> IN PARTICULAR, AS WE KNOW AND SOME SOMEBODY MENTIONED EARLIER, THAT PREME DO GROW, SOME INDIVIDUALS GROW OUT OF USE AND ABUSE IN ADOLESCENCE AND SO, A LOT OF TIMES THAT YOUNG ADULTHOOD PERIOD MOVING THROUGH THE 20S IS A TIME WHERE YOU START WITH THE RISK MOVING INTO MORE TROUBLE, RIGHT? AND THE INTERVENTIONS, PARTICULARLY MIGHT BE VARY IMPORTANT IN TERMS OF THINKING ABOUT INNOVATIVE PIECES OF DEVELOPMENT THERE. >> IT LOOKS LIKE ALL OF THESE ARE HUMAN RESEARCH OR--IS THAT TRUE? OR FOR EXAMPLE, MECHANISM [INDISCERNIBLE]--I CAN'T--BEHAVIORIAL MECHANISMS [INDISCERNIBLE]--ONE COULD IMAGINE FOLLOWING SOME OF THAT? >> YEAH, I MEAN THIS IS REALLY--THIS A P. A. SO IT'S A PROGRAM ANNOUNCEMENT THERE ISN'T TARGETED MONEY ASSOCIATE WIDE IT SO WE'RE JUST TRYING TO SORT OF SHINE A LIGHT ON SOMETHING THAT WE CERTAINLY RECOGNIZE THE NEED FOR BUT WE ALSO HAVE OTHER PROGRAM ANNOUNCEMENTS THAT ARE TARGETING AT DIFFERENT KINDS OF ANIMAL MODELS THAT HELP US--TO HELP US UNDERSTAND TREATMENT, SO I--I VALID TO LOOK CAREFULLY AT--I LOOK AT THIS A WHILE AGO SO I'M NOT SURE IF ANIMAL RESEARCH WOULD FALL UNDER THIS BUT IF IT DOESN'T, I'M SURE IT WOULD FALL THAT BOTH NIDAAND NIAAA WOULD HAVE,. >> YEAH AND BOBBY IT WAS CONSIDERED IN THE TRAINING IN THE SUPPLEMENTS, ADMINISTRATIVE SUPPLEMENTS, TRAINING GRANT SPECIALIZATION OF SPECIFIC ENDOTHELIAL WE'RE LAYING THE GROUND WORK SO WORK CAN BE DONE THROUGH THE SUPPLEMENT PROGRAM PROGRAM AS WELL WITH ANIMAL MODELS. >> THOSE ARE CLOSED CURRENTLY, YEAH, BUT IF YOU GO THROUGH THE LIST OF 25 AND I CAN GO THROUGH THEM AND SORT OF PICK OUT WHICH ONES ARE DIRECTED PERIODS ANIMAL RESEARCH. >> I WANT TO ASK SUSAN MAYBE YOU WANT TO COMMENT OR NORA ABOUT THE FACTS THAT THERE IS INTEREST IN EUROPE AND COLLABORATING ON THE OBCD STUDY, THERE'S BEEN CORRESPONDENCE SO YOU MIGHT WANT TO UPDATE THE COUNCIL. >> SURE THERE, 'S A GROUP IN THE NETHERLANDS THAT HAS APPROACHED US AND THEY ARE VERY INTERESTED IN POSSIBLY COLLABORATING AND WE ARE INTERESTED IN COLLABORATORS AND OTHER COUNTRIES. WE'RE LOOKING AT THIS AS YOU KNOW PREDOMINANTLY, A UNITED STATES FOCUSED STUDY THAT WE WILL BE SUPPORTING, ASK BUT ESTABLISHING COLLABORATIONS WHERE WE COULD BE USING COMMON DATA SETS AND COMMON PROTOCOLS, TO STUDY PEOPLE AT THESE--IN THE SAME AGE RANGES AND BEING ABLE TO TAKE ADVANTAGE OF THE UNIQUE ASPECTS OF THE ENVIRONMENT FOR EXAMPLE IN THE NETHERLANDS IF SOME WERE HOMOGENIUS ENVIRONMENT AND PEOPLE DON'T TEND TO LEAVE AND THERE'S A DIFFERENTIA ATTITUDE ABOUT DRUG USE SO TAKING ADVANTAGE OF INTERNATIONAL COLLABERATIONS IS SOMETHING THAT WE'RE VERY INTERESTED IN. AS I SAID WE'RE--BUT WE'RE ASKING THEM TO COME IN WITH THEIR OWN MONEY FOR THAT. >> [INDISCERNIBLE]--THE NUMBER OF SUPPLEMENTS FOR T33S AT THE BEGINNING? >> IT'S NOT THE LIST IT'S 14. >> SO MY QUESTION IS FOR NIAAA FUNDED T32, WILL THERE BE AN ENCOURAGEMENT FOR EXTENDING THE FOCUS OF RESEARCH AND TRAINING FOR WHOLE AND VICE VERSA FOR THE NIDA GROUP BECAUSE I THINK TRADITIONALLY WE'VE BEEN HOME TO PRETTY MUCH STICK WITH ALCOHOL OR DRUG ABUSE, WAS THIS A ONE TIME DEAL AND AND OVER AND DONE WITH, CAN YOU JUST COMMENT ON THAT? >> MAYBE KITAKE THIS BEFORE PEGGY WAS INVOLVED WE ACTUALLY HAD A MEETING WITH SOME OF THE COUNCIL MEMBERS ABOUT A YEAR AGO TO DISCUSS THIS BECAUSE--AND I THINK THERE MAY BE DIFFERENCES BETWEEN THE INSTITUTES BUT IN FACT, WHEN WE LOOK AT THE T32 PROGRAM THERE WAS A LOT OF OVERLAP BETWEEN--IN ALL OF THE PROGRAMS WHERE YOU HAD SOME OF THE SAME MENTORS, AT T32 PROGRAMS THAT WERE NIAAA PROGRAMS VERSES NIDA SPONSORS AND I THINK THE--EACH OF US--REACH OF THE INSTITUTES DOES OUR OWN REVIEWS OF THE T32 GRANTS AND I THINK THAT SOME OF THIS MAY COME DOWN TO MAKING SURE THAT THE REVIEWERS ARE MADE AWARE OF THE FACT THAT THE CULTURE HAS CHANGED AND THAT WE'RE NOT JUST INTERESTED IN SUPPORTING TRAINING OF PEOPLE THAT CAN DEAL WITH ONE PROBLEM AND NOT THE OTHERS ESPECIALLY WHEN THEY FEEL LIKE THESE BEING COMORBID THANK YOU FOR YOUR RESPONSE MAY AND I SUGGEST IF THERE'S A T32 DIRECTORS MEETING, THIS WILL BE MADE CLEAR THERE. >> WE HAVE ACTUALLY UPDATED OUR WEB SITE WITH REGARD TO T32 REVIEW, SO THE REVIEWERS ARE AWARE THAT THEY SHOULD NOT ONLY CONSIDER CONTROL BUT DRUG ABUSE AND OTHER COMORBID FACTORS IN THE PAST WE DIDN'T DO THAT BECAUSE OF THE PLAN WE ARE EXPANDING SO IT WILL NOW BE ALCOHOL AND AND DRUG ABUSE STUDY, BUT IT DOES HELP CONSIDER THAT THE THAT THE COMMITTEE IS HERE TO FIGURE OUT STRATEGIC PLAN EDGE STRATEGIES FOR ARE THAT. >> YEAH. >> OTHER COMMENTS, I REALIZED IN MY PRESENTATION I DIDN'T GIVE A SHOUT OUT TO CATHY YOUNG WHO IS IN CHARGE OF OUR BIOSENSOR AND SBIR PROGRAM SO IF YOU DO HAVE ANY SUGGESTIONS, PLEASE CONTACT CATHY, BUT SHE MAY NOT BE HAPPY I GAVE HER THE SHOUT. „ FULLY SUPPORT THE >> YEAH, I IDEA THAT ADDICTION TRAINING SHOULD INVOLVE ALCOHOL AND OTHER DRUGS AND MANY OF YOU KNOW I HAD A T32 FOR MANY YEARS AND THAT'S WHAT WE DID. WE GOT OFF TRACK ON IT BUT WE DID IT ANYWAY SO WE WERE WADE WAY AHEAD OF OUR TIME IN SCRIPTS. >> IT'S INTERESTING BECAUSE THE FIRST TIME I WENT BY TO SPEAK FOR THE COUNCIL HE GAVE DIRECTORS, I HAD BEEN AT NIDA FOR ONE YEAR AND I BROUGHT OUT THE NOTION THAT WE NEEDED TO ACTUALLY INVESTIGATE AND TRAIN RESEARCHERS TO UNDERSTAND MORE RELATED IN THE WAY THAT HUMANS TAKE DRUGS INCLUDING ALCOHOL AND MOST ALCOHOLICS ARE CIGARETTE SMOKERS AND YET ALL OF OF THE ANIMAL MODELS ARE BASICALLY FOCUSED ON ONE VERSES THE OTHER AND AT THAT TIME, THAT WAS CORRECT AND WE NEEDED REALLY TO START TO UNDERSTAND HOW WE THINK THE INTERACTIONS WENT AROUND AND INTERESTINGLY GEORGE CAME TO ME AND SAID, NORA, WE'VE BEEN TRYING TO DO THAT BUT STUDY SECTION, AND I REMEMBER THAT BOTH HARD WIRE [INDISCERNIBLE] REMEMBER THAT THAT ARE VERY WELL INTENTIONED THEORETICALLY FOR THE STORY SECTIONS WILL NOT ALLOW THESE TO HAPPEN AND I THINK THAT WITH THE EMERGENCE OF [INDISCERNIBLE]. AUTOMATICALLY BECOMES SEVEN FOLD AND HOPEFULLY WE WILL START TO SEE NOT JUST MORE TRAINING BUT THE PRODUCT OF THAT TRAINING FOR RESEARCHERS BEING BOLD ENOUGH TO START TO DO INVESTIGATIONS AND HELP US UNDERSTAND HOW THESE INTERACTIONS PLAY AROUND PHYSIOLOGICAL GENERATEDITTICS AND WHATEVER YOU ARE INVESTIGATED. >> I HAVE A--BOTH DIRECTORS, I HAVE A QUESTION, BOTH DIRECTORS IN YOUR REPORT MENTIONED THE FACT THAT THE MILEIN HAS A REDUCED DENSITY BECAUSE OF MARIJUANA USE AND ALCOHOL USE, AND WE HAVE RECEIVED INFORMATION FROM SLIDES FROM DR. [INDISCERNIBLE] IN RELATION TO THE ALCOHOL EFFECTIVE THAT AND ALSO WE HAVE SOME SLIDES ABOUT THE MARIJUANAS EFFECT OF THAT BUT MY QUESTION IS, CAN YOU COMMENT ON WHAT IS THE IMPACT ON BRAIN FUNCTION OF THE REDUCED DENSITY OF THE WHITE MATTER IN THE PREFRONTAL CORTEX AREA. I DON'T KNOW HOW TO TRANSLATE THAT? >> I'LL JUST SAY, AND I'LL LET NORA COMMENT BECAUSE IT'S BIGGER THAN THAT BECAUSE IT SUGGESTS THAT AS YOU'RE GOING THROUGH ADOLESCENCE, YOU'RE GAINING CIRCUITRY. AND THE CIRCUITRY, MUCH OF IT MILENNATED SO IF YOU'RE IMPAIRING THOSE--THE DEVELOPMENT OF THOSE CIRCUITS AND THOSE CIRCUITS IN A FUNCTIONAL WAY, IT'S--IT'S POTENTIALLY I DON'T WANT TO SAY PERMANENT BUT QUASI PERMANENT PERHAPS CHANGE IN THE WIRING DIAGRAM, THAT'S THE WAY I LOOK AT IT IN THE [INDISCERNIBLE]. >> YEAH, I MEAN PEOPLE BASICALLY WHAT ALLOWS ONE AREA OF THE BRAIN TO INTERACTION AND HAVE A DIALOGUE, WITH ANOTHER AREA OF THE BRAIN AND THE WHITE MATTER DETERMINES THE SPEED AT WHICH THE CONNECTION HAPPENS AND YOU DON'T HAVE A WHITE MATTER PROTECTING IT. [INDISCERNIBLE] NERVES GENERATE NOW THERE ARE TWO WAYS THAT DRUG CANS ACTUALLY INFLUENCE THE ACTIVITY. ONE OF THEM RELATES TO THE FACT THAT THIS CASE CLEARLY FOR CANNABINOIDS. CANNABINOIDS ARE INVOLVED WHEN NEURONS ARE WITH ONE ANOTHER AND THAT'S AN AREA AND SOME AREAS ARE MORE AND THESE GUYS ONE OF THEM AND THE HIPPOCAMPUS AND- [INDISCERNIBLE] THAT MEANS THAT THE ABILITY OF THOSE REGIONS OF THE BRAIN INCORPORATE INFORMATION THAT THEY NEED TO PROTECT IN ORDER TO COME UP WITH A PARTICULAR ACTION IS GOING TO BE RESTRICTIVE. THAT'S WHY, BUT THE OTHER WAY THAT DRUGS CAN INFLUENCE CONNECTIVE AND IT THIS IS RELEVANT FOR ALCOHOL IS THROW THE EFFECT AND SO ONE OF THE THINGS THAT THE ANIMALS IS PROINFLAMMATORY SO YOU PROCESS INFLAMMATION OF THE BRAIN, ONE OF THE AREAS THAT IS INFLUENCED THE WHITE MATTER TRACKS AND MULTIPLE SCLEROSIS, AS YOU KNOW, WHERE YOU SEE THE DAMAGED THE WHITE MATTER TRUST AND THAT CAN RESULT IN A WIDE VARIETY OF PATHOLOGIES, HAVE PROINFLAMMATORY EFFECT IN THE BRAIN AND THAT IS [INDISCERNIBLE] WITH MILENNATION, AND WHAT WE DON'T KNOW, SO CANNABINOID INFLUENCE BOTH INFLAMMA TORROR PROCESS SO WE THAN CAN ANINOIDS MAY HAVE THAT EFFECT SO AGAIN, I KNOW THE [INDISCERNIBLE] EFFECT, IN THOSE PROCESSES THAT COULD DAMAGE THE CONNECTIVITY OF THOSE WHITE MATTER [INDISCERNIBLE]. >> AND I WOULD URGE YOU TO WITHDRAWAL PRACTICES BOTH ALCOHOL AND MARIJUANA WOULD PROBABLY HAVE PROINFLAMMATORY ACTIVITY AND ONE OF THE WORLD'S EXPERTS ON THIS IS FULTON CRUZ WHO SPENT A GOOD BIT OF HIS CAREER SING NOTHING THE WILDERNESS, YOU WANT TO MAKE A COMMENT FULTON ABOUT THE PROINFLAMMATORY ACTIONS OF ALCOHOL. >> WELL, YES, I MEAN, WE STARTED OUT WITH THE GENERATION, BUT IT'S AMAZING HOW IT'S MOVED TO REALLILY CHANGING PSYCHOLOGICAL ASPECTS AND LOOKS LIKE--I ACTUALLY THINK THAT WHAT WE CALL CURRENTLY PROINFLAMMATORY SIGNALING WILL BE LIKE THE OPIATES DISCOVERED IN THE VAS DEFERENCES ANYMORE, WE DON'T CALL THEM THAT ANYMORE, WE CALL THEM WHOLE BODY SIGNALING AND THAT'S WHERE MANY OF THE CYTOKINES WILL BE IN ANOTHER FEW DECADES THAT THEY'RE SIGNALING MOLECULES, SOMETIMES INVOLVING THE IMMUNE SYSTEM, BUT REALLY REGULATING A LOT OF OTHER ACTIONS AND BECAUSE THEY'RE BIGGER MOLECULES, IT'S HARDER TO UNDERSTAND THE RECEPTOR SIGNALING INTERACTIONS, BUT YEAH, I THINK IT'S--IT'S BEEN EXCITING AND FUN TO WORK ON. >> CRAIG COULD YOU MAKE A COMMENT ON THE MICROBIOME IN THIS REGARD, I MEAN, IF YOU CAN SPEAK, I'M NOT SURE HOW FAR--YOUR VOICE IS DEGENERATED, MINE'S ON HIS WAY. >> [INDISCERNIBLE] THE MICROBIOME IS VERY IMPORTANT. [LAUGHTER] BUT WHAT I WANTED TO DO AS NORA WAS--MUCH OF YOUR CHILDREN'S [INDISCERNIBLE] ALSO RELATES TO CHILDREN'S STUDY THAT NIEHS FUNDS AND THE THEY HAVE 156 MILLION DOLLAR THIS YEAR TO SPEND SO [INDISCERNIBLE] PARALLELS OF THAT. >> GEORGE AND I WENT AND GEORGE IS BOLDER THAN ME AND HE SAID NORA, LET'S GO AND SPEAK WITH DR. TABAK ABOUT IT AND WE ROLL OUT PROPOSAL ABOUT HOW THIS WAS A PROJECT THAT WOULD BE VERY MUCH IN LINE WITH THE NATIONAL CHILDREN'S STORY AND THEN TOLD FRIDAY THAT WE WERE NOT SELECTED. SO UNFORTUNATELY, BECAUSE THE PROJECTS THEY SELECTED AND AGAIN, GEORGE IN HIS CLARITY SAID [INDISCERNIBLE]--CAN I QUOTE YOU? >> [INDISCERNIBLE]. >> [LAUGHTER] >> [INDISCERNIBLE] WATER HAS RETURNED TO THE WELL AND A PROJECT WE'RE IN LINE WITH DEVELOPING TOOLS THAT CAN HELP YOU N[INDISCERNIBLE]. >> VERY MUCH THE WAY THE NATIONAL CHILDREN'S HAD ORIGINALLY BEEN BORN OF BUT SLIGHTLY WORDED DIFFERENTLY SO BUT OUR PROJECT WAS NOT CHOSEN WHICH WOULD HAVE BEEN WONDERFUL BECAUSE IT WOULD HAVE ENABLED US TO REALLY EXPAND BUT IT IS WHAT IT IS, RIGHT? >> [INDISCERNIBLE] >> BE ASSURED WE ASKED. WE DID ASK. NORA AND I HAVE NO RESTRICTIONS IN ASKING WHEN IT COMES TO THE ABCD STUDY. YOU CAN COUNT ON US TO CONTINUE TO ASK, OUR TIN CUP IS ALWAYS OUT. >> ARE THERE ANY OTHER COMMENTS? WE'RE A LITTLE OVER TIME, I THINK? NO WE'RE ON TIME. >> ON TIME, MY GOD, HOW DID WE DO THAT? ANYWAY. SO--YEAH, WE'RE IN THE ROUND TABLE BUT WE'VE BEEN ROUND TABLING FOR SOMETIME. O OTHER COMMENTS, QUESTIONS. >> WAITING FOR THE ROUND TABLE AND IT'S BACK TO YOUR PRESENTATION, NORA WE HAD THE GRAPH THAT SHOWS HIGH BENEFIT, LOW RISK AND SO FORTH, DO HAVE YOU A SCHEME IN YOUR MIND ABOUT WHAT PERCENTAGE OF GRANTS WOULD APPLY TO THE DIFFERENT CATEGORIES, THOSE FOUR QUADRANTS THAT WERE THERE, THERE WAS ONE THAT WAS DELINEATED FOR SCIENCE ALONE AND I WONDERED WHEN YOU'RE ON--SITTING AT NIDA, WHAT IS YOUR--WHATEE YOUR GOAL TO SEE FUNDING FOR INFORMATION'S SAKE ALONE WHERE IT MIGHT NOT BE TRANSLATIONAL IMMEDIATELY AND WHAT POSITION HAD YOU TAKEN IN THAT REGARD? >> WE ARE TAKEN TO NIH AND NIH FUNDEDY RESEARCH WITH BHE UNDERSTANDING THAT TRANSLATION WILL COME OUT OF THOSE STUDIES AS OPPOSE TO INDUSTRY WHICH WILL FUND IT FOR IMMEDIATE [INDISCERNIBLE]. SO WE DO VERY MUCH VALUE THAT MISSION OF NIH AND THE SAME THING IS TRUE FOR NIDA, IN THE IMPORTANCE OF DEVELOPING KNOWLEDGE AND IN THIS STORY OF THE ABCD, IT'S A LOT ABOUT DEVELOPING BASIC KNOWLEDGE. IT'S HARD FOR ME TO SAY A PARTICULAR PERCENTAGE BECAUSE WE SAY, OKAY, WE'RE DEVELOPING THESE PROJECTS WHAT WE DO HAVE A VERY PROACTIVE SYSTEM, TO IDENTIFY OPPORTUNITIES FOR TRANSLATION. SO WHEN THAT KNOWLEDGE EMERGES, WE SEEK OUT PROACTIVELY BY EITHER SUPPLEMENTING THE INVESTIGATOR RESEARCHERS OR BY ACTUALLY HAVING RFAs TO TAKE ADVANTAGE OF THAT KNOWLEDGE AND [INDISCERNIBLE] TRANSLATION POTENTIAL BUT I WOULD FEEL VERY UNCOMFORTABLE GIVING YOU A SPECIFIC NUMBER ABOUT THAT I PRESENTED THAT BECAUSE WE WOULD MAKE IT EXPLICIT ON THOSE OF US WHO ARE INTERESTED IN DEVELOPING KNOWLEDGE BUT WE TAKE VERY, VERY SERIOUSLY THE OPPORTUNITY FOR TRANSITRATION OF KNOWLEDGE AND THAT WE ARE GOING TO DO IT. YOU BALANCING BUT I DON'T WANT TO GIVE THAT YOU NUMBER BECAUSE IT MAY BE DEPENDENT ON WHAT THE SCIENCE AND KNOWLEDGE AND THE OPPORTUNITY. >> [INDISCERNIBLE] EITHER BUT I JUST WANT TO BE SURE I'M UNDERSTANDING IT. SO, IN THE IRG DELIBERATIONS, THERE'S NOT AN OBLIGATION THAT SOMETHING IS BEING REVIEWED AS TRANSLATIONAL MECHANISMS IN IT. AND THAT IS THE HIGHEST PRIORITY FOR IT AT NIDA. >> YOU KNOW I THINK THAT'S BEEN A MISCONCEPTION ACROSS NIH, WE DISCUSSED THIS AT INSTITUTE DIRECTORS MEETINGS AND THERE IS NOTHING--DIRECT ME IF I'M WRONG BUT THERE'S NOTHING THAT SAYS WHEN YOU WRITE A GRANT THAT IT HAS TO HAVE A TRANSLATIONAL CONOPPOSITE BEHAVIORIAL PHENOTYPENT TO IT. WE TAPE SCIENCE AND WE DON'T CARE AS LONG AS IT'S GOOD SCIENCE. SO THIS IS ONE OF THESE URBAN LEGENDS RUMORS THAT HAS FLOATED THROUGH THE SCIENTIFIC COMMUNITY, AND SO, I KNOW THAT ABE AND I HAVE CORRECTED OUR STUDY SECTIONS AT NIAAA WE WOULD PROBABLY BE TALKING TO CSR ABOUT IT BECAUSE WE'RE PLANNING MEETING NAKAMURA ARE OTHER ISSUES BUT I THINK IT'S IMPORTANT THAT YOU GET THE WORD OUT THAT THAT'S NOT A REQUIREMENT, I THINK WE LOVE TRANSLATIONAL GRANDS AND WHEN THEY'RE THERE THAT'S FINE AND THEY'LL BE REVIEWED AS TRANSLATIONAL GRANT BUS IF YOU HAVE A BASIC RESEARCH OBSERVATION AND ABCD DATA WILL GIVE US NORMAL DATA ON NORMAL KID OVER 10 YEARS THAT WILL BE INVALUABLE. >> IF YOU'RE INTERESTED IN DOING TRANSLATIONAL WORK AND THERE'S SOMEONE WHO WILL SAY ANIMAL WORK BUT WANTS TO TEEM UP WITH SOMEBODY WHO DOES MORE CLINICAL HUMAN RESEARCH, I'M NOT SO SURE THERE ARE CLEAR MECHANISMS AT NIDA, FOR WHAT I WAS TOLD IN TALKING TO SOMEBODY YESTERDAY AT OUR COUNCIL ABOUT THIS, IS THAT YOU PROBABLY GET KILL INDEED THE STUDY SECTION IF YOU HAVE A GRANT WITH THE GRAPHS AND HUMANS SO, I'M JUST KIND OF CURIOUS ABOUT WHAT YOUR TAKE IS, IN TERMS OF THE TRANSLATIONAL AND CLINICAL DIVISION AND MAYBE THE OTHER DIVISION, I MEAN HOW DOES--HOW DO WE PROGRESS IN THAT REGARD IF WE WANT TO DO THAT. >> --WE ARE TRYING TO--NIDA HAS BEEN TRYING TO PROMOTE RESEARCH ACTUALLY HA HAS THE PRECLINICAL AND CLINICAL COMPONENT BECAUSE OF THIS STUDY SECTION WHICH ALSO AND AGAIN, STUDY SECTION NOT SUPPOSED TO BE LOOKING FOR [INDISCERNIBLE] AT THE BOTTOM BUT THAT IS ONE OF THE THINGS THAT REINTEGRATED SERVICES FLU ENSELS IT, WE HAVE NOT BEEN ABLE TO ADVANCE IT AS MUCH AS WE COULD. NOW THERE ARE WAYS THAT WE CAN, WE CAN SUPPLEMENT AND FACILITATE SO YOU ARE DOING A CLINICAL PROJECT FOR EXAMPLE IN THE ABCD AND WOULD FIND THERE'S SPECIFIC EFFECTS OF [INDISCERNIBLE] THEN WE CAN USE THAT AND THERE IS ONE OF THESE RESEARCHERS THAT SAYS, YOU KNOW WE HAVE A PRECLINICAL MODEL OR HAVE--CELL, ISOLATED CELL MODEL, AND ACTUALLY REALRY POTENTIAL CELLS, WE WOULD LIKE TO BE ABLE TO UNDERSTAND, THEN WE CAN FACILITATE THAT TRANSLATION AND WE'RE HOPING THAT THE ABCD STORY WILL PROVIDE MULTIPLE OPPORTUNITIES FOR THAT TYPE OF DIALOGUE BECAUSE IN A PERSPECTIVE STORY, YOU WILL ARE NOT GOING TO [INDISCERNIBLE] UNDERSTAND MECHANISMS, RESPONSIBLE FOR SOME OF THE CHANGES THAT WE MAY BE OBSERVING, SO IT WOULD BE A RICHNESS TO BE ABLE TO LINK THEM. SO BEING PROACTIVE WOULD SUPPLEMENT A WAY TO TRY TO DO IT. AND IF THERE ARE OTHER SUGGESTIONS THAT YOU HAVE, WE ARE OPEN TO THEM. >> [INDISCERNIBLE] I WOULD LIKE TO MAKE THIS TO OUR COUNCIL BUT, WE'VE HAD SOME SUCCESSES NIAAA THESE TRANSLATIONAL GRANTS WHERE ONE COMOPPOSITE ONE--COMOPPOSITE BEHAVIORIAL PHENOTYPE SENT RATS AND ONE COMPONENT IS HUMAN STUDIES BUT I THINK IT'S IMPORTANT THAT YOU CONTACT PROGRAM OFFICERS AT NIAAA AND ASSUMING THE SAME AT NIDA TO FIND AUGHT WHAT THE PRIORITIES AND ARE MECHANISMS ARE THAT ARE AVAILABLE FOR THESE KIND OF APPROACHES. BECAUSE DOING THESE HIT OR MISS IS NOT A WISE IDEA FOR BUDGET AND LOW PAY LINES. >> I AGREE AND THAT'S WHAT I DID YESTERDAY. >> O, YOU KNOW IN THE STUDY SECTION YOU'LL GET KILLED BUT PEOPLE WERE OPEN TO TRYING TO FIGURE OUT WAYS OF HOW THIS WORKS SO I JUST WANT TO PUT IT OUT THERE AND SAY THERE ARE SOME OF THESE THAT ARE INTERESTED IN THIS THAT GO BEYOND, I LOVE THAT YOU DOLL IT IN THE ABCD STUDY, BUT YOU KNOW OTHERS OF US WANT TO TRY TO FIND OPPORTUNITIES TO DO IT INDEPENDENT OF THAT AS WELL. AND IT'S JUST SEEMS LIKE THERE'S A ROAD BLOKE TO IT. AND. >> AND I DIDN'T KNOW WHAT YOU'RE SAY SUGGEST ALSO IN TERMS OF--AGAIN, ANTICIPATING WHERE THE SCIENCE IS GOING TO BE AND JUST [INDISCERNIBLE] AT OUR COUNSELS AND I WILL SPEAKING ABOUT WHERE THE GENETICS ARE GOING INTO THE FUTURE AND AS WE FIND GENES THAT ARE [INDISCERNIBLE] YOU WANT TO BE ABLE TO INVESTIGATOR ANOTHER, AND NOW THAT WE HAVE THE TOOLS TO MODIFY THE GENETIC CODE, SPECIFICALLY IN A CELL OR IN AN ANIMAL, IN A WAY THAT IS HUMAN, YOU WANT TO BE ABLE TO HAVE THAT ABILITY TO TRANSLATE. SO I THINK IN TERMS OF--MAYBE WE NEED TO RETHINK THE SPECIFIC WAYS OF PROPOSAL THAT TYPICALLY ARE TARGETED BECAUSE WE--I BELIEVE WE'RE GOING TO HAVE A GREATER AND GREATER NEED FOR THAT TYPE OF TRANSLATION. AND I AGREE AND I THOUGHT MAYBE, IT'S AN OPPORTUNITY FOR A STRATEGIC PLAN TO THINK ABOUT THAT. I DIDN'T HAVE THE ANSWER BUT I THOUGHT WE SHOULD THINK ABOUT IT. >> YEAH, NO, I--VERY GOOD THAT RELATES TO WHAT SUSAN SERS MENTIONING THAT WHEN WE ARE ACTUALLY TRYING TO INCENTIVIZE RESEARCHERS TO GO INTO A PARTICULAR AREA, WE PROVIDE MUCH GREATER FLEXIBILITY AND OPENNESS FOR RESEARCHERS TO GO TO PRODUCTS THAT WOULD HAVE CO-INFECTION, SO WE START WITH THE AVANT GUARD FOR THE PIONEER AWARD WHICH IS SUCCESSFUL THAT WAY AND SO THEY WANT US TO CALL THE PIONEER AWARD SO WE CAME OUT WITH THE AVANT GUARD, SO NOW WE HAVE THE HIV AND THEN WE DID IT FOR MEDICATION DEVELOPMENT AND AGAIN THE OPPORTUNITY TO TAKE A CLINICAL FINDING THAT YOU'RE INTERESTED INTO TRANSLATIONAL PROJECT BUT THESE GUYS SPECIFICALLY TARGETS MEDICATIONS. BUT WE'RE DOING EXACTLY THE SAME THING NOW, FOR A YOUNGER INVESTIGATOR, FOR GENETIC RESEARCH, SO CREATING THE OPPORTUNITY FOR SOMETHING THAT'S CREATIVE AND THEREFORE MAY NOT GO VERY WELL IN THE INFECTIONS AND MAYBE OTHER [INDISCERNIBLE] FOR THOSE, HOW DO YOU ALSO PROMOTE THAT RESEARCH THAT IS [INDISCERNIBLE] THAT WILL NOT GO WELL IN A STUDY SECTION? >> I'M OFF TOPIC BUT I THINK THE PROBLEM OF ALLOWING MECHANISMS FOR ALLOWING PEOPLE TO WORK AT DIFFERENT LEVELS WILL BE CONNECTED TO THAT MECHANISM? I KNOW THAT MECHANISMS ARE OUT THESE DAYS AND AND IT'S INCREDIBLE TO HAVE IT BE THE SAME GRANT AND ALL THIS STAFF AND ALL THAT. AND WE HAVE TO KEEP IN MIND THAT SOMETIMES THE ADDED VALUE OF THESE MECHANISMS IS CRITICAL IS THE OTHER KIND OF TRANSLATION IS THE PEOPLE BEING SORT OF FORCED BY THE MECHANISM TO BE TALKING AND EDUCATING EACH OTHER ABOUT THE SUBTLYS OF THE PHENOMENA THAT THEY'RE OBSERVING AT THE DIFFERENT LEVEL, BASIC SCIENTIST TO THE CLINICAL STUDIES OR TRANSLATION SETTING AND THE SUBTLY OF THE UNDERSTAND SUGGEST THERE BECAUSE PEOPLE ARE NOT ACTUALLY ENGAGE INDEED ACTIVE DIALOGUE ABOUT SCIENCE AND EDUCATING EACH OTHER SO THAT--SO THAT IT'S NOT SUPERFICIAL FOLLOW UP IF YOU KNOW WHAT I MEAN. SO SOMEHOW, I DON'T KNOW, HOW EXACTLY I WOULD DO THIS, BUT SOME APPRECIATION OF WHAT CAN BE THE ADDED VALUE OF HAVING PEOPLE CONNECTED TO EACH OTHER IN SOME WAY, USUALLY BY THE MECHANISM OF THE GRANT OR WHATEVER AND WORKING AT OTHER LEVELS AND UNDERSTANDING THINGS WELL FOR DIFFERENT LEVELS AND EDUCATING EACH OTHER SO THAT THE TRANSLATION IS SOPHISTICATED AND SUBTLE AS IT SHOULD BE. SOMEHOW THAT NEEDS TO BE CREDITED IN THERE. >> NOT ALL NIH INSTITUTE DOS THAT, SOME AFTER A CERTAIN AMOUNT OF TIME, OURS DE FACTO HAVE SOME BY THEMSELVES IN MANY CASES BECAUSE THE CRITICAL MASS HAS AGED AND MOVED ON OR RETIRED OR WHATEVER, BUT IN A FEW OF THE CENTERS, THEY CONTINUED OVER THE YEARS AND THEN THEY FORM A CRITICAL MASS FOR A WHOLE GROUP OF RO-1S AROUND THEM AND SO THAT'S BEEN A MODEL THAT I STILL FIND USEFUL, AND I THINK WE HAVE A LIMITED NUMBER OF AND IN A CENTER NOW, BUT THAT'S HOW WE STUDY BUT WE ARE A SMALLER INSTITUTE AND FOCUS ON A GIVEN TOPIC, SO THEY COULD BE HIV/AIDS, THEY COULD BE CENTRAL NERVOUS SYSTEM, THEY COULD EVEN BE ORGAN DAMAGE, BUT THAT'S HOW WE KIND OF WORD IT. >> I JUST WANT TO COMMENT ON YOUR STATEMENT WHERE THEY DO PROVIDE A FORUM FOR THEY LEARN THE LANGUAGE AND SCIENTISTS LEARN THE LANGUAGE AND BE ABLE TO COMMUNICATE AND OUR CENTERS JUST WENT THROUGH THE RENEWAL AND FOR THE FIRST TIME WILL HAVE HUMAN SUBJECTS IN THREE OF THE COMPONENTS AND MONKEYS AND TWO OTHER COMPONENTS. BUT IT TOOK LIKE 15 YEARS. >> BUT I WAS THINKING IT COULD BE CREATIVE AND BE PROMOTED BECAUSE WE'RE THINKING WITH THE SENSOR AND WHEN YOU'RE BUDGET RESTRICTED, RO-1s, YOUR RO-1 SUCCESS WILL GO DOWN FURTHER, BUT THERE ARE WAYS IN WHICH YOU CAN CREATE A NETWORK WITHOUT NECESSARILY HAVING TO MAKE IT TO A LAST CENTER AND THEN I REMEMBER I WAS PART OF A CENTER OF EXCELLENCE BY NIMH ON ADHD, THAT GAVE $50,000 A YEAR AND THAT WAS SUFFICIENT TO BRING US ALTOGETHER AND DISCUSS, IT WAS EXTREMELY PRODUCTIVE, ONE OF THE MOST PRODUCTIVE COLLABORATIONS AND THE AMOUNT OF MONEY WAS VERY MINIMAL AND AS YOU WERE SAYING THAT AND YOU WERE SPEAKING ABOUT THE CLINICAL AND THE PRECLINICAL I WAS THINK BEING COMPUTER SCIENTISTS, I WORK WITH SYSTEM MATHEMATICIANS AND IF I WANT TO OBSTRUCT INFORMATION FROM BRAIN IMAGING YOU HAVE TO DIALOGUE AND YOU QUESTIONS YOU WANT TO OBTAIN FROM THE DATABASE, NOT JUST LOOKING IN COMPLETE DARKNESS. AND EXPABDING MORE INTO DATABASES AND LOOKING MORE FOR THE INFORMATIONAL SCIENCES. >> I THINK WE ARE INTERESTED IN TRANSLATIONAL RESEARCH BUT IT'S NOT A REQUIREMENT FOR YOUR GRANT. >> I THINK THE BOTTOM LINE IS HERE, AND SO, WORK WITH US IF YOU HAVE CREATIVE WAYS THAT YOU WANT TO TRY AND INTEGRATE OR WORK ACROSS AND WITH MODERN TECHNOLOGY NOW, YOU KNOW, YOU CAN COOPERATE WITH INDIVIDUALS EVEN CLOSE COAST TO COAST AND THAT'S WHAT WE'RE DOING WITH THE ABCD STUDY, SO IT'S NOT IMPOSSIBLE ANYMORE THAT COMMUNICATION IS DIFFERENT FROM THE OLD DAY WHEN IS WE USE FAX MACHINE. WHICH I REMEMBER. >> OKAY, ARE THERE ANY OTHER COMMENTS OR QUESTIONS FROM EVERYBODY? I THINK MOST PEOPLE WOULD LIKE TO GET TO LUNCH? AND I GUESS NIAAA WE RECONVENE HERE AT 2:00 SO WE HAVE TO DO OUR--THE HARD WORK OF APPROVING GRANTS SO ANYWAY, THANKS EVERYONE COMING AND WE VALUE INPUT AND THANKS FOR TAKING FOR SUMMARIZING THE CRAN WORK AND NORA FOR COMING OUT TO ROCKVILLE. >> THANK YOU. GEORGE AND THE OPPORTUNITY FOR HOSTING, THANK YOU VERY MUCH AND PROVIDING US AND THERE AND I SAID, OKAY TO YOUR STAFF, DO HAVE YOU THE DECAFINATEED AND THEY THE FACE ON THEM.