1 00:00:05,800 --> 00:00:08,960 I'M GEORGE KOOB, I'M THE 2 00:00:08,960 --> 00:00:11,240 DIRECTOR OF THE NATIONAL 3 00:00:11,240 --> 00:00:12,640 INSTITUTE ON ALCOHOL ABUSE AND 4 00:00:12,640 --> 00:00:13,200 ALCOHOLISM. 5 00:00:13,200 --> 00:00:15,760 THIS IS THE 11th JOINT MEETING 6 00:00:15,760 --> 00:00:19,240 OF THE NATIONAL ADVISORY 7 00:00:19,240 --> 00:00:19,680 COUNCILS. 8 00:00:19,680 --> 00:00:23,800 IT'S THE 10th MEETING OF THE 9 00:00:23,800 --> 00:00:24,880 COLLABORATIVE RESEARCH ON 10 00:00:24,880 --> 00:00:28,000 ADDICTION NIH FONDLY KNOWN AS 11 00:00:28,000 --> 00:00:28,200 CRAN. 12 00:00:28,200 --> 00:00:29,560 OKAY. 13 00:00:29,560 --> 00:00:31,560 SO WELCOME TO THIS 11th MEETING 14 00:00:31,560 --> 00:00:35,560 OF OUR COUNCILS AND CRAN. 15 00:00:35,560 --> 00:00:38,920 WHAT I'D LIKE TO DO FIRST IS 16 00:00:38,920 --> 00:00:40,600 HAVE THE INDIVIDUALS WHO ARE 17 00:00:40,600 --> 00:00:42,880 HERE IN PERSON FROM OUR 18 00:00:42,880 --> 00:00:44,920 RESPECTIVE COUNCILS TO INTRODUCE 19 00:00:44,920 --> 00:00:45,240 THEMSELVES. 20 00:00:45,240 --> 00:00:46,640 I THINK WE'LL START ON THE LEFT 21 00:00:46,640 --> 00:00:48,840 WITH MICHAEL LEWIS AND THEN JUST 22 00:00:48,840 --> 00:00:51,040 MOVE AROUND THE TABLE AND THEN 23 00:00:51,040 --> 00:00:53,920 THOSE OF YOU ONLINE, WE'RE NOT 24 00:00:53,920 --> 00:00:56,560 GOING TO GO THROUGH AN ONLINE 25 00:00:56,560 --> 00:00:57,960 INTRODUCTION, BUT WE CAN SEE 26 00:00:57,960 --> 00:01:01,640 YOUR FACE AND WE CAN SEE YOUR 27 00:01:01,640 --> 00:01:04,520 NAME AND YOU HAVE A LISTING OF 28 00:01:04,520 --> 00:01:06,760 THE COUNCIL MEMBERS WHO ARE 29 00:01:06,760 --> 00:01:07,080 PARTICIPATING. 30 00:01:07,080 --> 00:01:09,080 SO WE'LL START WITH MICHAEL 31 00:01:09,080 --> 00:01:10,640 LEWIS AND MICHAEL? 32 00:01:10,640 --> 00:01:11,360 >>GOOD MORNING. 33 00:01:11,360 --> 00:01:15,720 I'M MICHAEL LEWIS, I'M PROFESSOR 34 00:01:15,720 --> 00:01:20,120 OF PSYCHOLOGY AT HUNTER COLLEGE 35 00:01:20,120 --> 00:01:23,520 CITY UNIVERSITY OF NEW YORK. 36 00:01:23,520 --> 00:01:26,080 NIAAA COUNCIL AND I'M INTERESTED 37 00:01:26,080 --> 00:01:28,680 IN ALCOHOL FEEDING AND NUTRITION 38 00:01:28,680 --> 00:01:31,680 AS THEY RELATE TO PROBLEMS OF 39 00:01:31,680 --> 00:01:40,520 THE DEPENDENCE WITH ALCOHOL. 40 00:01:40,520 --> 00:01:42,320 >>GOOD MORNING. 41 00:01:42,320 --> 00:01:46,520 I'M DIRECTOR OF THE INDIANA 42 00:01:46,520 --> 00:01:47,200 ALCOHOL RESEARCH CENTER AND MY 43 00:01:47,200 --> 00:01:48,880 OWN INTERESTS ARE IN THE AREA OF 44 00:01:48,880 --> 00:01:52,520 BRAIN IMAGING OF RISKS FOR 45 00:01:52,520 --> 00:01:54,720 ALCOHOL USE DISORDER. 46 00:01:54,720 --> 00:02:00,400 >>I'M TINA CHAMBER, 47 00:02:00,400 --> 00:02:05,160 EPICHEMOOLOGIST AT THE 48 00:02:05,160 --> 00:02:05,760 UNIVERSITY OF CALIFORNIA SAND 49 00:02:05,760 --> 00:02:12,400 DIEGO AND MY WORK IS IN FETAL 50 00:02:12,400 --> 00:02:15,240 AND CHILD DEVELOPMENT. 51 00:02:15,240 --> 00:02:18,040 >>PROFESSOR IN BEHAVIORAL AND 52 00:02:18,040 --> 00:02:18,760 SOCIAL SCIENCES. 53 00:02:18,760 --> 00:02:22,040 I STUDY ALCOHOL MISUSE AMONG 54 00:02:22,040 --> 00:02:23,240 ADOLESCENTS AND YOUNG ADULTS 55 00:02:23,240 --> 00:02:26,280 WITH A FOCUS ON PEER INFLUENCE 56 00:02:26,280 --> 00:02:28,520 BY STANDARD BEHAVIOR AND SOCIAL 57 00:02:28,520 --> 00:02:29,000 NETWORKS. 58 00:02:29,000 --> 00:02:35,840 I ALSO STUDY ALCOHOL BIO 59 00:02:35,840 --> 00:02:37,560 SENSORS. 60 00:02:37,560 --> 00:02:43,600 >>I'M THE AAA COUNCIL AND I'M 61 00:02:43,600 --> 00:02:52,520 ALSO CHIEF OF THE AAA. 62 00:02:52,520 --> 00:02:54,640 >>I'M THE SGOOD MORNING. I'M 63 00:02:54,640 --> 00:02:55,640 VOLKOW. 64 00:02:55,640 --> 00:02:57,200 I'M DIRECTOR OF THE NATIONAL 65 00:02:57,200 --> 00:02:59,280 INSTITUTE ON DRUG ABUSE. 66 00:02:59,280 --> 00:03:01,760 IT'S A PLEASURE TO BE HERE WITH 67 00:03:01,760 --> 00:03:04,320 MY COLLEAGUE DR. GEORGE KOOB AND 68 00:03:04,320 --> 00:03:09,240 WE ARE BRINGING TOGETHER BOTH 69 00:03:09,240 --> 00:03:11,960 OUR COUNCIL AND IT'S THE FIRST 70 00:03:11,960 --> 00:03:12,400 TIME WE WORK TOGETHER. 71 00:03:12,400 --> 00:03:13,040 WITH THAT I'M GOING TO TURN IT 72 00:03:13,040 --> 00:03:13,760 DOWN TO MY RIGHT. 73 00:03:13,760 --> 00:03:17,000 >>WILSON COMP STON NATIONAL 74 00:03:17,000 --> 00:03:20,400 DIRECTOR ON DRUG ABUSE. 75 00:03:20,400 --> 00:03:21,840 >>SUSAN WEISS, NATIONAL 76 00:03:21,840 --> 00:03:25,040 INSTITUTE ON DRUG ABUSE AND 77 00:03:25,040 --> 00:03:26,560 EXECUTIVE SECRETARY FOR COUNCIL. 78 00:03:26,560 --> 00:03:28,360 >>GOOD MORNING. 79 00:03:28,360 --> 00:03:29,880 I'M FROM WASHINGTON UNIVERSITY 80 00:03:29,880 --> 00:03:31,120 IN ST. LOUIS AND MY INTERESTS 81 00:03:31,120 --> 00:03:34,640 ARE IN GENETICS AND NEUROSCIENCE 82 00:03:34,640 --> 00:03:37,920 OF ALCOHOL OPIOIDS AND CANNABIS. 83 00:03:37,920 --> 00:03:38,520 >>GOOD MORNING. 84 00:03:38,520 --> 00:03:40,240 I'M AT THE UNIVERSITY OF 85 00:03:40,240 --> 00:03:41,240 PENNSYLVANIA IN THE DEPARTMENT 86 00:03:41,240 --> 00:03:43,880 OF PSYCHIATRY. 87 00:03:43,880 --> 00:03:44,960 I DO BRAIN IMAGING AND ADDICTION 88 00:03:44,960 --> 00:03:47,920 LOOKING FOR SUBSTRATES OF 89 00:03:47,920 --> 00:03:48,760 RELAPSE VULNERABILITY AND SOME 90 00:03:48,760 --> 00:03:53,360 MEDICATION DEVELOPMENT WHEN IT 91 00:03:53,360 --> 00:03:53,560 WORKS. 92 00:03:53,560 --> 00:03:57,640 >>GOOD MORNING. 93 00:03:57,640 --> 00:03:58,120 I'M SHELLY GREENFIELD. 94 00:03:58,120 --> 00:03:58,760 I'M AN ADDICTION PSYCHIATRIST 95 00:03:58,760 --> 00:04:03,440 AND PROFESSOR OF PSYCHIATRY AT 96 00:04:03,440 --> 00:04:05,240 HARVARD MEDICAL SCHOOL. 97 00:04:05,240 --> 00:04:07,000 I'M INTERESTED IN GENDER 98 00:04:07,000 --> 00:04:10,320 DIFFERENCES IN SUBSTANCE USE 99 00:04:10,320 --> 00:04:12,200 DISORDERS AND ALSO TREATMENT FOR 100 00:04:12,200 --> 00:04:14,280 SUBSTANCE USE DISORDERS ALONG 101 00:04:14,280 --> 00:04:15,240 WITH DISSEMINATION. 102 00:04:15,240 --> 00:04:18,000 >>GOOD MORNING. 103 00:04:18,000 --> 00:04:19,920 I'M AT THE UNIVERSITY OF SCHOOL 104 00:04:19,920 --> 00:04:22,520 OF MEDICINE, PROFESSOR OF 105 00:04:22,520 --> 00:04:23,760 PSYCHIATRY, NEUROSCIENCE AND 106 00:04:23,760 --> 00:04:27,320 CHILD STUDY AND MY WORK IS ON 107 00:04:27,320 --> 00:04:29,680 STRESS AND ALCOHOL AND SUBSTANCE 108 00:04:29,680 --> 00:04:32,360 DISORDERS FOCUSING ON ADDICTION 109 00:04:32,360 --> 00:04:36,640 RISK AND RELAPSE AND TREATMENT 110 00:04:36,640 --> 00:04:44,640 OUTCOMES DURING IMAGING, OTHER 111 00:04:44,640 --> 00:04:46,320 PHYSIOLOGICAL MEASURES AND 112 00:04:46,320 --> 00:04:47,160 CLINICAL TRIALS TO ADDRESS 113 00:04:47,160 --> 00:04:50,600 STRESS REDUCTION WITH ADDICTION. 114 00:04:50,600 --> 00:04:50,840 THANKS. 115 00:04:50,840 --> 00:04:51,360 >>OKAY. 116 00:04:51,360 --> 00:04:55,520 SO WELCOME, EVERYONE. 117 00:04:55,520 --> 00:04:58,400 WELCOME EVERYONE, ONLINE. 118 00:04:58,400 --> 00:05:00,200 MY DEPUTY IS GETTING OVER A COLD 119 00:05:00,200 --> 00:05:03,080 SO DO YOU WANT TO JUST SAY HI? 120 00:05:03,080 --> 00:05:04,200 >>HI, GOOD MORNING, EVERYBODY. 121 00:05:04,200 --> 00:05:06,040 I DECIDED TO STAY HOME AND SHARE 122 00:05:06,040 --> 00:05:07,800 MY GERMS ONLY WITH MY FAMILY 123 00:05:07,800 --> 00:05:10,160 INSTEAD OF ALL OAF YOU, BUT I'M 124 00:05:10,160 --> 00:05:11,680 GLAD TO BE HERE. 125 00:05:11,680 --> 00:05:14,240 SORRY NOT TO BE IN PERSON TODAY. 126 00:05:14,240 --> 00:05:15,640 >>THANKS, TRISH. 127 00:05:15,640 --> 00:05:17,040 >>OKAY. 128 00:05:17,040 --> 00:05:21,240 SO I THINK WE'RE ON SCHEDULE AS 129 00:05:21,240 --> 00:05:25,040 THE BRITS SAY, SO I THINK WE'LL 130 00:05:25,040 --> 00:05:25,640 JUST MOVE TO MY PRESENTATION 131 00:05:25,640 --> 00:05:27,400 UNLESS THERE'S ANY OTHER 132 00:05:27,400 --> 00:05:27,720 BUSINESS. 133 00:05:27,720 --> 00:05:28,000 OKAY. 134 00:05:28,000 --> 00:05:34,520 SO IF YOU PUT THE SLIDES UP, 135 00:05:34,520 --> 00:05:37,960 JOHN, WHICH YOU DID, AND SO THE 136 00:05:37,960 --> 00:05:39,960 FIRST THING I WANT TO SAY IS 137 00:05:39,960 --> 00:05:43,880 WHAT A PLEASURE IT'S BEEN 138 00:05:43,880 --> 00:05:50,720 WORKING WITH NORA AND NIDA OVER 139 00:05:50,720 --> 00:05:51,120 THE LAST NINE YEARS. 140 00:05:51,120 --> 00:05:51,480 IT 141 00:05:51,480 --> 00:05:52,520 IT'S NINE YEARS SINCE I DID MY 142 00:05:52,520 --> 00:05:54,640 FIRST CRAN MEETING AND I DON'T 143 00:05:54,640 --> 00:06:05,360 KNOW WHY BUT I'M FEELING EXI-- 144 00:06:08,840 --> 00:06:12,840 TODAY MOSTLY BECAUSE OF THE LOSS 145 00:06:12,840 --> 00:06:18,440 OF MY FRIENDS. 146 00:06:18,440 --> 00:06:20,840 ABE WAS RESPONSIBLE FOR 147 00:06:20,840 --> 00:06:24,080 EXTRAMURAL GRANT AND CONTRACTRY 148 00:06:24,080 --> 00:06:25,240 VIEW, THE MANAGEMENT OF CHARTER 149 00:06:25,240 --> 00:06:26,920 REVIEW GROUPS AND SPECIAL 150 00:06:26,920 --> 00:06:29,240 EMPHASIS PANELS AND ALL GRANTS, 151 00:06:29,240 --> 00:06:30,160 MANAGEMENT ACTIVITIES. 152 00:06:30,160 --> 00:06:32,560 HE SERVED AS EXECUTIVE SECRETARY 153 00:06:32,560 --> 00:06:36,200 OF NIAAA'S ADVISORY COUNCIL AND 154 00:06:36,200 --> 00:06:39,480 WAS RESPONSE L FOR OVERSEEING 155 00:06:39,480 --> 00:06:40,080 AND COORDINATING COMMENDING 156 00:06:40,080 --> 00:06:43,000 MANAGEMENT ACTIVITIES INCLUDING 157 00:06:43,000 --> 00:06:44,240 FEDERAL ADVISORY COMMITTEES. 158 00:06:44,240 --> 00:06:46,040 HE CLAIMS IN HIS RETIREMENT THAT 159 00:06:46,040 --> 00:06:47,640 HE'S LOOKING FORWARD TO 160 00:06:47,640 --> 00:06:49,280 EXPANDING HIS TRAVELS AND 161 00:06:49,280 --> 00:06:52,120 FINDING OTHER EXCITING WAYS TO 162 00:06:52,120 --> 00:06:53,680 FILL HIS DAYS BUT HE WILL BE 163 00:06:53,680 --> 00:06:56,320 MISSED AND I THINK YOU ALREADY 164 00:06:56,320 --> 00:06:58,800 KNOW THE ACTING OFFICE OF 165 00:06:58,800 --> 00:07:02,840 EXTRAMURAL ACTIVITIES DIRECTOR 166 00:07:02,840 --> 00:07:11,240 AND RV SRINIVAS IS SERVING AS 167 00:07:11,240 --> 00:07:11,800 EXECUTIVE SECRETARY FOR THE 168 00:07:11,800 --> 00:07:15,080 NIAAA DOWCOUNCIL. 169 00:07:15,080 --> 00:07:16,960 LOTS OF THANKS FOR STEPPING UP. 170 00:07:16,960 --> 00:07:18,800 ONE OF THE MAJOR LOSSES THAT 171 00:07:18,800 --> 00:07:22,520 OCCURRED IN THE ALCOHOL FIELD 172 00:07:22,520 --> 00:07:27,400 VERY RECENTLY WAS GORDAS, HE 173 00:07:27,400 --> 00:07:31,520 SERVED AS NIAAA DIRECTOR FROM 174 00:07:31,520 --> 00:07:33,240 1986 TO 2001. 175 00:07:33,240 --> 00:07:34,520 HE EMPHASIZED SCIENCE AS A WAY 176 00:07:34,520 --> 00:07:36,480 OF UNDERSTANDING ALCOHOL USE 177 00:07:36,480 --> 00:07:37,240 DISORDER. 178 00:07:37,240 --> 00:07:39,120 HE TRAINED IN INTERNAL MEDICINE. 179 00:07:39,120 --> 00:07:49,080 HE CONDUCTED RESEARCH. 180 00:07:49,080 --> 00:07:55,240 DR. ROSALYN DURING HIS RESIDENCY 181 00:07:55,240 --> 00:07:59,680 IN MOUNT SINAI HOSPITAL IN NEW 182 00:07:59,680 --> 00:08:00,240 YORK. 183 00:08:00,240 --> 00:08:04,600 HE DID SOME RESEARCH IN THE 184 00:08:04,600 --> 00:08:06,400 ROCKEFELLER UNIVERSITY WHERE HE 185 00:08:06,400 --> 00:08:09,960 BEGAN HIS CAREER IN THE STUDY OF 186 00:08:09,960 --> 00:08:10,560 ADDICT 187 00:08:10,560 --> 00:08:10,800 ADDICTION. 188 00:08:10,800 --> 00:08:13,240 AND LATER, HE WORKED WITH 189 00:08:13,240 --> 00:08:14,760 PSYCHIATRIC RESEARCHER DR. RUTH 190 00:08:14,760 --> 00:08:23,920 FOX WHO HELPED INTRODUCE A 191 00:08:23,920 --> 00:08:24,240 MEDICATION. 192 00:08:24,240 --> 00:08:28,200 YOU PROBABLY DONE KNOW HOW MUCH 193 00:08:28,200 --> 00:08:30,160 A HAND HE HAD IN MEDICATION 194 00:08:30,160 --> 00:08:31,280 DEVELOPMENT BUT HE WAS A 195 00:08:31,280 --> 00:08:33,720 VISIONARY IN THAT REGARD. 196 00:08:33,720 --> 00:08:36,040 HE FOUNDED A NEW ALCOHOL 197 00:08:36,040 --> 00:08:37,040 TREATMENT PROGRAM IN QUEENS NEW 198 00:08:37,040 --> 00:08:37,240 YORK. 199 00:08:37,240 --> 00:08:39,360 HE REMAINED THERE UNTIL HIS 200 00:08:39,360 --> 00:08:42,080 APPOINTMENT TO AIAAA. 201 00:08:42,080 --> 00:08:45,040 HE IS REMEMBERED AS A VISIONARY 202 00:08:45,040 --> 00:08:46,520 LEADER DURING HIS TENURE. 203 00:08:46,520 --> 00:08:48,840 AS DIRECTOR HE OVERSAW THE 204 00:08:48,840 --> 00:08:50,160 LAUNCH OF SEVERAL RESEARCH 205 00:08:50,160 --> 00:08:51,640 INITIATIVES INCLUDING THE 206 00:08:51,640 --> 00:08:53,840 COLLABORATIVE STUDY ON THE 207 00:08:53,840 --> 00:08:57,440 GENETICS OF ALCOHOLISM. 208 00:08:57,440 --> 00:09:02,080 THE NATIONAL LONGITUDINAL 209 00:09:02,080 --> 00:09:04,520 EPIDEEM LOGIC STUDY AND THE 210 00:09:04,520 --> 00:09:06,480 COMBINING THERAPIES AND CLINICAL 211 00:09:06,480 --> 00:09:08,520 STUDY. 212 00:09:08,520 --> 00:09:12,040 HIS LEADERSHIP IS EMBODIED BY 213 00:09:12,040 --> 00:09:13,760 HIS LOVE OF SCIENCE, HIS 214 00:09:13,760 --> 00:09:15,360 COMPASSION AS A CLINICIAN AND 215 00:09:15,360 --> 00:09:17,240 HIS DEMEANOR AS A GENTLEMAN. 216 00:09:17,240 --> 00:09:19,800 HE INSPIRED MANY AND LEFT A 217 00:09:19,800 --> 00:09:22,920 LASTING IMPACT ON NIAAA, NIH AND 218 00:09:22,920 --> 00:09:27,920 THE ALCOHOL RESEARCH FIELD. 219 00:09:27,920 --> 00:09:31,040 I REALLY CONSIDERED E-NOCH A 220 00:09:31,040 --> 00:09:32,720 MENTOR, A ROLE MODEL, SCHOLAR 221 00:09:32,720 --> 00:09:35,680 AND PARTICULARLY A GENTLEMAN AND 222 00:09:35,680 --> 00:09:37,960 THOSE OF YOU KNOW HE SPONSORS 223 00:09:37,960 --> 00:09:41,960 THE GORDIS AWARDS AT RSA WHICH 224 00:09:41,960 --> 00:09:45,240 HAVE TAKEN ON A REALLY SALIENT 225 00:09:45,240 --> 00:09:51,760 ROLE IN -- FOR YOUNG PEOPLE. 226 00:09:51,760 --> 00:09:52,440 THE AWARD EE AND THE RUNNER UP 227 00:09:52,440 --> 00:09:55,400 AND HAVE THEIR POSTERS YOU KNOW, 228 00:09:55,400 --> 00:09:57,920 EVALUATED AND ENOCH USED TO GO 229 00:09:57,920 --> 00:09:59,600 TO ALL OF THESE FOR YEARS AND 230 00:09:59,600 --> 00:10:00,880 YEARS AFTER HE RETIRED. 231 00:10:00,880 --> 00:10:02,640 AND HE ALSO PARTICIPATED IN MANY 232 00:10:02,640 --> 00:10:06,800 OF OUR ACTIVITIES LIKE THE 233 00:10:06,800 --> 00:10:10,080 MENDELSON LECTURE AT NIH. 234 00:10:10,080 --> 00:10:15,920 SO HE'LL BE SORELY MISSED AND IT 235 00:10:15,920 --> 00:10:23,120 JUST MARKS A MAJOR CHANGE IN ONE 236 00:10:23,120 --> 00:10:25,000 GENERATION IS MOVING ON TO 237 00:10:25,000 --> 00:10:28,360 ANOTHER GENERATION SO TO SPEAK. 238 00:10:28,360 --> 00:10:28,960 NEXT SLIDE. 239 00:10:28,960 --> 00:10:30,440 SO I'M NOT GOING TO BORE YOU 240 00:10:30,440 --> 00:10:32,560 WITH THIS BUT I JUST WANT TO 241 00:10:32,560 --> 00:10:38,760 REMIND YOU THAT THE DSMV WHICH 242 00:10:38,760 --> 00:10:40,640 INCORPORATES THE 11 CRITERIA AND 243 00:10:40,640 --> 00:10:42,680 BASICALLY A MERGE OF THE 244 00:10:42,680 --> 00:10:45,240 CRITERIA OF THE OLD ABUSE 245 00:10:45,240 --> 00:10:47,280 CRITERIA AND DEPENDENCE CRITERIA 246 00:10:47,280 --> 00:10:49,160 ESTIMATES THAT USING THAT METRIC 247 00:10:49,160 --> 00:10:50,880 THERE ARE 29 MILLION INDIVIDUALS 248 00:10:50,880 --> 00:10:53,640 WITH ALCOHOL USE DISORDER IN THE 249 00:10:53,640 --> 00:10:54,000 UNITED STATES. 250 00:10:54,000 --> 00:10:56,560 AND THERE ARE A NUMBER OF 251 00:10:56,560 --> 00:10:58,120 EMERGENCY DEPARTMENT VISITS AND 252 00:10:58,120 --> 00:10:59,960 DEATHS THAT ARE ASSOCIATED WITH 253 00:10:59,960 --> 00:11:00,200 ALCOHOL. 254 00:11:00,200 --> 00:11:02,400 I MEAN, YOU'VE ALL HEARD ME SAY 255 00:11:02,400 --> 00:11:04,760 THIS BEFORE BUT IF YOU GO INTO 256 00:11:04,760 --> 00:11:07,120 ANY MAJOR EMERGENCY ROOM AT ANY 257 00:11:07,120 --> 00:11:08,920 MAJOR MEDICAL CENTER IN THE 258 00:11:08,920 --> 00:11:10,400 UNITED STATES, AND I UNDERSTAND 259 00:11:10,400 --> 00:11:12,040 IT'S ALSO TRUE IN CANADA, ON A 260 00:11:12,040 --> 00:11:13,560 FRIDAY OR SATURDAY NIGHT, HALF 261 00:11:13,560 --> 00:11:16,080 THE PEOPLE THERE ARE BECAUSE OF 262 00:11:16,080 --> 00:11:21,240 ALCOHOL ONE WAY OR ANOTHER. 263 00:11:21,240 --> 00:11:22,560 THE NEXT SLIDE. 264 00:11:22,560 --> 00:11:24,120 AND AARON WHITE JUST PUT THIS 265 00:11:24,120 --> 00:11:26,240 TOGETHER, BUT YOU CAN SEE WHAT 266 00:11:26,240 --> 00:11:28,640 WE WILL CALL PROBABLY WILL CALL 267 00:11:28,640 --> 00:11:31,400 IN ULTIMATELY THE PANDEMIC SURGE 268 00:11:31,400 --> 00:11:33,240 IN ALCOHOL RELATED DEATHS. 269 00:11:33,240 --> 00:11:35,000 THESE ARE ACTUAL DEATHS THAT ARE 270 00:11:35,000 --> 00:11:37,240 LISTED ON THE CERTIFICATE AND 271 00:11:37,240 --> 00:11:38,400 ALCOHOL RELATED. 272 00:11:38,400 --> 00:11:41,080 AND YOU CAN SEE THERE WAS A HUGE 273 00:11:41,080 --> 00:11:43,520 INCREASE BETWEEN 2019 AND 2020 274 00:11:43,520 --> 00:11:46,800 AND SUSTAINED IN 2021 AND LOOKS 275 00:11:46,800 --> 00:11:48,680 LIKE FINGERS CROSSED, THAT 276 00:11:48,680 --> 00:11:50,320 THINGS ARE STARTING TO GO BACK 277 00:11:50,320 --> 00:11:52,560 DOWN AND THIS IS NOT UNUSUAL I 278 00:11:52,560 --> 00:11:55,000 MIGHT POINT OUT, THAT THESE KIND 279 00:11:55,000 --> 00:11:57,240 OF SURGES IN ALCOHOL DEATHS HAVE 280 00:11:57,240 --> 00:11:59,320 BEEN ASSOCIATED WITH OTHER MAJOR 281 00:11:59,320 --> 00:12:01,840 EVENTS LIKE 9/11 AND HURRICANE 282 00:12:01,840 --> 00:12:03,680 KATRINA AND OTHER THINGS IN OUR 283 00:12:03,680 --> 00:12:07,520 SOCIETY, SO IT SPEAKS TO THE 284 00:12:07,520 --> 00:12:09,480 SOCIAL DETERMINANTS AND SOME OF 285 00:12:09,480 --> 00:12:10,560 THE OTHER THINGS WHICH I'LL 286 00:12:10,560 --> 00:12:13,480 TOUCH ON IN A FEW MINUTES. 287 00:12:13,480 --> 00:12:14,440 NEXT SLIDE. 288 00:12:14,440 --> 00:12:18,840 AND YOU KNOW, ONE IN SIX 289 00:12:18,840 --> 00:12:20,640 ALCOHOL -- OPIOID OVERDOSES 290 00:12:20,640 --> 00:12:21,440 INVOLVE ALCOHOL. 291 00:12:21,440 --> 00:12:23,280 IT'S ABOUT 15% AND YOU CAN 292 00:12:23,280 --> 00:12:26,360 PARALLEL THE LINE OF INCREASES 293 00:12:26,360 --> 00:12:28,800 IN DEATHS ASSOCIATED WITH 294 00:12:28,800 --> 00:12:30,480 OPIOIDS WITH THE DEATHS 295 00:12:30,480 --> 00:12:31,440 ASSOCIATED WITH ALCOHOL AND 296 00:12:31,440 --> 00:12:33,400 OPIOIDS. THEY GO IN PARALLEL 297 00:12:33,400 --> 00:12:38,520 AND THIS INDEED MAY BE AN 298 00:12:38,520 --> 00:12:38,880 UNDERESTIMATION. 299 00:12:38,880 --> 00:12:39,160 NEXT SLIDE. 300 00:12:39,160 --> 00:12:41,280 AND SPEAKING OF WHICH, I WAS 301 00:12:41,280 --> 00:12:44,440 INVITED TO PARTICIPATE WITH NORA 302 00:12:44,440 --> 00:12:48,600 AND LARRY AT THE RX AND ILLICIT 303 00:12:48,600 --> 00:12:52,080 DRUG SUMMIT LAST MONTH AND I 304 00:12:52,080 --> 00:12:53,600 JUST WANT TO HIT FOUR QUICK 305 00:12:53,600 --> 00:12:54,320 BULLETS. 306 00:12:54,320 --> 00:12:56,240 THE OPIOID CRISIS OVERLAPS WITH 307 00:12:56,240 --> 00:12:59,520 OTHER PUBLIC HEALTH CHALLENGES 308 00:12:59,520 --> 00:13:04,800 SUCH AS UNDERTREATED CHRONIC 309 00:13:04,800 --> 00:13:06,800 PAIN. 310 00:13:06,800 --> 00:13:08,720 AND PAIN CONTRIBUTES TO ALCOHOL 311 00:13:08,720 --> 00:13:09,760 MISUSE THROUGH DRINKING TO COPE. 312 00:13:09,760 --> 00:13:13,360 AS MANY OF YOU KNOW THERE ARE 313 00:13:13,360 --> 00:13:16,600 OVERLAPPING BRAIN MECHANISMS IN 314 00:13:16,600 --> 00:13:17,120 CHRONIC PAIN, OPIOID USE 315 00:13:17,120 --> 00:13:17,400 DISORDER. 316 00:13:17,400 --> 00:13:19,120 A DETAILED UNDERSTANDING 317 00:13:19,120 --> 00:13:20,880 PROVIDES AN OPPORTUNITY FOR 318 00:13:20,880 --> 00:13:22,960 PREVENTING AND TREATING THESE 319 00:13:22,960 --> 00:13:24,240 PROBLEMS. 320 00:13:24,240 --> 00:13:26,640 ADDRESSING ALCOHOL MISUSE WITH 321 00:13:26,640 --> 00:13:28,240 CHRONIC PAIN MAY HELP IMPROVE 322 00:13:28,240 --> 00:13:30,080 PATIENT OUTCOMES. 323 00:13:30,080 --> 00:13:33,240 ALL MY ANECDOTAL DATA FROM MY 324 00:13:33,240 --> 00:13:34,920 PHYSICIAN FRIENDS TELL ME THAT 325 00:13:34,920 --> 00:13:36,720 PEOPLE ARE DRINKING EVEN THOUGH 326 00:13:36,720 --> 00:13:38,320 THEY SIGN AN AGREEMENTS NOT TO 327 00:13:38,320 --> 00:13:40,440 DRINK WHEN THEY'RE UNDER PAIN 328 00:13:40,440 --> 00:13:42,960 TREATMENTS, THEY'RE DRINKING AND 329 00:13:42,960 --> 00:13:45,240 THEY'RE DRINKING MORE FOR THE 330 00:13:45,240 --> 00:13:47,480 FACT THAT OPIOIDS ARE LESS 331 00:13:47,480 --> 00:13:48,280 AVAILABLE. 332 00:13:48,280 --> 00:13:50,600 SO THIS IS A PHENOMENON THAT HAS 333 00:13:50,600 --> 00:13:53,200 BEEN GROWING FOR SOME TIME. 334 00:13:53,200 --> 00:13:53,760 NEXT SLIDE. 335 00:13:53,760 --> 00:13:55,640 SO I'M NOT GOING TO GO THROUGH 336 00:13:55,640 --> 00:13:57,240 ALL OF THESE THIS GREAT DETAIL. 337 00:13:57,240 --> 00:13:58,200 DON'T PANIC. 338 00:13:58,200 --> 00:14:01,120 I ONLY HAVE A FEW MORE SLIDES, 339 00:14:01,120 --> 00:14:04,080 BUT THIS IS MY MESSAGE FOR THE 340 00:14:04,080 --> 00:14:04,280 YEAR. 341 00:14:04,280 --> 00:14:08,080 I'LL REPEAT THIS TALK A LITTLE 342 00:14:08,080 --> 00:14:10,000 MORE EXPANDED AT COLLEGE ON THE 343 00:14:10,000 --> 00:14:12,120 DRUG DEPENDENCE AND CERTAINLY ON 344 00:14:12,120 --> 00:14:15,160 THE MEETING, BUT WE'VE NOTICED A 345 00:14:15,160 --> 00:14:15,840 MAJOR CHANGE IN THE CONVERSATION 346 00:14:15,840 --> 00:14:16,360 AROUND ALCOHOL. 347 00:14:16,360 --> 00:14:17,560 THERE'S INCREASING KNOWLEDGE 348 00:14:17,560 --> 00:14:20,960 ABOUT THE HARMFUL EFFECTS OF 349 00:14:20,960 --> 00:14:21,760 ALCOHOL. THERE'S RETHINKING 350 00:14:21,760 --> 00:14:25,200 DRINKING IN U.S. CULTURE. 351 00:14:25,200 --> 00:14:27,360 THERE' PROMOTING DEFERAL TO 352 00:14:27,360 --> 00:14:28,520 TREATMENT AS PART OF ROUTINE 353 00:14:28,520 --> 00:14:31,280 HEALTH CARE. 354 00:14:31,280 --> 00:14:33,680 THERE'S SUPPORTING RESEARCH FOR 355 00:14:33,680 --> 00:14:34,680 ALCOHOL USE DISORDER. 356 00:14:34,680 --> 00:14:36,640 HEPATOLOGISTS ARE LEADING THE 357 00:14:36,640 --> 00:14:36,800 WAY. 358 00:14:36,800 --> 00:14:39,440 I'LL SHOW A QUICK SLIDE ON THAT. 359 00:14:39,440 --> 00:14:41,280 I'LL SPEND A LITTLE TIME ON THE 360 00:14:41,280 --> 00:14:43,120 ADDICTION NEUROCLINICAL 361 00:14:43,120 --> 00:14:45,120 ASSESSMENT FRAMEWORK WHICH 362 00:14:45,120 --> 00:14:45,960 BASICALLY EVOLVED FROM THE 363 00:14:45,960 --> 00:14:48,320 INTRAMURAL PROGRAMS AT NIH ON 364 00:14:48,320 --> 00:14:50,560 THE INDIVIDUALIZED ETIOLOGY 365 00:14:50,560 --> 00:14:51,480 PREVENTION AND TREATMENT. 366 00:14:51,480 --> 00:14:53,240 I'M GOING TO TALK ABOUT 367 00:14:53,240 --> 00:14:55,880 SUPPORTING RECOVERY RESEARCH. 368 00:14:55,880 --> 00:14:58,560 I PROBABLY WON'T SPEND TIME ON 369 00:14:58,560 --> 00:14:59,640 COMBATTING STIGMA BUT WE'VE 370 00:14:59,640 --> 00:15:00,560 TALKED AND WRITTEN ABOUT THAT 371 00:15:00,560 --> 00:15:04,560 BEFORE, NORA AND I, AND I'LL 372 00:15:04,560 --> 00:15:08,280 MENTION AT THE END, 373 00:15:08,280 --> 00:15:08,880 DISSEMINATING NIAAA RESOURCES 374 00:15:08,880 --> 00:15:10,360 INCLUDING THE HLT CARE 375 00:15:10,360 --> 00:15:11,480 PROFESSIONAL'S CORE RESOURCE ON 376 00:15:11,480 --> 00:15:11,680 ALCOHOL. 377 00:15:11,680 --> 00:15:12,680 NEXT SLIDE. 378 00:15:12,680 --> 00:15:14,680 I DON'T HAVE TO DWELL ON THIS. 379 00:15:14,680 --> 00:15:17,080 ALCOHOL IS ASSOCIATED -- ALCOHOL 380 00:15:17,080 --> 00:15:19,240 MISUSE IS ASSOCIATED WITH MORE 381 00:15:19,240 --> 00:15:21,160 THAN 200 DISEASES AND INJURY 382 00:15:21,160 --> 00:15:22,040 RELATED CONDITIONS. 383 00:15:22,040 --> 00:15:23,760 I WOULD ARGUE THAT PROBABLY 384 00:15:23,760 --> 00:15:25,560 LIVER, MENTAL HEALTH AND CANCER 385 00:15:25,560 --> 00:15:27,680 ARE SOME OF THE MORE PROMINENT 386 00:15:27,680 --> 00:15:28,600 ONES AND THE NATIONAL CANCER 387 00:15:28,600 --> 00:15:29,960 INSTITUTE HAS BEEN WORKING WITH 388 00:15:29,960 --> 00:15:31,720 US ON REALLY EMPHASIZING THE 389 00:15:31,720 --> 00:15:34,600 FACT THAT 5% OF CANCER NOW IS 390 00:15:34,600 --> 00:15:38,400 ATTRIBUTABLE TO ALCOHOL MISUSE. 391 00:15:38,400 --> 00:15:39,840 SO IT'S A PATHOGEN WHEN YOU 392 00:15:39,840 --> 00:15:42,480 ENGAGE IN IT TOO MUCH AND IT IS 393 00:15:42,480 --> 00:15:44,920 A GOOD POINT -- PLACE TO SAY IT 394 00:15:44,920 --> 00:15:49,600 REALLY IS NO HEALTHY AMOUNT OF 395 00:15:49,600 --> 00:15:49,840 ALCOHOL. 396 00:15:49,840 --> 00:15:52,280 THE J OF THE J SHAPED CURVE HAS 397 00:15:52,280 --> 00:15:54,160 FLATTENED IF YOU START USING THE 398 00:15:54,160 --> 00:15:55,600 APPROPRIATE CONTROL GROUPS LIKE 399 00:15:55,600 --> 00:15:58,520 LOW LEVEL DRINKERS AS OPPOSED TO 400 00:15:58,520 --> 00:16:02,880 NONDRINKERS AND OTHER ISSUES. 401 00:16:02,880 --> 00:16:03,440 NEXT SLIDE. 402 00:16:03,440 --> 00:16:05,920 AND THEN WE'VE BEEN DOING A LOT 403 00:16:05,920 --> 00:16:07,360 WITH THE PRESS ON A WHOLE NUMBER 404 00:16:07,360 --> 00:16:09,960 OF THINGS, BUT ONE IS I DON'T 405 00:16:09,960 --> 00:16:11,840 REMEMBER HOW MANY WE DID, BUT 406 00:16:11,840 --> 00:16:14,520 IT'S SOMETHING LIKE 18 PRESS 407 00:16:14,520 --> 00:16:17,600 INTERVIEWS BETWEEN MYSELF AND 408 00:16:17,600 --> 00:16:19,480 AARON WHITE IN JANUARY JUST ON 409 00:16:19,480 --> 00:16:21,000 THIS CONSTRUCT OF DRY JANUARY. 410 00:16:21,000 --> 00:16:23,520 AND WHAT WE CALL IN GENERAL THE 411 00:16:23,520 --> 00:16:24,440 SOBER CURIOUS MOVEMENT. 412 00:16:24,440 --> 00:16:27,680 THERE ARE DRY JANUARIES AND DRY 413 00:16:27,680 --> 00:16:29,760 OCTOBERS AND DRY JANUARIES IS 414 00:16:29,760 --> 00:16:34,440 QUOTE SAYS HELP US EVALUATE OUR 415 00:16:34,440 --> 00:16:35,200 RELATIONSHIP WITH ALCOHOL. 416 00:16:35,200 --> 00:16:36,520 IF YOU STOP DRINKING IN THE 417 00:16:36,520 --> 00:16:38,240 MONTH OF JANUARY AND YOU 418 00:16:38,240 --> 00:16:39,840 SUDDENLY FEEL BETTER THEN YOUR 419 00:16:39,840 --> 00:16:41,200 BODY IS TRYING TO TELL YOU 420 00:16:41,200 --> 00:16:42,640 SOMETHING SOLISEN TO YOUR BODY. 421 00:16:42,640 --> 00:16:45,040 AND SO WE'VE BEEN VERY 422 00:16:45,040 --> 00:16:48,040 SUPPORTIVE OF THESE MOVEMENTS 423 00:16:48,040 --> 00:16:49,240 AND USING IT AS -- AND 424 00:16:49,240 --> 00:16:51,120 LEVERAGING IT TO BASICALLY TALK 425 00:16:51,120 --> 00:16:54,960 ABOUT RETHINKING DRINKING, WHICH 426 00:16:54,960 --> 00:16:56,840 IS A WEBSITE THAT -- WHICH YOU 427 00:16:56,840 --> 00:16:59,080 CAN ACCESS AT OUR WEBSITE WHICH 428 00:16:59,080 --> 00:17:02,640 BASICALLY SAYS WHAT THIS QUOTE 429 00:17:02,640 --> 00:17:02,960 SAYS. 430 00:17:02,960 --> 00:17:03,440 NEXT SLIDE. 431 00:17:03,440 --> 00:17:05,560 AND IT EXTENDS TO OTHER THINGS. 432 00:17:05,560 --> 00:17:09,600 YOU KNOW, THERE'S A LOT OF 433 00:17:09,600 --> 00:17:10,200 CONVERSATION ABOUT MOCK TAILS. 434 00:17:10,200 --> 00:17:11,800 IF YOU DON'T KNOW WHAT THAT IS, 435 00:17:11,800 --> 00:17:13,000 IT MEANS A COCKTAIL WITHOUT THE 436 00:17:13,000 --> 00:17:13,240 ALCOHOL. 437 00:17:13,240 --> 00:17:14,800 THERE ARE DRY BARS THAT ARE 438 00:17:14,800 --> 00:17:15,880 CROPPING UP ALL OVER THE PLACE 439 00:17:15,880 --> 00:17:18,320 IN MAJOR CITIES AND I THINK THE 440 00:17:18,320 --> 00:17:20,120 GREAT ADVANTAGES THAT IT ALLOWS 441 00:17:20,120 --> 00:17:20,800 PEOPLE A CHOICE. 442 00:17:20,800 --> 00:17:22,280 IF THEY WANT TO DRINK THEY CAN 443 00:17:22,280 --> 00:17:24,520 DRINK BUT THEY CAN HAVE FUN, 444 00:17:24,520 --> 00:17:29,560 INTERACT WITH OTHERS, HAVE A DRY 445 00:17:29,560 --> 00:17:31,160 SOCIAL LUBRICANT EVENING, YOU 446 00:17:31,160 --> 00:17:33,720 KNOW, PATRICK KENNEDY WAS ALL 447 00:17:33,720 --> 00:17:35,800 OVER ME A COUPLE OF WEEKS AGO 448 00:17:35,800 --> 00:17:37,800 BECAUSE HE WAS INVITED TO BE THE 449 00:17:37,800 --> 00:17:40,880 MASTER OF CEREMONIES FOR THE 450 00:17:40,880 --> 00:17:44,680 SOBER ST. PATRICK'S DAY PARADE 451 00:17:44,680 --> 00:17:47,000 AND HE WAS SO PROUD OF THAT AND 452 00:17:47,000 --> 00:17:49,840 MANY OF YOU KNOW THAT IT'S HIS 453 00:17:49,840 --> 00:17:50,120 13th YEAR. 454 00:17:50,120 --> 00:17:53,680 HE'S VERY PROUD OF THAT TOO. 455 00:17:53,680 --> 00:17:54,280 NEXT SLIDE. 456 00:17:54,280 --> 00:17:56,680 AND THEN YOU KNOW, WE NEED TO 457 00:17:56,680 --> 00:17:58,200 MOVE -- THIS IS AN EFFORT THAT 458 00:17:58,200 --> 00:18:00,480 WILL BE PART -- A MAJOR PART OF 459 00:18:00,480 --> 00:18:05,600 OUR STRATEGIC PLAN AND IT IS 460 00:18:05,600 --> 00:18:07,000 COMING, AS THE GENTLEMAN NEXT TO 461 00:18:07,000 --> 00:18:09,080 ME HAS PROMISED ME. 462 00:18:09,080 --> 00:18:11,760 THE NEXT YEAR STRATEGIC PLAN FOR 463 00:18:11,760 --> 00:18:14,920 NIAAA, BUT WE DO SEE A LOT OF 464 00:18:14,920 --> 00:18:16,840 SCREENING IN PRIMARY CARE 465 00:18:16,840 --> 00:18:18,600 OFFICES AND CLINICS, BUT WHAT WE 466 00:18:18,600 --> 00:18:20,200 DON'T SEE IS THE INTERVENTION 467 00:18:20,200 --> 00:18:21,520 AND WE DON'T SEE THE REFERRAL TO 468 00:18:21,520 --> 00:18:23,200 TREATMENT AND THAT'S WHAT THIS 469 00:18:23,200 --> 00:18:26,840 SLIDE SHOWS FROM A PAPER SHOWING 470 00:18:26,840 --> 00:18:28,600 THAT SCREENING WITH LITTLE 471 00:18:28,600 --> 00:18:29,880 ADVICE AND REFERRAL TO TREATMENT 472 00:18:29,880 --> 00:18:31,240 FOR PEOPLE WITH ALCOHOL USE 473 00:18:31,240 --> 00:18:32,840 DISORDER AND I SUSPECT THAT THIS 474 00:18:32,840 --> 00:18:34,960 IS SIMILAR FOR SUBSTANCE USE 475 00:18:34,960 --> 00:18:35,880 DISORDERS IN GENERAL. 476 00:18:35,880 --> 00:18:39,400 SO IN ADDITION TO ITS IMPORTANT 477 00:18:39,400 --> 00:18:42,800 IN PREVENTING AND INTERVENING 478 00:18:42,800 --> 00:18:46,560 ALCOHOL USE DISORDER, CAREENING 479 00:18:46,560 --> 00:18:48,800 AND ALCOHOL MISUSE CAN ALSO HELP 480 00:18:48,800 --> 00:18:50,040 CLINICIANS SPOT OTHER HEALTH 481 00:18:50,040 --> 00:18:52,320 RELATED ISSUES. 482 00:18:52,320 --> 00:18:54,440 THE ALCOHOL AND SUBSTANCE MISUSE 483 00:18:54,440 --> 00:18:56,920 IF I MAY SPEAK TO YOU ALL AS 484 00:18:56,920 --> 00:19:00,600 WELL, IT COULD BE WINDOWS ON 485 00:19:00,600 --> 00:19:02,720 OTHER PATHOLOGIES THAT ARE 486 00:19:02,720 --> 00:19:04,120 SHOWING UP AT THE DOCTOR'S 487 00:19:04,120 --> 00:19:04,360 OFFICE. 488 00:19:04,360 --> 00:19:08,760 AND SO I THINK IT'S IMPORTANT 489 00:19:08,760 --> 00:19:11,520 THAT OTHER HEALTH ISSUES IN 490 00:19:11,520 --> 00:19:17,360 REVERSE CAN HELP CLINICIANS ALSO 491 00:19:17,360 --> 00:19:17,960 SPOT PROBLEMS WITH ALCOHOL 492 00:19:17,960 --> 00:19:18,160 MISUSE. 493 00:19:18,160 --> 00:19:20,120 SO THIS IS AN AREA WE'RE PUTTING 494 00:19:20,120 --> 00:19:21,520 A GOOD BIT OF ENERGY INTO. 495 00:19:21,520 --> 00:19:25,160 AND THEN THE HEPATOLOGISTS ARE 496 00:19:25,160 --> 00:19:25,920 HELPING US CHANGE THE 497 00:19:25,920 --> 00:19:26,640 CONVERSATION AROUND ALCOHOL AND 498 00:19:26,640 --> 00:19:28,600 LIVER DISEASE. 499 00:19:28,600 --> 00:19:30,680 ALCOHOL MISUSE ACCOUNTS FOR 500 00:19:30,680 --> 00:19:32,760 NEARLY HALF OF LIVER DISEASE 501 00:19:32,760 --> 00:19:34,000 DEATHS EACH YEAR. 502 00:19:34,000 --> 00:19:35,400 IT'S THE MOST COMMON ALCOHOL 503 00:19:35,400 --> 00:19:37,920 RELATED CAUSE OF DEATH AND THE 504 00:19:37,920 --> 00:19:43,600 LEADING CAUSE OF LIVER 505 00:19:43,600 --> 00:19:43,960 TRANSPLANTATION. 506 00:19:43,960 --> 00:19:44,600 ALCOHOL ASSOCIATED LIVER DISEASE 507 00:19:44,600 --> 00:19:46,560 RELATED DEATHS INCREASED 47% IN 508 00:19:46,560 --> 00:19:47,640 THE LAST 20 YEARS. 509 00:19:47,640 --> 00:19:49,320 RATES ARE INCREASING FASTER FOR 510 00:19:49,320 --> 00:19:51,480 WOMEN AND YOUNG ADULTS. 511 00:19:51,480 --> 00:19:53,880 AGE 25 TO 34. 512 00:19:53,880 --> 00:19:56,680 AND SO THE PARADIGM SHIFT IS 513 00:19:56,680 --> 00:19:58,480 INTEGRATED TREATMENT OF ALCOHOL 514 00:19:58,480 --> 00:19:59,520 ASSOCIATED LIVER DISEASE AND 515 00:19:59,520 --> 00:20:01,920 ALCOHOL USE DISORDER WE FEEL CAN 516 00:20:01,920 --> 00:20:03,560 IMPROVE PATIENT OUTCOMES, 517 00:20:03,560 --> 00:20:05,240 TREATING ALCOHOL USE DISORDER 518 00:20:05,240 --> 00:20:09,600 WITH MEDICATIONS REDUCES THE 519 00:20:09,600 --> 00:20:12,000 LIKELIHOOD OF DEVELOPING ALD AND 520 00:20:12,000 --> 00:20:14,280 THE PROGRESSION OF ALCOHOL 521 00:20:14,280 --> 00:20:24,800 ASSOCIATION LIVER DISEASE AND 522 00:20:25,200 --> 00:20:26,000 BEHAVIORAL PHARMACOLOGY -- FOR 523 00:20:26,000 --> 00:20:27,960 AUD, IT REDUCES REMISSION AND 524 00:20:27,960 --> 00:20:29,200 DEATH. 525 00:20:29,200 --> 00:20:33,640 SO YOU CAN SEE HERE THAT ALCOHOL 526 00:20:33,640 --> 00:20:37,240 ASSOCIATED LIVER DISEASE HAS NOW 527 00:20:37,240 --> 00:20:38,480 SURPASSED NONALCOHOL LIVER 528 00:20:38,480 --> 00:20:40,320 DISEASE IN THE GRAPH AND IT'S 529 00:20:40,320 --> 00:20:41,640 BEEN STEADILY INCREASING. 530 00:20:41,640 --> 00:20:44,120 YOUNG PEOPLE ARE THE SOURCE OF A 531 00:20:44,120 --> 00:20:50,800 MAJOR EFFORT IN TRANSPLANTATION 532 00:20:50,800 --> 00:20:52,520 NOW OF LIVER FOR PEOPLE WITH 533 00:20:52,520 --> 00:20:55,800 ALCOHOL ASSOCIATED LIVER DISEASE 534 00:20:55,800 --> 00:20:59,160 AND -- AND A RE-EVALUATION ALSO 535 00:20:59,160 --> 00:21:03,320 OF THE CRITERIA FOR ALLOWING 536 00:21:03,320 --> 00:21:04,600 LIVER TRANSPLANTATION IN 537 00:21:04,600 --> 00:21:06,680 INDIVIDUALS WITH ALCOHOL 538 00:21:06,680 --> 00:21:08,960 ASSOCIATED LIVER DISEASE. 539 00:21:08,960 --> 00:21:09,600 NEXT SLIDE. 540 00:21:09,600 --> 00:21:11,440 SO THAT'S THIS SLIDE. 541 00:21:11,440 --> 00:21:13,320 SO CURRENTLY MANY U.S. 542 00:21:13,320 --> 00:21:14,640 TRANSPLANT CENTERS TYPICALLY 543 00:21:14,640 --> 00:21:21,280 REQUIRE A SIX MONTH PERIOD OF 544 00:21:21,280 --> 00:21:27,160 ALCOHOL ABSTINENCE BEFORE THE 545 00:21:27,160 --> 00:21:27,480 TRANSPLANT. 546 00:21:27,480 --> 00:21:29,560 IT IS NOT REALISTIC IN HEPATITIS 547 00:21:29,560 --> 00:21:32,040 WHERE THE MAJORITY OF PATIENT 548 00:21:32,040 --> 00:21:33,280 DEATHS OCCUR WITHIN TWO MONTHS 549 00:21:33,280 --> 00:21:34,320 OF DIAGNOSIS. 550 00:21:34,320 --> 00:21:35,720 SO IF YOU HAVE TO WAIT SIX 551 00:21:35,720 --> 00:21:38,080 MONTHS TO GET A TRANSPLANT 552 00:21:38,080 --> 00:21:39,000 YOU'RE LIKELY TO BE DEAD, TO BE 553 00:21:39,000 --> 00:21:39,360 HONEST. 554 00:21:39,360 --> 00:21:41,960 SO DATA SUGGESTS THAT PATIENTS 555 00:21:41,960 --> 00:21:43,640 WHO RECEIVE A LIVER TRANSPLANT 556 00:21:43,640 --> 00:21:45,240 WITHOUT THE SIX MONTH WAITING 557 00:21:45,240 --> 00:21:51,680 PERIOD WHICH WE CALL EARLY LIVER 558 00:21:51,680 --> 00:21:52,320 TRANSPLANT HAVE SIMILAR SURVIVAL 559 00:21:52,320 --> 00:21:54,480 OUTCOMES AND ALCOHOL RELAPSE 560 00:21:54,480 --> 00:21:57,240 RATES AS PEOPLE WHO RECEIVE THE 561 00:21:57,240 --> 00:21:57,720 TRANSPLANT. 562 00:21:57,720 --> 00:22:06,840 SO TO BUILD ON THIS, NIAAA 563 00:22:06,840 --> 00:22:07,880 ISSUED STUDIES TO ENCOURAGE 564 00:22:07,880 --> 00:22:10,200 STUDIES ON FACTORS THAT 565 00:22:10,200 --> 00:22:10,840 INFLUENCE THE SELECTION, 566 00:22:10,840 --> 00:22:12,800 MANAGEMENT AND OUTCOMES OF 567 00:22:12,800 --> 00:22:22,160 PATIENTS WHO RECEIVE EARLY LIVER 568 00:22:22,160 --> 00:22:22,520 TRANSPLANTATION. 569 00:22:22,520 --> 00:22:25,560 IN A GALAXY FAR, FAR AWAY A LONG 570 00:22:25,560 --> 00:22:31,560 TIME AGO, LAURA KWAKO WHO IS NOW 571 00:22:31,560 --> 00:22:33,280 DEPUTY DIRECTOR OF THE HEALTH 572 00:22:33,280 --> 00:22:35,920 SERVICES BRANCH OF OUR DIVISION 573 00:22:35,920 --> 00:22:41,280 OF TREATMENT AND RECOVERY 574 00:22:41,280 --> 00:22:44,600 RESEARCH WAS AN INTREPID 575 00:22:44,600 --> 00:22:45,600 RESEARCHER IN OUR INTERMURAL 576 00:22:45,600 --> 00:22:48,440 PROGRAM AND SHE CAME UP WITH THE 577 00:22:48,440 --> 00:22:50,920 HYPOTHESIS THAT MAYBE THERE 578 00:22:50,920 --> 00:22:53,040 WOULD BE A WAY THAT WE COULD DO 579 00:22:53,040 --> 00:22:55,080 DIAGNOSIS OF ALCOHOL USE 580 00:22:55,080 --> 00:22:58,200 DISORDERS BY INCORPORATING THE 581 00:22:58,200 --> 00:23:00,080 THREE STAGE ADDICTION CYCLE 582 00:23:00,080 --> 00:23:03,000 FRAMEWORK AND THE DOMAINS OF 583 00:23:03,000 --> 00:23:04,600 DYSFUNCTION WITHIN THE THREE 584 00:23:04,600 --> 00:23:05,760 CYCLE ADDICTION FRAMEWORK. 585 00:23:05,760 --> 00:23:09,040 AND SO YOU CAN THINK OF THIS AS 586 00:23:09,040 --> 00:23:10,720 USING SCALES THAT MEASURE 587 00:23:10,720 --> 00:23:14,240 INCENTIVE SALIENTS OR REACTIVITY 588 00:23:14,240 --> 00:23:19,520 TASKS TO MEASURE INSCENTIVE 589 00:23:19,520 --> 00:23:21,280 SALIENTS OR THE INVENTORY FOR 590 00:23:21,280 --> 00:23:24,880 THE NEGATIVE EMOTIONALITY BUT 591 00:23:24,880 --> 00:23:26,480 USING THE PSYCHOLOGICAL TESTS 592 00:23:26,480 --> 00:23:28,200 AND THE SAME FOR EXECUTIVE 593 00:23:28,200 --> 00:23:30,360 FUNCTION PERHAPS USING DELAYED 594 00:23:30,360 --> 00:23:32,080 DISCOUNTING BUT IN ADDITION 595 00:23:32,080 --> 00:23:34,680 MEASURES OF CRAVING. 596 00:23:34,680 --> 00:23:38,320 AND SO SHE CAME UP WITH THE 597 00:23:38,320 --> 00:23:39,200 HYPOTHESIS AND PLAN THAT THE 598 00:23:39,200 --> 00:23:41,640 GOALS OF THE ADDICTIONS AND 599 00:23:41,640 --> 00:23:46,880 CLINICAL ASSESSMENT ARE TO 600 00:23:46,880 --> 00:23:50,520 IDENTIFY HOW THREE DOMAINS WHICH 601 00:23:50,520 --> 00:23:52,400 CAN THEN GUIDE TREATMENT CENTERS 602 00:23:52,400 --> 00:23:54,920 TO BETTER UNDERSTAND THE 603 00:23:54,920 --> 00:23:55,600 INDIVIDUALS WITH AND WITHOUT 604 00:23:55,600 --> 00:23:57,440 ALCOHOL USE DISORDER. 605 00:23:57,440 --> 00:23:59,440 THIS WAS IN 2016. 606 00:23:59,440 --> 00:24:04,720 IT WAS IN COLLABORATION WITH 607 00:24:04,720 --> 00:24:07,000 NORA VOLKOW AND I JUST WANT TO 608 00:24:07,000 --> 00:24:08,960 UPDATE YOU ON PROGRESS IN THIS 609 00:24:08,960 --> 00:24:10,600 DOMAIN. 610 00:24:10,600 --> 00:24:12,040 SO THE NEXT SLIDE. 611 00:24:12,040 --> 00:24:14,320 AND TO BE TOTALLY TRUTHFUL THIS 612 00:24:14,320 --> 00:24:15,320 WAS NORA'S IDEA. 613 00:24:15,320 --> 00:24:17,080 LAURA WAS WRITING A PROTOCOL TO 614 00:24:17,080 --> 00:24:21,240 DO WHAT I JUST OUTLINED FOR THE 615 00:24:21,240 --> 00:24:23,160 ADDICTION CLINICAL ASSESSMENT 616 00:24:23,160 --> 00:24:24,440 AND NORA SAID YOU ALREADY HAVE 617 00:24:24,440 --> 00:24:25,640 PATIENTS THAT HAVE PASSED 618 00:24:25,640 --> 00:24:26,800 THROUGH THE CLINICAL CENTER. 619 00:24:26,800 --> 00:24:28,600 WHY DON'T YOU JUST EXAMINE ALL 620 00:24:28,600 --> 00:24:31,120 THESE DOMAINS AND PREDICTORS AND 621 00:24:31,120 --> 00:24:32,840 INDICATORS IN THAT GROUP OF 622 00:24:32,840 --> 00:24:33,080 PATIENTS? 623 00:24:33,080 --> 00:24:35,840 SO IN A LARGE DIVERSE CLINICAL 624 00:24:35,840 --> 00:24:36,880 SAMPLE REPRESENTING THE SPECTRUM 625 00:24:36,880 --> 00:24:39,400 OF ALCOHOL USE DISORDER THE 626 00:24:39,400 --> 00:24:45,280 THREE NEUROBIOLOGICAL DOMAINS 627 00:24:45,280 --> 00:24:47,720 HYPOTHESIZED TO BE CRITICAL TO 628 00:24:47,720 --> 00:24:49,280 THE CYCLE WERE IDENTIFIED 629 00:24:49,280 --> 00:24:50,680 THROUGH FACTOR ANALYSIS. 630 00:24:50,680 --> 00:24:53,120 WE USED MEASURES OF ADISHGS, 631 00:24:53,120 --> 00:24:55,560 PERSONALITY, COGNITION, BEHAVIOR 632 00:24:55,560 --> 00:24:57,240 AND EXPOSURE TO EARLY LIFE 633 00:24:57,240 --> 00:24:59,000 STRESS AND THEY WERE COLLECTED 634 00:24:59,000 --> 00:25:01,080 IN 454 PATIENTS WHO HAD PASSED 635 00:25:01,080 --> 00:25:02,000 THROUGH THE CLINICAL CENTER. 636 00:25:02,000 --> 00:25:04,600 THE STUDY CONFIRMED THE 637 00:25:04,600 --> 00:25:05,800 RELEVANCE OF THE THREE 638 00:25:05,800 --> 00:25:08,000 NEUROFUNCTIONAL DOMAINS TO AUD 639 00:25:08,000 --> 00:25:10,280 AND USING MULTIPLE CAUSES 640 00:25:10,280 --> 00:25:11,680 APPROACH EARLY LIFE STRESS AND 641 00:25:11,680 --> 00:25:13,280 SOCIO DEMOGRAPHIC PREDICTORS 642 00:25:13,280 --> 00:25:13,680 WERE IDENTIFIED. 643 00:25:13,680 --> 00:25:15,760 AND WHAT I'M GOING TO SHOW YOU 644 00:25:15,760 --> 00:25:17,720 VERY QUICKLY IS THAT THIS HAS 645 00:25:17,720 --> 00:25:20,240 BEEN TAKEN UP BY A NUMBER OF 646 00:25:20,240 --> 00:25:22,520 RESEARCHERS IN THE FIELD AND 647 00:25:22,520 --> 00:25:28,160 BASICALLY VALIDATED AND 648 00:25:28,160 --> 00:25:29,440 REVALIDATED AS AN EFFECTIVE 649 00:25:29,440 --> 00:25:32,280 FRAMEWORK OF WHICH TO ORGANIZE 650 00:25:32,280 --> 00:25:32,840 INDIVIDUAL DIFFERENCES IN 651 00:25:32,840 --> 00:25:35,480 PRECISION MEDICINE IN THE 652 00:25:35,480 --> 00:25:36,400 CONTEXT OF ADDICTION. 653 00:25:36,400 --> 00:25:36,840 NEXT SLIDE. 654 00:25:36,840 --> 00:25:38,840 I KEEP TRYING TO CHANGE THE 655 00:25:38,840 --> 00:25:39,320 SLIDE. 656 00:25:39,320 --> 00:25:41,240 ANYWAY, SO HERE'S SOME 657 00:25:41,240 --> 00:25:42,440 ADDITIONAL VALIDATION OF THE 658 00:25:42,440 --> 00:25:44,520 THREE NEUROFUNCTIONAL DOMAINS IN 659 00:25:44,520 --> 00:25:44,880 ADDICTION. 660 00:25:44,880 --> 00:25:48,320 I'M NOT GOING TO SPEND A LOT OF 661 00:25:48,320 --> 00:25:53,320 TIME ON THESE BUT AMONG HEAVY 662 00:25:53,320 --> 00:25:54,560 DRINKERS, EXECUTIVE FUNCTION, 663 00:25:54,560 --> 00:25:57,840 INCENTIVE SALIENCE, 664 00:25:57,840 --> 00:25:59,840 EMOTIONALITY, POSITIVE FAMILY 665 00:25:59,840 --> 00:26:01,640 HISTORY, EARLIER AGE OF FIRST 666 00:26:01,640 --> 00:26:03,400 DRINK AND HISTORY OF CHILDHOOD 667 00:26:03,400 --> 00:26:07,000 EMOTIONAL ABUSE AND PHYSICAL 668 00:26:07,000 --> 00:26:10,720 DRINKERS, NEGLECT AS PREDICTORS 669 00:26:10,720 --> 00:26:18,680 AND THIS WAS A DE-MARTNI IN 670 00:26:18,680 --> 00:26:18,880 2021. 671 00:26:18,880 --> 00:26:20,720 FOUR CORE CONSTRUCTS WERE 672 00:26:20,720 --> 00:26:21,360 IDENTIFIED. 673 00:26:21,360 --> 00:26:26,560 INVENTIVE SALIENCE, NEGATIVE 674 00:26:26,560 --> 00:26:28,120 EMOTIONALITY AND EXECUTIVE 675 00:26:28,120 --> 00:26:30,440 FUNCTION AND NEGATIVE ALCOHOL 676 00:26:30,440 --> 00:26:31,840 RELATED CONSEQUENCES. 677 00:26:31,840 --> 00:26:33,560 COMBINED WITH ANALYTIC TECHN 678 00:26:33,560 --> 00:26:40,600 TECHNIQUES DOMAINS WITH 679 00:26:40,600 --> 00:26:42,720 METHAMPHETAMINE USE SO THIS AN 680 00:26:42,720 --> 00:26:45,200 EXTENSION TO ANOTHER DRUG OF 681 00:26:45,200 --> 00:26:45,440 ADDICTION. 682 00:26:45,440 --> 00:26:49,160 THIS NONTREATMENT SEEKERS, WHO 683 00:26:49,160 --> 00:26:52,440 WERE UNDERGOING FUNCTIONAL MRI 684 00:26:52,440 --> 00:26:54,360 AFTER ALCOHOL CUES AND NEGATIVE 685 00:26:54,360 --> 00:26:57,480 CUES, FUNCTIONAL CHANGES IN THE 686 00:26:57,480 --> 00:27:01,120 AMYGDALA WERE ASSOCIATED WITH 687 00:27:01,120 --> 00:27:03,160 INCENTIVE SALIENCE AND NEGATIVE 688 00:27:03,160 --> 00:27:08,960 EMOTIONALITY DOMAINS. AND AMONG 689 00:27:08,960 --> 00:27:11,760 TREATMENT SEEKERS WITH AUD, THE 690 00:27:11,760 --> 00:27:14,000 INCENTIVE SALIENCE DOMAIN SHOWED 691 00:27:14,000 --> 00:27:16,400 CONSTRUCT VALIDITY AND GREATER 692 00:27:16,400 --> 00:27:18,840 PREDICTIVE VALIDITY FOR DRINKING 693 00:27:18,840 --> 00:27:21,920 OUTCOMES COMPARED TO PREEXISTING 694 00:27:21,920 --> 00:27:25,000 SCALES AND THIS IS THE WORK FROM 695 00:27:25,000 --> 00:27:28,600 STIN AND FROM HER GROUP THE 696 00:27:28,600 --> 00:27:29,200 NEGATIVE EMOTIONALITY DOMAIN 697 00:27:29,200 --> 00:27:31,720 SHOWED CONSTRUCT VALIDITY AND 698 00:27:31,720 --> 00:27:32,760 SHOWED MORE FREQUENT AND HEAVIER 699 00:27:32,760 --> 00:27:35,120 DRINKING AND DRINKING TO 700 00:27:35,120 --> 00:27:36,560 REGULATE NEGATIVE AFFECT. 701 00:27:36,560 --> 00:27:37,120 NEXT SLIDE. 702 00:27:37,120 --> 00:27:41,280 AND SO YOU KNOW, WE WROTE A 703 00:27:41,280 --> 00:27:43,320 PAPER ARGUING THAT YOU CAN ADD 704 00:27:43,320 --> 00:27:46,600 TO THESE DOMAINS, PARTICULARLY 705 00:27:46,600 --> 00:27:48,280 THE WITHDRAW NEGATIVE AFFECT 706 00:27:48,280 --> 00:27:53,720 STAGE AND THE NEGATIVE EMOTIONAL 707 00:27:53,720 --> 00:27:57,000 DOMAIN BY ENVIRONMENTAL AND 708 00:27:57,000 --> 00:28:00,880 GENETIC AND EPIGENETIC INSULTS 709 00:28:00,880 --> 00:28:02,800 AND THAT THIS WAS POSSIBLY 710 00:28:02,800 --> 00:28:03,920 EXACERBATED BY THE ISOLATION OF 711 00:28:03,920 --> 00:28:06,120 STRESS RELATED TO THE COVID-19 712 00:28:06,120 --> 00:28:06,400 PANDEMIC. 713 00:28:06,400 --> 00:28:08,160 SOME OF YOU HAVE HEARD ME TALK 714 00:28:08,160 --> 00:28:09,600 ABOUT THIS BEFORE, BUT THAT -- 715 00:28:09,600 --> 00:28:11,720 THE INCREASE IN DEATHS 716 00:28:11,720 --> 00:28:12,560 ASSOCIATED WITH THE PANDEMIC, I 717 00:28:12,560 --> 00:28:14,240 JUST SHOWED YOU ON THE SLIDE, 718 00:28:14,240 --> 00:28:16,080 BUT WE ALSO KNOW FROM A NUMBER 719 00:28:16,080 --> 00:28:18,160 OF STUDIES THAT THERE IS A 720 00:28:18,160 --> 00:28:20,480 SUBGROUP OF PATIENTS WHO ARE 721 00:28:20,480 --> 00:28:22,680 DRINKING TO COPE WITH STRESS 722 00:28:22,680 --> 00:28:23,120 DURING THE PANDEMIC. 723 00:28:23,120 --> 00:28:25,520 AND HOPEFULLY THAT WILL DECLINE 724 00:28:25,520 --> 00:28:27,440 SOMEWHAT AS WE EXIT FROM THE 725 00:28:27,440 --> 00:28:27,720 PANDEMIC. 726 00:28:27,720 --> 00:28:31,920 BUT OUR ARGUMENT IS THAT 727 00:28:31,920 --> 00:28:32,680 PSYCHIATRIC COMORBIDITY, 728 00:28:32,680 --> 00:28:36,920 CHILDHOOD TRAUMA, GENETICS, 729 00:28:36,920 --> 00:28:38,400 EPIGENETICS ALL CONTRIBUTE TO 730 00:28:38,400 --> 00:28:40,600 THE NEGATIVE EMOTIONAL STATE 731 00:28:40,600 --> 00:28:44,080 THAT'S ASSOCIATED WITH THE 732 00:28:44,080 --> 00:28:46,680 WITHDRAWAL NEGATIVE AFFECT 733 00:28:46,680 --> 00:28:47,840 STAGE. NEXT SLIDE. 734 00:28:47,840 --> 00:28:51,840 AND THIS ALL FITS WITH ONE OF 735 00:28:51,840 --> 00:28:58,080 THE FOCUSES FOR NIAAA THAT WE'RE 736 00:28:58,080 --> 00:29:00,120 LOOKING AT RIGHT NOW AND AGAIN 737 00:29:00,120 --> 00:29:03,360 WILL BE A MAJOR PART OF OUR 738 00:29:03,360 --> 00:29:05,320 STRATEGIC PLAN AND CHANGING THE 739 00:29:05,320 --> 00:29:06,920 CONVERSATION AROUND RECOVERY. 740 00:29:06,920 --> 00:29:08,200 MOST PEOPLE WHO NEED TREATMENT 741 00:29:08,200 --> 00:29:10,480 RECEIVE NO TREATMENT OF ANY KIND 742 00:29:10,480 --> 00:29:11,960 AND LITTLE IS KNOWN ABOUT WHAT 743 00:29:11,960 --> 00:29:15,920 SUSTAINS LONGER TERM RECOVERY. 744 00:29:15,920 --> 00:29:17,800 NIAAA IS EXPANDING FOCUS ON 745 00:29:17,800 --> 00:29:21,160 LONGER TERM RECOVERY. 746 00:29:21,160 --> 00:29:25,000 NIAAA HAS DEFINED RECOVERY FROM 747 00:29:25,000 --> 00:29:27,680 ALCOHOL USE DISORDER BASED ON 748 00:29:27,680 --> 00:29:29,200 QUALITATIVE FEEDBACK FROM KEY 749 00:29:29,200 --> 00:29:30,640 RECOVERY STAKEHOLDERS. 750 00:29:30,640 --> 00:29:33,520 SO WE VIEW RECOVERY AS BOTH A 751 00:29:33,520 --> 00:29:35,160 PROCESS OF BEHAVIORAL CHANGE AND 752 00:29:35,160 --> 00:29:40,400 AN OUTCOME TO INCORPORATE TIME 753 00:29:40,400 --> 00:29:43,320 PERIODS FOR TWO KEY COMPONENTS. 754 00:29:43,320 --> 00:29:47,160 REMISSION FROM DSM5AUD AND 755 00:29:47,160 --> 00:29:48,520 CESSATION FROM HEAVY DRINKING. 756 00:29:48,520 --> 00:29:51,800 OUR DEFINITION OF RECOVERY ALSO 757 00:29:51,800 --> 00:29:54,920 EMPHASIZES THE IMPORTANCE OF BIO 758 00:29:54,920 --> 00:29:57,160 PSYCH SOCIAL FUNCTIONING AND 759 00:29:57,160 --> 00:29:58,760 QUALITY OF LIFE AND ENHANCE L 760 00:29:58,760 --> 00:30:03,840 RECOVERY OUTCOMES. 761 00:30:03,840 --> 00:30:05,040 AND SO NEXT SLIDE. 762 00:30:05,040 --> 00:30:09,000 YOU KNOW, I JUST WANTED TO 763 00:30:09,000 --> 00:30:11,400 QUICKLY TOUCH -- I'LL MAKE THIS 764 00:30:11,400 --> 00:30:13,400 VERY QUICK, THAT A RECENT PAPER, 765 00:30:13,400 --> 00:30:15,520 SHE TALKED ABOUT THIS IN HER 766 00:30:15,520 --> 00:30:16,960 TALK YESTERDAY HAS SHOWN THAT 767 00:30:16,960 --> 00:30:18,520 GREATER RELIEF NEGATIVE 768 00:30:18,520 --> 00:30:20,320 EMOTIONALITY AT BASELINE 769 00:30:20,320 --> 00:30:22,360 PREDICTED GREATER DRINKING 770 00:30:22,360 --> 00:30:25,120 INTENSITY AND MORE FREQUENT 771 00:30:25,120 --> 00:30:26,560 DRINKING AT ONE YEAR OUT IN 772 00:30:26,560 --> 00:30:27,760 OUTCOMES FOLLOWING TREATMENT 773 00:30:27,760 --> 00:30:30,000 USING -- THEY USED A LINEAR 774 00:30:30,000 --> 00:30:31,840 REGRESSION ANALYSIS AND YOU CAN 775 00:30:31,840 --> 00:30:34,360 SEE BETA HERE WHICH BASICALLY IS 776 00:30:34,360 --> 00:30:37,160 SHOWING A VERY STRONG 777 00:30:37,160 --> 00:30:40,640 RELATIONSHIP BETWEEN THIS 778 00:30:40,640 --> 00:30:44,280 NEGATIVE EMOTIONALITY AND HEAVY 779 00:30:44,280 --> 00:30:45,360 DRINKING DAYS. 780 00:30:45,360 --> 00:30:46,280 THE NEXT SLIDE. 781 00:30:46,280 --> 00:30:54,320 AND THE OPPOSITE WAS ALSO TRUE. 782 00:30:54,320 --> 00:30:55,000 WHEN YOU PARSE THE GROUPS BY 783 00:30:55,000 --> 00:30:56,240 DIFFERENT PROFILE AND YOU USED A 784 00:30:56,240 --> 00:30:58,120 LOWER RELIEF NEGATIVE 785 00:30:58,120 --> 00:31:01,800 EMOTIONALITY GROUP, THAT 786 00:31:01,800 --> 00:31:03,680 PREDICTED HIGH FUNCTIONING 787 00:31:03,680 --> 00:31:04,600 INFREQUENT DRINKING PROFILE. 788 00:31:04,600 --> 00:31:07,800 AND SO THOSE INDIVIDUALS SHOWING 789 00:31:07,800 --> 00:31:10,800 LESS PROBLEMS WITH NEGATIVE 790 00:31:10,800 --> 00:31:12,440 EMOTIONALITY WERE MORE 791 00:31:12,440 --> 00:31:14,040 REPRESENTED IN THE GROUP THAT 792 00:31:14,040 --> 00:31:16,000 YOU WERE HOPING WOULD BE HIGH 793 00:31:16,000 --> 00:31:18,080 FUNCTIONING AND NOT DRINKING OR 794 00:31:18,080 --> 00:31:18,880 DRINKING MUCH LESS. 795 00:31:18,880 --> 00:31:24,240 AND SO I THINK THIS VALIDATES 796 00:31:24,240 --> 00:31:26,520 THE THREE DOMAIN FRAMEWORK BUT 797 00:31:26,520 --> 00:31:28,600 NOW ALSO IN THE CONTEXT OF 798 00:31:28,600 --> 00:31:30,960 RECOVERY AND ALLOWS US TO START 799 00:31:30,960 --> 00:31:32,240 LOOKING AND BREAKING DOWN 800 00:31:32,240 --> 00:31:35,480 INDIVIDUALS AS TO WHO IS GOING 801 00:31:35,480 --> 00:31:37,000 TO RECOVER AND WHAT STEPS MIGHT 802 00:31:37,000 --> 00:31:42,040 BE TAKEN, YOU MIGHT VERY QUICKLY 803 00:31:42,040 --> 00:31:43,400 YOU MIGHT CONSIDER A DIFFERENT 804 00:31:43,400 --> 00:31:44,520 MEDICATION FOR PEOPLE WHO ARE IN 805 00:31:44,520 --> 00:31:47,760 THE RELIEF NEGATIVE EMOTIONALITY 806 00:31:47,760 --> 00:31:50,080 PROFILE, YOU MIGHT CONSIDER A 807 00:31:50,080 --> 00:31:52,320 DIFFERENT BEHAVIORAL TREATMENT. 808 00:31:52,320 --> 00:31:54,280 NEXT SLIDE. 809 00:31:54,280 --> 00:31:57,880 AND YOU KNOW, THIS IS AN OLDER 810 00:31:57,880 --> 00:32:01,320 STUDY FROM DANIEL'S GROUP BY DR. 811 00:32:01,320 --> 00:32:06,800 CHO AND BASICALLY, THIS SHOWS 812 00:32:06,800 --> 00:32:09,000 THAT -- THAT IN INDIVIDUALS WITH 813 00:32:09,000 --> 00:32:13,240 ALCOHOL DEPENDENCE, THEY SWITCH 814 00:32:13,240 --> 00:32:14,880 FROM NEG -- POSITIVE 815 00:32:14,880 --> 00:32:18,120 REENFORCEMENT BEING THE DRIVING 816 00:32:18,120 --> 00:32:21,240 FORCE IN THEIR DRINKING TO 817 00:32:21,240 --> 00:32:23,120 ACTUALLY NEGATIVE REENFORCEMENT 818 00:32:23,120 --> 00:32:26,080 AND WE USED A DIFFERENT SCALES 819 00:32:26,080 --> 00:32:27,160 OF PHYSICAL AND SOCIAL PLEASURE 820 00:32:27,160 --> 00:32:28,960 SCALE FOR THE POSITIVE 821 00:32:28,960 --> 00:32:31,080 REENFORCEMENT AND A RELAXATION 822 00:32:31,080 --> 00:32:32,920 AND ATTENTION FOR NEGATIVE 823 00:32:32,920 --> 00:32:35,000 REENFORCEMENT AND THEY USED THE 824 00:32:35,000 --> 00:32:36,560 SEMISTRUCTURED ASSESSMENT FOR 825 00:32:36,560 --> 00:32:39,040 THE GENETICS OF ALCOHOLISM AS A 826 00:32:39,040 --> 00:32:40,720 MEASURE OF ALCOHOL DEPENDENCE, 827 00:32:40,720 --> 00:32:45,000 BUT YOU CAN SEE A DRAMATIC 828 00:32:45,000 --> 00:32:49,880 INCREASE IN NEGATIVE 829 00:32:49,880 --> 00:32:50,240 REENFORCEMENT. 830 00:32:50,240 --> 00:32:50,640 NEXT SLIDE. 831 00:32:50,640 --> 00:32:53,680 AND SO I JUST WANT TO END BY 832 00:32:53,680 --> 00:32:54,640 MENTIONING THAT A LOT OF THE 833 00:32:54,640 --> 00:32:57,040 THINGS I'VE DISCUSSED ARE 834 00:32:57,040 --> 00:32:58,640 AVAILABLE FOR HEALTHCARE 835 00:32:58,640 --> 00:33:04,400 PROFESSIONALS IN TIN HEALTHCARE 836 00:33:04,400 --> 00:33:06,200 CORE RESOURCES THAT WE LAUNCHED 837 00:33:06,200 --> 00:33:10,680 LAST MAY A YEAR AGO. 838 00:33:10,680 --> 00:33:17,960 THERE ARE 14 PRECISE ARTICLES. 839 00:33:17,960 --> 00:33:20,320 AND INCLUDES INFORMATION ABOUT 840 00:33:20,320 --> 00:33:22,120 CLINICAL IMPACTS OF ALCOHOL 841 00:33:22,120 --> 00:33:23,200 INCLUDING CANCER, PAIN, 842 00:33:23,200 --> 00:33:24,840 MEDICATION INTERACTIONS, AND 843 00:33:24,840 --> 00:33:25,680 COOCCURRENCE WITH OTHER 844 00:33:25,680 --> 00:33:27,360 SUBSTANCE USE DISORDERS AND 845 00:33:27,360 --> 00:33:28,360 MENTAL HEALTH DISORDERS. 846 00:33:28,360 --> 00:33:30,960 AND YOU CAN ACTUALLY GET CME 847 00:33:30,960 --> 00:33:31,480 CREDIT FOR THIS. 848 00:33:31,480 --> 00:33:34,600 IF YOU HAVEN'T CHECKED OUT THE 849 00:33:34,600 --> 00:33:37,280 HPCR AS WE CALL IT FONDLY, YOU 850 00:33:37,280 --> 00:33:40,120 KNOW WHAT A PCR IS, BUT IN THIS 851 00:33:40,120 --> 00:33:41,720 CASE IT'S A PROFESSIONAL CORE 852 00:33:41,720 --> 00:33:43,920 RESOURCE AND I THINK WE LIKE 853 00:33:43,920 --> 00:33:45,840 THAT ACRONYM ON PURPOSE. 854 00:33:45,840 --> 00:33:46,200 NEXT SLIDE. 855 00:33:46,200 --> 00:33:47,520 SO THANKS A LOT. 856 00:33:47,520 --> 00:33:49,800 SORRY I WENT OVER A LITTLE BIT, 857 00:33:49,800 --> 00:33:55,440 NORA, BUT FEEL FREE TO DO THE 858 00:33:55,440 --> 00:33:55,720 SAME. 859 00:33:55,720 --> 00:33:57,600 >>THANKS VERY MUCH AND I 860 00:33:57,600 --> 00:33:59,040 ACTUALLY -- I APPRECIATE IT. 861 00:33:59,040 --> 00:34:01,400 AGAIN, IT'S A GREAT OPPORTUNITY 862 00:34:01,400 --> 00:34:04,240 AND I'M GOING TO DO -- I'M NOT 863 00:34:04,240 --> 00:34:05,680 GOING TO SPEAK FROM OVER THERE 864 00:34:05,680 --> 00:34:06,800 BECAUSE GEORGE INSPIRED ME TO DO 865 00:34:06,800 --> 00:34:09,040 IT HERE SO I APOLOGIZE, GUYS. 866 00:34:09,040 --> 00:34:10,400 WHAT I'M GOING TO DO IS SHARE MY 867 00:34:10,400 --> 00:34:13,120 SCREEN SO I'M GOING TO -- AND I 868 00:34:13,120 --> 00:34:15,920 HOPE THERE ARE NO PROBLEMS WITH 869 00:34:15,920 --> 00:34:16,200 THAT. 870 00:34:16,200 --> 00:34:18,840 I JUST WILL NEED TO LET YOU -- 871 00:34:18,840 --> 00:34:20,800 LET ME KNOW IF YOU CAN SEE IT. 872 00:34:20,800 --> 00:34:23,560 HOLD ON ONE SECOND SINCE I'M 873 00:34:23,560 --> 00:34:28,080 HERE I CAN SEE IF I CAN SEE. 874 00:34:28,080 --> 00:34:29,560 OKAY. 875 00:34:29,560 --> 00:34:30,120 YES. 876 00:34:30,120 --> 00:34:30,440 PERFECT. 877 00:34:30,440 --> 00:34:33,440 AND I MEAN, WE HAVE COUNCIL 878 00:34:33,440 --> 00:34:34,600 YESTERDAY SO I GAVE A 879 00:34:34,600 --> 00:34:36,680 PRESENTATION IN TERMS OF SOME OF 880 00:34:36,680 --> 00:34:38,840 OUR TOP PRIORITIES AND OUR 881 00:34:38,840 --> 00:34:40,480 THINKING IN TERMS SO WHAT I 882 00:34:40,480 --> 00:34:41,880 WOULD WANT TO PRESENT TO CRAN 883 00:34:41,880 --> 00:34:43,200 THAT ARE VERY, VERY RELEVANT AND 884 00:34:43,200 --> 00:34:44,760 I DO WANT TO HIGHLIGHT WHAT 885 00:34:44,760 --> 00:34:45,160 GEORGE SAID. 886 00:34:45,160 --> 00:34:47,560 I MEAN, THE REALITY THAT WE'RE 887 00:34:47,560 --> 00:34:48,640 LIVING IS THAT MORE AND MORE 888 00:34:48,640 --> 00:34:49,960 PEOPLE ARE MIXING DRUGS AND ONE 889 00:34:49,960 --> 00:34:52,600 OF THE DRUGS THAT THEY'RE MORE 890 00:34:52,600 --> 00:34:58,080 FREQUENTLY MIXING IS ALCOHOL AND 891 00:34:58,080 --> 00:34:58,600 ALSO AS WE LOOK AT THE 892 00:34:58,600 --> 00:34:59,160 TRAJECTORIES OF DRUG USE AS 893 00:34:59,160 --> 00:35:00,400 PEOPLE GO FROM ADOLESCENCE INTO 894 00:35:00,400 --> 00:35:01,600 ADULTHOOD, ALCOHOL IS ONE OF THE 895 00:35:01,600 --> 00:35:04,440 MAIN DRUGS THAT INITIATE THAT 896 00:35:04,440 --> 00:35:04,720 CONSUMPTION. 897 00:35:04,720 --> 00:35:06,160 SO UNDERSTANDING HOW DRUGS 898 00:35:06,160 --> 00:35:07,760 INTERACT WITH ONE ANOTHER AND 899 00:35:07,760 --> 00:35:12,080 HOW THOSE DYNAMIC INFLUENCE 900 00:35:12,080 --> 00:35:14,080 BASICALLY DEVELOPMENT THE USE OF 901 00:35:14,080 --> 00:35:16,000 OTHER ABUSE DISORDERS AND 902 00:35:16,000 --> 00:35:16,960 RESPONSES TO TREATMENT ARE 903 00:35:16,960 --> 00:35:18,560 CRUCIAL IN TERMS OF OUR 904 00:35:18,560 --> 00:35:20,320 PREVENTION AND TREATMENT 905 00:35:20,320 --> 00:35:20,960 INTERVENTIONS. 906 00:35:20,960 --> 00:35:23,000 BEFORE I JUMP INTO THE SPECIFICS 907 00:35:23,000 --> 00:35:26,560 I DO WANT TO BASICALLY JUST GIVE 908 00:35:26,560 --> 00:35:28,040 YOU AN UPDATE RAPIDLY OF CHANGES 909 00:35:28,040 --> 00:35:30,400 IN THE OFFICE BECAUSE THESE ARE 910 00:35:30,400 --> 00:35:33,240 VERY RELEVANT FOR ALL SUBSTANCE 911 00:35:33,240 --> 00:35:34,440 DISORDERS INCLUDING ALCOHOL USE 912 00:35:34,440 --> 00:35:38,200 DISORDER OF COURSE AND THAT IS 913 00:35:38,200 --> 00:35:41,160 WELCOMING DR. CRUMP WHO IS 914 00:35:41,160 --> 00:35:43,880 BASICALLY REPLACING DR. AVILA 915 00:35:43,880 --> 00:35:45,240 AND SHE IS THE DIRECTOR OF 916 00:35:45,240 --> 00:35:47,280 OFFICE OF DIVERSITY AND 917 00:35:47,280 --> 00:35:48,600 DISPARITIES AND SHE'S ALSO THE 918 00:35:48,600 --> 00:35:52,640 DEPUTY DIRECTOR FOR THE OFFICE 919 00:35:52,640 --> 00:35:54,720 OF TRANSLATIONAL -- OFFICE OF 920 00:35:54,720 --> 00:35:56,080 RESEARCH AND TRAINING DIVERSITY 921 00:35:56,080 --> 00:35:56,960 AND DISPARITIES. 922 00:35:56,960 --> 00:36:00,520 THE OTHER ONE THAT I WANT TO 923 00:36:00,520 --> 00:36:02,760 OFFICIAL ANNOUNCE IS THAT DR. 924 00:36:02,760 --> 00:36:05,600 LEGGIO WHO ALSO HAS JOINED 925 00:36:05,600 --> 00:36:07,920 APPOINTMENTS WITH THE PROGRAM AT 926 00:36:07,920 --> 00:36:10,080 NIAAA AND IS NOW OFFICIALLY OUR 927 00:36:10,080 --> 00:36:12,800 CLINICAL DIRECTOR AT THE NIDA 928 00:36:12,800 --> 00:36:14,520 INTRAMURAL PROGRAM AND I WANT TO 929 00:36:14,520 --> 00:36:15,720 WELCOME THEM. 930 00:36:15,720 --> 00:36:20,320 SO LET ME NOW JUMP SPECIFICALLY 931 00:36:20,320 --> 00:36:21,800 INTO THE DATA AND WITH GETTING 932 00:36:21,800 --> 00:36:24,960 BASE CHI ALL TOGETHER AS PART OF 933 00:36:24,960 --> 00:36:25,600 THE CRAN. 934 00:36:25,600 --> 00:36:27,120 WITH THE COVID PANDEMIC THERE 935 00:36:27,120 --> 00:36:28,480 WAS SOMETHING VERY INTERESTING 936 00:36:28,480 --> 00:36:29,600 HAPPENING AMONG THE USE OF DRUGS 937 00:36:29,600 --> 00:36:32,360 IN TEENAGERS AND THIS WAS VERY 938 00:36:32,360 --> 00:36:33,280 DIFFERENT FROM THE VERY 939 00:36:33,280 --> 00:36:34,560 SIGNIFICANT RISE THAT WE SAW AND 940 00:36:34,560 --> 00:36:36,920 THAT GEORGE WAS JUST SPEAKING OF 941 00:36:36,920 --> 00:36:38,760 JUST NOW FOR ALCOHOL, THE SAME 942 00:36:38,760 --> 00:36:41,000 HAPPENED FOR OTHER DRUGS IN OUR 943 00:36:41,000 --> 00:36:43,840 COUNTRY FOR ADULTS INCLUDING 944 00:36:43,840 --> 00:36:45,840 MARIJUANA, VERY IMPORTANTLY 945 00:36:45,840 --> 00:36:46,120 MARIJUANA. 946 00:36:46,120 --> 00:36:48,440 BUT THAT DID NOT HAPPEN IN 947 00:36:48,440 --> 00:36:48,960 TEENAGERS. 948 00:36:48,960 --> 00:36:50,520 IN FACT WE SAW A VERY 949 00:36:50,520 --> 00:36:53,280 SIGNIFICANT REDUCTION IN DRUG 950 00:36:53,280 --> 00:36:55,400 CONSUMPTION FOR LEGAL AND 951 00:36:55,400 --> 00:36:57,200 ILLEGAL DRUGS FOR TEENAGERS AS 952 00:36:57,200 --> 00:36:59,720 ASSESSED BY MONITORING THE 953 00:36:59,720 --> 00:37:04,960 FUTURE AND ALSO CORROBORATED BY 954 00:37:04,960 --> 00:37:07,120 OTHER SURVEYS. 955 00:37:07,120 --> 00:37:08,760 AS SCHOOLS CLOSED DOWN THERE 956 00:37:08,760 --> 00:37:10,880 WERE MANY LESS OPPORTUNITIES FOR 957 00:37:10,880 --> 00:37:12,120 TEENAGERS TO INTERACT WITH 958 00:37:12,120 --> 00:37:13,600 OTHERS, TO HAVE THE PEER 959 00:37:13,600 --> 00:37:16,520 PRESSURE TO CONSUME DRUGS, BUT 960 00:37:16,520 --> 00:37:17,800 BASICALLY EVENTS LIKE SPORTS 961 00:37:17,800 --> 00:37:19,560 EVENTS WHERE THEY ACTUALLY DRINK 962 00:37:19,560 --> 00:37:20,760 ALCOHOL OR MAY SMOKE MARIJUANA 963 00:37:20,760 --> 00:37:23,240 WERE NO LONGER POSSIBLE. 964 00:37:23,240 --> 00:37:25,720 SO THIS ACTUALLY PROTECTED KIDS, 965 00:37:25,720 --> 00:37:27,720 THE CLOSING OF THE SCHOOLS AND 966 00:37:27,720 --> 00:37:29,560 OVERSIGHT OF THE PARENTS THAT 967 00:37:29,560 --> 00:37:30,360 WERE THERE. 968 00:37:30,360 --> 00:37:32,040 AND SO WE WERE VERY CONCERNED 969 00:37:32,040 --> 00:37:34,360 THAT WHEN THE COVID PANDEMIC 970 00:37:34,360 --> 00:37:36,040 ENDED AND IMPORTANTLY WHEN THE 971 00:37:36,040 --> 00:37:43,200 SCHOOL STARTS TO OPEN UP WE WILL 972 00:37:43,200 --> 00:37:44,200 SEE AN UP TICK IN THE PREVALENCE 973 00:37:44,200 --> 00:37:46,800 RATES OF DRUG USE IN TEENAGERS. 974 00:37:46,800 --> 00:37:49,240 SO LAST YEAR IN 2022, WHEN MOST 975 00:37:49,240 --> 00:37:51,760 OF THE SCHOOLS BASICALLY ALL OF 976 00:37:51,760 --> 00:37:53,040 THE SCHOOLS HAD OPENED WE WERE 977 00:37:53,040 --> 00:37:55,480 VERY SURPRISED, VERY HAPPILY 978 00:37:55,480 --> 00:37:57,880 SURPRISED TO SEE THAT WE DID NOT 979 00:37:57,880 --> 00:38:00,960 SEE THE UPTICK WHERE VALUES DID 980 00:38:00,960 --> 00:38:04,280 NOT GO FURTHER DOWN, BUT THEY 981 00:38:04,280 --> 00:38:05,280 DID NOT WENT UP EXCEPT THERE 982 00:38:05,280 --> 00:38:07,080 WERE A FEW EXCEPTIONS AND VERY 983 00:38:07,080 --> 00:38:09,000 NOTABLY AND THAT'S WHY I'M 984 00:38:09,000 --> 00:38:10,360 PUTTING IT HERE. 985 00:38:10,360 --> 00:38:13,240 IT WAS ALCOHOL USE AMONG 12th 986 00:38:13,240 --> 00:38:14,960 GRADERS WHICH ACTUALLY JUMPED TO 987 00:38:14,960 --> 00:38:17,000 THE PREPANDEMIC LEVELS AND I 988 00:38:17,000 --> 00:38:18,800 THINK IT HELPS US TO UNDERSTAND 989 00:38:18,800 --> 00:38:20,560 OVERALL WHAT IS CHANGING IN THE 990 00:38:20,560 --> 00:38:22,200 PATTERN OF DRUG CONSUMPTION OF 991 00:38:22,200 --> 00:38:24,600 TEENAGERS, BECAUSE CERTAINLY THE 992 00:38:24,600 --> 00:38:28,360 COVID ACCENTUATED A DECLINE BUT 993 00:38:28,360 --> 00:38:29,840 THAT DECLINE WE HAVE BEEN 994 00:38:29,840 --> 00:38:33,280 OBSERVING SINCE I WOULD SAY 995 00:38:33,280 --> 00:38:34,840 2003, 2005. 996 00:38:34,840 --> 00:38:36,680 THE DECLINING CONSUMPTION BY 997 00:38:36,680 --> 00:38:37,920 TEENAGERS, IT'S STILL VERY HIGH 998 00:38:37,920 --> 00:38:40,520 AND WE HAVE A LOT OF WORK TO DO 999 00:38:40,520 --> 00:38:42,000 IN PREVENTION AMONG TEENAGERS 1000 00:38:42,000 --> 00:38:42,920 BUT WE HAVE TO RECOGNIZE THAT 1001 00:38:42,920 --> 00:38:45,240 THERE ARE CHANGES IN THE 1002 00:38:45,240 --> 00:38:46,440 CONSUMPTION OF DRUGS IN 1003 00:38:46,440 --> 00:38:48,760 ADOLESCENTS IN OUR COUNTRY. 1004 00:38:48,760 --> 00:38:50,600 THIS ACTUALLY JUST ILLUSTRATES 1005 00:38:50,600 --> 00:38:52,600 WHAT I'M SPEAKING ABOUT. 1006 00:38:52,600 --> 00:38:56,520 THIS IS PERCENT OF REPORTING ANY 1007 00:38:56,520 --> 00:38:58,560 ILLICIT DRUG USING BY YEAR, BY 1008 00:38:58,560 --> 00:38:58,880 GRADE. 1009 00:38:58,880 --> 00:39:01,160 MOST OF ILLICIT DRUG REFLECTS 1010 00:39:01,160 --> 00:39:04,280 MARIJUANA AND YOU CAN SEE 1011 00:39:04,280 --> 00:39:06,200 BASICALLY HOW BETWEEN 19 AND 202 1012 00:39:06,200 --> 00:39:10,640 WHEN THE CLOSED AND YOU CAN SEE 1013 00:39:10,640 --> 00:39:12,720 THAT 2020 DECREASE, VERY 1014 00:39:12,720 --> 00:39:13,720 DRAMATIC DECREASE IN CONSUMPTION 1015 00:39:13,720 --> 00:39:16,600 OF DRUGS AND THEN YOU CAN SEE 1016 00:39:16,600 --> 00:39:18,160 THE STABILIZATION AND WE NEED TO 1017 00:39:18,160 --> 00:39:19,960 MONITOR WHAT EXTENT THAT REMAINS 1018 00:39:19,960 --> 00:39:22,080 OR WHETHER IT'S MODIFIED AND 1019 00:39:22,080 --> 00:39:29,240 WHAT CHARACTERISTICS IS AT 1020 00:39:29,240 --> 00:39:29,600 STAKES. 1021 00:39:29,600 --> 00:39:31,520 I MENTIONED IT'S GOING DOWN BUT 1022 00:39:31,520 --> 00:39:33,840 WE STILL HAVE PRETTY HIGH 1023 00:39:33,840 --> 00:39:35,200 PREVALENCE RATES AMONG TEENAGERS 1024 00:39:35,200 --> 00:39:37,800 IN OUR COUNTRIES FOR CONSUMPTION 1025 00:39:37,800 --> 00:39:40,240 OF SUBSTANCES INCLUDING ALCOHOL 1026 00:39:40,240 --> 00:39:41,680 WHICH YOU SEE OVER THERE IS THE 1027 00:39:41,680 --> 00:39:43,320 NUMBER ONE DRUG CONSUMED. 1028 00:39:43,320 --> 00:39:45,280 THESE METRICS REPRESENT THE 1029 00:39:45,280 --> 00:39:48,640 PREVALENCE OF PAST YEAR DRUG USE 1030 00:39:48,640 --> 00:39:51,880 AMONGST 12th GRADERS, AS 1031 00:39:51,880 --> 00:39:53,320 TEENAGERS AGE OUT THEY ACTUALLY 1032 00:39:53,320 --> 00:39:55,840 CONSUME MORE AND MORE DRUGS AND 1033 00:39:55,840 --> 00:39:58,000 THEN IN THAT TRANSITION THAT 1034 00:39:58,000 --> 00:39:59,400 ACTUALLY FURTHER INCREASES. 1035 00:39:59,400 --> 00:40:02,680 SO WHAT I AM PRESENTING THEN TO 1036 00:40:02,680 --> 00:40:04,120 GET A SENSE ABOUT PREVALENCE 1037 00:40:04,120 --> 00:40:09,000 RATES WHAT WE'RE SPEAKING, 50% 1038 00:40:09,000 --> 00:40:10,280 ALCOHOL, MOSTLY THAT IS 1039 00:40:10,280 --> 00:40:13,160 NICOTINE, ONE THIRD OF THEM. 1040 00:40:13,160 --> 00:40:15,080 MARIJUANA, MOST SPEAKING IS THE 1041 00:40:15,080 --> 00:40:16,880 MAIN DRUG OTHER THAN ALCOHOL AND 1042 00:40:16,880 --> 00:40:19,720 THEN WE HAVE VAPING OF MARIJUANA 1043 00:40:19,720 --> 00:40:21,680 WHERE 20% OF 12th GRADERS REPORT 1044 00:40:21,680 --> 00:40:22,880 THE VAPING. 1045 00:40:22,880 --> 00:40:27,400 IN RED THOUGH I HIGHLIGHT THE 1046 00:40:27,400 --> 00:40:28,480 PRESCRIPTION -- ILLICIT 1047 00:40:28,480 --> 00:40:30,360 PRESCRIPTION -- USE OF 1048 00:40:30,360 --> 00:40:31,600 PRESCRIPTION DRUGS BY TEENAGERS 1049 00:40:31,600 --> 00:40:32,840 BECAUSE THIS IS SOMETHING THAT 1050 00:40:32,840 --> 00:40:33,400 TEENAGERS FAVOR. 1051 00:40:33,400 --> 00:40:35,520 WE'RE SEEING THE LOWEST RATES OF 1052 00:40:35,520 --> 00:40:37,640 COCAINE USE, OF HEROIN USE, 1053 00:40:37,640 --> 00:40:42,040 BASICALLY WE HAVEN'T ACTUALLY -- 1054 00:40:42,040 --> 00:40:45,160 WE ARE WORRY ABOUT THE USE OF 1055 00:40:45,160 --> 00:40:46,280 FENTANYL PER SE BECAUSE THESE 1056 00:40:46,280 --> 00:40:47,880 ARE PATTERNS THAT THEY FAVOR. 1057 00:40:47,880 --> 00:40:50,440 THEY FAVOR DRUGS THAT ARE 1058 00:40:50,440 --> 00:40:51,800 ILLEGAL AND THEY FAVOR ACTUALLY 1059 00:40:51,800 --> 00:40:54,040 PRESCRIPTION DRUGS AND THESE ARE 1060 00:40:54,040 --> 00:41:01,280 THE PRESCRIPTION DRUGS OF WHICH 1061 00:41:01,280 --> 00:41:04,800 MEDICATIONS BUT ADDERALL HAS THE 1062 00:41:04,800 --> 00:41:07,160 HIGHEST RATES. 1063 00:41:07,160 --> 00:41:10,640 THEY ALSO FAVOR OPIOID 1064 00:41:10,640 --> 00:41:11,360 MEDICATIONS AND THESE 1065 00:41:11,360 --> 00:41:14,360 MEDICATIONS, THESE PRESCRIPTION 1066 00:41:14,360 --> 00:41:15,280 MEDICATIONS OVERALL CAN HAVE -- 1067 00:41:15,280 --> 00:41:17,080 MAYBE USED OCCASIONALLY BUT THE 1068 00:41:17,080 --> 00:41:20,080 PROBLEM IS NOW DURING THE COVID 1069 00:41:20,080 --> 00:41:21,880 PANDEMIC SOMETHING PRETTY 1070 00:41:21,880 --> 00:41:23,000 DRAMATIC CHANGED WHICH WAS FIRST 1071 00:41:23,000 --> 00:41:25,000 OF ALL FENTANYL COVERED THE 1072 00:41:25,000 --> 00:41:26,560 WHOLE COUNTRY BUT ONE, DURING 1073 00:41:26,560 --> 00:41:27,320 THE COVID PANDEMIC IN PARTICULAR 1074 00:41:27,320 --> 00:41:29,480 ONE OF THE WAYS THAT FENTANYL IS 1075 00:41:29,480 --> 00:41:31,440 BEING BROUGHT INTO OUR COUNTRY 1076 00:41:31,440 --> 00:41:35,040 IS THESE GUYS IN ILLICITLY 1077 00:41:35,040 --> 00:41:39,400 MANUFACTURED MILLS THAT ARE 1078 00:41:39,400 --> 00:41:41,120 ALMOST IDENTICALLY LOOKING PILLS 1079 00:41:41,120 --> 00:41:47,800 FOR EXAMPLE AS ADERALL OR 1080 00:41:47,800 --> 00:41:50,000 OTHERSnd IF YOU WANT TO BUY THEM 1081 00:41:50,000 --> 00:41:52,360 ON THE WEB THEY'RE MUCH LESS 1082 00:41:52,360 --> 00:41:53,600 EXPENSIVE THAN THE REAL ONES SO 1083 00:41:53,600 --> 00:41:55,120 YOU CAN SEE WHY PEOPLE ARE NOW 1084 00:41:55,120 --> 00:41:57,960 GETTING EXPOSED TO OVERDOSES BY 1085 00:41:57,960 --> 00:41:59,000 BUYING PRESCRIPTION PILLS 1086 00:41:59,000 --> 00:42:02,480 WITHOUT KNOWING IF IT'S 1087 00:42:02,480 --> 00:42:04,880 CONTAMINATED AND REPRESENT A WAY 1088 00:42:04,880 --> 00:42:08,520 OF FENTANYL ENTERING THE 1089 00:42:08,520 --> 00:42:09,480 COUNTRY. 1090 00:42:09,480 --> 00:42:12,400 TEENAGERS THEREFORE ARE 90% 1091 00:42:12,400 --> 00:42:15,440 OF -- DEATHS FROM FENTANYL IN 1092 00:42:15,440 --> 00:42:17,440 TEENAGERS FROM RISED AND THIS IS 1093 00:42:17,440 --> 00:42:20,120 LIKELY TO REPRESENT THIS AND YOU 1094 00:42:20,120 --> 00:42:20,840 SEE THAT WITH THE COVID PANDEMIC 1095 00:42:20,840 --> 00:42:22,560 HOW ALL OF THESE NUMBERS ARE 1096 00:42:22,560 --> 00:42:23,920 GOING WAY, WAY UP AND THAT'S THE 1097 00:42:23,920 --> 00:42:25,000 BLUE LINE. 1098 00:42:25,000 --> 00:42:27,600 BUT I DID WANT TO BRING FORWARD 1099 00:42:27,600 --> 00:42:29,680 THAT THE ORANGE LINE, BECAUSE 1100 00:42:29,680 --> 00:42:32,480 EVEN THOUGH THE OVERDOSE DEATHS 1101 00:42:32,480 --> 00:42:34,520 ON TEENAGERS FOR NONFENTANYL 1102 00:42:34,520 --> 00:42:38,040 RELATED CASES ARE LOW, AND THE 1103 00:42:38,040 --> 00:42:38,960 BASICALLY MORE OR LESS PLATEAU, 1104 00:42:38,960 --> 00:42:40,640 I MEAN, IN TRYING TO UNDERSTAND 1105 00:42:40,640 --> 00:42:42,200 WHAT IS DRIVING THIS AND I THINK 1106 00:42:42,200 --> 00:42:44,240 PERHAPS ONE OF THE MAIN CULPRITS 1107 00:42:44,240 --> 00:42:45,600 MAY BE ALCOHOL OVERDOSES AND 1108 00:42:45,600 --> 00:42:47,600 GEORGE AND I HAVE SPOKEN ABOUT 1109 00:42:47,600 --> 00:42:50,400 IT BECAUSE THIS IS SOMETHING 1110 00:42:50,400 --> 00:42:51,040 THAT PEOPLE DON'T NECESSARILY 1111 00:42:51,040 --> 00:42:53,000 RECOGNIZE THAT YOU CAN DIE FROM 1112 00:42:53,000 --> 00:42:57,000 AN OVERDOSE FOR ALCOHOL AND THIS 1113 00:42:57,000 --> 00:43:00,400 IN TEENAGERS MAY RESULT 1114 00:43:00,400 --> 00:43:01,640 PRACTICES THAT THEY FEEL ARE 1115 00:43:01,640 --> 00:43:02,640 SAFE AND THEY DON'T WANT THEIR 1116 00:43:02,640 --> 00:43:04,880 PARENTS TO KNOW, SO SOMEONE THAT 1117 00:43:04,880 --> 00:43:06,520 IS UNCONSCIOUS THEY DON'T BRING 1118 00:43:06,520 --> 00:43:07,720 THEM TO THE EMERGENCY DEPARTMENT 1119 00:43:07,720 --> 00:43:09,920 SO UNDERSTANDING THAT ALCOHOL IS 1120 00:43:09,920 --> 00:43:11,760 A RISK FACTOR FOR OVERDOSE IS 1121 00:43:11,760 --> 00:43:13,360 IMPORTANT AND WHEN YOU ADD THE 1122 00:43:13,360 --> 00:43:16,320 NOTION THAT TEENAGERS COMBINE 1123 00:43:16,320 --> 00:43:17,800 LIKE ADULTS COMBINE DRUGS YOU 1124 00:43:17,800 --> 00:43:20,360 CAN SEE WHY THESE CAN BE 1125 00:43:20,360 --> 00:43:20,640 EXACERBATED. 1126 00:43:20,640 --> 00:43:26,880 SO AS WE LOOK AT DATA LIKE THIS, 1127 00:43:26,880 --> 00:43:27,560 TO ME, IT HIGHLIGHTS HOW SOME OF 1128 00:43:27,560 --> 00:43:33,280 THAT KEY RESEARCH FOR ALL OF US 1129 00:43:33,280 --> 00:43:36,360 IS IMPLEMENTATION AND GEORGE WAS 1130 00:43:36,360 --> 00:43:37,280 SPEAKING ABOUT IT. 1131 00:43:37,280 --> 00:43:39,520 THAT'S ACTUALLY INCLUDES OF 1132 00:43:39,520 --> 00:43:42,560 COURSE ALCOHOL BUT IT'S THE 1133 00:43:42,560 --> 00:43:44,040 NOTION THAT EARLY IDENTIFICATION 1134 00:43:44,040 --> 00:43:47,320 AND THE IMPORTANCE OF ACTUALLY 1135 00:43:47,320 --> 00:43:50,360 ADVANTAGE OF SYSTEMS TO DO THAT 1136 00:43:50,360 --> 00:43:52,640 SCREENING IS CRUCIAL AND GEORGE 1137 00:43:52,640 --> 00:43:56,760 AND I IN PARTNERSHIP WROTE A 1138 00:43:56,760 --> 00:43:58,000 COMMENTARY WHERE WE WERE 1139 00:43:58,000 --> 00:44:02,240 PROPOSING THE NOTION OF 1140 00:44:02,240 --> 00:44:04,640 DEVELOPING A TERM THAT WE 1141 00:44:04,640 --> 00:44:06,280 TEMPORARY DESCRIBE AS 1142 00:44:06,280 --> 00:44:07,760 PREADDICTION, BUT THE MANNER, 1143 00:44:07,760 --> 00:44:09,400 WHAT IS IMPORTANT IS RECOGNIZING 1144 00:44:09,400 --> 00:44:13,320 A MEANS TO HELP FOR PHYSICIANS 1145 00:44:13,320 --> 00:44:21,240 OR OTHER CLINICIANS HELP 1146 00:44:21,240 --> 00:44:22,320 IDENTIFY SOMEONE FOR THESE 1147 00:44:22,320 --> 00:44:24,400 DISORDERS AND THEY CAN HAVE 1148 00:44:24,400 --> 00:44:26,120 CODES THAT CAN APPLY FOR 1149 00:44:26,120 --> 00:44:27,080 REIMBURSEMENT AND THAT IS THE 1150 00:44:27,080 --> 00:44:27,280 GOAL. 1151 00:44:27,280 --> 00:44:29,240 I THINK THE OTHER ASPECT IS NOT 1152 00:44:29,240 --> 00:44:30,840 JUST ABOUT SCREENING BUT WHAT 1153 00:44:30,840 --> 00:44:33,520 ARE THE INTERVENTIONS THAT ARE 1154 00:44:33,520 --> 00:44:35,760 ACTUALLY GOING TO LEAD TO 1155 00:44:35,760 --> 00:44:38,360 IMPROVED OUTCOMES AND 1156 00:44:38,360 --> 00:44:40,480 HIGHLIGHTING THE SUBSTANCE USE 1157 00:44:40,480 --> 00:44:41,480 DISORDER THE IMPORTANCE OF 1158 00:44:41,480 --> 00:44:46,560 DEVELOPMENT AND RESEARCH FOR THE 1159 00:44:46,560 --> 00:44:47,240 TREATMENT OF ADOLESCENTS, WITH 1160 00:44:47,240 --> 00:44:49,120 MILD, MODERATE OR SEVERE 1161 00:44:49,120 --> 00:44:50,400 SUBSTANCE USE DISORDER BECAUSE 1162 00:44:50,400 --> 00:44:52,920 THE DATA THAT WE HAVE IS VERY 1163 00:44:52,920 --> 00:44:54,520 LIMITED AND JUST LOOK AT A MED 1164 00:44:54,520 --> 00:44:56,280 SEARCH IN TERMS OF CLINICAL 1165 00:44:56,280 --> 00:44:59,680 TRIALS TO DOCUMENT THE USE OF 1166 00:44:59,680 --> 00:45:01,240 MEDICATIONS FOR ADOLESCENTS AND 1167 00:45:01,240 --> 00:45:03,600 YOU WILL SEE HOW VERY FEW THEY 1168 00:45:03,600 --> 00:45:05,040 ARE. 1169 00:45:05,040 --> 00:45:05,840 I ALSO WANT BRING THE SLIDE 1170 00:45:05,840 --> 00:45:08,040 WHICH I PRESENTED IN OUR 1171 00:45:08,040 --> 00:45:09,240 FEBRUARY COUNCIL TO MAKE 1172 00:45:09,240 --> 00:45:10,360 EVERYONE AWARE OF IT. 1173 00:45:10,360 --> 00:45:15,440 I MEAN, WE ALL KNOW THAT 1174 00:45:15,440 --> 00:45:19,680 MARIJUANA IS BEING LEGALIZED ALL 1175 00:45:19,680 --> 00:45:20,880 OVER THE COUNTRY. 1176 00:45:20,880 --> 00:45:25,520 WE SEE 21 STATES AND I MENTIONED 1177 00:45:25,520 --> 00:45:31,320 YESTERDAY IN COUNCIL, I -- I WAS 1178 00:45:31,320 --> 00:45:32,800 WORKING IN AUSTIN. 1179 00:45:32,800 --> 00:45:35,960 I GO INTO A STORE THAT SELLS 1180 00:45:35,960 --> 00:45:38,120 DRUG PARAPHERNALIA AND LO AND 1181 00:45:38,120 --> 00:45:40,240 BEHOLD, THEY ARE SELLING 9 AND 1182 00:45:40,240 --> 00:45:41,640 10 -- NOT 10. 1183 00:45:41,640 --> 00:45:44,800 8 AND 10THC PRODUCTS WITH VERY 1184 00:45:44,800 --> 00:45:46,600 HIGH CONTENT AND DOSES THAT 1185 00:45:46,600 --> 00:45:49,280 ACTUALLY ARE LIKELY TO PRODUCE 1186 00:45:49,280 --> 00:45:51,520 VERY SEVERE INTOXICATION. 1187 00:45:51,520 --> 00:45:54,680 AND THE CONSEQUENCES IS WHAT I 1188 00:45:54,680 --> 00:45:55,320 PRESENTED IN FEBRUARY. 1189 00:45:55,320 --> 00:45:58,840 THIS IS DATA SHOWING THAT YES, 1190 00:45:58,840 --> 00:46:03,960 WE KNOW THAT LEGALIZATION HAS 1191 00:46:03,960 --> 00:46:04,520 INCREASED THE MARIJUANA USE 1192 00:46:04,520 --> 00:46:06,000 AMONG ADULTS ALL OVER THE 1193 00:46:06,000 --> 00:46:07,360 COUNTRY AND THE NUMBERS ARE 1194 00:46:07,360 --> 00:46:10,840 GOING UP AND IT'S ACTUALLY -- IT 1195 00:46:10,840 --> 00:46:13,640 HAS TRIPLED BASED ON THIS ONE. 1196 00:46:13,640 --> 00:46:16,640 BUT IF YOU LOOK AT BASICALLY 1197 00:46:16,640 --> 00:46:18,680 NORMAL USERS IT HAS QUADRUPLED. 1198 00:46:18,680 --> 00:46:20,440 SO REGULAR USE IS GOING UP. 1199 00:46:20,440 --> 00:46:22,840 AND LOOK THEN AT THE RED LINES. 1200 00:46:22,840 --> 00:46:26,440 DAILY USERS INCREASED 14 FOLD 1201 00:46:26,440 --> 00:46:28,880 FROM 1992 TO 2020. 1202 00:46:28,880 --> 00:46:31,480 AND ALSO IN THE YELLOW LINE IS 1203 00:46:31,480 --> 00:46:35,600 THE AMOUNT OF THC THAT PEOPLE 1204 00:46:35,600 --> 00:46:37,160 ARE CONSUMING ON A REGULAR BASIS 1205 00:46:37,160 --> 00:46:39,400 IS GOING UP. 1206 00:46:39,400 --> 00:46:42,000 SO YOU THINK INCREASES, MASSIVE 1207 00:46:42,000 --> 00:46:43,400 INCREASES IN REGULAR USE OF 1208 00:46:43,400 --> 00:46:45,240 MARIJUANA ASSOCIATED WITH VERY 1209 00:46:45,240 --> 00:46:49,240 HIGH DOSES OF THC AND THAT LEADS 1210 00:46:49,240 --> 00:46:50,680 TO NEGATIVE OUTCOMES AT MULTIPLE 1211 00:46:50,680 --> 00:46:52,280 LEVELS SO WE NEED TO INVESTIGATE 1212 00:46:52,280 --> 00:46:53,920 THESE AND I ACTUALLY -- I 1213 00:46:53,920 --> 00:46:57,720 ALSO -- THIS ONE I SHOWED 1214 00:46:57,720 --> 00:46:59,000 YESTERDAY BECAUSE I WANT PEOPLE 1215 00:46:59,000 --> 00:47:01,400 TO BE AWARE OF THE DYNAMICS OF 1216 00:47:01,400 --> 00:47:03,240 POLY SUBSTANCE USE. THIS IS THE 1217 00:47:03,240 --> 00:47:05,920 MORTALITY ASSOCIATED IN PEOPLE 1218 00:47:05,920 --> 00:47:09,240 THAT BASICALLY WHAT THEY SEE 1219 00:47:09,240 --> 00:47:10,880 THAT THERE WAS DETECTION OF THE 1220 00:47:10,880 --> 00:47:11,160 MARIJUANA. 1221 00:47:11,160 --> 00:47:13,240 THAT DOESN'T MEAN THAT THE 1222 00:47:13,240 --> 00:47:14,200 MARIJUANA CREATED THE OVERDOSE 1223 00:47:14,200 --> 00:47:16,000 THERE BUT IT MEANS THAT THE 1224 00:47:16,000 --> 00:47:19,600 PERSON THAT WAS DECEASED HAD 1225 00:47:19,600 --> 00:47:20,600 MARIJUANA IN THEIR SYSTEM. 1226 00:47:20,600 --> 00:47:24,680 THE LIGHT GREEN ACTUALLY IS 1227 00:47:24,680 --> 00:47:26,440 MARIJUANA, BASICALLY IN 1228 00:47:26,440 --> 00:47:28,320 COMBINATION WITH OPIOIDS OR 1229 00:47:28,320 --> 00:47:30,080 STIMULANTS WHICH HIGHLIGHTS THE 1230 00:47:30,080 --> 00:47:31,160 LIKELIHOOD THAT THESE PEOPLE ARE 1231 00:47:31,160 --> 00:47:32,560 USING MULTIPLE DRUGS AND THIS IS 1232 00:47:32,560 --> 00:47:34,320 THE DYNAMIC THAT WE NEED TO 1233 00:47:34,320 --> 00:47:34,720 INVESTIGATE. 1234 00:47:34,720 --> 00:47:36,120 JUST LIKE WE NEED TO INVESTIGATE 1235 00:47:36,120 --> 00:47:37,360 THE DYNAMIC WITH ALCOHOL. 1236 00:47:37,360 --> 00:47:38,800 BUT IF YOU LOOK AT THE DARK 1237 00:47:38,800 --> 00:47:44,440 GREEN, THOSE ARE INDIVIDUALS 1238 00:47:44,440 --> 00:47:50,080 THAT BASICALLY ARE PREDOMINANTLY 1239 00:47:50,080 --> 00:47:52,520 PLANT BASED AND MORE AND MORE 1240 00:47:52,520 --> 00:47:53,960 WE'RE SEEING PEOPLE CONSUMING 1241 00:47:53,960 --> 00:47:55,640 VERY HIGH DOSES OF THC IN 1242 00:47:55,640 --> 00:47:55,880 AMERICA. 1243 00:47:55,880 --> 00:47:58,000 THAT IS TOTALLY UNREGULATED FOR 1244 00:47:58,000 --> 00:48:00,080 THE MOST PART AND PUTTING PEOPLE 1245 00:48:00,080 --> 00:48:00,600 AT RISK. 1246 00:48:00,600 --> 00:48:02,440 AND WE NEED TO KEEP AN EYE ON 1247 00:48:02,440 --> 00:48:02,720 IT. 1248 00:48:02,720 --> 00:48:05,680 THAT NOTION THAT MARIJUANA IS 1249 00:48:05,680 --> 00:48:07,400 SAFE IS NOT REALLY SUPPORTED BY 1250 00:48:07,400 --> 00:48:08,680 THE EVIDENCE AND I THINK THAT 1251 00:48:08,680 --> 00:48:13,080 THIS IS SOME OF THE DATA THAT 1252 00:48:13,080 --> 00:48:13,560 SHOWS THIS. 1253 00:48:13,560 --> 00:48:15,160 SO WHAT ARE OUR PRIORITIES? 1254 00:48:15,160 --> 00:48:18,960 WE NEED TO PRIORITIZE OBVIOUSLY 1255 00:48:18,960 --> 00:48:19,960 UNDERSTANDING ABOUT HOW 1256 00:48:19,960 --> 00:48:21,240 BASICALLY THE PHARMACOLOGY OF 1257 00:48:21,240 --> 00:48:25,240 THESE COMPOUNDS AND AGAIN, IT'S 1258 00:48:25,240 --> 00:48:27,520 NOW WE'RE SEEING MORE 8 AND 1259 00:48:27,520 --> 00:48:29,840 10THC AND WHEN THEY COMBINE WITH 1260 00:48:29,840 --> 00:48:31,400 OTHER DRUGS LIKE ALCOHOL FOR 1261 00:48:31,400 --> 00:48:33,120 EXAMPLE THAT AFFECTS THEIR 1262 00:48:33,120 --> 00:48:33,560 OUTCOMES. 1263 00:48:33,560 --> 00:48:34,600 WE NEED TO UNDERSTAND FACTORS 1264 00:48:34,600 --> 00:48:36,920 THAT LEAD TO RISK. 1265 00:48:36,920 --> 00:48:38,480 THERE'S BEEN A LOT OF WORK IN 1266 00:48:38,480 --> 00:48:40,840 TERMS OF GENETIC VULNERABILITY 1267 00:48:40,840 --> 00:48:42,760 AND THE VULNERABILITY MAY 1268 00:48:42,760 --> 00:48:46,320 REFLECT VERY POWERFUL A GENETIC 1269 00:48:46,320 --> 00:48:48,000 VULNERABILITY FOR ADDICTION IN 1270 00:48:48,000 --> 00:48:51,200 GENERAL AND FEW GENES THEN 1271 00:48:51,200 --> 00:48:53,960 REFLECT VULNERABILITY FOR 1272 00:48:53,960 --> 00:48:55,040 SPECIFIC TYPES OF DRUGS. 1273 00:48:55,040 --> 00:48:56,560 THIS IS AGAIN, IMPORTANT BECAUSE 1274 00:48:56,560 --> 00:48:59,840 THESE GENES ALSO INFLUENCE OTHER 1275 00:48:59,840 --> 00:49:00,120 OUTCOMES. 1276 00:49:00,120 --> 00:49:03,560 THEY ARE NOT JUST CAUSING FOR 1277 00:49:03,560 --> 00:49:04,920 INCREASED RUSK FOR MARIJUANA 1278 00:49:04,920 --> 00:49:08,480 RISK BUT INCREASED RISK FOR 1279 00:49:08,480 --> 00:49:10,000 SCHIZOPHRENIA BUT ALSO THEY MAY 1280 00:49:10,000 --> 00:49:12,120 BE FACTORS THAT NONETHELESS 1281 00:49:12,120 --> 00:49:14,520 DESPITE THESE GENETIC INCREASES 1282 00:49:14,520 --> 00:49:16,640 IN RISKS THAT ARE COMMON, 1283 00:49:16,640 --> 00:49:21,560 THEY'RE FACTORS THAT MAINLY FROM 1284 00:49:21,560 --> 00:49:25,640 A PHARMACOLOGICAL RESULT FROM 1285 00:49:25,640 --> 00:49:26,200 MARIJUANA ITSELF. 1286 00:49:26,200 --> 00:49:28,600 WE HAVE A NEED TO UNDERSTAND 1287 00:49:28,600 --> 00:49:30,640 ALSO NEGATIVE CONSEQUENCES IF 1288 00:49:30,640 --> 00:49:32,080 THERE ARE OF CHRONIC CONSUMPTION 1289 00:49:32,080 --> 00:49:33,720 OF MARIJUANA WHICH WE KNOW THERE 1290 00:49:33,720 --> 00:49:34,000 ARE. 1291 00:49:34,000 --> 00:49:35,440 BUT WE NEED TO UNDERSTAND THEM 1292 00:49:35,440 --> 00:49:37,600 BETTER IN WAYS THAT CAN BE 1293 00:49:37,600 --> 00:49:38,280 TRANSLATED INTO INTERVENTIONS 1294 00:49:38,280 --> 00:49:42,360 AND IMPORTANTLY, WE DO NOT HAVE 1295 00:49:42,360 --> 00:49:43,560 ANY TREATMENT MITIGATIONS 1296 00:49:43,560 --> 00:49:44,840 APPROVED FOR CANNABIS USE 1297 00:49:44,840 --> 00:49:47,520 DISORDER SO THIS IS ANOTHER AREA 1298 00:49:47,520 --> 00:49:48,400 OF PRIORITY. 1299 00:49:48,400 --> 00:49:51,160 SO NOW I JUMP INTO THE OPIOID 1300 00:49:51,160 --> 00:49:53,320 CRISIS BECAUSE THIS IS WHAT HAS 1301 00:49:53,320 --> 00:49:55,040 BEEN TAKING AN ENORMOUS AMOUNT 1302 00:49:55,040 --> 00:49:56,600 OF OUR EFFORT AT THE INSTITUTE 1303 00:49:56,600 --> 00:49:58,520 WHERE WE HAVE AN OPPORTUNITY TO 1304 00:49:58,520 --> 00:49:59,760 BRING KNOWLEDGE THAT CAN HELP US 1305 00:49:59,760 --> 00:50:01,120 ADDRESS THE ISSUES. 1306 00:50:01,120 --> 00:50:03,560 THIS IS DATA SHOWING THE 1307 00:50:03,560 --> 00:50:04,640 DIFFERENT DRUGS THAT ARE 1308 00:50:04,640 --> 00:50:06,640 COUNTING FOR THE OVERALL 1309 00:50:06,640 --> 00:50:07,440 OVERDOSE MORTALITY IN OUR 1310 00:50:07,440 --> 00:50:09,200 COUNTRY AND I'M BASICALLY 1311 00:50:09,200 --> 00:50:13,760 PUTTING AND ACTUALLY IN THE 1312 00:50:13,760 --> 00:50:15,480 BROWN OR GOLDEN BROWN THOSE THAT 1313 00:50:15,480 --> 00:50:19,440 ARE RELATED TO FENTANYL AND YOU 1314 00:50:19,440 --> 00:50:22,440 CAN SEE THE SYNTHETIC OPIOIDS, 1315 00:50:22,440 --> 00:50:25,120 73,000 OUT OF THE 81,000 OPIOID 1316 00:50:25,120 --> 00:50:27,640 DEPTHS ARE RELATED TO FENTANYL. 1317 00:50:27,640 --> 00:50:29,240 SO WHAT IS THIS TELLING US? 1318 00:50:29,240 --> 00:50:31,920 IT'S TELLING US CERTAINLY THAT 1319 00:50:31,920 --> 00:50:33,560 FENTANYL IS A MAIN, MAIN 1320 00:50:33,560 --> 00:50:33,800 CULPRIT. 1321 00:50:33,800 --> 00:50:36,560 BUT IT'S ALSO TELLING US THAT 1322 00:50:36,560 --> 00:50:38,920 MORE AND MORE AND MORE OF THE 1323 00:50:38,920 --> 00:50:41,840 OVERDOSE DEATHS RELATED TO -- IN 1324 00:50:41,840 --> 00:50:45,600 GENERAL ARE ALSO DRIVEN BY 1325 00:50:45,600 --> 00:50:47,280 SYNTHETICS SO THE OTHER CULPRITS 1326 00:50:47,280 --> 00:50:48,760 IS THE METHAMPHETAMINE. 1327 00:50:48,760 --> 00:50:50,320 THIS IS A SYNTHETIC DRUG AND 1328 00:50:50,320 --> 00:50:52,400 THIS IS SOMETHING WE'LL BE 1329 00:50:52,400 --> 00:50:54,240 SEEING INTO THE FUTURE. 1330 00:50:54,240 --> 00:50:56,520 INNOVATION FOR DEVELOPMENT OF 1331 00:50:56,520 --> 00:50:57,560 INCREASINGLY MORE POWERFUL DRUGS 1332 00:50:57,560 --> 00:50:59,800 AND THIS IS A CHALLENGE THAT WE 1333 00:50:59,800 --> 00:51:00,000 FACE. 1334 00:51:00,000 --> 00:51:03,240 AND SO THE CONCEPT WE ALL KNOW 1335 00:51:03,240 --> 00:51:05,920 WHY -- WHY FENTANYL IS SUCH AN 1336 00:51:05,920 --> 00:51:07,360 IMPORTANT CONTRIBUTOR, BUT 1337 00:51:07,360 --> 00:51:10,400 NUMBER ONE, EXTREMELY POTENT SO 1338 00:51:10,400 --> 00:51:12,840 IT HAS A 50% HIGHER POTENCY THAN 1339 00:51:12,840 --> 00:51:16,400 HEROIN ITSELF WHICH MEANS IT'S A 1340 00:51:16,400 --> 00:51:17,720 MUCH MORE DRUG REQUIRED, 1341 00:51:17,720 --> 00:51:19,520 BASICALLY A HIGHER RISK FOR 1342 00:51:19,520 --> 00:51:22,880 ADDICTION BUT ALSO HIGHER RISK 1343 00:51:22,880 --> 00:51:25,400 FOR RESPIRATORY DEPRESSION. 1344 00:51:25,400 --> 00:51:28,120 OTHER ELEMENT ABOUT IT, IT 1345 00:51:28,120 --> 00:51:29,720 ENTERS INTO THE BRAIN VERY 1346 00:51:29,720 --> 00:51:31,400 RAPIDLY, MUCH FASTER THAN THE 1347 00:51:31,400 --> 00:51:31,640 HEROIN. 1348 00:51:31,640 --> 00:51:34,640 WHICH MEANS YOU NEED TO DO THE 1349 00:51:34,640 --> 00:51:37,240 OVERDOSE REVERSAL ADMINISTRATION 1350 00:51:37,240 --> 00:51:38,680 OF DRUGS IN A MUCH SHORT ERWIN 1351 00:51:38,680 --> 00:51:41,600 DOE AND THAT HAS LED TO MAJOR 1352 00:51:41,600 --> 00:51:43,320 CHALLENGES IN BEING ABLE TO SAVE 1353 00:51:43,320 --> 00:51:43,880 LIVES. 1354 00:51:43,880 --> 00:51:47,520 AND THE OTHER THING IS FENTANYL, 1355 00:51:47,520 --> 00:51:50,600 DEPRESS IFR EFFECTS ARE LONGER 1356 00:51:50,600 --> 00:51:54,800 EFFECTS. WHICH MEANS THAT MORE 1357 00:51:54,800 --> 00:51:55,440 AND MORE REPORTS ARE DOCUMENTING 1358 00:51:55,440 --> 00:52:01,240 THE NEED OF MULTIPLE DOSES OF 1359 00:52:01,240 --> 00:52:03,240 NALOXONE. 1360 00:52:03,240 --> 00:52:05,360 THE ASPECT TOO THAT REQUIRES 1361 00:52:05,360 --> 00:52:07,040 ATTENTION ON ALL OF THIS IS THAT 1362 00:52:07,040 --> 00:52:11,040 FENTANYL IS VERY, VERY POTENT BY 1363 00:52:11,040 --> 00:52:12,520 ITSELF BUT THAT WE ARE FACING 1364 00:52:12,520 --> 00:52:14,280 WITH TERMS OF OVERDOSE REVERSALS 1365 00:52:14,280 --> 00:52:18,120 ARE EXACERBATED BY THE FACT THAT 1366 00:52:18,120 --> 00:52:21,240 FENTANYL IS BEING CONTAMINATED 1367 00:52:21,240 --> 00:52:23,440 AND CONSUMED WITH OTHER DRUGS, 1368 00:52:23,440 --> 00:52:25,280 WHETHER IT IS COCAINE, WHETHER 1369 00:52:25,280 --> 00:52:27,680 IT'S ALCOHOL, WHETHER IT'S OTHER 1370 00:52:27,680 --> 00:52:30,600 DRUGS, NOW WE'RE SEEING IT AND 1371 00:52:30,600 --> 00:52:32,760 THIS IS NOT THE DRUG THAT 1372 00:52:32,760 --> 00:52:34,080 THEY'RE SEEKING SPECIFICALLY BUT 1373 00:52:34,080 --> 00:52:36,120 IT'S BY THE DEALERS AND I 1374 00:52:36,120 --> 00:52:37,240 APPRECIATE THE UPDATE ON THAT 1375 00:52:37,240 --> 00:52:39,080 YESTERDAY SO I'M NOT GOING TO 1376 00:52:39,080 --> 00:52:41,760 BELABOR ON THAT, BUT WHAT IT 1377 00:52:41,760 --> 00:52:42,440 DOES TELL US IS THAT WE NEED TO 1378 00:52:42,440 --> 00:52:45,240 UNDERSTAND BETTER HOW TO 1379 00:52:45,240 --> 00:52:46,640 PROPERLY PREVENT, TREAT 1380 00:52:46,640 --> 00:52:48,000 INDIVIDUALS WITH FENTANYL USE 1381 00:52:48,000 --> 00:52:52,320 DISORDER AND HOW TO TREAT THOSE 1382 00:52:52,320 --> 00:52:52,600 OVERDOSES. 1383 00:52:52,600 --> 00:52:55,560 THE FENTANYL EPIDEMIC HAS 1384 00:52:55,560 --> 00:52:58,280 DRAMATICALLY CHANGED THE 1385 00:52:58,280 --> 00:52:59,560 DYNAMICS OF WHO GETS INFLUENCED, 1386 00:52:59,560 --> 00:53:01,280 FENTANYL HAS MADE MANY 1387 00:53:01,280 --> 00:53:03,200 DEMOGRAPHICS NOW VULNERABLE FOR 1388 00:53:03,200 --> 00:53:04,640 OVERDOSES THAT WERE NOT IN THE 1389 00:53:04,640 --> 00:53:04,840 PAST. 1390 00:53:04,840 --> 00:53:07,520 SO I'M PRESENTING YOU THE 1391 00:53:07,520 --> 00:53:09,560 DIFFERENCES BASICALLY IN PINK OF 1392 00:53:09,560 --> 00:53:15,120 OVERDOES DEATHS DURING THE 1393 00:53:15,120 --> 00:53:15,760 PANDEMIC TO SHOW YOU THEY WENT 1394 00:53:15,760 --> 00:53:18,400 UP OVER THE THREE YEARS OF THE 1395 00:53:18,400 --> 00:53:20,120 COVID PANDEMIC BUT IT WAS 1396 00:53:20,120 --> 00:53:21,480 ACTUALLY THE INCREASES WERE MUCH 1397 00:53:21,480 --> 00:53:25,240 MORE DRAMATIC AMONG MEN THAT 1398 00:53:25,240 --> 00:53:29,760 WERE AFRICAN AMERICAN OR OF 1399 00:53:29,760 --> 00:53:34,800 AMERICAN INDIAN OR ALASKA 1400 00:53:34,800 --> 00:53:36,400 NATIVES. 1401 00:53:36,400 --> 00:53:37,800 2.4 TO 2.8 HIGHER MORTALITY IN 1402 00:53:37,800 --> 00:53:39,960 MEN THAN WOMEN. 1403 00:53:39,960 --> 00:53:42,000 MORTALITY IS HIGHEST IN THOSE 1404 00:53:42,000 --> 00:53:43,320 THAT ARE 24 TO 34. 1405 00:53:43,320 --> 00:53:45,880 THAT'S NOT THE DISTINCTION YOU 1406 00:53:45,880 --> 00:53:47,440 HAVE THERE BUT OVERALL YOU SEE 1407 00:53:47,440 --> 00:53:49,760 THESE MEN IN THE MIDDLE AGE, 1408 00:53:49,760 --> 00:53:52,760 YOUNG MIDDLE AGE THAT ARE AT 1409 00:53:52,760 --> 00:53:55,040 HIGHEST RISK, BUT I DO ALSO WANT 1410 00:53:55,040 --> 00:53:56,360 TO POINT SOMETHING I FIND VERY 1411 00:53:56,360 --> 00:53:58,600 SHOCKING WHICH IS LOOK AT WOMEN 1412 00:53:58,600 --> 00:54:01,160 AGE 35 TO 54 IN TERMS OF THE 1413 00:54:01,160 --> 00:54:02,840 OVERDOSE MORTALITY. 1414 00:54:02,840 --> 00:54:05,200 THEY HAVE RATESES OF OVERDOSE 1415 00:54:05,200 --> 00:54:08,280 MORTALITY THAT ARE HIGHER THAN 1416 00:54:08,280 --> 00:54:10,080 THOSE OF MEN THAT -- FROM OTHER 1417 00:54:10,080 --> 00:54:12,320 RACIAL AND ETHNIC GROUPS 1418 00:54:12,320 --> 00:54:13,280 HIGHLIGHTING THE IMPORTANCE THAT 1419 00:54:13,280 --> 00:54:15,840 WE NEED TO DO IN FENTANYL, IT'S 1420 00:54:15,840 --> 00:54:18,360 BASICALLY CONTAMINATED ALL THE 1421 00:54:18,360 --> 00:54:20,560 ILLICIT DRUGS THAT WE KNOW OF, 1422 00:54:20,560 --> 00:54:22,600 NOT NECESSARILY MARIJUANA, 1423 00:54:22,600 --> 00:54:24,000 MAKING INDIVIDUALS THAT DO NOT 1424 00:54:24,000 --> 00:54:27,200 USE HEROIN IN THE PAST ARE NOW 1425 00:54:27,200 --> 00:54:29,040 VERY VULNERABLE FOR OVERDOSES. 1426 00:54:29,040 --> 00:54:30,840 TARGET INTERVENTIONS TO BLACK 1427 00:54:30,840 --> 00:54:34,040 AMERICANS, TARGET INTERVENTIONS 1428 00:54:34,040 --> 00:54:40,640 TO AMERICAN INDIANS AND ALASKA 1429 00:54:40,640 --> 00:54:43,680 NATIVES THAT ARE CULTURAL 1430 00:54:43,680 --> 00:54:43,960 SENSITIVE. 1431 00:54:43,960 --> 00:54:47,280 I WANT TO END MY PRESENTATION IN 1432 00:54:47,280 --> 00:54:49,240 SAYING ALL OF THIS HAS BEEN A 1433 00:54:49,240 --> 00:54:51,000 MAJOR PRIORITY FOR US AND IT IS 1434 00:54:51,000 --> 00:54:55,800 CLEAR TO CONTINUE BE ONE OF THE 1435 00:54:55,800 --> 00:54:57,240 USES FOR THE ALCOHOL USE 1436 00:54:57,240 --> 00:54:59,160 DISORDER AND IN GENERAL FOR ANY 1437 00:54:59,160 --> 00:55:01,160 SUBSTANCE USE DISORDER. 1438 00:55:01,160 --> 00:55:03,480 AS WE THINK ABOUT THE ALCOHOL 1439 00:55:03,480 --> 00:55:09,400 ABUSE DISORDER IT IS FENTANYL 1440 00:55:09,400 --> 00:55:14,520 THAT HAS MORE SEVERE TOLERANCE. 1441 00:55:14,520 --> 00:55:16,720 AND HOW CAN WE OPTIMALLY UTILIZE 1442 00:55:16,720 --> 00:55:19,640 THEM TO LEAD TO BETTER OUTCOMES. 1443 00:55:19,640 --> 00:55:21,120 GEORGE WAS NOTING AND I THINK 1444 00:55:21,120 --> 00:55:24,080 THIS IS, AGAIN, AN EXTREMELY 1445 00:55:24,080 --> 00:55:24,720 IMPORTANT MESSAGE THAT HAS 1446 00:55:24,720 --> 00:55:26,080 CLINICAL IMPLICATIONS WHICH IS 1447 00:55:26,080 --> 00:55:30,080 THE NEGATIVE EMOTIONAL COMPONENT 1448 00:55:30,080 --> 00:55:32,560 IS ONE OF THE MOST CONSEQUENTIAL 1449 00:55:32,560 --> 00:55:36,000 IN DRIVING BASICALLY STOPPING -- 1450 00:55:36,000 --> 00:55:37,960 NOT PARTICIPATING IN TREATMENT 1451 00:55:37,960 --> 00:55:39,840 BUT ALSO ONCE THEY ARE 1452 00:55:39,840 --> 00:55:41,240 PARTICIPATING IN TREATMENT TO 1453 00:55:41,240 --> 00:55:42,040 ACTUALLY NOT STAYING IN 1454 00:55:42,040 --> 00:55:48,520 TREATMENT, TO ADDRESSING THE 1455 00:55:48,520 --> 00:55:52,360 OPPORTUNITY OF -- THAT NEGATIVE 1456 00:55:52,360 --> 00:55:53,680 EMOTIONAL STATE IS KEY IN 1457 00:55:53,680 --> 00:55:54,680 ASSOCIATION WITH MANY OF THESE 1458 00:55:54,680 --> 00:55:56,080 TREATMENTS SO THIS IS SOMETHING 1459 00:55:56,080 --> 00:55:58,320 THAT WE ARE BASICALLY 1460 00:55:58,320 --> 00:56:00,960 ENCOURAGING RESEARCHERS. 1461 00:56:00,960 --> 00:56:03,280 LET'S PASS MULTIPLE THERAPIES. 1462 00:56:03,280 --> 00:56:04,920 WE ARE NOT BOUND TO GIVE ONE 1463 00:56:04,920 --> 00:56:06,200 MEDICATION OR ONE INTERVENTION. 1464 00:56:06,200 --> 00:56:09,760 AND THE SAME THING WITH RESPECT 1465 00:56:09,760 --> 00:56:13,640 TO TECHNOLOGIES WHICH ACTUALLY 1466 00:56:13,640 --> 00:56:16,960 ARE QUITE EXTRAORDINARY 1467 00:56:16,960 --> 00:56:18,600 POTENTIAL BECAUSE AS WE 1468 00:56:18,600 --> 00:56:20,160 UNDERSTAND BETTER, GEORGE WAS 1469 00:56:20,160 --> 00:56:22,160 SPEAKING ABOUT THE CYCLE AND THE 1470 00:56:22,160 --> 00:56:24,000 NETWORKS IN THE BRAIN THAT ARE 1471 00:56:24,000 --> 00:56:25,840 ENGAGED IN THESE DIFFERENT 1472 00:56:25,840 --> 00:56:26,720 PROCESSES, AS WE UNDERSTAND 1473 00:56:26,720 --> 00:56:32,760 THOSE NETWORKS BETTER, WE CAN 1474 00:56:32,760 --> 00:56:34,640 TARGET THEM WITH NEURAL 1475 00:56:34,640 --> 00:56:35,800 MODULATION AND IMPORTANTLY HE 1476 00:56:35,800 --> 00:56:39,240 WAS HINTING YOU CAN CHARACTERIZE 1477 00:56:39,240 --> 00:56:40,520 THE PATTERN OF CLINICAL 1478 00:56:40,520 --> 00:56:41,240 PRESENTATION OF AN INDIVIDUAL 1479 00:56:41,240 --> 00:56:48,000 WITH A SUBSTANCE USE DISORDER 1480 00:56:48,000 --> 00:56:48,600 THEN DETERMINE WHICH ARE THE 1481 00:56:48,600 --> 00:56:49,880 NETWORKS WHICH THEY HAVE 1482 00:56:49,880 --> 00:56:51,480 STRAINED AND WHICH ARE THE 1483 00:56:51,480 --> 00:56:53,840 WEAKER ONES, WHERE YOU CAN 1484 00:56:53,840 --> 00:56:54,280 TARGET PERSONALIZED 1485 00:56:54,280 --> 00:56:56,400 INTERVENTIONS AND I THINK THIS 1486 00:56:56,400 --> 00:56:57,720 SEASON AREA OF EXTRAORDINARY 1487 00:56:57,720 --> 00:56:58,640 IMPORTANCE AND AT THE SAME TIME 1488 00:56:58,640 --> 00:57:01,200 WE NEED TO FURTHER DEVELOP MORE 1489 00:57:01,200 --> 00:57:03,520 INTERVENTIONS IN THE CASE OF 1490 00:57:03,520 --> 00:57:06,760 OVERDOSES THAT WE'LL BE ABLE TO 1491 00:57:06,760 --> 00:57:08,440 REVERSE, NOT JUST OVERDOSES OF 1492 00:57:08,440 --> 00:57:11,160 PURE OPIOIDS BECAUSE THEY ARE 1493 00:57:11,160 --> 00:57:12,840 INCREASINGLY LESS FREQUENT FOR 1494 00:57:12,840 --> 00:57:14,960 OVERDOSES THAT ARE DRUG 1495 00:57:14,960 --> 00:57:15,560 COMBINATIONS INCLUDING THOSE 1496 00:57:15,560 --> 00:57:15,880 WITH ALCOHOL. 1497 00:57:15,880 --> 00:57:17,240 AND WITH THAT I WANT TO THANK 1498 00:57:17,240 --> 00:57:21,200 YOU FOR YOUR ATTENTION. 1499 00:57:21,200 --> 00:57:23,720 >>THANK YOU, NORA. 1500 00:57:23,720 --> 00:57:27,240 SO I THINK WE'LL JUST NOT PAUSE 1501 00:57:27,240 --> 00:57:28,680 FOR QUESTIONS FOR EITHER ONE OF 1502 00:57:28,680 --> 00:57:34,640 US AND JUST MOVE ON TO WILLIAM 1503 00:57:34,640 --> 00:57:36,640 KLEIN WHO'S GOING TO TALK ABOUT 1504 00:57:36,640 --> 00:57:38,960 CRAN RELATED NCI ACTIVITIES AND 1505 00:57:38,960 --> 00:57:39,280 PRIORITIES. 1506 00:57:39,280 --> 00:57:43,080 WE DO HAVE A DISCUSSION LATER 1507 00:57:43,080 --> 00:57:45,720 TODAY AND IF WE -- AND SO SAVE 1508 00:57:45,720 --> 00:57:47,600 UP YOUR QUESTIONS AND THINK 1509 00:57:47,600 --> 00:57:49,720 ABOUT THEM FOR BOTH OF US AND 1510 00:57:49,720 --> 00:57:53,360 WE'LL TRY AND CARVE OUT THAT 1511 00:57:53,360 --> 00:57:57,480 TIME IN THE SCHEDULE LATER. 1512 00:57:57,480 --> 00:57:57,800 ALL RIGHT. 1513 00:57:57,800 --> 00:58:01,800 SO HOW ARE WE PROCEEDING, JOHN? 1514 00:58:01,800 --> 00:58:04,640 IS DR. KLEIN'S TALK READY TO 1515 00:58:04,640 --> 00:58:07,720 ROLL? 1516 00:58:07,720 --> 00:58:09,920 >>I CAN SHARE THEM OR DR. KLEIN 1517 00:58:09,920 --> 00:58:10,120 CAN. 1518 00:58:10,120 --> 00:58:11,040 WHATEVER THE PREFERENCE IS. 1519 00:58:11,040 --> 00:58:12,880 >>OH, PLEASE GO AHEAD. 1520 00:58:12,880 --> 00:58:13,160 YEAH. 1521 00:58:13,160 --> 00:58:14,400 >>ALL RIGHT. 1522 00:58:14,400 --> 00:58:15,440 LET ME FIND THEM. 1523 00:58:15,440 --> 00:58:17,960 >>I'VE GOT THEM TOO IF THAT'S 1524 00:58:17,960 --> 00:58:18,240 EASIER. 1525 00:58:18,240 --> 00:58:20,480 >>SO DR. KLEIN IS THE ASSOCIATE 1526 00:58:20,480 --> 00:58:22,400 DIRECTOR OF NCI'S BEHAVE I DON'T 1527 00:58:22,400 --> 00:58:23,800 RECALL RESEARCH PROGRAM. 1528 00:58:23,800 --> 00:58:25,040 I THINK WE'VE ALL MET HIM BEFORE 1529 00:58:25,040 --> 00:58:31,160 AND I'M LOOKING FORWARD TO HIS 1530 00:58:31,160 --> 00:58:32,360 TALK. 1531 00:58:32,360 --> 00:58:34,040 >>YOU GOT IT. 1532 00:58:34,040 --> 00:58:35,480 >>SAY NEXT PLEASE AND I'LL 1533 00:58:35,480 --> 00:58:36,680 CLICK IT FOR YOU. 1534 00:58:36,680 --> 00:58:38,520 >>IS THERE ANY WAY YOU CAN MAKE 1535 00:58:38,520 --> 00:58:42,280 THE MAIN SCREEN HERE DISAPPEAR? 1536 00:58:42,280 --> 00:58:43,640 THE PICTURES ON THE RIGHT-HAND 1537 00:58:43,640 --> 00:58:43,840 SIDE? 1538 00:58:43,840 --> 00:58:48,320 >>I'M SURE IT CAN BE DONE BUT 1539 00:58:48,320 --> 00:58:49,160 NOT BY ME. 1540 00:58:49,160 --> 00:58:50,360 >>PHILLIP IS GOING TO LOOK AT 1541 00:58:50,360 --> 00:58:52,200 IT HERE. 1542 00:58:52,200 --> 00:58:53,800 >>THANKS. 1543 00:58:53,800 --> 00:58:55,600 >>NORA'S SLIDES BLESSEDLY WERE 1544 00:58:55,600 --> 00:58:56,800 ALL ON THE LEFT SIDE OF THE 1545 00:58:56,800 --> 00:58:58,640 SCREEN SO WE WERE ABLE TO SEE 1546 00:58:58,640 --> 00:59:02,040 MOST OF THEM VERY CLEARLY, BUT I 1547 00:59:02,040 --> 00:59:05,080 THINK IT LOOKS LIKE -- THE YOU 1548 00:59:05,080 --> 00:59:06,280 GO BY BILL, DR. KLEIN? 1549 00:59:06,280 --> 00:59:07,720 >>YES, BILL IS FINE. 1550 00:59:07,720 --> 00:59:09,480 >>SO LOOKS LIKE YOURS ARE ON 1551 00:59:09,480 --> 00:59:10,800 THE RIGHT SIDE OF THE SCREEN SO 1552 00:59:10,800 --> 00:59:12,640 WE JUST CLEARED THEM SO WE CAN 1553 00:59:12,640 --> 00:59:13,520 SEE THEM NOW. 1554 00:59:13,520 --> 00:59:14,360 IT'S ALL YOURS. 1555 00:59:14,360 --> 00:59:14,920 >>GREAT. 1556 00:59:14,920 --> 00:59:16,360 THANK YOU, GEORGE. 1557 00:59:16,360 --> 00:59:19,280 AND THANKS, FOR TWO TERRIFIC 1558 00:59:19,280 --> 00:59:19,600 PRESENTATIONS. 1559 00:59:19,600 --> 00:59:22,080 I APOLOGIZE I'M NOT THERE IN 1560 00:59:22,080 --> 00:59:22,320 PERSON. 1561 00:59:22,320 --> 00:59:23,840 I'M IN PITTSBURGH JUST HAVING 1562 00:59:23,840 --> 00:59:26,600 GIVEN A TALK AT THE CANCER 1563 00:59:26,600 --> 00:59:27,160 CENTER AT THE UNIVERSITY OF 1564 00:59:27,160 --> 00:59:28,680 PITTSBURGH AND SO I'M HOPING 1565 00:59:28,680 --> 00:59:30,200 NEXT TIME I'LL BE THERE IN 1566 00:59:30,200 --> 00:59:31,840 PERSON BUT FOR NOW WE'RE GOING 1567 00:59:31,840 --> 00:59:32,440 TO DO VIRTUAL. 1568 00:59:32,440 --> 00:59:36,240 IF YOU CAN GO TO THE NEXT SLIDE. 1569 00:59:36,240 --> 00:59:37,600 I WOULD LIKE TO TALK ABOUT WHAT 1570 00:59:37,600 --> 00:59:39,640 WE'VE BEEN DOING AT NCI RELATED 1571 00:59:39,640 --> 00:59:41,120 TO CRAN PRIORITIES BUT I WANTED 1572 00:59:41,120 --> 00:59:42,880 TO SAY A FEW THINGS UPFRONT. 1573 00:59:42,880 --> 00:59:44,240 FIRST THE LAST TIME YOU HEARD 1574 00:59:44,240 --> 00:59:46,680 FROM ME A YEAR AGO WE DIDN'T 1575 00:59:46,680 --> 00:59:50,640 HAVE A NEW NCI DIRECTOR. WE HAD 1576 00:59:50,640 --> 00:59:54,080 AN APPOINTEE WHO HADN'T BEEN IN 1577 00:59:54,080 --> 00:59:58,080 PLACE YET SO MONICA BERTAGNOLLI 1578 00:59:58,080 --> 01:00:01,320 IS OUR NEW DIRECTOR. AND SHE'S 1579 01:00:01,320 --> 01:00:02,600 BEEN TERRIFIC SO FAR AND IS WELL 1580 01:00:02,600 --> 01:00:06,040 AWARE OF THE INTEREST WE HAVE IN 1581 01:00:06,040 --> 01:00:08,840 TOBACCO CESSATION AND TOBACCO 1582 01:00:08,840 --> 01:00:10,120 CONTROL MORE GENERALLY AND HAS 1583 01:00:10,120 --> 01:00:12,560 BEEN ENGAGED WITH THIS TOPIC SO 1584 01:00:12,560 --> 01:00:12,960 REALLY IMPORTANT. 1585 01:00:12,960 --> 01:00:14,280 YOU CAN HIT THE NEXT SLIDE. 1586 01:00:14,280 --> 01:00:15,920 IT'S ACTUALLY AN ANIMATION. 1587 01:00:15,920 --> 01:00:21,160 YOU PROBABLY HAVE SEEN THESE 1588 01:00:21,160 --> 01:00:21,760 NEWS ARTICLES THAT PRESIDENT 1589 01:00:21,760 --> 01:00:23,520 BIDEN IS GOING TO NOMINATE 1590 01:00:23,520 --> 01:00:29,720 MONICA TO BE THE NEW DIRECTOR OF 1591 01:00:29,720 --> 01:00:30,800 THE NATIONAL INSTITUTES OF 1592 01:00:30,800 --> 01:00:31,240 HEA 1593 01:00:31,240 --> 01:00:31,480 HEALTH. 1594 01:00:31,480 --> 01:00:33,200 WE HAVE BEEN ASKED TO REASSURE 1595 01:00:33,200 --> 01:00:34,320 THE EXTRAMURAL COMMUNITY THAT 1596 01:00:34,320 --> 01:00:36,400 SHE WILL CONTINUE TO SERVE THE 1597 01:00:36,400 --> 01:00:38,240 ROLE OF NCI DIRECTOR AND I CAN 1598 01:00:38,240 --> 01:00:39,560 TELL YOU SHE'S VERY ACTIVE. 1599 01:00:39,560 --> 01:00:41,880 FOR ANY OF YOU THAT ATTEND 1600 01:00:41,880 --> 01:00:43,080 MEETINGS LIKE THE AMERICAN 1601 01:00:43,080 --> 01:00:45,440 ASSOCIATION OF CANCER RESEARCH 1602 01:00:45,440 --> 01:00:47,520 OR ASCO, VARIOUS OTHERS, SHE 1603 01:00:47,520 --> 01:00:49,080 RUNS AROUND AND ENGAGES WITH THE 1604 01:00:49,080 --> 01:00:50,720 COMMUNITY IN MANY WAYS, GIVERS 1605 01:00:50,720 --> 01:00:54,800 LOTS OF TALKS ON HER PRIORITIES. 1606 01:00:54,800 --> 01:00:55,360 SHE'S BEEN VERY ACTIVE AND 1607 01:00:55,360 --> 01:00:56,720 REALLY A TERRIFIC DIRECTOR SO 1608 01:00:56,720 --> 01:00:58,360 FAR AND WE'LL SEE WHAT HAPPENS 1609 01:00:58,360 --> 01:01:00,000 WITH THE NIH DIRECTOR 1610 01:01:00,000 --> 01:01:02,360 APPOINTMENT. 1611 01:01:02,360 --> 01:01:05,280 NEXT SLIDE, PLEASE. 1612 01:01:05,280 --> 01:01:09,240 WE OF COURSE ARE CONSTANTLY 1613 01:01:09,240 --> 01:01:12,000 ENGAGED IN CANCER MOON SHOT 1614 01:01:12,000 --> 01:01:12,440 ACTIVITIES. 1615 01:01:12,440 --> 01:01:14,880 HOPEFULLY YOU'RE FAMILIAR WITH 1616 01:01:14,880 --> 01:01:17,240 THE MOON SHOT INITIATIVES THAT 1617 01:01:17,240 --> 01:01:22,480 WAS INITIATED IN THE OBAMA 1618 01:01:22,480 --> 01:01:26,520 ADMINISTRATION AND IS CURRENTLY 1619 01:01:26,520 --> 01:01:32,560 CONTINUING IN HIS TERM AS 1620 01:01:32,560 --> 01:01:32,800 PRESIDENT. 1621 01:01:32,800 --> 01:01:33,480 AND IT INCLUDES TOBACCO CONTROL 1622 01:01:33,480 --> 01:01:35,320 AND ALSO ALCOHOL, AND SO WE ARE 1623 01:01:35,320 --> 01:01:37,000 VERY MUCH ENGAGED IN CANCER MOON 1624 01:01:37,000 --> 01:01:38,640 SHOT ACTIVITIES WITHIN OUR 1625 01:01:38,640 --> 01:01:44,400 DIVISION AND ALSO WITHIN THE 1626 01:01:44,400 --> 01:01:45,240 BEH 1627 01:01:45,240 --> 01:01:50,800 BEHAVIORAL RESEARCH DIVISION 1628 01:01:50,800 --> 01:01:51,880 THAT I LEAD. 1629 01:01:51,880 --> 01:01:54,360 SHE ASKED US TO ENGAGE IN A 1630 01:01:54,360 --> 01:01:56,080 STRATEGIC PLANNING ACTIVITY OVER 1631 01:01:56,080 --> 01:01:57,160 THE LAST YEAR AND A HALF TO KEY 1632 01:01:57,160 --> 01:01:58,960 IN ON SOME AREAS THAT EITHER 1633 01:01:58,960 --> 01:02:01,240 NEED RENEWED ATTENTION OR NEW 1634 01:02:01,240 --> 01:02:02,200 ATTENTION AND YOU CAN SEE WHAT 1635 01:02:02,200 --> 01:02:04,120 THOSE ARE HERE AND I DO WANT TO 1636 01:02:04,120 --> 01:02:05,240 ADD A CAVEAT BEFORE SAYING 1637 01:02:05,240 --> 01:02:07,160 ANYTHING MORE, WHICH IS THAT 1638 01:02:07,160 --> 01:02:10,560 MOST OF OUR PORTFOLIO INCLUDES 1639 01:02:10,560 --> 01:02:11,480 INVESTIGATOR INITIATED GRANTS 1640 01:02:11,480 --> 01:02:13,000 AND WE'RE OPEN TO A LOT OF 1641 01:02:13,000 --> 01:02:14,080 DIFFERENT TOPICS SO THAT'S NOT 1642 01:02:14,080 --> 01:02:15,320 TO SAY THESE ARE THE ONLY THINGS 1643 01:02:15,320 --> 01:02:17,680 WE WANT TO FUND BUT THESE ARE 1644 01:02:17,680 --> 01:02:20,000 SOME TOPICS THAT ARE CAPTURING 1645 01:02:20,000 --> 01:02:21,600 OUR IMAGINATION MORE RECENTLY 1646 01:02:21,600 --> 01:02:23,400 AND I'M SURE NONE OF THESE ARE 1647 01:02:23,400 --> 01:02:23,680 SURPRISING. 1648 01:02:23,680 --> 01:02:28,680 HEALTH EQUITY A MAJOR PRIORITY 1649 01:02:28,680 --> 01:02:31,480 FOR US AND A PRIORITY THROUGHOUT 1650 01:02:31,480 --> 01:02:31,920 NIH. 1651 01:02:31,920 --> 01:02:33,640 DATA SHARING AND ALL THE ISSUES 1652 01:02:33,640 --> 01:02:35,360 THAT GO WITH THAT ARE A BIG 1653 01:02:35,360 --> 01:02:39,240 TOPIC OF CONVERSATION WITHIN OUR 1654 01:02:39,240 --> 01:02:39,520 DIVISION. 1655 01:02:39,520 --> 01:02:40,400 MOD FINAL RISK FACTORS INCLUDE 1656 01:02:40,400 --> 01:02:42,160 AGO LOT THAT WE TALK ABOUT HERE 1657 01:02:42,160 --> 01:02:44,160 WITHIN CRAN AND ALSO TRYING TO 1658 01:02:44,160 --> 01:02:47,040 UNDERSTAND COUSE AND HOW 1659 01:02:47,040 --> 01:02:48,800 BEHAVIORS INTERACT. 1660 01:02:48,800 --> 01:02:50,000 AND THAT'S SOMETHING THAT'S 1661 01:02:50,000 --> 01:02:51,680 GOTTEN LESS ATTENTION IN THE 1662 01:02:51,680 --> 01:02:52,000 LITERATURE. 1663 01:02:52,000 --> 01:02:53,680 DIGITAL HEALTH, WE CAN DO MUCH 1664 01:02:53,680 --> 01:02:56,680 WITH THE TECHNOLOGY AVAILABLE TO 1665 01:02:56,680 --> 01:02:57,680 US. 1666 01:02:57,680 --> 01:02:59,440 OBVIOUSLY AI IS A BIG PIECE OF 1667 01:02:59,440 --> 01:03:00,680 THIS BUT WE ALSO WANT TO KNOW 1668 01:03:00,680 --> 01:03:03,240 HOW SENSORS AND VARIOUS KINDS OF 1669 01:03:03,240 --> 01:03:04,680 DIGITAL TECHNOLOGY CAN BE USED 1670 01:03:04,680 --> 01:03:06,240 TO UNDERSTAND AND CAPTURE 1671 01:03:06,240 --> 01:03:08,720 PEOPLE'S BEHAVIORS IN REAL TIME. 1672 01:03:08,720 --> 01:03:11,560 EVIDENCE BASED POLICY, OBVIOUSLY 1673 01:03:11,560 --> 01:03:13,200 SOME STRONG CONNECTIONS TO CRAN 1674 01:03:13,200 --> 01:03:13,720 PRIORITIES. 1675 01:03:13,720 --> 01:03:15,480 WE NEED TO SUPPORT EVIDENCE 1676 01:03:15,480 --> 01:03:16,560 BASED POLICY IN THE BEST WAY 1677 01:03:16,560 --> 01:03:19,480 POSSIBLE AND I'LL BE SAYING A 1678 01:03:19,480 --> 01:03:21,560 BIT ABOUT THE WORK THAT WE DO TO 1679 01:03:21,560 --> 01:03:25,480 SUPPORT FDA REGULATION OF 1680 01:03:25,480 --> 01:03:25,720 TOBACCO. 1681 01:03:25,720 --> 01:03:27,200 CLIMATE CHANGE AND CANCER, WHAT 1682 01:03:27,200 --> 01:03:29,280 DO THEY HAVE TO DO WITH EACH 1683 01:03:29,280 --> 01:03:29,480 OTHER? 1684 01:03:29,480 --> 01:03:32,640 BUT IT DOESN'T TAKE MUCH TO 1685 01:03:32,640 --> 01:03:33,760 THINK ABOUT HOW THESE MIGHT BE 1686 01:03:33,760 --> 01:03:34,960 CONNECTED. 1687 01:03:34,960 --> 01:03:36,520 CLIMATE EVENTS INFLUENCE CANCER 1688 01:03:36,520 --> 01:03:37,720 CARE IN SIGNIFICANT WAYS. 1689 01:03:37,720 --> 01:03:40,600 YOU CAN IMAGINE A HURRICANE, A 1690 01:03:40,600 --> 01:03:41,920 TORNADO CAN HAVE AN EFFECT ON 1691 01:03:41,920 --> 01:03:44,520 WHETHER A PATIENT CAN GET 1692 01:03:44,520 --> 01:03:45,320 ADEQUATE CARE BUT CLIMATE CHANGE 1693 01:03:45,320 --> 01:03:48,760 CAN INFLUENCE BEHAVIORAL RISK 1694 01:03:48,760 --> 01:03:49,160 FACTORS. 1695 01:03:49,160 --> 01:03:52,920 CLIMATE CHANGE AFFECTS THE FOOD 1696 01:03:52,920 --> 01:03:57,240 SUPPLY, WHICH CAN INFLUENCE 1697 01:03:57,240 --> 01:04:02,360 CANCER MORBIDITY AND MORTALITY. 1698 01:04:02,360 --> 01:04:03,480 NEXT SLIDE PLEASE. 1699 01:04:03,480 --> 01:04:04,560 SO THIS IS THE PROGRAM THAT I 1700 01:04:04,560 --> 01:04:06,080 LEAD AND MUCH OF THE WORK THAT 1701 01:04:06,080 --> 01:04:07,680 WE DO ON ADDICTION AND 1702 01:04:07,680 --> 01:04:10,360 PARTICULARLY TOBACCO CONTROL IS 1703 01:04:10,360 --> 01:04:11,720 HOUSED WITHIN THIS PROGRAM AT 1704 01:04:11,720 --> 01:04:12,920 THE NATIONAL CANCER INSTITUTE 1705 01:04:12,920 --> 01:04:14,320 AND THIS IS OUR LEADERSHIP TEAM 1706 01:04:14,320 --> 01:04:16,360 AND I ENCOURAGE YOU TO REACH OUT 1707 01:04:16,360 --> 01:04:17,800 TO ANY OF THEM IF YOU HAVE 1708 01:04:17,800 --> 01:04:19,040 QUESTIONS ABOUT TOPICS OF 1709 01:04:19,040 --> 01:04:20,240 INTEREST BUT I DO WANT TO 1710 01:04:20,240 --> 01:04:23,360 HIGHLIGHT THE LOWER RIGHT, WE 1711 01:04:23,360 --> 01:04:25,920 NOW HAVE A NEW BRANCH CHIEF. 1712 01:04:25,920 --> 01:04:27,920 MICHELLE BLOCK HAS SERVED IN 1713 01:04:27,920 --> 01:04:29,520 THIS ROLE OVER THE LAST TEN OR 1714 01:04:29,520 --> 01:04:31,360 SO YEARS AND MICHELLE IS ON THE 1715 01:04:31,360 --> 01:04:33,520 CALL SO I WANT TO THANK HER FOR 1716 01:04:33,520 --> 01:04:36,280 HER TREMENDOUS DEDICATION AND 1717 01:04:36,280 --> 01:04:39,000 CONTRIBUTIONS TO NCI AND NIH. 1718 01:04:39,000 --> 01:04:42,560 MICHELLE IS NOW FACING 1719 01:04:42,560 --> 01:04:43,960 RETIREMENT AND WE NOW HAVE NEAL 1720 01:04:43,960 --> 01:04:47,920 FRIEDMANN TAKING ON THE ROLE OF 1721 01:04:47,920 --> 01:04:50,560 THE BRANCH CHIEF OF TOBACCO 1722 01:04:50,560 --> 01:04:50,880 CONTROL. 1723 01:04:50,880 --> 01:04:53,360 NEAL COMES TO US FROM ANOTHER 1724 01:04:53,360 --> 01:04:58,680 PART OF NCI. HE WAS IN THE 1725 01:04:58,680 --> 01:05:00,000 METABOLIC EPIDEMIOLOGY BRANCH 1726 01:05:00,000 --> 01:05:03,800 AND HE'S MAKING THE SWITCH FROM 1727 01:05:03,800 --> 01:05:05,240 INTRAYURL TO EXTRAMURAL AND 1728 01:05:05,240 --> 01:05:06,560 WE'RE EXCITED TO HAVE HIM ON 1729 01:05:06,560 --> 01:05:07,800 BOARD IN THIS NEW ROLE. 1730 01:05:07,800 --> 01:05:11,200 HE ALREADY HAS A GREAT DEAL OF 1731 01:05:11,200 --> 01:05:12,000 KNOWLEDGE ABOUT TOBACCO AND 1732 01:05:12,000 --> 01:05:15,120 TOBACCO CONTROL AND ALSO OTHER 1733 01:05:15,120 --> 01:05:15,800 BEHAVIORS INCLUDING ALCOHOL AND 1734 01:05:15,800 --> 01:05:18,120 I THINK HE'S GOING TO DO A 1735 01:05:18,120 --> 01:05:21,960 REALLY TERRIFIC JOB HELPING US 1736 01:05:21,960 --> 01:05:25,600 THINK ABOUT WHERE ALCOHOL SITS 1737 01:05:25,600 --> 01:05:28,680 WITHIN THE WIDER LINKS TO CANCER 1738 01:05:28,680 --> 01:05:29,080 OUTCOMES. 1739 01:05:29,080 --> 01:05:32,720 NEXT SLIDE, PLEASE. NOW OUR 1740 01:05:32,720 --> 01:05:34,080 TOBACCO CONTROL RESEARCH BRANCH 1741 01:05:34,080 --> 01:05:36,960 HAS ENGAGED IN MANY ACTIVITIES 1742 01:05:36,960 --> 01:05:37,400 OVER THE YEARS. 1743 01:05:37,400 --> 01:05:39,760 WE HAVE A BIG GRANTS PORTFOLIO 1744 01:05:39,760 --> 01:05:40,640 AND I WILL BE MENTIONING SOME OF 1745 01:05:40,640 --> 01:05:42,920 OUR FUNDING OPPORTUNITIES BUT WE 1746 01:05:42,920 --> 01:05:45,480 DO A LOT OF OTHER WORK INCLUDING 1747 01:05:45,480 --> 01:05:46,680 AN IMPORTANT MONOGRAPH SERIES 1748 01:05:46,680 --> 01:05:48,840 THAT CONTINUES TO REALLY HAVE A 1749 01:05:48,840 --> 01:05:51,320 TREMENDOUS IMPACT ON POLICY AND 1750 01:05:51,320 --> 01:05:52,160 ON RESEARCH AND IN MANY 1751 01:05:52,160 --> 01:05:53,120 DIFFERENT VENUES. 1752 01:05:53,120 --> 01:05:57,240 AND SO THE MOST RECENT ONE WAS 1753 01:05:57,240 --> 01:05:59,160 TOBACCO MONOGRAPH 23 WHICH 1754 01:05:59,160 --> 01:06:00,600 FOCUSED ON SMOKING AND CANCER 1755 01:06:00,600 --> 01:06:00,880 PATIENTS. 1756 01:06:00,880 --> 01:06:02,240 THIS IS A VERY IMPORTANT 1757 01:06:02,240 --> 01:06:04,200 POPULATION. WE NOW KNOW THAT 1758 01:06:04,200 --> 01:06:05,480 CANCER SURVIVORSHIP IS NOT A 1759 01:06:05,480 --> 01:06:06,520 DEATH SENTENCE. 1760 01:06:06,520 --> 01:06:09,080 CANCER SURVIVORSHIP IS A 1761 01:06:09,080 --> 01:06:11,480 LONG-TERM EXPERIENCE AND THAT IS 1762 01:06:11,480 --> 01:06:13,320 BECAUSE OF ALL THE NEW CANCER 1763 01:06:13,320 --> 01:06:14,560 THERAPIES THAT HAVE DEVELOPED 1764 01:06:14,560 --> 01:06:17,600 OVER THE LAST 30, 40, 50 YEARS. 1765 01:06:17,600 --> 01:06:18,720 THERE ARE MANY PEOPLE WHO ARE 1766 01:06:18,720 --> 01:06:24,840 LIVING AFTER A CANCER DIAGNOSIS 1767 01:06:24,840 --> 01:06:26,400 EVEN MORE THAN BEFORE THE CANCER 1768 01:06:26,400 --> 01:06:27,520 DIAGNOSIS, SO WE NEED TO MAKE 1769 01:06:27,520 --> 01:06:29,240 SURE THAT WE ARE ATTENDING TO 1770 01:06:29,240 --> 01:06:32,360 THEIR NEEDS AND ONE OF THOSE IS 1771 01:06:32,360 --> 01:06:39,320 TO ADDRESS BEHAVIORS THAT -- AND 1772 01:06:39,320 --> 01:06:41,680 MANY CANCER SURVIVORS ARE 1773 01:06:41,680 --> 01:06:43,560 SMOKERS AND SO THIS MONOGRAPH 1774 01:06:43,560 --> 01:06:46,520 REALLY FOCUSES ON HOW TO ADDRESS 1775 01:06:46,520 --> 01:06:47,720 TOBACCO CESSATION IN THIS 1776 01:06:47,720 --> 01:06:48,640 PARTICULAR SUBPOPULATION THAT 1777 01:06:48,640 --> 01:06:51,120 REALLY NEEDS ATTENTION. AND IT 1778 01:06:51,120 --> 01:06:52,880 TURNS OUT THERE AREN'T A LOT OF 1779 01:06:52,880 --> 01:06:54,960 STUDIES THAT ADDRESS TOBACCO 1780 01:06:54,960 --> 01:06:56,440 CESSATION IN THE CANCER PATIENT 1781 01:06:56,440 --> 01:06:56,720 POPULATION. 1782 01:06:56,720 --> 01:06:58,960 BUT THERE'S A VERY RIFRP 1783 01:06:58,960 --> 01:07:02,400 LITERATURE ON APPROACHES THAT DO 1784 01:07:02,400 --> 01:07:03,040 WORK IN ADULTS MORE GENERALLY 1785 01:07:03,040 --> 01:07:04,440 AND THOSE HAVE NOW BEEN ADAPTED 1786 01:07:04,440 --> 01:07:07,240 TO CANCER PATIENTS AND ARE 1787 01:07:07,240 --> 01:07:10,400 INCREASINGLY BEING ADAPTED TO 1788 01:07:10,400 --> 01:07:10,800 CANCER PATIENTS. 1789 01:07:10,800 --> 01:07:12,720 I ENCOURAGE YOU TO TAKE A LOOK 1790 01:07:12,720 --> 01:07:13,200 AT THIS. 1791 01:07:13,200 --> 01:07:15,200 WE ARE NOW WORKING ON OUR NEXT 1792 01:07:15,200 --> 01:07:16,640 MONOGRAPH, THIS ONE WILL FOCUS 1793 01:07:16,640 --> 01:07:18,400 ON UNDERSTANDING THE EFFECTS OF 1794 01:07:18,400 --> 01:07:22,400 ALCOHOL USE ACROSS THE TOBACCO 1795 01:07:22,400 --> 01:07:22,800 CONTROL CONTINUUM. 1796 01:07:22,800 --> 01:07:26,800 WE'RE INCREASINGLY FINDING HOW 1797 01:07:26,800 --> 01:07:27,560 IMPORTANTLY THESE GO HAND IN 1798 01:07:27,560 --> 01:07:30,880 HAND AND SO THIS WILL ADDRESS A 1799 01:07:30,880 --> 01:07:34,000 NUMBER OF QUESTIONS INCLUDING 1800 01:07:34,000 --> 01:07:34,680 EPIDEMIOLOGICAL QUESTIONS AND UP 1801 01:07:34,680 --> 01:07:36,480 TO POLICY QUESTIONS AND WE'RE IN 1802 01:07:36,480 --> 01:07:40,680 THE PROCESS OF GETTING THAT 1803 01:07:40,680 --> 01:07:42,320 GOING. 1804 01:07:42,320 --> 01:07:44,200 NEXT SLIDE, PLEASE. 1805 01:07:44,200 --> 01:07:44,560 GREAT. 1806 01:07:44,560 --> 01:07:44,920 THANK YOU. 1807 01:07:44,920 --> 01:07:46,600 SO THE DEPARTMENT OF HEALTH AND 1808 01:07:46,600 --> 01:07:48,640 HUMAN SERVICES SPONSORS WHAT I 1809 01:07:48,640 --> 01:07:51,960 CONSIDER TO BE A REALLY CRUCIAL 1810 01:07:51,960 --> 01:07:53,960 TOOL TO FACILITATE SMOKING 1811 01:07:53,960 --> 01:07:59,680 CESSATION AND THAT IS SMOKE 1812 01:07:59,680 --> 01:08:01,440 FREE.GOV. IT IS A COLLABORATION 1813 01:08:01,440 --> 01:08:04,080 ACROSS SEVERAL FEDERAL AGENCIES 1814 01:08:04,080 --> 01:08:09,520 PARTICULARLY FDA AND CDC. 1815 01:08:09,520 --> 01:08:12,520 IT BUILDS ON THE PSYCHOLOGY OF 1816 01:08:12,520 --> 01:08:13,720 CESSATION WHICH REALLY 1817 01:08:13,720 --> 01:08:14,760 EMPHASIZES THE IMPORTANCE OF 1818 01:08:14,760 --> 01:08:16,000 FOCUSING ON THE POSITIVE AND NOT 1819 01:08:16,000 --> 01:08:21,240 SCARING PEOPLE AND SHAMING THEM 1820 01:08:21,240 --> 01:08:23,040 BUT GIVING THEM MOTIVATION TO 1821 01:08:23,040 --> 01:08:25,040 CONTINUE TO QUIT AND TO TRY TO 1822 01:08:25,040 --> 01:08:25,240 QUIT. 1823 01:08:25,240 --> 01:08:26,800 THIS IS A MOBILE BASED RESOURCES 1824 01:08:26,800 --> 01:08:29,040 THAT CAN BE ACCESSED BY SMOKERS 1825 01:08:29,040 --> 01:08:30,760 AT ANY TIME AND WE ALSO HAVE A 1826 01:08:30,760 --> 01:08:32,280 NUMBER OF DIFFERENT SMALLER 1827 01:08:32,280 --> 01:08:33,880 PIECES OF A SMOKE FREE SUITE 1828 01:08:33,880 --> 01:08:35,440 THAT FOCUS ON SPECIFIC 1829 01:08:35,440 --> 01:08:36,720 POPULATIONS SUCH AS ADOLESCENCE 1830 01:08:36,720 --> 01:08:38,960 AND MILITARY AND WOMEN AND SO 1831 01:08:38,960 --> 01:08:39,320 ON. 1832 01:08:39,320 --> 01:08:43,120 AND YOU CAN SEE HERE THAT WE'VE 1833 01:08:43,120 --> 01:08:44,720 REACHED 7 TO 8 MILLION PEOPLE IN 1834 01:08:44,720 --> 01:08:46,160 THE LAST YEAR, 2022. 1835 01:08:46,160 --> 01:08:48,200 SO IT'S A WIDELY USED RESOURCE 1836 01:08:48,200 --> 01:08:49,960 AND AN IMPORTANT ONE AND WE DO 1837 01:08:49,960 --> 01:08:51,920 WHAT WE CAN DO TRY TO REACH MANY 1838 01:08:51,920 --> 01:08:53,280 SUBPOPULATIONS AND ALSO WE TRY 1839 01:08:53,280 --> 01:08:55,680 TO KEEP UP THE CON TENTS TO MAKE 1840 01:08:55,680 --> 01:08:58,200 SURE IT'S AS UP TO DATE AS 1841 01:08:58,200 --> 01:08:59,800 POSSIBLE. 1842 01:08:59,800 --> 01:09:00,920 NEXT SLIDE, PLEASE. 1843 01:09:00,920 --> 01:09:02,640 NOW, OF COURSE AS I SAID BEFORE, 1844 01:09:02,640 --> 01:09:04,800 MUCH OF THE WORK THAT WE DO AND 1845 01:09:04,800 --> 01:09:10,520 ALSO NIDA AND THE SCIENCE 1846 01:09:10,520 --> 01:09:16,680 PROGRAM WITHIN THE OFFICE OF 1847 01:09:16,680 --> 01:09:21,760 DISEASE PREVENTION AT NIH, SO 1848 01:09:21,760 --> 01:09:24,520 FDA HAS PROPOSED PRODUCT 1849 01:09:24,520 --> 01:09:28,120 STANDARDS TO PROHIBIT MENTHOL AS 1850 01:09:28,120 --> 01:09:30,280 A CHARACTERIZING FLAVOR IN 1851 01:09:30,280 --> 01:09:30,640 CIGARETTES. 1852 01:09:30,640 --> 01:09:32,840 THAT'S A REALLY BIG DEAL. 1853 01:09:32,840 --> 01:09:34,280 WE'RE GOING TO SEE WHERE THAT 1854 01:09:34,280 --> 01:09:34,640 GOES. 1855 01:09:34,640 --> 01:09:37,040 THE PUBLIC COMMENT PERIOD HAS 1856 01:09:37,040 --> 01:09:37,560 NOW CLOSED AND THEY ARE 1857 01:09:37,560 --> 01:09:38,920 REVIEWING THOSE COMMENTS AND 1858 01:09:38,920 --> 01:09:40,080 DECIDING HOW TO MOVE FORWARD. 1859 01:09:40,080 --> 01:09:41,480 IT'S VERY CLEAR THAT WE'RE GOING 1860 01:09:41,480 --> 01:09:43,600 TO NEED SOME RESEARCH ON HOW 1861 01:09:43,600 --> 01:09:46,320 BEST TO FACILITATE CESSATION IN 1862 01:09:46,320 --> 01:09:47,880 COMMUNITIES, PARTICULARLY BLACK 1863 01:09:47,880 --> 01:09:51,440 COMMUNITIES WHERE MENTHOL IS 1864 01:09:51,440 --> 01:09:52,680 USED QUITE FREQUENTLY AND FOR 1865 01:09:52,680 --> 01:09:56,680 WHICH RESOURCES ARE NOT AS 1866 01:09:56,680 --> 01:09:57,400 AVAILABLE AS THEY SHOULD BE. 1867 01:09:57,400 --> 01:09:59,000 I HAVE ANIMATION ON THE SLIDE SO 1868 01:09:59,000 --> 01:10:00,800 IF YOU CAN GO TO THE NEXT 1869 01:10:00,800 --> 01:10:01,600 ANIMATION. 1870 01:10:01,600 --> 01:10:05,040 YOU MIGHT HAVE HEARD THE TERM 1871 01:10:05,040 --> 01:10:08,760 SYNTHETIC NICOTINE AND WE'VE NOW 1872 01:10:08,760 --> 01:10:11,920 MOVED TO THE TERM NONTOBACCO 1873 01:10:11,920 --> 01:10:12,240 NICOTINE. 1874 01:10:12,240 --> 01:10:14,480 SO IT'S NOT DERIVED FROM TOBACCO 1875 01:10:14,480 --> 01:10:16,680 AND THAT'S REALLY LED FDA TO 1876 01:10:16,680 --> 01:10:22,720 THINK ABOUT WHAT FALLS UNDER 1877 01:10:22,720 --> 01:10:23,680 THEIR DEFINITIONS. 1878 01:10:23,680 --> 01:10:26,520 WE NEED MUCH MORE RESEARCH ON 1879 01:10:26,520 --> 01:10:29,560 HOW PEOPLE USE NONTOBACCO 1880 01:10:29,560 --> 01:10:30,920 NICOTINE PRODUCTS AND WHAT THE 1881 01:10:30,920 --> 01:10:32,520 IMPACT WILL BE OVER TIME AND 1882 01:10:32,520 --> 01:10:34,600 THEN NEXT ANIMATION, THE FDA IS 1883 01:10:34,600 --> 01:10:36,440 ALSO WORKING TO DEVELOP A 1884 01:10:36,440 --> 01:10:38,400 PROPOSED PRODUCT STANDARD THAT 1885 01:10:38,400 --> 01:10:39,760 WOULD ESTABLISH A MAXIMUM 1886 01:10:39,760 --> 01:10:40,240 NICOTINE LEVEL. 1887 01:10:40,240 --> 01:10:42,280 THIS IS CONSIDERED TO BE AN END 1888 01:10:42,280 --> 01:10:42,960 GAME STRATEGY. 1889 01:10:42,960 --> 01:10:45,360 IF YOU REDUCE NICOTINE LEVELS 1890 01:10:45,360 --> 01:10:47,280 SUBSTANTIALLY IN CIGARETTES AND 1891 01:10:47,280 --> 01:10:48,800 OTHER TOBACCO PRODUCTS YOU CAN 1892 01:10:48,800 --> 01:10:50,480 IMAGINE THAT WILL REDUCE 1893 01:10:50,480 --> 01:10:51,480 ADDICTION AND THEN THEREFORE 1894 01:10:51,480 --> 01:10:52,000 REDUCE USE. 1895 01:10:52,000 --> 01:10:53,920 AND PROBABLY GET US TO A POINT 1896 01:10:53,920 --> 01:10:57,040 WHERE WE ARE DOING MUCH BETTER 1897 01:10:57,040 --> 01:10:58,040 IN TERMS OF USE AND THEN 1898 01:10:58,040 --> 01:10:59,760 ULTIMATE HEALTH IMPACT. 1899 01:10:59,760 --> 01:11:03,640 SO THESE ARE THREE FDA 1900 01:11:03,640 --> 01:11:04,680 INITIATIVES, THAT ARE VERY 1901 01:11:04,680 --> 01:11:05,800 IMPORTANT TO TRACK AND FOR WHICH 1902 01:11:05,800 --> 01:11:07,760 THEY NEED THE KINDS OF DATA THAT 1903 01:11:07,760 --> 01:11:10,560 WE SUPPORT AND WE SUPPORT 1904 01:11:10,560 --> 01:11:13,760 INVESTIGATORS TO DEVELOP. 1905 01:11:13,760 --> 01:11:14,640 NEXT SLIDE, PLEASE. 1906 01:11:14,640 --> 01:11:16,400 I WANT TO SAY A LITTLE BIT ABOUT 1907 01:11:16,400 --> 01:11:16,680 ALCOHOL. 1908 01:11:16,680 --> 01:11:18,200 YOU HEARD ME TALK ABOUT THIS 1909 01:11:18,200 --> 01:11:23,480 LAST YEAR AND THE YEAR BEFORE. 1910 01:11:23,480 --> 01:11:24,720 THIS IS SOMETHING THAT HAS BEEN 1911 01:11:24,720 --> 01:11:25,040 C 1912 01:11:25,040 --> 01:11:26,120 CAPTURING OUR IMAGINATION. THE 1913 01:11:26,120 --> 01:11:28,080 DATA HAS COME OUT SAYING ALCOHOL 1914 01:11:28,080 --> 01:11:32,640 IS A SIGNIFICANT RISK FACTOR FOR 1915 01:11:32,640 --> 01:11:32,960 CANCER. 1916 01:11:32,960 --> 01:11:36,320 BREAST CANCER AND COLORECTAL 1917 01:11:36,320 --> 01:11:38,640 CANCER WHICH ARE UP IN THE TOP 1918 01:11:38,640 --> 01:11:39,840 OF THE LIST SO REALLY IMPORTANT 1919 01:11:39,840 --> 01:11:40,640 TO ATTEND TO THESE. 1920 01:11:40,640 --> 01:11:42,800 YOU CAN SEE ON THE GRAPH ON THE 1921 01:11:42,800 --> 01:11:43,840 RIGHT THAT ALCOHOL IS NOW 1922 01:11:43,840 --> 01:11:45,960 CONSIDERED TO BE THE THIRD 1923 01:11:45,960 --> 01:11:47,680 LEADING MOD FINAL RISK FACTOR 1924 01:11:47,680 --> 01:11:51,680 FOR CANCER MORBIDITY AND 1925 01:11:51,680 --> 01:11:51,960 MORTALITY. 1926 01:11:51,960 --> 01:11:54,440 CIGARETTE SMOKING IS ALWAYS 1927 01:11:54,440 --> 01:11:57,240 NUMBER ONE AND FOLLOWED BY 1928 01:11:57,240 --> 01:11:58,160 EXCESSIVE BODY WEIGHT AND 1929 01:11:58,160 --> 01:11:59,520 ALCOHOL IS NUMBER THREE. 1930 01:11:59,520 --> 01:12:01,280 AND IT SEEMS TO BE THE CASE THAT 1931 01:12:01,280 --> 01:12:04,520 THE CARDIOVASCULAR STORY THAT 1932 01:12:04,520 --> 01:12:05,760 WE'VE BEEN HEARING FOR THE LAST 1933 01:12:05,760 --> 01:12:07,720 MANY DECADES IS STARTING TO 1934 01:12:07,720 --> 01:12:09,560 BREAK DOWN. THE FAMOUS J CURVE 1935 01:12:09,560 --> 01:12:12,560 THAT SUGGESTS THAT MODERATE 1936 01:12:12,560 --> 01:12:13,800 CONSUMPTION MIGHT BE HEALTHIER 1937 01:12:13,800 --> 01:12:15,360 THAN NO CONSUMPTION, THAT 1938 01:12:15,360 --> 01:12:17,000 DOESN'T SEEM TO BE WORKING OUT 1939 01:12:17,000 --> 01:12:19,880 WHEN YOU DO A DEEP DIVE INTO THE 1940 01:12:19,880 --> 01:12:20,640 DATA. 1941 01:12:20,640 --> 01:12:22,680 MANY PEOPLE WHO DON'T DRINK OR 1942 01:12:22,680 --> 01:12:24,720 FORMER DRINKERS OR PEOPLE WITH 1943 01:12:24,720 --> 01:12:25,680 HEALTH PROBLEMS WHO DON'T DRINK 1944 01:12:25,680 --> 01:12:27,240 BECAUSE OF THOSE HEALTH PROBLEMS 1945 01:12:27,240 --> 01:12:29,400 AND WHEN YOU PARSE ALL OF THAT 1946 01:12:29,400 --> 01:12:31,880 OUT THE CARDIOVASCULAR STORY 1947 01:12:31,880 --> 01:12:33,680 REALLY STARTS BREAKING DOWN. 1948 01:12:33,680 --> 01:12:37,960 THE RED WINE PIECE OF THE 1949 01:12:37,960 --> 01:12:40,720 MEDITERRANEAN DIET DOESN'T ADD 1950 01:12:40,720 --> 01:12:50,000 TO THE BENEFITS. 1951 01:12:50,000 --> 01:12:52,200 SO NEXT, SLIDE. 1952 01:12:52,200 --> 01:12:53,120 WE'VE BEEN ENGAGED IN THIS TOPIC 1953 01:12:53,120 --> 01:12:54,480 IN MANY DIFFERENT WAYS. 1954 01:12:54,480 --> 01:12:56,400 A NUMBER OF COMMENTARIES, 1955 01:12:56,400 --> 01:12:59,560 COLLECTIVE DATA, WE HAVE HAD A 1956 01:12:59,560 --> 01:13:00,120 BIG MAJOR MEETING BRINGING 1957 01:13:00,120 --> 01:13:02,040 INVESTIGATORS TO THE TABLE 1958 01:13:02,040 --> 01:13:03,880 INCLUDING PEOPLE IN THE CANCER 1959 01:13:03,880 --> 01:13:06,040 COMMUNITY BUT ALSO THE ALCOHOL 1960 01:13:06,040 --> 01:13:08,240 CANCER AND REALLY WANT TO THANK 1961 01:13:08,240 --> 01:13:09,720 NIAAA FOR THEIR ENGAGEMENT AND 1962 01:13:09,720 --> 01:13:12,120 MANY OTHER ACTIVITIES WE'VE BEEN 1963 01:13:12,120 --> 01:13:12,960 INVOLVEMENT IN THIS SPACE. 1964 01:13:12,960 --> 01:13:14,680 WE HAVE A COUPLE OF RELEVANT 1965 01:13:14,680 --> 01:13:19,600 FUNDING OPPORTUNITIES BUT I'LL 1966 01:13:19,600 --> 01:13:20,560 TELL YOU THE BOOTTOM LINE IS WE 1967 01:13:20,560 --> 01:13:23,600 HAVE A VERY SMOUL PORTFOLIO ON 1968 01:13:23,600 --> 01:13:24,680 ALCOHOL AND CANCER AND WE HOPE 1969 01:13:24,680 --> 01:13:26,560 TO DO BETTER AT THAT AND WE'RE 1970 01:13:26,560 --> 01:13:28,160 HOPING TO ENGAGE THE COMMUNITY 1971 01:13:28,160 --> 01:13:31,040 IN DOING MORE WORK IN THIS 1972 01:13:31,040 --> 01:13:31,240 SPACE. 1973 01:13:31,240 --> 01:13:31,760 NEXT SLIDE. 1974 01:13:31,760 --> 01:13:33,960 ONE THING I DO REALLY WANT TO 1975 01:13:33,960 --> 01:13:34,840 HIGHLIGHT IS THAT DESPITE 1976 01:13:34,840 --> 01:13:36,440 ALCOHOL BEING A SIGNIFICANT RISK 1977 01:13:36,440 --> 01:13:39,320 FACTOR FOR CANCER, AWARENESS OF 1978 01:13:39,320 --> 01:13:41,960 ALCOHOL AS A RISK FACTOR IS 1979 01:13:41,960 --> 01:13:42,520 REALLY QUITE LOW. 1980 01:13:42,520 --> 01:13:44,400 SO WHEN I SHOW YOU ON THE RIGHT 1981 01:13:44,400 --> 01:13:46,080 HERE IS A GRAPH TAKEN FROM A 1982 01:13:46,080 --> 01:13:49,280 PAPER WE PUBLISHED USING DATA 1983 01:13:49,280 --> 01:13:51,600 FROM THE HEALTH INFORMATIONAL 1984 01:13:51,600 --> 01:13:55,920 HEALTH SURVEY WHICH IS A SURVEY 1985 01:13:55,920 --> 01:13:57,240 WE CONDUCT ON AN EVERY OTHER 1986 01:13:57,240 --> 01:13:57,760 YEAR BASIS. 1987 01:13:57,760 --> 01:14:00,600 ONE OF THE QUESTIONS ON A RECENT 1988 01:14:00,600 --> 01:14:01,880 SURVEY WAS WHETHER ALCOHOL WAS A 1989 01:14:01,880 --> 01:14:04,960 RISK FACTOR FOR CANCER AND WE 1990 01:14:04,960 --> 01:14:06,920 INCLUDED A DON'T KNOW OPTION 1991 01:14:06,920 --> 01:14:09,160 WHICH BY THE WAY IS MANY HAVE 1992 01:14:09,160 --> 01:14:10,600 SUGGESTED WE DO IN OUR SURVEYS 1993 01:14:10,600 --> 01:14:12,960 BECAUSE IF YOU DON'T HAVE A 1994 01:14:12,960 --> 01:14:14,280 DON'T KNOW OPTION PEOPLE DON'T 1995 01:14:14,280 --> 01:14:16,520 KNOW WHAT TO DO AND THEY JUST 1996 01:14:16,520 --> 01:14:18,200 MAKE UP AN ANSWER OR CHOOSE 1997 01:14:18,200 --> 01:14:19,440 SOMETHING IN THE MIDDLE WHICH 1998 01:14:19,440 --> 01:14:22,720 REALLY CAN GUM UP YOUR RESULTS 1999 01:14:22,720 --> 01:14:25,160 AND MAKE THEM UNINTERPRETABLE. 2000 01:14:25,160 --> 01:14:28,720 YOU CAN SEE THAT WAS THE MOST 2001 01:14:28,720 --> 01:14:31,000 FREQUENT OPTION SELECTED. 2002 01:14:31,000 --> 01:14:33,120 SO 55% ARE SAYING THEY DON'T 2003 01:14:33,120 --> 01:14:35,520 KNOW WHETHER ALCOHOL IS A RISK 2004 01:14:35,520 --> 01:14:37,480 FACTOR FOR CANCER AND A 2005 01:14:37,480 --> 01:14:39,640 NONTRIVIAL PEOPLE ARE SAYING 2006 01:14:39,640 --> 01:14:41,000 THAT ALCOHOL DECREASES THE RISK 2007 01:14:41,000 --> 01:14:43,200 OF CANCER SO YOU CAN SEE IN THE 2008 01:14:43,200 --> 01:14:46,400 THIRD SET OF BARS, THE BLUE ONE, 2009 01:14:46,400 --> 01:14:47,040 THAT'S WHY. 2010 01:14:47,040 --> 01:14:50,560 AND ABOUT 10% OF THE POPULATION 2011 01:14:50,560 --> 01:14:52,560 THINKS WINE DECREASES CANCER 2012 01:14:52,560 --> 01:14:52,920 RISK. 2013 01:14:52,920 --> 01:14:56,400 IT'S A NONTRIVIAL PERCENTAGE OF 2014 01:14:56,400 --> 01:14:56,960 AMERICANS AND SO WE HAVE 2015 01:14:56,960 --> 01:14:58,160 AWARENESS PROBLEMS HERE AND 2016 01:14:58,160 --> 01:15:01,760 THOSE NEED TO BE ADDRESSED. 2017 01:15:01,760 --> 01:15:03,160 NEXT SLIDE, PLEASE. 2018 01:15:03,160 --> 01:15:04,320 NOW, OF COURSE CANNABIS IS NOW 2019 01:15:04,320 --> 01:15:06,400 PART OF THE LANDSCAPE AND NORA 2020 01:15:06,400 --> 01:15:08,520 DID A GREAT JOB OF SUMMARIZING 2021 01:15:08,520 --> 01:15:09,360 WHERE THAT STANDS. 2022 01:15:09,360 --> 01:15:13,280 SHE TALKED ABOUT AND SHE SHOWED 2023 01:15:13,280 --> 01:15:15,560 A PIC OF THE UNITED STATES AND 2024 01:15:15,560 --> 01:15:18,520 AS YOU CAN SEE 38 DIFFERENT 2025 01:15:18,520 --> 01:15:20,520 STATES ALLOW USE OF CANNABIS 2026 01:15:20,520 --> 01:15:23,400 PRODUCTS AND 23 STATES HAVE 2027 01:15:23,400 --> 01:15:25,240 ENACTED CANNABIS FOR ADULT 2028 01:15:25,240 --> 01:15:25,640 NONMEDICAL USE. 2029 01:15:25,640 --> 01:15:27,560 WE NEED TO PAY ATTENTION TO IT. 2030 01:15:27,560 --> 01:15:29,560 WE NEED TO THINK ABOUT COUSE, WE 2031 01:15:29,560 --> 01:15:31,520 NEED TO THINK ABOUT CANNABIS AS 2032 01:15:31,520 --> 01:15:33,880 A GATEWAY TO TOBACCO USE AND 2033 01:15:33,880 --> 01:15:35,960 ALSO LOOK AT THAT ACROSS THE 2034 01:15:35,960 --> 01:15:36,400 ENTIRE LIFE SPAN. 2035 01:15:36,400 --> 01:15:39,080 SO THE NATIONAL ACADEMIES HAS 2036 01:15:39,080 --> 01:15:40,520 PAID ATTENTION TO THIS AND HAD A 2037 01:15:40,520 --> 01:15:42,040 REPORT ON CANNABIS AND IS NOW 2038 01:15:42,040 --> 01:15:44,040 WORKING ON A NEW ONE THAT WE'RE 2039 01:15:44,040 --> 01:15:46,680 CONTRIBUTING TO WHICH IS 2040 01:15:46,680 --> 01:15:47,720 TENTATIVELY SCHEDULED FOR 2024 2041 01:15:47,720 --> 01:15:47,960 RELEASE. 2042 01:15:47,960 --> 01:15:49,800 AND YOU CAN SEE HERE THERE'S A 2043 01:15:49,800 --> 01:15:51,760 BIT OF ATTENTION IN THAT 2044 01:15:51,760 --> 01:15:53,320 CANNABIS IS STUDIED AND 2045 01:15:53,320 --> 01:15:54,560 CONSIDERED AND THOUGHT ABOUT IN 2046 01:15:54,560 --> 01:15:56,720 THE CONTEXT OF CANCER CARE, 2047 01:15:56,720 --> 01:16:00,320 RIGHT, THERE'S A PALLIATIVE 2048 01:16:00,320 --> 01:16:01,600 MEDICINE AND PART OF PALLIATIVE 2049 01:16:01,600 --> 01:16:03,000 CARE BUT ALSO IT'S A SUBSTANCE 2050 01:16:03,000 --> 01:16:05,600 THAT CAN BE USED ALONG WITH 2051 01:16:05,600 --> 01:16:07,560 TOBACCO WHICH INCREASES CANCER 2052 01:16:07,560 --> 01:16:08,880 RISK SO WHICH OF THOSE TWO 2053 01:16:08,880 --> 01:16:11,040 SHOULD WE FOCUS ON THE MOST? 2054 01:16:11,040 --> 01:16:12,440 PROBABLY BOTH OF THEM BUT 2055 01:16:12,440 --> 01:16:13,240 THEY'RE GOING TO REQUIRE 2056 01:16:13,240 --> 01:16:15,000 DIFFERENT KINDS OF APPROACHES 2057 01:16:15,000 --> 01:16:15,960 AND DIFFERENT RESEARCH 2058 01:16:15,960 --> 01:16:17,240 QUESTIONS. 2059 01:16:17,240 --> 01:16:18,640 NEXT SLIDE, PLEASE. 2060 01:16:18,640 --> 01:16:20,800 I WANT TO WIND UP BY JUST 2061 01:16:20,800 --> 01:16:22,680 MENTIONING A COUPLE OF KEY 2062 01:16:22,680 --> 01:16:23,360 FUNDING INITIATIVES THAT WE HAVE 2063 01:16:23,360 --> 01:16:27,320 PUT OUT THAT WE THINK ADDRESS 2064 01:16:27,320 --> 01:16:31,240 CSIGNIFICANT GAPS IN THE 2065 01:16:31,240 --> 01:16:31,520 LITERATURE. 2066 01:16:31,520 --> 01:16:33,160 BY THE WAY, YOU PROBABLY ARE 2067 01:16:33,160 --> 01:16:34,800 AWARE OF THE FACT THAT 2068 01:16:34,800 --> 01:16:36,000 CIGARETTES ARE NOT THE BIG 2069 01:16:36,000 --> 01:16:37,560 PROBLEM HERE WITH ADOLESCENTS. 2070 01:16:37,560 --> 01:16:40,080 IT'S NO SURPRISE, I THINK WE ALL 2071 01:16:40,080 --> 01:16:41,040 KNOW THAT MOST OF WHAT'S 2072 01:16:41,040 --> 01:16:42,960 HAPPENING IN THE ADDLESS SENT 2073 01:16:42,960 --> 01:16:44,000 POPULATION THANKS TO WORK THAT 2074 01:16:44,000 --> 01:16:46,840 HAS BEEN SUPPORTED BY NIDA AND 2075 01:16:46,840 --> 01:16:49,000 NCI AND OTHER INSTITUTES WE KNOW 2076 01:16:49,000 --> 01:16:51,320 NOW THAT ADOLESCENTS ARE USING 2077 01:16:51,320 --> 01:16:54,760 VAPING PRODUCTS AND GETTING 2078 01:16:54,760 --> 01:16:57,240 ADDICTED TO VAPING PRODUCTS AND 2079 01:16:57,240 --> 01:16:58,320 HAVING TROUBLE WITH CESSATION 2080 01:16:58,320 --> 01:17:01,040 FROM THOSE VAPING PRODUCTS. 2081 01:17:01,040 --> 01:17:01,680 WHAT WE'RE FINDING IS THAT MANY 2082 01:17:01,680 --> 01:17:04,720 OF THE TRADITIONAL CONVENTIONAL 2083 01:17:04,720 --> 01:17:07,560 SUCCESSFUL APPROACHES TO 2084 01:17:07,560 --> 01:17:09,520 CESSATION IN ADULTS, SO 2085 01:17:09,520 --> 01:17:13,240 PHARMACOLOGICAL APPROACHES ARE 2086 01:17:13,240 --> 01:17:16,920 JUST NOT WORKING WITH ADDLEOLEST 2087 01:17:16,920 --> 01:17:17,200 POPULATIONS. 2088 01:17:17,200 --> 01:17:20,120 THE FACT OF THE MATTER IS THAT 2089 01:17:20,120 --> 01:17:21,640 ADOLESCENT BRAIN DEVELOPMENT 2090 01:17:21,640 --> 01:17:22,640 JUST LOOKS DIFFERENT. 2091 01:17:22,640 --> 01:17:23,640 THEY'RE FROM A DIFFERENT PLANET 2092 01:17:23,640 --> 01:17:25,160 AND THEIR BRAINS JUST LOOK 2093 01:17:25,160 --> 01:17:26,560 DIFFERENT THAN ADULTS' DO AND WE 2094 01:17:26,560 --> 01:17:28,320 KNOW THAT FROM A LOT OF WORK 2095 01:17:28,320 --> 01:17:30,400 SUPPORTED BY NIDA AND OTHER 2096 01:17:30,400 --> 01:17:32,080 AGENCIES AND SO WE NEED 2097 01:17:32,080 --> 01:17:33,920 DIFFERENT APPROACHES TO 2098 01:17:33,920 --> 01:17:35,920 CESSATION AND SO WE'VE PUT OUT 2099 01:17:35,920 --> 01:17:40,120 THIS RFA ON TOBACCO CESSATION 2100 01:17:40,120 --> 01:17:41,240 INTERVENTION RESEARCH AND THE 2101 01:17:41,240 --> 01:17:42,840 EXPIRATION DATE IS COMING UP IN 2102 01:17:42,840 --> 01:17:45,040 OCTOBER AND NIDA IS WORKING WITH 2103 01:17:45,040 --> 01:17:45,880 US ON THIS. 2104 01:17:45,880 --> 01:17:49,240 WE REALLY HOPE WE'LL GET SOME 2105 01:17:49,240 --> 01:17:49,920 STRONG APPLICATIONS THAT WILL 2106 01:17:49,920 --> 01:17:51,400 CONSIDER SOME INNOVATIVE 2107 01:17:51,400 --> 01:17:53,280 APPROACHES TO CESSATION WITH 2108 01:17:53,280 --> 01:17:54,600 THIS VERY IMPORTANT POPULATION 2109 01:17:54,600 --> 01:17:56,080 THAT'S GETTING MORE AND MORE 2110 01:17:56,080 --> 01:17:57,640 INTERESTED IN VAPING AND MANY OF 2111 01:17:57,640 --> 01:18:00,840 THEM ARE GOING FROM VAPING 2112 01:18:00,840 --> 01:18:02,320 DIRECTLY TO CIGARETTE USE. 2113 01:18:02,320 --> 01:18:03,800 WE KNOW THAT FROM HALF DATA AND 2114 01:18:03,800 --> 01:18:05,440 FROM OTHER DATA SETS AND SO THIS 2115 01:18:05,440 --> 01:18:08,120 IS OF COURSE AN ALARMING 2116 01:18:08,120 --> 01:18:08,360 PROBLEM. 2117 01:18:08,360 --> 01:18:10,000 YOU CAN SEE THAT THERE ARE A 2118 01:18:10,000 --> 01:18:12,720 NUMBER OF DIFFERENT KINDS OF 2119 01:18:12,720 --> 01:18:12,960 STUDIES. 2120 01:18:12,960 --> 01:18:17,240 SO THOSE THAT PROMOTE CESSATION 2121 01:18:17,240 --> 01:18:26,040 OF NONCIGARETTE TOBACCO 2122 01:18:26,040 --> 01:18:26,520 PRODUCTS. 2123 01:18:26,520 --> 01:18:29,040 AND YOU CAN SEE SOME EXAMPLES OF 2124 01:18:29,040 --> 01:18:31,840 GROUPS THERE AT THE BOTTOM. 2125 01:18:31,840 --> 01:18:33,920 WE ALSO HAVE BEEN INTERESTED IN 2126 01:18:33,920 --> 01:18:35,400 TOBACCO AND CANNABIS AND LAST 2127 01:18:35,400 --> 01:18:38,680 YEAR WE POSTED A SUPPLEMENTAL 2128 01:18:38,680 --> 01:18:40,160 OPPORTUNITY AND GOT REALLY 2129 01:18:40,160 --> 01:18:41,800 STRONG APPLICATIONS AND YOU CAN 2130 01:18:41,800 --> 01:18:45,520 SEE THE TITLES OF THE PROJECTS 2131 01:18:45,520 --> 01:18:46,760 THAT WE WERE ABLE TO SUPPORT. 2132 01:18:46,760 --> 01:18:47,960 WE ARE VERY INTERESTED IN WHAT 2133 01:18:47,960 --> 01:18:50,400 THE OUTCOMES ARE OF COUSE AND 2134 01:18:50,400 --> 01:18:51,600 WE'RE GOING TO CONTINUE TO BE 2135 01:18:51,600 --> 01:18:53,000 PLAYING IN THE SPACE AND SO WE 2136 01:18:53,000 --> 01:18:54,520 HOPE THOSE OF YOU WHO ARE 2137 01:18:54,520 --> 01:18:55,800 ENGAGED IN THIS WORK AND YOUR 2138 01:18:55,800 --> 01:18:57,040 COLLEAGUES WILL PAY ATTENTION TO 2139 01:18:57,040 --> 01:19:01,760 THESE OPPORTUNITIES. 2140 01:19:01,760 --> 01:19:02,200 NEXT SLIDE, PLEASE. 2141 01:19:02,200 --> 01:19:03,600 I'M NOT GOING TO GO THROUGH THE 2142 01:19:03,600 --> 01:19:04,760 NEXT TWO SLIDES VERY CLOSELY, 2143 01:19:04,760 --> 01:19:06,080 BUT JUST WANT TO HIGHLIGHT THAT 2144 01:19:06,080 --> 01:19:09,720 WE HAVE A NUMBER OF FUNDING 2145 01:19:09,720 --> 01:19:10,400 OPPORTUNITIES VERY RELEVANT TO 2146 01:19:10,400 --> 01:19:12,600 THE PRIORITIES OF CRAN FOCUSING 2147 01:19:12,600 --> 01:19:16,240 ON POLICY, FOCUSING ON 2148 01:19:16,240 --> 01:19:17,920 CESSATION, FOCUSING ON QUESTIONS 2149 01:19:17,920 --> 01:19:20,160 AND ALL OF THESE ARE ADDRESSING 2150 01:19:20,160 --> 01:19:21,000 TOBACCO CONTROL BUT ALSO GET 2151 01:19:21,000 --> 01:19:22,720 INTO THE ALCOHOL SPACE AND THE 2152 01:19:22,720 --> 01:19:23,800 CANNABIS SPACE. 2153 01:19:23,800 --> 01:19:24,800 NEXT SLIDE, PLEASE. 2154 01:19:24,800 --> 01:19:27,680 THIS IS AN ADDITIONAL LIST OF 2155 01:19:27,680 --> 01:19:28,720 DIFFERENT OPPORTUNITIES AND I 2156 01:19:28,720 --> 01:19:30,680 HOPE YOU'LL TAKE ADVANTAGE OF 2157 01:19:30,680 --> 01:19:31,760 THEM AND I BELIEVE THE SLIDES 2158 01:19:31,760 --> 01:19:32,600 WILL BE MADE AVAILABLE SO YOU 2159 01:19:32,600 --> 01:19:34,560 CAN TAKE A CLOSER LOOK AT THESE 2160 01:19:34,560 --> 01:19:36,760 AND IF YOU DON'T GET ACCESS TO 2161 01:19:36,760 --> 01:19:39,200 THE SLIDES, WE DO HAVE A PRETTY 2162 01:19:39,200 --> 01:19:40,560 NIFTY WEBSITE THAT LISTS ALL OUR 2163 01:19:40,560 --> 01:19:41,840 FUNDING OPPORTUNITIES. 2164 01:19:41,840 --> 01:19:45,480 I ENCOURAGE YOU TO TAKE A LOOK 2165 01:19:45,480 --> 01:19:45,920 AT THAT. 2166 01:19:45,920 --> 01:19:47,480 IF YOU GOOGLE THAT YOU'LL GET 2167 01:19:47,480 --> 01:19:49,200 RIGHT TO OUR FUNDING 2168 01:19:49,200 --> 01:19:50,160 OPPORTUNITIES AND YOU'LL SEE ALL 2169 01:19:50,160 --> 01:19:50,760 OF THEM. 2170 01:19:50,760 --> 01:19:52,600 AND WE TRY VERY HARD TO USE AS 2171 01:19:52,600 --> 01:19:54,560 MANY DIFFERENT KINDS OF 2172 01:19:54,560 --> 01:19:55,960 MECHANISMS AS POSSIBLE. 2173 01:19:55,960 --> 01:19:58,560 RFAS, PARS WHICH ARE PROGRAM 2174 01:19:58,560 --> 01:20:02,880 ANNOUNCEMENTS WITH SPECIAL 2175 01:20:02,880 --> 01:20:04,720 REVIEW TYPICALLY, NOTICES OF 2176 01:20:04,720 --> 01:20:06,400 SPECIAL INTEREST, WE REALLY DO 2177 01:20:06,400 --> 01:20:08,840 TRY TO USE MULTIPLE DIFFERENT 2178 01:20:08,840 --> 01:20:11,360 MECHANISMS AND WE HOPE THERE ARE 2179 01:20:11,360 --> 01:20:13,000 EXTRAMURAL COMMUNITY PAYS 2180 01:20:13,000 --> 01:20:13,480 ATTENTION TO THEM. 2181 01:20:13,480 --> 01:20:15,120 NEXT SLIDE, PLEASE. I ALSO WANT 2182 01:20:15,120 --> 01:20:16,520 TO MENTION THAT WE HAVE A NUMBER 2183 01:20:16,520 --> 01:20:19,560 OF RESOURCES AVAILABLE TO THE 2184 01:20:19,560 --> 01:20:20,040 EXTRAMURAL COMMUNITY. 2185 01:20:20,040 --> 01:20:21,960 ONE OF THEM IS A BIG NATIONAL 2186 01:20:21,960 --> 01:20:23,800 SURVEY THAT I'VE MENTIONED 2187 01:20:23,800 --> 01:20:24,120 ALREADY. 2188 01:20:24,120 --> 01:20:24,840 THE HEALTH INFORMATION NATIONAL 2189 01:20:24,840 --> 01:20:25,960 TREND SURVEY. 2190 01:20:25,960 --> 01:20:28,120 AND WE MAKE OUR DATA PUBLICLY 2191 01:20:28,120 --> 01:20:29,560 AVAILABLE AS SOON AS WE CLEAN 2192 01:20:29,560 --> 01:20:32,800 THEM UP AND MAKE SURE THEY'RE 2193 01:20:32,800 --> 01:20:33,440 READY TO BE USED AND WE HAVE A 2194 01:20:33,440 --> 01:20:37,240 NUMBER F ITERATIONS OF OUR 2195 01:20:37,240 --> 01:20:40,120 SURVEY ONLINE FOR PEOPLE TO 2196 01:20:40,120 --> 01:20:40,440 DOWNLOAD. 2197 01:20:40,440 --> 01:20:46,720 WE DID A SPECIAL HINTS SURVEY 2198 01:20:46,720 --> 01:20:47,800 WITH OVER 1,000 CANCER 2199 01:20:47,800 --> 01:20:48,080 SURVIVORS. 2200 01:20:48,080 --> 01:20:49,520 ONE OF THE MOST COMMON COMMENTS 2201 01:20:49,520 --> 01:20:52,120 FROM THE COMMUNITY WAS THAT WE 2202 01:20:52,120 --> 01:20:53,160 WEREN'T COLLECTING ENOUGH DATA 2203 01:20:53,160 --> 01:20:54,680 FROM CANCER SURVIVORS AND SO WE 2204 01:20:54,680 --> 01:20:56,560 DO THAT NOW AND THERE ARE MANY 2205 01:20:56,560 --> 01:20:58,440 QUESTIONS ABOUT TOBACCO USE AND 2206 01:20:58,440 --> 01:21:01,240 ALSO OTHER SUBSTANCES ON THAT 2207 01:21:01,240 --> 01:21:01,800 SURVEY INCLUDING ALCOHOL. 2208 01:21:01,800 --> 01:21:03,840 AND SO I ENCOURAGE YOU TO TAKE A 2209 01:21:03,840 --> 01:21:05,880 LOOK AT THAT WEBSITE. I FIND 2210 01:21:05,880 --> 01:21:08,040 ACTUALLY THAT GRADUATE STUDENTS 2211 01:21:08,040 --> 01:21:10,520 AND POST DOCS LOVE TO USE OUR 2212 01:21:10,520 --> 01:21:12,400 HINTS DATA BECAUSE IT'S EASY TO 2213 01:21:12,400 --> 01:21:14,120 DOWNLOAD AND PUBLISH PRETTY 2214 01:21:14,120 --> 01:21:16,720 QUICKLY AND THERE'S SOME VERY 2215 01:21:16,720 --> 01:21:27,400 IMPORTANT SQUESTIONS ON THESE 2216 01:21:28,520 --> 01:21:30,720 SURVEYS. ALSO WANT TO HIGHLIGHT 2217 01:21:30,720 --> 01:21:33,960 THAT WE SUPPORT THE TOBACCO USE 2218 01:21:33,960 --> 01:21:34,960 SUPPLEMENT TO THE POPULATION 2219 01:21:34,960 --> 01:21:36,200 SURVEY WHICH IS LINKED TO THE 2220 01:21:36,200 --> 01:21:38,440 U.S. CENSUS AND THESE DATA ARE 2221 01:21:38,440 --> 01:21:39,680 ALSO PUBLICLY AVAILABLE AND WE 2222 01:21:39,680 --> 01:21:41,120 STRONGLY ENCOURAGE THE COMMUNITY 2223 01:21:41,120 --> 01:21:42,880 TO ACCESS THESE DATA. 2224 01:21:42,880 --> 01:21:44,680 WE HAVE A TEAM, A REALLY STRONG 2225 01:21:44,680 --> 01:21:46,680 TEAM WITHIN NCI THAT HELPS 2226 01:21:46,680 --> 01:21:53,280 PRODUCE THE ITEMS THAT GO ON TO 2227 01:21:53,280 --> 01:21:55,080 SUPPLEMENT AND ALSO HELP CUE 2228 01:21:55,080 --> 01:21:56,720 RATE THE DATA SO THAT OUR 2229 01:21:56,720 --> 01:21:57,560 COMMUNITY CAN USE THEM. 2230 01:21:57,560 --> 01:21:59,360 I WANT TO STRONGLY ENCOURAGE YOU 2231 01:21:59,360 --> 01:22:01,920 TO CONNECT WITH OUR WEBSITE, OUR 2232 01:22:01,920 --> 01:22:03,080 TWITTER FEED, OUR NEWSLETTER 2233 01:22:03,080 --> 01:22:04,680 JUST TO KEEP UP WITH WHAT WE'RE 2234 01:22:04,680 --> 01:22:09,160 DOING IN TERMS OF FUNDING 2235 01:22:09,160 --> 01:22:09,800 INITIATIVES AND PRIORITY SETTING 2236 01:22:09,800 --> 01:22:10,320 AND STRATEGIC PLANNING. 2237 01:22:10,320 --> 01:22:13,240 WE'RE CONSTANTLY WORKING ON 2238 01:22:13,240 --> 01:22:15,640 ACTIVITIES RELATED TO CRAN 2239 01:22:15,640 --> 01:22:15,960 PRIORITIES. 2240 01:22:15,960 --> 01:22:18,080 I KNOW TIME IS LIMITED BUT WE'RE 2241 01:22:18,080 --> 01:22:20,920 ALWAYS HAPPY TO TALK TO 2242 01:22:20,920 --> 01:22:21,640 INVESTIGATORS ABOUT ANY OF OUR 2243 01:22:21,640 --> 01:22:22,720 IDEAS, ANYTHING THAT WE'RE 2244 01:22:22,720 --> 01:22:24,600 TALKING ABOUT INTERNALLY AND 2245 01:22:24,600 --> 01:22:26,480 CLEARLY, THE LANDSCAPE IS 2246 01:22:26,480 --> 01:22:26,880 CHANGING. 2247 01:22:26,880 --> 01:22:29,280 WE'RE SPENDING LOTS OF TIME 2248 01:22:29,280 --> 01:22:34,720 THINKING ABOUT COVID-19 AND THE 2249 01:22:34,720 --> 01:22:37,120 RISKS OF CANCER AND ON AND ON. 2250 01:22:37,120 --> 01:22:38,080 SO MUCH HAS HAPPENED OVER THE 2251 01:22:38,080 --> 01:22:39,960 LAST THREE TO FIVE YEARS THAT 2252 01:22:39,960 --> 01:22:41,120 HAS AN IMPACT ON CANCER CONTROL 2253 01:22:41,120 --> 01:22:42,920 AND THAT KEEPS US UP AT NIGHTS 2254 01:22:42,920 --> 01:22:47,200 AND KEEPS US BUSY DEVELOPING NEW 2255 01:22:47,200 --> 01:22:47,640 FUNDING INITIATIVES. 2256 01:22:47,640 --> 01:22:49,600 SO WITH THAT I WILL END AND TURN 2257 01:22:49,600 --> 01:22:51,160 THINGS BACK OVER TO GEORGE. 2258 01:22:51,160 --> 01:22:52,600 >>THANK YOU, BILL. 2259 01:22:52,600 --> 01:22:53,360 THAT WAS GRADE. 2260 01:22:53,360 --> 01:22:55,440 AND I WANT TO THANK BOTH NORA 2261 01:22:55,440 --> 01:22:58,000 AND BILL FOR REALLY WONDERFUL 2262 01:22:58,000 --> 01:22:59,720 TALKS THAT COMPREHENSIVELY 2263 01:22:59,720 --> 01:23:03,560 OUTLINE SOME OF THE CHALLENGES 2264 01:23:03,560 --> 01:23:07,560 WE FACE. 2265 01:23:07,560 --> 01:23:09,600 THE SLIDES WILL BE AVAILABLE ON 2266 01:23:09,600 --> 01:23:12,000 THE NIH WEBSITE, SO THOSE OF YOU 2267 01:23:12,000 --> 01:23:16,160 WHO WANTED TO GET SOME OF THIS 2268 01:23:16,160 --> 01:23:17,440 INFORMATION AND UTILIZE IT, 2269 01:23:17,440 --> 01:23:18,960 YOU'LL BE ABLE TO FIND IT THERE. 2270 01:23:18,960 --> 01:23:19,160 OKAY. 2271 01:23:19,160 --> 01:23:21,000 SO I'M GOING TO TURN IT OVER TO 2272 01:23:21,000 --> 01:23:26,400 NORA WHO'S GOING TO INTRODUCE 2273 01:23:26,400 --> 01:23:29,000 DR. GAL GAL AND THE ABCD TEAM. 2274 01:23:29,000 --> 01:23:31,280 >>IT'S A PLEASURE FOR ME TO DO 2275 01:23:31,280 --> 01:23:32,840 THIS BECAUSE I THINK THAT THIS 2276 01:23:32,840 --> 01:23:34,680 PROJECT IS PERHAPS THE MOST 2277 01:23:34,680 --> 01:23:37,480 NOTABLE AND SALIENT THAT HAS 2278 01:23:37,480 --> 01:23:42,040 COME OUT OF THE CRAN INITIATIVE 2279 01:23:42,040 --> 01:23:43,920 AND BASICALLY HAS RESULTED IN AN 2280 01:23:43,920 --> 01:23:45,960 OUTCOME THAT WE NEVER ACTUALLY 2281 01:23:45,960 --> 01:23:47,840 WERE PREDICTING WAS GOING TO BE 2282 01:23:47,840 --> 01:23:50,160 SO SPECTACULAR AND THIS IS 2283 01:23:50,160 --> 01:23:52,720 POSSIBLE BECAUSE OF THE 2284 01:23:52,720 --> 01:23:57,200 EXTRAORDINARY LEADERSHIP THAT 2285 01:23:57,200 --> 01:23:58,520 DR. GAYATHRI DOWLING HAS HAD 2286 01:23:58,520 --> 01:24:00,120 OVER THE YEARS SINCE IT STARTED 2287 01:24:00,120 --> 01:24:04,760 AND SHE WILL BE GIVING US AN 2288 01:24:04,760 --> 01:24:06,480 UPDATE AND IT ALSO WOULDN'T HAVE 2289 01:24:06,480 --> 01:24:07,000 BEEN POSSIBLE WITHOUT THE 2290 01:24:07,000 --> 01:24:08,720 SUPPORT ALL ALONG OF DR. GEORGE 2291 01:24:08,720 --> 01:24:11,800 KOOB, SO IT HAS BEEN POSSIBLE 2292 01:24:11,800 --> 01:24:13,920 BECAUSE OF ALL OF THESE PEOPLE 2293 01:24:13,920 --> 01:24:16,720 AND THEIR COMING TOGETHER AND 2294 01:24:16,720 --> 01:24:23,960 THEIR FOLLOWING UP THAT IS VERY 2295 01:24:23,960 --> 01:24:25,240 RELEVANT. 2296 01:24:25,240 --> 01:24:27,000 HOW DOES THE HUMAN BRAIN DEVELOP 2297 01:24:27,000 --> 01:24:30,200 AND HOW IT IS AFFECTED. 2298 01:24:30,200 --> 01:24:39,480 SO GAYATHRI, PLEASE JUMP IN. 2299 01:24:39,480 --> 01:24:41,080 >>THANK YOU FOR THE OPPORTUNITY 2300 01:24:41,080 --> 01:24:41,840 TO SPEAK ABOUT ABCD AGAIN THIS YEAR 2301 01:24:41,840 --> 01:24:44,680 I WANTED TO JUST START BY 2302 01:24:44,680 --> 01:24:45,800 REINTRODUCING AND INTRODUCING 2303 01:24:45,800 --> 01:24:47,560 SOME NEW MEMBERS OF OUR TEAM. 2304 01:24:47,560 --> 01:24:52,880 IN THE PAST YOU'VE HEARD MEMBERS 2305 01:24:52,880 --> 01:24:56,000 OF THE ABCD TEAM AT NIDA AND 2306 01:24:56,000 --> 01:24:57,760 YOU'LL BE HEARING A LITTLE BIT 2307 01:24:57,760 --> 01:24:58,760 MORE FROM THEM TODAY AND THEY'LL 2308 01:24:58,760 --> 01:25:00,400 BE HIGHLIGHTED THROUGHOUT THE 2309 01:25:00,400 --> 01:25:02,160 PRESENTATION FOR A NUMBER OF 2310 01:25:02,160 --> 01:25:03,400 THINGS THAT THEY CONTRIBUTE TO 2311 01:25:03,400 --> 01:25:05,320 THE STUDY. 2312 01:25:05,320 --> 01:25:06,400 BUT I ALSO WANTED TO INTRODUCE 2313 01:25:06,400 --> 01:25:07,800 TWO NEW MEMBERS TO THE TEAM 2314 01:25:07,800 --> 01:25:10,960 SINCE THE LAST TIME I WAS HERE. 2315 01:25:10,960 --> 01:25:14,160 DR. DIANA JOINED NIDA AS A 2316 01:25:14,160 --> 01:25:16,480 PROGRAM ANALYST FOR ABCD AND SHE 2317 01:25:16,480 --> 01:25:18,800 EVERYBODIED HER PH.D. IN 2318 01:25:18,800 --> 01:25:20,160 NEUROSCIENCE AND COGNITIVE 2319 01:25:20,160 --> 01:25:22,880 SCIENCE AND DID HER POST 2320 01:25:22,880 --> 01:25:24,040 DOCTORAL TRAINING WHERE SHE 2321 01:25:24,040 --> 01:25:26,160 CONDUCTED RESEARCH ON SOCIAL 2322 01:25:26,160 --> 01:25:29,840 COGNITION AND AUTISTIC AND 2323 01:25:29,840 --> 01:25:31,080 TYPICALLY DEVELOPING YOUTH. 2324 01:25:31,080 --> 01:25:33,920 SHE IS REALLY MOST NOTABLY BEEN 2325 01:25:33,920 --> 01:25:35,280 LEADING RETENTION DATA CORE 2326 01:25:35,280 --> 01:25:37,200 WHICH I'LL TALK A LITTLE BIT 2327 01:25:37,200 --> 01:25:38,480 ABOUT AND CONDUCTING SOME 2328 01:25:38,480 --> 01:25:40,000 PORTFOLIO ANALYSIS THAT YOU'LL 2329 01:25:40,000 --> 01:25:40,960 SEE MORE ABOUT TODAY. 2330 01:25:40,960 --> 01:25:44,160 AND THEN I'D ALSO LIKE TO 2331 01:25:44,160 --> 01:25:45,680 INTRODUCE TRACI MURRAY WHO HAS 2332 01:25:45,680 --> 01:25:55,000 JOINED NIDA AS A SCIENTIFIC 2333 01:25:55,000 --> 01:25:59,680 ADVISOR FOR DIVERSITY EQUITY AND 2334 01:25:59,680 --> 01:25:59,920 INCLUSION. 2335 01:25:59,920 --> 01:26:02,440 SHE EARNED HER PH.D. AT THE 2336 01:26:02,440 --> 01:26:03,800 UNIVERSITY OF TEXAS AT TYLER AND 2337 01:26:03,800 --> 01:26:06,040 HER MASTER'S IN PUBLIC HEALTH AT 2338 01:26:06,040 --> 01:26:07,960 THE UNIVERSITY OF NORTH TEXAS 2339 01:26:07,960 --> 01:26:08,560 HEALTH SCIENCES CENTER. 2340 01:26:08,560 --> 01:26:10,720 SHE SPENT NEARLY THREE YEARS 2341 01:26:10,720 --> 01:26:14,160 WITH THE INDIAN HEALTH SERVICE 2342 01:26:14,160 --> 01:26:16,680 SERVING THE TRIBE OF NEBRASKA 2343 01:26:16,680 --> 01:26:20,840 AND SHE SERVED AS REGIONAL 2344 01:26:20,840 --> 01:26:24,680 ADMINISTRATOR FOR THE HEALTH 2345 01:26:24,680 --> 01:26:27,480 SERVICES ADMINISTRATION IN 2346 01:26:27,480 --> 01:26:28,280 DALLAS. 2347 01:26:28,280 --> 01:26:30,080 SHE'LL BE SPEAKING A LITTLE BIT 2348 01:26:30,080 --> 01:26:33,560 LATER ABOUT SOME OF THE 2349 01:26:33,560 --> 01:26:34,520 INITIATIVES IN HER REALM. 2350 01:26:34,520 --> 01:26:37,320 SO AS ALWAYS IT'S HARD TO SELECT 2351 01:26:37,320 --> 01:26:38,760 WHAT TO BRING INTO CRAN COUNCIL 2352 01:26:38,760 --> 01:26:41,360 TO TALK ABOUT FOR ABCD, SO 2353 01:26:41,360 --> 01:26:43,680 HERE'S A QUICK OUTLINE OF WHAT I 2354 01:26:43,680 --> 01:26:45,200 WANT TO TALK ABOUT. 2355 01:26:45,200 --> 01:26:46,560 RETENTION PRIORITIES AND 2356 01:26:46,560 --> 01:26:48,600 STRATEGIES AS THAT'S ALWAYS VERY 2357 01:26:48,600 --> 01:26:50,160 IMPORTANT FOR A LONGITUDINAL 2358 01:26:50,160 --> 01:26:50,360 STUDY. 2359 01:26:50,360 --> 01:26:52,640 SOME UPDATES ON DATA AND BIO 2360 01:26:52,640 --> 01:26:54,040 SPECIMEN SHARING. I'D LIKE TO 2361 01:26:54,040 --> 01:26:55,880 TALK ABOUT SOME OF THE OUTCOMES 2362 01:26:55,880 --> 01:26:58,680 WE'RE SEEING FROM THE ABCD STORY 2363 01:26:58,680 --> 01:27:00,680 AND KIM WILL HIGHLIGHT A COUPLE 2364 01:27:00,680 --> 01:27:03,720 OF PAPERS IN THAT REGARD. 2365 01:27:03,720 --> 01:27:07,600 TRACI MURRAY WILL GIVE AN UPDATE 2366 01:27:07,600 --> 01:27:09,360 AND ELIZABETH HOFFMAN WILL 2367 01:27:09,360 --> 01:27:10,480 HIGHLIGHT A PAPER THAT SHOWS 2368 01:27:10,480 --> 01:27:13,440 SOME OF THAT WORK AND I'LL 2369 01:27:13,440 --> 01:27:14,640 CONCLUDE WITH RESEARCH 2370 01:27:14,640 --> 01:27:15,680 DISSEMINATION IN THE STUDY. 2371 01:27:15,680 --> 01:27:17,400 SO FOR RETENTION WE'RE ALWAYS 2372 01:27:17,400 --> 01:27:19,800 VERY EXCITED TO SHOW THAT THE 2373 01:27:19,800 --> 01:27:21,440 STUDY OVERALL IS DOING VERY WELL 2374 01:27:21,440 --> 01:27:24,040 AT RETAINING OUR CLOSE TO 12,000 2375 01:27:24,040 --> 01:27:24,320 YOUTH. 2376 01:27:24,320 --> 01:27:28,680 WE HAVE 97% THAT HAVE -- 2377 01:27:28,680 --> 01:27:30,960 CONTINUE TO BE PART OF THE 2378 01:27:30,960 --> 01:27:31,160 STUDY. 2379 01:27:31,160 --> 01:27:32,680 THEY HAVEN'T OFFICIALLY WITH 2380 01:27:32,680 --> 01:27:33,640 DRAWN FROM THE STUDY. 2381 01:27:33,640 --> 01:27:35,480 THIS FIGURE SHOWS HOW MANY 2382 01:27:35,480 --> 01:27:36,200 PARTICIPANTS HAVE COMPLETED EACH 2383 01:27:36,200 --> 01:27:38,160 OF THE TIME POINTS SO JUST TO 2384 01:27:38,160 --> 01:27:41,040 REFRESH YOUR MEMORY WE SEE 2385 01:27:41,040 --> 01:27:42,400 EVERYBODY IN PERSON ANNUALLY AND 2386 01:27:42,400 --> 01:27:44,000 THEN IN THE MID YEAR WE HAVE A 2387 01:27:44,000 --> 01:27:45,360 PHONE TOUCH BASE SO THIS SHOWS 2388 01:27:45,360 --> 01:27:47,640 ALL OF THE DATA TIME POINTS. 2389 01:27:47,640 --> 01:27:50,640 YOU CAN SEE OUR COVID BLIP HERE 2390 01:27:50,640 --> 01:27:52,000 AND WE ARE STILL IN THE PROCESS 2391 01:27:52,000 --> 01:27:54,400 OF KIND OF TRYING TO RECOVER OUR 2392 01:27:54,400 --> 01:27:56,200 TRAJECTORIES FOR ALL OF OUR TIME 2393 01:27:56,200 --> 01:28:00,960 POINTS FROM COVID TO MAKE SURE 2394 01:28:00,960 --> 01:28:02,360 THAT WE'RE SEEING EVERYBODY IN 2395 01:28:02,360 --> 01:28:03,880 PERSON AND GETTING EVERYBODY 2396 01:28:03,880 --> 01:28:05,680 BACK ON SCHEDULE FROM WHEN SITES 2397 01:28:05,680 --> 01:28:06,560 WERE CLOSED DOWN. 2398 01:28:06,560 --> 01:28:09,560 BUT THERE ARE A COUPLE OF AREAS 2399 01:28:09,560 --> 01:28:10,520 THAT ARE OF PARTICULAR FOCUS FOR 2400 01:28:10,520 --> 01:28:12,680 US IN TERMS OF ENSURING THAT WE 2401 01:28:12,680 --> 01:28:15,640 RETAIN THE FULL DIVERSE COHORT. 2402 01:28:15,640 --> 01:28:17,120 ONE IS LOW INCOME FAMILIES. 2403 01:28:17,120 --> 01:28:19,040 YOU CAN SEE FROM THIS FIGURE, 2404 01:28:19,040 --> 01:28:21,560 THIS IS FROM OUR FOUR-YEAR 2405 01:28:21,560 --> 01:28:23,640 FOLLOWUP, THAT -- AND THE ORANGE 2406 01:28:23,640 --> 01:28:25,080 ARE PEOPLE WHO HAVE MISSED A 2407 01:28:25,080 --> 01:28:27,000 VISIT AND YOU CAN SEE THERE'S A 2408 01:28:27,000 --> 01:28:29,000 GREATER PROPORTION OF FAMILIES 2409 01:28:29,000 --> 01:28:31,200 WHOSE HOUSEHOLD INCOME IS LESS 2410 01:28:31,200 --> 01:28:33,240 THAN $50,000 IN THAT MISSED 2411 01:28:33,240 --> 01:28:34,320 CATEGORY. SO THIS IS A 2412 01:28:34,320 --> 01:28:36,680 SIGNIFICANT AREA OF FOCUS FOR 2413 01:28:36,680 --> 01:28:38,040 OUR RETENTION GROUPS AND I'LL 2414 01:28:38,040 --> 01:28:39,800 SPEAK TO THAT A LITTLE BIT MORE 2415 01:28:39,800 --> 01:28:40,280 IN A MOMENT. 2416 01:28:40,280 --> 01:28:43,120 ANOTHER AREA OF FOCUS IS REMOTE 2417 01:28:43,120 --> 01:28:43,520 VISITS. 2418 01:28:43,520 --> 01:28:44,880 WHEN THE PANDEMIC HIT, WE OF 2419 01:28:44,880 --> 01:28:47,200 COURSE WENT FULLY REMOTE FOR 2420 01:28:47,200 --> 01:28:48,920 EVERYTHING, BUT AS SITES OPENED 2421 01:28:48,920 --> 01:28:52,000 UP, WE CONTINUED TO SEE MANY 2422 01:28:52,000 --> 01:28:53,240 FAMILIES WANTING TO CONTINUE TO 2423 01:28:53,240 --> 01:28:55,040 DO THEIR VISITS REMOTELY. 2424 01:28:55,040 --> 01:28:58,800 AND SO THERE'S BEEN A REAL PUSH 2425 01:28:58,800 --> 01:29:00,680 LATELY TO RETURN EVERYBODY TO IN 2426 01:29:00,680 --> 01:29:02,480 PERSON VISITS BECAUSE THE REMOTE 2427 01:29:02,480 --> 01:29:04,000 VISITS ARE PARTICULARLY 2428 01:29:04,000 --> 01:29:05,520 PROBLEMATIC I THINK FOR THE -- 2429 01:29:05,520 --> 01:29:07,840 EVEN YOUR VISITS WHERE WE HAVE 2430 01:29:07,840 --> 01:29:12,080 THE NEURO IMAGING BUT IT'S ALSO 2431 01:29:12,080 --> 01:29:14,640 IMPORTANT FOR THE ODD YEAR 2432 01:29:14,640 --> 01:29:16,040 VISITS BECAUSE WE DO COLLECT 2433 01:29:16,040 --> 01:29:16,960 SPECIMENS THAT WE AREN'T ABLE TO 2434 01:29:16,960 --> 01:29:18,360 DO REMOTELY. 2435 01:29:18,360 --> 01:29:20,840 WE'RE REALLY STRONGLY PUSHING TO 2436 01:29:20,840 --> 01:29:22,480 HAVE EVERYBODY COME IN PERSON OR 2437 01:29:22,480 --> 01:29:23,800 AT LEAST HYBRID. 2438 01:29:23,800 --> 01:29:26,160 THAT IS THEY'LL COME IN FOR THE 2439 01:29:26,160 --> 01:29:27,840 IMAGING AND THE BIO SPECIMENS 2440 01:29:27,840 --> 01:29:30,200 BUT CAN DO THE REST OF THE 2441 01:29:30,200 --> 01:29:33,320 ASSESSMENT REMOTELY. 2442 01:29:33,320 --> 01:29:34,640 AND THEN THE -- ANOTHER MAJOR 2443 01:29:34,640 --> 01:29:36,200 AREA OF FOCUS IS THIS CATEGORY 2444 01:29:36,200 --> 01:29:38,080 THAT WE'RE CALLING POTENTIAL 2445 01:29:38,080 --> 01:29:38,400 WITH DRAW. 2446 01:29:38,400 --> 01:29:40,160 SO LIKE I SAID, IN TERMS OF 2447 01:29:40,160 --> 01:29:42,440 RETENTION WE HAVE FAMILIES THAT 2448 01:29:42,440 --> 01:29:43,120 HAVE OFFICIALLY WITHDRAWN. 2449 01:29:43,120 --> 01:29:45,080 THESE ARE FAMILIES THAT HAVE NOT 2450 01:29:45,080 --> 01:29:46,200 OFFICIALLY WITHDRAWN BUT WE 2451 01:29:46,200 --> 01:29:47,760 HAVEN'T SEEN THEM SINCE THEIR 2452 01:29:47,760 --> 01:29:49,000 TWO-YEAR FOLLOWUP. 2453 01:29:49,000 --> 01:29:55,320 AND SO WE FEEL THAT THESE ARE 2454 01:29:55,320 --> 01:29:55,920 THE MOST AT RISK FAMILIES AND WE 2455 01:29:55,920 --> 01:29:57,440 HAVE THESE METRICS THAT IDENTIFY 2456 01:29:57,440 --> 01:30:00,160 PEOPLE THAT ARE AT GREATEST RISK 2457 01:30:00,160 --> 01:30:01,120 AND WE'RE TRYING TO UNDERSTAND 2458 01:30:01,120 --> 01:30:02,760 WHY THAT IS AND WHAT WE CAN DO 2459 01:30:02,760 --> 01:30:03,240 ABOUT THAT. 2460 01:30:03,240 --> 01:30:05,480 AND TO THAT END WE ARE REALLY 2461 01:30:05,480 --> 01:30:07,200 TRYING TO TAKE A DATA DRIVEN 2462 01:30:07,200 --> 01:30:08,000 APPROACH TO RETENTION. 2463 01:30:08,000 --> 01:30:09,520 ALL ALONG YOU'VE HEARD ME TALK 2464 01:30:09,520 --> 01:30:11,640 ABOUT THE METRICS THAT WE'RE 2465 01:30:11,640 --> 01:30:15,240 USING TO TRACK RECRUITMENT AND 2466 01:30:15,240 --> 01:30:15,840 RETENTION BUT WE'RE KIND OF 2467 01:30:15,840 --> 01:30:16,880 STEPPING THAT UP A LEVEL NOW AND 2468 01:30:16,880 --> 01:30:18,880 WITH DIANA'S INVOLVEMENT, SHE'S 2469 01:30:18,880 --> 01:30:20,880 NOW LEADING THIS RETENTION DATA 2470 01:30:20,880 --> 01:30:22,200 CORE THAT WORKS WITH ALL OF 2471 01:30:22,200 --> 01:30:24,320 THESE OTHER SUBGROUPS IN OUR 2472 01:30:24,320 --> 01:30:25,560 ATTENTION WORK GROUP TO ANALYZE 2473 01:30:25,560 --> 01:30:27,640 DATA, TO HELP US GIVE US MORE 2474 01:30:27,640 --> 01:30:29,200 INFORMATION ABOUT WHO'S MOST AT 2475 01:30:29,200 --> 01:30:31,480 RISK, WHY THEY'RE MOST AT RISK 2476 01:30:31,480 --> 01:30:33,160 AND HOPEFULLY INFORM STRATEGIES 2477 01:30:33,160 --> 01:30:35,880 TO BRING THEM BACK INTO THE 2478 01:30:35,880 --> 01:30:36,080 STUDY. 2479 01:30:36,080 --> 01:30:37,520 SO WE COLLECT FEEDBACK FROM 2480 01:30:37,520 --> 01:30:39,000 FAMILIES AT THE END OF EVERY 2481 01:30:39,000 --> 01:30:40,400 VISIT. 2482 01:30:40,400 --> 01:30:41,920 SHE'S BEEN LOOKING AT 2483 01:30:41,920 --> 01:30:42,480 RELATIONSHIPS BETWEEN THE 2484 01:30:42,480 --> 01:30:44,760 FEEDBACK WE'RE GETTING AND THE 2485 01:30:44,760 --> 01:30:47,520 REASONS THAT PEOPLE ARE 2486 01:30:47,520 --> 01:30:49,680 WITHDRAWING OR MISSING VISITS. 2487 01:30:49,680 --> 01:30:50,360 WE'RE ALSO COLLECTING 2488 01:30:50,360 --> 01:30:51,640 INFORMATION FROM OUR SITES ON 2489 01:30:51,640 --> 01:30:54,440 WHAT PRACTICES THEY EMPLOY TO 2490 01:30:54,440 --> 01:30:55,560 RETAIN PARTICIPANTS AND SHE AND 2491 01:30:55,560 --> 01:30:58,640 THE GROUP ARE GOING TO BE DOING 2492 01:30:58,640 --> 01:30:59,760 SOME CORRELATIONS BETWEEN THOSE 2493 01:30:59,760 --> 01:31:00,920 PRACTICES AND RETENTION METS 2494 01:31:00,920 --> 01:31:02,920 RICKS TO SEE WHICH ONES ARE 2495 01:31:02,920 --> 01:31:03,960 PRODUCING THE BEST RESULTS. 2496 01:31:03,960 --> 01:31:06,040 AND WE'VE DONE PREDICTIVE 2497 01:31:06,040 --> 01:31:06,960 MODELLING THROUGHOUT THE STUDY 2498 01:31:06,960 --> 01:31:08,640 BUT WE'RE REALLY RAMPING THAT UP 2499 01:31:08,640 --> 01:31:10,320 AS WELL NOW TO UNDERSTAND -- TO 2500 01:31:10,320 --> 01:31:12,680 REALLY BE ABLE TO IDENTIFY WHO 2501 01:31:12,680 --> 01:31:14,800 THE MOST AT RISK OF BEING LOST 2502 01:31:14,800 --> 01:31:15,640 TO THE STUDY. 2503 01:31:15,640 --> 01:31:17,720 AND WE HOPE THAT THESE ANALYSIS 2504 01:31:17,720 --> 01:31:20,240 THAT THE DATA CORE ARE PLANNING 2505 01:31:20,240 --> 01:31:21,720 WILL HELP TO INFORM THE OTHER 2506 01:31:21,720 --> 01:31:25,680 RETENTION SUBGROUPS TO DEVELOP 2507 01:31:25,680 --> 01:31:26,920 ACTION TO ADDRESS THESE. 2508 01:31:26,920 --> 01:31:29,320 SO FOR EXAMPLE, WE -- THROUGH 2509 01:31:29,320 --> 01:31:30,720 LOOKING AT THE BEST PRACTICES 2510 01:31:30,720 --> 01:31:33,640 WE'RE LOOKING AT DIFFERENT 2511 01:31:33,640 --> 01:31:35,720 COMPENSATION MODELS ACROSS THE 2512 01:31:35,720 --> 01:31:36,800 CONSORTIUM, LOOKING AT DIFFERENT 2513 01:31:36,800 --> 01:31:38,640 STAFFING MODELS TO SEE WHAT 2514 01:31:38,640 --> 01:31:41,360 IS -- WHAT IS WORKING BEST. 2515 01:31:41,360 --> 01:31:42,880 WE'RE ALSO RAMPING UP SOME OF 2516 01:31:42,880 --> 01:31:45,440 OUR ENGAGEMENT EFFORTS SO WE 2517 01:31:45,440 --> 01:31:47,800 HAVE A NEW SUBGROUP AND 2518 01:31:47,800 --> 01:31:48,960 RETENTION CALLED THE 2519 01:31:48,960 --> 01:31:50,240 RECONNECTING WITH PARTICIPANTS 2520 01:31:50,240 --> 01:31:53,400 AND THEY'RE REALLY FOCUSED ON 2521 01:31:53,400 --> 01:31:55,160 THAT RETENTION WITHDRAWAL GROUP 2522 01:31:55,160 --> 01:31:57,160 AND DISCUSSING TARGETED OUTREACH 2523 01:31:57,160 --> 01:31:59,640 TO GROUPS THAT ARE MOST AT RISK 2524 01:31:59,640 --> 01:32:00,440 OF WITHDRAWING. 2525 01:32:00,440 --> 01:32:03,200 WE'RE ALSO DOING MORE ENGAGEMENT 2526 01:32:03,200 --> 01:32:06,080 WITH OUR FAMILIES. 2527 01:32:06,080 --> 01:32:07,640 SO LED BY ELIZABETH HOFFMAN 2528 01:32:07,640 --> 01:32:09,520 WE'RE DEVELOPING SOME THANK YOU 2529 01:32:09,520 --> 01:32:10,920 VIDEOS THAT ARE MORE IN STYLE 2530 01:32:10,920 --> 01:32:12,120 FOR THE YOUTH PARTICIPANTS AS 2531 01:32:12,120 --> 01:32:14,320 THEY ARE GETTING A LITTLE BIT 2532 01:32:14,320 --> 01:32:14,720 OLDER. 2533 01:32:14,720 --> 01:32:17,120 WE'RE DEVELOPING EDUCATIONAL 2534 01:32:17,120 --> 01:32:18,160 MATERIALS AND I'LL TALK A LITTLE 2535 01:32:18,160 --> 01:32:20,320 BIT MORE ABOUT THAT AT THE END. 2536 01:32:20,320 --> 01:32:22,200 WE'RE ALSO DEVELOPING RESOURCES 2537 01:32:22,200 --> 01:32:28,160 FOR YOUTH SO HOW CAN THEY 2538 01:32:28,160 --> 01:32:28,800 LEVERAGE THEIR PARTICIPATION IN 2539 01:32:28,800 --> 01:32:29,440 ABCD IN APPLYING FOR JOBS OR 2540 01:32:29,440 --> 01:32:31,240 COLLEGE AND GIVING THEM THE 2541 01:32:31,240 --> 01:32:32,920 LANGUAGE THEY CAN USE TO 2542 01:32:32,920 --> 01:32:34,240 INCORPORATE THOSE IN THEIR 2543 01:32:34,240 --> 01:32:34,560 APPLICATIONS. 2544 01:32:34,560 --> 01:32:37,920 SO NOW I'D LIKE TO TRANSITION TO 2545 01:32:37,920 --> 01:32:40,320 BIO DATA AND BIO SPECIMEN 2546 01:32:40,320 --> 01:32:41,840 SHARING IN ABCD. 2547 01:32:41,840 --> 01:32:44,200 I'M SURE MANY OF YOU ARE AWARE 2548 01:32:44,200 --> 01:32:46,520 THAT OUR RELEASE OF THE 5.0 DATA 2549 01:32:46,520 --> 01:32:48,720 HAS BEEN DELAYED AND THIS WAS 2550 01:32:48,720 --> 01:32:51,400 DUE TO SOME UNFORESEEN ISSUES 2551 01:32:51,400 --> 01:32:53,280 WITH SECURITY REQUIREMENTS AND 2552 01:32:53,280 --> 01:32:56,400 NOT BEING ABLE TO RELEASE THE 2553 01:32:56,400 --> 01:32:58,640 DATA ANALYSIS PORTAL THE WAY WE 2554 01:32:58,640 --> 01:32:59,120 INTENDED. 2555 01:32:59,120 --> 01:33:02,240 SO WE'RE REVAMPING THE WAY WE 2556 01:33:02,240 --> 01:33:03,200 WILL RELEASE IT. 2557 01:33:03,200 --> 01:33:07,240 IT WILL STILL BE IN THE NIH DATA 2558 01:33:07,240 --> 01:33:09,840 ARCHIVE AND ALL OF IT WILL BE IN 2559 01:33:09,840 --> 01:33:15,840 THE ABCD COLLECTION PAGE IN THE 2560 01:33:15,840 --> 01:33:16,000 NDA. 2561 01:33:16,000 --> 01:33:19,000 THE TAB LATED DATA INSTEAD OF 2562 01:33:19,000 --> 01:33:22,360 BEING AVAILABLE THROUGH THE NDA 2563 01:33:22,360 --> 01:33:24,400 DATABASE WILL BE STORED IN ZIP 2564 01:33:24,400 --> 01:33:26,200 FILES THAT CAN BE DOWNLOADED. 2565 01:33:26,200 --> 01:33:33,080 SO BECAUSE OF THAT, I'M NOT -- 2566 01:33:33,080 --> 01:33:36,680 YOU WON'T BE ABLE TO FILTER THE 2567 01:33:36,680 --> 01:33:37,640 DATA STRUCTURE BUT THE ABCD DATA 2568 01:33:37,640 --> 01:33:39,240 TEAM IS DEVELOPING DATA 2569 01:33:39,240 --> 01:33:41,480 DICTIONARY EXPLORER TO HELP 2570 01:33:41,480 --> 01:33:42,560 PEOPLE IDENTIFY WHAT MEASURES 2571 01:33:42,560 --> 01:33:43,920 THAT THEY'RE LOOKING FOR SO WE 2572 01:33:43,920 --> 01:33:45,520 WILL HAVE THAT FEATURE THAT WAS 2573 01:33:45,520 --> 01:33:48,720 PART -- USED TO BE PART OF THE 2574 01:33:48,720 --> 01:33:51,200 DATA EXPLORATION ANALYSIS PORTAL 2575 01:33:51,200 --> 01:33:52,240 WHICH WON'T BE AVAILABLE BUT 2576 01:33:52,240 --> 01:33:53,520 THAT WILL BE AVAILABLE IN THIS 2577 01:33:53,520 --> 01:33:54,360 NEW APPLICATION. 2578 01:33:54,360 --> 01:33:56,280 AND THEN MOVING FORWARD, IN 2579 01:33:56,280 --> 01:33:59,640 TERMS OF DATA RELEASES, IN 2580 01:33:59,640 --> 01:34:02,240 FEBRUARY OF THIS YEAR, NIDA 2581 01:34:02,240 --> 01:34:03,760 COUNCIL APPROVED CONCEPT FOR NEW 2582 01:34:03,760 --> 01:34:06,240 DATA SHARING PLATFORM THAT WE'RE 2583 01:34:06,240 --> 01:34:11,480 HOPING WILL BE AVAILABLE FOR THE 2584 01:34:11,480 --> 01:34:13,400 6.0 RELEASE NEXT YEAR. WE ALSO 2585 01:34:13,400 --> 01:34:14,760 WANT TO MAKE AVAILABLE THE BIO 2586 01:34:14,760 --> 01:34:16,400 SPECIMENS THAT ARE COLLECTED IN 2587 01:34:16,400 --> 01:34:20,240 THE ABCD STUDY AND THIS IS 2588 01:34:20,240 --> 01:34:20,840 SOMETHING WE'VE BEEN TALKING 2589 01:34:20,840 --> 01:34:21,880 ABOUT FOR A LONG TIME BUT IT'S 2590 01:34:21,880 --> 01:34:22,760 COMING TO FRUITION HOPEFULLY 2591 01:34:22,760 --> 01:34:23,240 VERY SOON. 2592 01:34:23,240 --> 01:34:27,440 SO AS YOU KNOW, WE COLLECT HAIR 2593 01:34:27,440 --> 01:34:30,280 SAMPLES, SALIVA, BABY TEETH, WE 2594 01:34:30,280 --> 01:34:32,720 HAVE DNA THAT'S BEEN EXTRACTED 2595 01:34:32,720 --> 01:34:35,480 FROM SALIVA. 2596 01:34:35,480 --> 01:34:39,040 WHOLE BLOOD SERUM. 2597 01:34:39,040 --> 01:34:40,680 WE COLLECT THESE, MANY OF WHICH 2598 01:34:40,680 --> 01:34:42,800 ARE ANALYZED TO DO CERTAIN 2599 01:34:42,800 --> 01:34:45,280 ANALYSIS AND THEN THE RESIDUALS 2600 01:34:45,280 --> 01:34:46,600 HAVE BEEN STORED IN A NUMBER OF 2601 01:34:46,600 --> 01:34:47,320 DIFFERENT LOCATION. 2602 01:34:47,320 --> 01:34:50,120 AND THE PLAN HAS ALWAYS BEEN TO 2603 01:34:50,120 --> 01:34:51,400 MAKE AVAILABLE TO THE SCIENTIFIC 2604 01:34:51,400 --> 01:34:52,640 COMMUNITY FOR ADDITIONAL 2605 01:34:52,640 --> 01:34:53,720 RESEARCH. 2606 01:34:53,720 --> 01:34:55,440 I THINK EARLIER THIS YEAR WE 2607 01:34:55,440 --> 01:34:56,760 PUBLISHED A NOTICE OF INTENT TO 2608 01:34:56,760 --> 01:34:59,960 PUBLISH OF A FUNDING OPPORTUNITY 2609 01:34:59,960 --> 01:35:01,840 ANNOUNCEMENT WHICH IS A MISNOMER 2610 01:35:01,840 --> 01:35:05,040 FOR THIS PROGRAM FOR A BIO 2611 01:35:05,040 --> 01:35:05,960 SPECIMEN ACCESS PROGRAM THAT 2612 01:35:05,960 --> 01:35:08,200 WILL UTILIZE THE XO1 MECHANISM 2613 01:35:08,200 --> 01:35:10,680 FOR PEOPLE TO APPLY FOR ACCESS 2614 01:35:10,680 --> 01:35:11,560 TO THESE SPECIMENS. 2615 01:35:11,560 --> 01:35:13,400 TO DO RESEARCH THAT'S CONSISTENT 2616 01:35:13,400 --> 01:35:16,680 WITH THE ABCD STUDY OBJECTS OR 2617 01:35:16,680 --> 01:35:17,440 ADDLESS SENT HEALTH MORE 2618 01:35:17,440 --> 01:35:17,720 BROADLY. 2619 01:35:17,720 --> 01:35:19,880 THIS IS ONLY TO GET ACCESS TO 2620 01:35:19,880 --> 01:35:20,320 THE SPECIMENS. 2621 01:35:20,320 --> 01:35:22,120 IT DOES NOT PROVIDE FUNDING. 2622 01:35:22,120 --> 01:35:24,960 SO WE EXPECT THAT PEOPLE WHO 2623 01:35:24,960 --> 01:35:27,720 APPLY FOR ACCESS TO THESE 2624 01:35:27,720 --> 01:35:28,520 SPECIMENS WILL HAVE FUNDING FROM 2625 01:35:28,520 --> 01:35:29,920 ANOTHER SOURCE AND WILL HAVE TO 2626 01:35:29,920 --> 01:35:31,520 DEMONSTRATE THAT IN THEIR 2627 01:35:31,520 --> 01:35:31,840 APPLICATIONS. 2628 01:35:31,840 --> 01:35:34,560 WE WILL SOON HAVE A BIO SPECIMEN 2629 01:35:34,560 --> 01:35:36,640 EXPLORER WHERE PEOPLE WILL GO IN 2630 01:35:36,640 --> 01:35:40,000 AND SEE WHAT SPECIMENS WE HAVE 2631 01:35:40,000 --> 01:35:42,000 BY DEMOGRAPHICS SO THEY CAN THEN 2632 01:35:42,000 --> 01:35:43,760 DETERMINE WHAT IS NEEDED FOR 2633 01:35:43,760 --> 01:35:44,240 THEIR RESEARCH. 2634 01:35:44,240 --> 01:35:48,680 ONE EXCEPTION TO WHAT WILL BE 2635 01:35:48,680 --> 01:35:50,240 AVAILABLE IN -- IMMEDIATELY ARE 2636 01:35:50,240 --> 01:35:53,560 SPECIMENS FROM PARTICIPANTS WHO 2637 01:35:53,560 --> 01:35:56,240 SELF-IDENTIFY AS AMERICAN I 2638 01:35:56,240 --> 01:36:06,760 UNDERSTAND -- INDIAN, ALASKA 2639 01:36:09,160 --> 01:36:15,200 NATIVE. 2640 01:36:15,200 --> 01:36:18,080 NOW I'D LIKE TO TRANSITION TO 2641 01:36:18,080 --> 01:36:20,240 SOME OF THE EXCITING OUTCOMES 2642 01:36:20,240 --> 01:36:21,800 FROM THE STUDY. 2643 01:36:21,800 --> 01:36:24,080 SO I'VE USED THIS SLIDE MANY 2644 01:36:24,080 --> 01:36:25,360 TIMES BEFORE TO TALK ABOUT WHAT 2645 01:36:25,360 --> 01:36:28,800 OUR VISION IS FOR HOW ABCD DATA 2646 01:36:28,800 --> 01:36:30,000 IS GOING TO BE USED. 2647 01:36:30,000 --> 01:36:31,040 OF COURSE WE HAVE RESEARCH 2648 01:36:31,040 --> 01:36:32,200 QUESTIONS THAT WE STARTED OFF 2649 01:36:32,200 --> 01:36:33,440 WITH BUT WE KNOW THERE ARE MANY 2650 01:36:33,440 --> 01:36:36,640 OTHER RESEARCH QUESTIONS THAT 2651 01:36:36,640 --> 01:36:38,240 PEOPLE ARE INTERESTED IN AND 2652 01:36:38,240 --> 01:36:39,840 WHAT WE FOUND IS THAT IT'S -- 2653 01:36:39,840 --> 01:36:42,360 THE DATA SET HAS BECOME VERY 2654 01:36:42,360 --> 01:36:44,000 POPULAR SO DIANA HAS DONE AN 2655 01:36:44,000 --> 01:36:46,600 ANALYSIS OF THE PORTFOLIO OF 2656 01:36:46,600 --> 01:36:48,080 GRANTS THAT HAVE BEEN FUNDED 2657 01:36:48,080 --> 01:36:50,240 ACROSS NIH AND ACTUALLY BEYOND 2658 01:36:50,240 --> 01:36:55,120 NIH USING ABCD DATA OVER TIME 2659 01:36:55,120 --> 01:36:57,360 AND NIH HAS NOW FUNDED 154 2660 01:36:57,360 --> 01:36:59,400 GRANDS USING THE DATA COVERING A 2661 01:36:59,400 --> 01:37:01,000 NUMBER OF DIFFERENT AREAS AS YOU 2662 01:37:01,000 --> 01:37:04,720 CAN SEE IN THIS DIAGRAM. 2663 01:37:04,720 --> 01:37:08,000 WHAT'S REALLY EXCITING IS THAT 2664 01:37:08,000 --> 01:37:09,560 THERE HAVE BEEN 14 INSTITUTES 2665 01:37:09,560 --> 01:37:11,760 AND CENTERS AT NIH THAT HAVE 2666 01:37:11,760 --> 01:37:13,040 FUNDED THESE GRANTS SO THAT'S 2667 01:37:13,040 --> 01:37:16,080 BEYOND THE TEN ICS THAT ARE 2668 01:37:16,080 --> 01:37:17,440 SUPPORTING ABCD IT'S REALLY 2669 01:37:17,440 --> 01:37:20,240 ENGAGED THE INTERESTS OF ICS 2670 01:37:20,240 --> 01:37:22,320 ACROSS THE NIH AS WELL AS 2671 01:37:22,320 --> 01:37:25,440 NON-NIH FUNDERS WHO ARE ALSO 2672 01:37:25,440 --> 01:37:27,120 SUPPORTING RESEARCH USING ABCD 2673 01:37:27,120 --> 01:37:27,880 DATA. 2674 01:37:27,880 --> 01:37:30,040 IN TERMS OF THE MECHANISMS THAT 2675 01:37:30,040 --> 01:37:32,240 ARE BEING FUNDED, THE MAJORITY 2676 01:37:32,240 --> 01:37:34,080 OF THESE ARE RESEARCH GRANTS, 2677 01:37:34,080 --> 01:37:36,680 BUT ALSO QUITE A NUMBER OF 2678 01:37:36,680 --> 01:37:38,240 INDIVIDUAL TRAINING GRANTS AND 2679 01:37:38,240 --> 01:37:39,920 THIS HAS GONE UP OVER TIME 2680 01:37:39,920 --> 01:37:42,080 ALTHOUGH THERE WAS A SLIGHT DIP 2681 01:37:42,080 --> 01:37:43,040 IN TRAINING IN 2022. 2682 01:37:43,040 --> 01:37:48,760 I KNOW IT'S HARD TO SEE HERE. 2683 01:37:48,760 --> 01:37:50,240 READ ALL OF THE LABELS HERE BUT 2684 01:37:50,240 --> 01:37:56,120 I JUST WANTED TO SHOW KIND OF A 2685 01:37:56,120 --> 01:37:57,480 QUICK IMAGE TO DESCRIBE THE MANY 2686 01:37:57,480 --> 01:37:59,440 DIFFERENT AREAS THAT ARE BEING 2687 01:37:59,440 --> 01:38:00,280 COVERED BY THIS. 2688 01:38:00,280 --> 01:38:02,040 SO THIS IS THAT ADDITIONAL 2689 01:38:02,040 --> 01:38:03,440 RESEARCH QUESTIONS AND WE HAVE 2690 01:38:03,440 --> 01:38:05,320 ANNOUNCEMENTS FOR PEOPLE TO USE 2691 01:38:05,320 --> 01:38:07,200 ABCD DATA ANALYSIS BUT THESE 2692 01:38:07,200 --> 01:38:10,840 GRANTS ARE COMING IN LIKE I 2693 01:38:10,840 --> 01:38:15,400 SAID, FROM MANY ICS IN RESPONSE 2694 01:38:15,400 --> 01:38:16,000 RFAS THAT ARE NOT ASSOCIATED 2695 01:38:16,000 --> 01:38:18,520 WITH ABCD AT ALL SO IT'S REALLY 2696 01:38:18,520 --> 01:38:20,920 BROADENING THE USE OF ABCD DATA. 2697 01:38:20,920 --> 01:38:22,600 ANOTHER THING THAT WE WANTED TO 2698 01:38:22,600 --> 01:38:24,040 LOOK AT IS HOW PEOPLE ARE USING 2699 01:38:24,040 --> 01:38:27,120 OR WHAT ARE THEY USING ABCD FOR. 2700 01:38:27,120 --> 01:38:29,400 SO WE LOOKED AT WHETHER THEY'RE 2701 01:38:29,400 --> 01:38:30,840 USING THE DATA, WHETHER THEY'RE 2702 01:38:30,840 --> 01:38:32,040 USING THE METHODS WHICH I THINK 2703 01:38:32,040 --> 01:38:34,520 IS ALSO AN OUTCOME FROM ABCD 2704 01:38:34,520 --> 01:38:35,840 THAT WE'VE DEVELOPED METHODS 2705 01:38:35,840 --> 01:38:37,520 THAT OTHERS ARE NOW ADOPTING AND 2706 01:38:37,520 --> 01:38:39,440 THAT REALLY GOES TOWARDS BEING 2707 01:38:39,440 --> 01:38:44,720 ABLE TO HARMONIZE ACROSS 2708 01:38:44,720 --> 01:38:44,960 STUDIES. 2709 01:38:44,960 --> 01:38:46,880 AND LOOK AT WHAT IS REALLY -- 2710 01:38:46,880 --> 01:38:48,480 THIS IS KIND OF A QUICK OVERVIEW 2711 01:38:48,480 --> 01:38:50,440 OF WHAT WE'RE SEEING, SO PEOPLE 2712 01:38:50,440 --> 01:38:53,960 ARE DEFINITELY USING ABCD DATA 2713 01:38:53,960 --> 01:38:56,360 TO DEVELOP METHODOLOGIES, AND 2714 01:38:56,360 --> 01:39:00,720 ANALYSIS TOOLS, PEOPLE ARE 2715 01:39:00,720 --> 01:39:01,920 POOLING DATA WITH OTHER DATA 2716 01:39:01,920 --> 01:39:07,880 SETS SO THEY'RE USING IT AS A 2717 01:39:07,880 --> 01:39:12,440 COMPARATIVE TO AUTISM, TURRETS, 2718 01:39:12,440 --> 01:39:13,960 POOLING ABCD DATA WITH OTHER 2719 01:39:13,960 --> 01:39:15,440 DATA SETS AND WE ARE SEEING 2720 01:39:15,440 --> 01:39:18,520 STUDIES THAT ARE TAKING ABCD 2721 01:39:18,520 --> 01:39:19,720 TASKS AND DEVELOPING ANIMAL 2722 01:39:19,720 --> 01:39:21,080 MODELS TO BE ABLE TO START 2723 01:39:21,080 --> 01:39:22,720 LOOKING AT MECHANISMS WHICH IS 2724 01:39:22,720 --> 01:39:24,200 ONE OF THE LONG-TERM GOALS THAT 2725 01:39:24,200 --> 01:39:28,360 WE WANTED TO SEE WITH ABCD AS 2726 01:39:28,360 --> 01:39:28,800 WELL. 2727 01:39:28,800 --> 01:39:30,320 AND AS A RESULT OF ALL OF THESE 2728 01:39:30,320 --> 01:39:31,680 GRANTS THAT HAVE BEEN FUNDED 2729 01:39:31,680 --> 01:39:33,320 WE'VE ALSO SEEN A DRAMATIC 2730 01:39:33,320 --> 01:39:35,400 INCREASE IN THE NUMBER OF 2731 01:39:35,400 --> 01:39:37,200 PUBLICATIONS THAT HAVE COME OUT 2732 01:39:37,200 --> 01:39:40,840 USING ABCD DATA SO OVER 550 2733 01:39:40,840 --> 01:39:43,120 PAPERS HAVE COME OUT WHICH IS 2734 01:39:43,120 --> 01:39:44,200 REALLY EXCITING TO SEE AND I 2735 01:39:44,200 --> 01:39:46,680 EXPECT THIS IS EARLY IN 2023. 2736 01:39:46,680 --> 01:39:49,680 I EXPECT THIS SLOPE TO GO MUCH 2737 01:39:49,680 --> 01:39:51,160 HIGHER AS WE GET CLOSER TO THE 2738 01:39:51,160 --> 01:39:53,360 END OF THE YEAR. SO I'D NOW 2739 01:39:53,360 --> 01:39:57,440 LIKE TO HAND IT OFF TO KIM 2740 01:39:57,440 --> 01:40:00,960 LEBLANC TO IDENTIFY A COUPLE OF 2741 01:40:00,960 --> 01:40:02,400 PAPERS THAT EXEMPLIFIES THE WORK 2742 01:40:02,400 --> 01:40:11,440 THAT WE'RE SEEING COME OUT OF 2743 01:40:11,440 --> 01:40:12,640 ABCD. 2744 01:40:12,640 --> 01:40:13,840 >>THANK YOU, EVERYONE, FOR 2745 01:40:13,840 --> 01:40:15,320 BEING HERE. I'M GOING TO 2746 01:40:15,320 --> 01:40:19,080 PRESENT TWO PAPERS THAT HAVE 2747 01:40:19,080 --> 01:40:22,280 RECENTLY COME OUT. 2748 01:40:22,280 --> 01:40:24,040 ACTUALLY THE SENIOR AUTHOR ON 2749 01:40:24,040 --> 01:40:26,240 ONE OF THESE PAPERS SO I'LL 2750 01:40:26,240 --> 01:40:31,680 MENTION WE'RE ONLY GOING TO BE 2751 01:40:31,680 --> 01:40:36,640 TOUCHING ON THE PORTION OF THE 2752 01:40:36,640 --> 01:40:38,240 PAPER SO I HOPE YOU'LL READ IT 2753 01:40:38,240 --> 01:40:40,080 WHEN YOU HAVE A CHANCE. 2754 01:40:40,080 --> 01:40:42,600 THIS IS WHAT THEY EXPECT ALCOHOL 2755 01:40:42,600 --> 01:40:44,640 MIGHT DO OR THE SORT OF EFFECTS 2756 01:40:44,640 --> 01:40:46,840 IT MIGHT HAVE, WHETHER OR NOT 2757 01:40:46,840 --> 01:40:47,960 THEY HAVE PERSONAL EXPERIENCE 2758 01:40:47,960 --> 01:40:48,640 CONSUMING IT BEFORE. 2759 01:40:48,640 --> 01:40:54,280 AN EXAMPLE OF A POSITIVE ALCOHOL 2760 01:40:54,280 --> 01:40:57,840 EXPECTANCY, IS ALCOHOL HELPS A 2761 01:40:57,840 --> 01:41:02,920 PERSON TO RELAX. 2762 01:41:02,920 --> 01:41:03,560 NEGATIVE, ALCOHOL CAN AFFECT HOW 2763 01:41:03,560 --> 01:41:07,800 A PERSON GETS ALONG WITH OTHERS. 2764 01:41:07,800 --> 01:41:10,840 WE ALSO MEASURE ALCOHOL SIPPING 2765 01:41:10,840 --> 01:41:13,560 AND OTHER CASES FOUND THAT 2766 01:41:13,560 --> 01:41:18,400 ALCOHOL SIPPING BY THE AGE OF 2767 01:41:18,400 --> 01:41:18,560 10. 2768 01:41:18,560 --> 01:41:22,440 SO ALCOHOL SIPPING MAY A 2769 01:41:22,440 --> 01:41:24,680 PREDICTOR IN FUTURE ALCOHOL USE 2770 01:41:24,680 --> 01:41:27,800 IN ADVERSE OUTCOMES. 2771 01:41:27,800 --> 01:41:29,800 TRAUMATIC EVENTS THAT OCCUR 2772 01:41:29,800 --> 01:41:32,480 BEFORE THE AGE OF 18 AND INCLUDE 2773 01:41:32,480 --> 01:41:36,320 ABUSE, NEGLECT AND HOUSEHOLD 2774 01:41:36,320 --> 01:41:40,720 DYSFUNCTION AND AFFECTS A 2775 01:41:40,720 --> 01:41:42,960 SIGNIFICANT PERCENT OF THE 2776 01:41:42,960 --> 01:41:44,560 POPULATION. ACE HAS BEEN LINKED 2777 01:41:44,560 --> 01:41:46,800 TO A NUMBER OF DOWNSTREAM 2778 01:41:46,800 --> 01:41:48,680 BEHAVIORAL, PHYSICAL AND MENTAL 2779 01:41:48,680 --> 01:41:50,000 HEALTH CONDITIONS INCLUDING 2780 01:41:50,000 --> 01:41:52,320 ALCOHOL YOU DISORDER AND WHILE 2781 01:41:52,320 --> 01:41:56,240 THIS LINK TO AUD HAS BEEN WELL 2782 01:41:56,240 --> 01:41:58,280 ESTABLISHED THE LINK IS MUCH 2783 01:41:58,280 --> 01:41:59,880 MORE EARLIER ONSET HAS NOT BEEN 2784 01:41:59,880 --> 01:42:01,320 NEARLY AS WELL STUDIED. 2785 01:42:01,320 --> 01:42:04,720 SO THEY'RE HELPING TO ADDRESS 2786 01:42:04,720 --> 01:42:04,920 THAT. 2787 01:42:04,920 --> 01:42:09,960 THEY USED BASELINE ABCD STUDY 2788 01:42:09,960 --> 01:42:10,400 DATA. 2789 01:42:10,400 --> 01:42:13,720 IN THE PAPER IT WAS ALCOHOL 2790 01:42:13,720 --> 01:42:18,440 NAIVE CHILDREN SO THEY HAD NEVER 2791 01:42:18,440 --> 01:42:19,920 TRIED IT BEFORE. 2792 01:42:19,920 --> 01:42:20,520 SOCIO DEMOGRAPHIC FACTORS ON 2793 01:42:20,520 --> 01:42:21,320 THEIR POSITIVE AND NEGATIVE 2794 01:42:21,320 --> 01:42:23,000 ALCOHOL EXPECTANCIES AND THE 2795 01:42:23,000 --> 01:42:24,840 PAPER LOOKED AT PARTICIPANTS WHO 2796 01:42:24,840 --> 01:42:27,800 HAD DONE SOME AMOUNT OF ALCOHOL 2797 01:42:27,800 --> 01:42:30,040 SIPPING AND EXAMINED THE 2798 01:42:30,040 --> 01:42:32,280 RELATIONSHIP BETWEEN THE AS AND 2799 01:42:32,280 --> 01:42:35,680 SIPPING BEHAVIOR AND THIS IS 2800 01:42:35,680 --> 01:42:37,280 SHOWING THE PREVALENCE OF 2801 01:42:37,280 --> 01:42:39,920 ALCOHOL SIPPING. 2802 01:42:39,920 --> 01:42:42,600 SO 23% HAD ALREADY DONE SOME 2803 01:42:42,600 --> 01:42:43,200 SIPPING. 2804 01:42:43,200 --> 01:42:44,640 THIS IS THE ADDITIONAL 2805 01:42:44,640 --> 01:42:47,160 PREVALENCE IN THE ABCD STUDIES 2806 01:42:47,160 --> 01:42:49,160 AND YOU CAN SEE THERE'S ACTUALLY 2807 01:42:49,160 --> 01:42:50,360 FAIRLY SIGNIFICANT PORTIONS THAT 2808 01:42:50,360 --> 01:42:52,640 HAVE EXPERIENCED SOME AMOUNT OF 2809 01:42:52,640 --> 01:42:54,000 HOUSEHOLD VIOLENCE, SUBSTANCE 2810 01:42:54,000 --> 01:42:59,560 ABUSE, MENTAL ILLNESS AND 2811 01:42:59,560 --> 01:42:59,800 OTHERS. 2812 01:42:59,800 --> 01:43:01,440 AND WHILE THE TWO STUDIES LOOKED 2813 01:43:01,440 --> 01:43:04,000 AT SLIGHTLY DIFFERENT BEHAVIORS 2814 01:43:04,000 --> 01:43:05,520 AND ATTITUDES, THEY BOTH FOUND 2815 01:43:05,520 --> 01:43:07,320 THAT HAVING MORE AS WAS 2816 01:43:07,320 --> 01:43:08,680 ASSOCIATED WITH AN INCREASED 2817 01:43:08,680 --> 01:43:11,720 RISK OF THOSE BEHAVIORS SO A 2818 01:43:11,720 --> 01:43:13,560 LARGER NUMBER OF AS WERE 2819 01:43:13,560 --> 01:43:17,800 ASSOCIATED WITH A GREATER 2820 01:43:17,800 --> 01:43:24,120 LIKELIHOOD OF ALCOHOLIC 2821 01:43:24,120 --> 01:43:24,440 EXPECTANCIES. 2822 01:43:24,440 --> 01:43:26,080 SO THAT'S REALLY YOU SEE ON THE 2823 01:43:26,080 --> 01:43:26,600 RIGHT. 2824 01:43:26,600 --> 01:43:27,680 ADVERSE CHILDHOOD EXPERIENCES 2825 01:43:27,680 --> 01:43:29,280 THE SUM OF THEM IS GOING ON THE 2826 01:43:29,280 --> 01:43:31,160 X AXIS AND THE PROBABILITY OF 2827 01:43:31,160 --> 01:43:32,720 THEIR SIPPING ALCOHOL ON THE Y. 2828 01:43:32,720 --> 01:43:34,680 YOU CAN SEE THE NEARLY LINEAR 2829 01:43:34,680 --> 01:43:36,320 RELATIONSHIP THERE. 2830 01:43:36,320 --> 01:43:38,280 THEY ALSO LOOKED AT SUBTYPES IN 2831 01:43:38,280 --> 01:43:41,720 THE HOUSEHOLD VIOLENCE AND 2832 01:43:41,720 --> 01:43:44,520 HOUSEHOLD ALCOHOL ABUSE WERE 2833 01:43:44,520 --> 01:43:45,040 SIGNIFICANT PREDICTORS. 2834 01:43:45,040 --> 01:43:46,640 SO AS PLAY A SIGNIFICANT ROLE IN 2835 01:43:46,640 --> 01:43:48,320 EARLY ALCOHOL BEHAVIORS. 2836 01:43:48,320 --> 01:43:51,760 THEY FOUND THAT AS WERE 2837 01:43:51,760 --> 01:43:52,720 ASSOCIATED WITH POSITIVE ALCOHOL 2838 01:43:52,720 --> 01:43:56,240 EXPECTANCIES AND THE 2839 01:43:56,240 --> 01:43:56,880 ACCUMULATING WERE GREATER WITH 2840 01:43:56,880 --> 01:43:58,520 THE ALCOHOL SIPPING IN THOSE WHO 2841 01:43:58,520 --> 01:44:00,400 HAD DONE AN AMOUNT OF SIPPING. 2842 01:44:00,400 --> 01:44:02,920 WE'LL BE ABLE TO INVESTIGATE 2843 01:44:02,920 --> 01:44:03,960 THEIR FUTURE ALCOHOL DRINKING IN 2844 01:44:03,960 --> 01:44:06,240 THESE PARTICIPANTS TO SEE IF IT 2845 01:44:06,240 --> 01:44:08,040 DOES DEVELOP INTO MORE SERIOUS 2846 01:44:08,040 --> 01:44:08,920 DRINKING HABITS AND ALSO 2847 01:44:08,920 --> 01:44:18,640 HIGHLIGHTS THAT AS ALONG WITH 2848 01:44:18,640 --> 01:44:19,120 OTHER SOCIO DEMOGRAPHIC 2849 01:44:19,120 --> 01:44:21,360 ENVIRONMENTAL VARIABLES FOR 2850 01:44:21,360 --> 01:44:21,920 EARLY PREVENTION AND 2851 01:44:21,920 --> 01:44:24,360 INTERVENTION STRATEGIES. 2852 01:44:24,360 --> 01:44:25,840 >>I'M NOW GOING TO TURN IT OVER 2853 01:44:25,840 --> 01:44:28,840 TO TRACI MURRAY TO GIVE AN 2854 01:44:28,840 --> 01:44:30,320 UPDATE ON JEDI. 2855 01:44:30,320 --> 01:44:30,920 ARE YOU THERE? 2856 01:44:30,920 --> 01:44:32,720 >>I AM. 2857 01:44:32,720 --> 01:44:33,760 CAN YOU HEAR ME. 2858 01:44:33,760 --> 01:44:34,120 >>YES. 2859 01:44:34,120 --> 01:44:34,880 >>AWESOME. 2860 01:44:34,880 --> 01:44:36,680 SO I'D LIKE TO TAKE THIS 2861 01:44:36,680 --> 01:44:38,240 OPPORTUNITY TO HIGHLIGHT A 2862 01:44:38,240 --> 01:44:45,560 NUMBER OF ACTIVITIES IN EQUITY, 2863 01:44:45,560 --> 01:44:46,400 DIVERSITY AND INCLUSION AND SO 2864 01:44:46,400 --> 01:44:48,280 FIRST THERE'S A LOT OF WORK TO 2865 01:44:48,280 --> 01:44:50,520 BE DONE AND MRORS OF OUR MEMBERS 2866 01:44:50,520 --> 01:44:53,000 WORK IN ABCD AS A PURSUIT OF 2867 01:44:53,000 --> 01:45:01,120 THEIR EFFORT. 2868 01:45:01,120 --> 01:45:03,640 AS A RESULT, DEDICATED FTES -- 2869 01:45:03,640 --> 01:45:06,720 THIS ENSURES JEDI PRIORITIES 2870 01:45:06,720 --> 01:45:08,600 HAVE THE SAME LEVEL OF AUTHORITY 2871 01:45:08,600 --> 01:45:12,000 AND OVERSIGHT AS OTHER KEY STUDY 2872 01:45:12,000 --> 01:45:13,840 COMPONENTS WITH ASSOCIATE 2873 01:45:13,840 --> 01:45:14,120 DIRECTORS. 2874 01:45:14,120 --> 01:45:17,480 THE DIRECTORS ALSO GIVE 2875 01:45:17,480 --> 01:45:20,320 ADMINISTRATIVE SUPPORT TO MANAGE 2876 01:45:20,320 --> 01:45:25,040 A SIGNIFICANT NUMBER OF TASKS. 2877 01:45:25,040 --> 01:45:27,040 MY ROLE IS QUITE UNIQUE. 2878 01:45:27,040 --> 01:45:30,720 I DIRECTLY SUPPORT ABCD STUDIES 2879 01:45:30,720 --> 01:45:35,360 BY PARTICIPATING IN ALL JEDI 2880 01:45:35,360 --> 01:45:35,560 WORK. 2881 01:45:35,560 --> 01:45:40,120 I SHARE IDEAS AND LESSONS 2882 01:45:40,120 --> 01:45:42,000 LEARNED AND THIS ALLOWS US TO 2883 01:45:42,000 --> 01:45:43,920 BRING THOSE RESOURCES INTO THE 2884 01:45:43,920 --> 01:45:44,680 STUDY AND ALSO USE INFORMATION 2885 01:45:44,680 --> 01:45:47,080 FROM THE STUDIES TO PERFORM DEI 2886 01:45:47,080 --> 01:45:48,520 WORK ACROSS THE AGENCY. 2887 01:45:48,520 --> 01:45:51,680 LAST YEAR ABCD BROUGHT IN AN 2888 01:45:51,680 --> 01:45:52,720 EXTERNAL CONSULTANT TO ASSESS 2889 01:45:52,720 --> 01:45:55,080 THE JEDI CULTURE WITHIN OUR 2890 01:45:55,080 --> 01:45:55,280 STUDY. 2891 01:45:55,280 --> 01:45:55,600 IT INCLUDED A ROAD 2892 01:45:57,960 --> 01:45:58,760 AND RECOMMENDATIONS THAT ARE 2893 01:45:58,760 --> 01:46:01,960 GUIDING OUR EFFORTS TO 2894 01:46:01,960 --> 01:46:05,760 CONTINUOUSLY IMPROVE JEDI AND 2895 01:46:05,760 --> 01:46:07,480 SOME OF THOSE ARE LISTED HERE ON 2896 01:46:07,480 --> 01:46:08,400 THE SLIDE. 2897 01:46:08,400 --> 01:46:10,160 NEXT SLIDE? THE CONSULTANTS 2898 01:46:10,160 --> 01:46:13,520 REPORT HELPED US TAKE A MOMENT 2899 01:46:13,520 --> 01:46:15,840 TO REFLECT ON JEDI ACTIVITIES IN 2900 01:46:15,840 --> 01:46:16,480 THE STUDY. 2901 01:46:16,480 --> 01:46:19,280 IT HAS BEEN A PART OF ABCD SINCE 2902 01:46:19,280 --> 01:46:21,760 ITS INCEPTION, THE MURDER OF 2903 01:46:21,760 --> 01:46:23,800 GEORGE FLOYD FURTHER HIGHLIGHTED 2904 01:46:23,800 --> 01:46:26,880 THE NEED TO ADDRESS RACIAL 2905 01:46:26,880 --> 01:46:28,040 DISCRIMINATION IN ALL SYSTEMS 2906 01:46:28,040 --> 01:46:29,480 INCLUDING SCIENCE. WE WANT TO 2907 01:46:29,480 --> 01:46:32,320 BUILD ON THAT MOMENTUM AND 2908 01:46:32,320 --> 01:46:34,760 ADDRESS ALL TYPES OF 2909 01:46:34,760 --> 01:46:39,000 DISCRIMINATION. WITHIN ABCD, 2910 01:46:39,000 --> 01:46:41,400 JEDI IS LED BY THREE WORK 2911 01:46:41,400 --> 01:46:41,640 GROUPS. 2912 01:46:41,640 --> 01:46:44,040 THE EQUITABLE AND INCLUSIVE 2913 01:46:44,040 --> 01:46:46,560 METHODS REVIEWS ALL AREAS AND 2914 01:46:46,560 --> 01:46:50,280 PROTOCOLS FOR POTENTIAL BIAS AND 2915 01:46:50,280 --> 01:46:54,000 DEVELOPING MORE INCLUSIVE 2916 01:46:54,000 --> 01:46:54,240 MEASURES. 2917 01:46:54,240 --> 01:46:57,120 THE DIVERSITY AND INCLUSION LED 2918 01:46:57,120 --> 01:46:58,960 A DEMOGRAPHIC SURVEY TO 2919 01:46:58,960 --> 01:47:01,760 UNDERSTAND THE MAKEUP OF OUR 2920 01:47:01,760 --> 01:47:05,800 MEMBERS, AFFINITY GROUPS TO 2921 01:47:05,800 --> 01:47:07,920 SUPPORT UNDERREPRESENTED GROUPS 2922 01:47:07,920 --> 01:47:08,880 AND BUILD COMMUNITY AND 2923 01:47:08,880 --> 01:47:12,720 BELONGING WITHIN ABCD. OUR 2924 01:47:12,720 --> 01:47:14,240 RESPONSIBLE USE OF DATA WORK 2925 01:47:14,240 --> 01:47:20,400 GROUP LOOKED AT HOW THE USE OF 2926 01:47:20,400 --> 01:47:22,400 ABCD WORK, ELIZABETH'S 2927 01:47:22,400 --> 01:47:24,680 PRESENTATION ON DIFFERENCES IN 2928 01:47:24,680 --> 01:47:26,120 BRAIN STRUCTURE IS AN EXAMPLE OF 2929 01:47:26,120 --> 01:47:27,480 THE IMPORTANCE OF SUCH WORK. 2930 01:47:27,480 --> 01:47:34,480 WE ALSO RESTRUCK CTURED JEDI WO. 2931 01:47:34,480 --> 01:47:38,320 AND WE'RE INTEGRATING JEDI INTO 2932 01:47:38,320 --> 01:47:40,400 MORE SPACES BY CREATING A JEDI 2933 01:47:40,400 --> 01:47:44,120 ALL HANDS TO PROVIDE UPDATES AND 2934 01:47:44,120 --> 01:47:44,600 TRAINING TO THE ENTIRE 2935 01:47:44,600 --> 01:47:44,920 CONSORTIUM. 2936 01:47:44,920 --> 01:47:47,240 FOR OUR FIRST ALL HANDS OVER 80 2937 01:47:47,240 --> 01:47:48,840 MEMBERS ACROSS ALL LEVELS JOINED 2938 01:47:48,840 --> 01:47:50,960 US TO LEARN ABOUT CURRENT AND 2939 01:47:50,960 --> 01:47:52,480 PROPOSED CHANGES TO THE FEDERAL 2940 01:47:52,480 --> 01:47:54,400 RACE AND ETHNICITY CATEGORIES ON 2941 01:47:54,400 --> 01:47:56,400 THE CENSUS INCLUDING THE HISTORY 2942 01:47:56,400 --> 01:48:00,480 OF THOSE CATEGORIES. 2943 01:48:00,480 --> 01:48:01,360 NEXT SLIDE. 2944 01:48:01,360 --> 01:48:01,840 THANK YOU. 2945 01:48:01,840 --> 01:48:04,560 IN CLOSING I'D LIKE TO HIGHLIGHT 2946 01:48:04,560 --> 01:48:07,280 THE SCIENTIFIC TRAINING IN 2947 01:48:07,280 --> 01:48:09,200 ADDICTION RESEARCH TECHNIQUES OR 2948 01:48:09,200 --> 01:48:09,800 START PROGRAM. 2949 01:48:09,800 --> 01:48:13,120 START IS DEDICATED TO ENHANCING 2950 01:48:13,120 --> 01:48:15,520 DEI IN THE SUBSTANCE MISUSE 2951 01:48:15,520 --> 01:48:17,960 RESEARCH WORK FORCE THROUGH A 2952 01:48:17,960 --> 01:48:20,560 MENTORED APPROACH WHERE SCHOLARS 2953 01:48:20,560 --> 01:48:27,360 AT THE PREDOT, POST DOT AND 2954 01:48:27,360 --> 01:48:27,760 FACULTY LEVEL. 2955 01:48:27,760 --> 01:48:34,360 IF YOU'RE ATTENDING AN UPCOMING 2956 01:48:34,360 --> 01:48:36,440 CONFERENCE PLEASE JOIN THEIR 2957 01:48:36,440 --> 01:48:36,760 SESSION. 2958 01:48:36,760 --> 01:48:37,440 THANK YOU. 2959 01:48:37,440 --> 01:48:40,320 >>THANK YOU, TRACI. 2960 01:48:40,320 --> 01:48:41,120 ELIZABETH, ARE YOU THERE? 2961 01:48:41,120 --> 01:48:43,760 >>CAN YOU ALL HEAR ME? 2962 01:48:43,760 --> 01:48:44,680 >>A LITTLE BIT LOUDER. 2963 01:48:44,680 --> 01:48:45,120 >>OKAY. 2964 01:48:45,120 --> 01:48:46,200 IS THAT BETTER? 2965 01:48:46,200 --> 01:48:48,400 >>YEP. 2966 01:48:48,400 --> 01:48:48,680 THANK YOU. 2967 01:48:48,680 --> 01:48:48,920 >>SUPER. 2968 01:48:48,920 --> 01:48:50,240 GOOD AFTERNOON, EVERYONE. 2969 01:48:50,240 --> 01:48:51,760 I'M SORRY I CAN'T BE THERE IN 2970 01:48:51,760 --> 01:48:52,320 PERSON. 2971 01:48:52,320 --> 01:48:54,240 I'M GOING TO TELL YOU ABOUT A 2972 01:48:54,240 --> 01:48:56,240 VERY RECENT PAPER LOOKING AT 2973 01:48:56,240 --> 01:48:59,400 RACIAL DISPARITIES AND ADVERSITY 2974 01:48:59,400 --> 01:49:01,920 DURING CHILDHOOD AND ALSO RACE 2975 01:49:01,920 --> 01:49:02,800 RELATED DIFFERENCES IN BRAIN 2976 01:49:02,800 --> 01:49:03,080 STRUCTURE. 2977 01:49:03,080 --> 01:49:06,040 THIS PAPER, MANY OF YOU KNOW 2978 01:49:06,040 --> 01:49:06,720 HAVE GOTTEN A LOT OF PRESS JUST 2979 01:49:06,720 --> 01:49:08,280 IN THE LAST COUPLE OF MONTHS 2980 01:49:08,280 --> 01:49:12,880 SINCE FS PUBLISHED AND IT REALLY 2981 01:49:12,880 --> 01:49:15,440 DISSPELLS NOTIONS OF INHERENT 2982 01:49:15,440 --> 01:49:15,720 DIFFERENCES. 2983 01:49:15,720 --> 01:49:20,280 SO THIS IS A SUPER IMPORTANT 2984 01:49:20,280 --> 01:49:21,560 CONTRIBUTION TO THE FIELD 2985 01:49:21,560 --> 01:49:22,640 BECAUSE AS WE -- MANY OF US 2986 01:49:22,640 --> 01:49:25,560 KNOW, PAST RESEARCH HAS REALLY 2987 01:49:25,560 --> 01:49:34,040 FOCUSED ON RACE DIFFERENCES, 2988 01:49:34,040 --> 01:49:35,880 EVEN BDOING ANALYSIS TO WHAT'S 2989 01:49:35,880 --> 01:49:38,680 BEHIND RACE AND WE KNOW RACE IS 2990 01:49:38,680 --> 01:49:40,680 A SOCIAL CONSTRUCT WITH 2991 01:49:40,680 --> 01:49:41,680 ENVIRONMENT TALL FACTORS 2992 01:49:41,680 --> 01:49:42,720 EMBEDDED WITHIN. 2993 01:49:42,720 --> 01:49:44,680 AND SO IT'S ABSOLUTELY 2994 01:49:44,680 --> 01:49:46,120 IMPERATIVE THAT WE LOOK AT THOSE 2995 01:49:46,120 --> 01:49:46,880 FACTORS CRITICALLY. 2996 01:49:46,880 --> 01:49:48,520 AND SO THIS PAPER DOES JUST 2997 01:49:48,520 --> 01:49:49,800 THAT. 2998 01:49:49,800 --> 01:49:51,160 NEXT SLIDE, PLEASE. 2999 01:49:51,160 --> 01:49:54,120 SO WE KNOW THAT BLACK YOUTH IN 3000 01:49:54,120 --> 01:49:56,440 THE U.S. ARE DISPROPORTIONATELY 3001 01:49:56,440 --> 01:49:58,760 BURDENED WITH ADVERSITY, 3002 01:49:58,760 --> 01:50:01,080 INCLUDING MATERIAL HARDSHIP AND 3003 01:50:01,080 --> 01:50:01,960 TRAUMA AND THIS TABLE TO THE 3004 01:50:01,960 --> 01:50:08,200 RIGHT IS FROM A FEW YEARS AGO 3005 01:50:08,200 --> 01:50:09,480 HIGHLIGHTING THIS DISPORTIONAL 3006 01:50:09,480 --> 01:50:09,720 BURDEN. 3007 01:50:09,720 --> 01:50:12,200 WE ALSO KNOW THAT EARLY 3008 01:50:12,200 --> 01:50:16,680 ADVERSITY IS ASSOCIATED WITH 3009 01:50:16,680 --> 01:50:20,040 STRUCTURAL BRAIN REGIONS. 3010 01:50:20,040 --> 01:50:25,480 THE CORTEX AND THE HIPPOCAMPUS 3011 01:50:25,480 --> 01:50:29,440 AND PREVIOUS WORK HAS SHOWN 3012 01:50:29,440 --> 01:50:30,640 LARGER NEURAL RESPONSES WITHIN 3013 01:50:30,640 --> 01:50:32,480 THESE SAME REGIONS IN BLACK 3014 01:50:32,480 --> 01:50:36,360 COMPARED TO WHITE YOUNG ADULTS 3015 01:50:36,360 --> 01:50:36,920 AND THESE WERE PARTIALLY 3016 01:50:36,920 --> 01:50:44,240 ATTRIBUTABLE TO DISPARITIES AND 3017 01:50:44,240 --> 01:50:45,360 NEGATIVE LIFE EXPENRIENCE. 3018 01:50:45,360 --> 01:50:47,480 THIS PAPER GOES A STEP FURTHER 3019 01:50:47,480 --> 01:50:48,800 TO INVESTIGATE THE RELATIONSHIP 3020 01:50:48,800 --> 01:50:50,680 BETWEEN RACIAL DISPARITIES AND 3021 01:50:50,680 --> 01:50:53,080 ADVERSITY AND THE STRUCTURE OF 3022 01:50:53,080 --> 01:50:54,760 THE WHOLE DURING CHILDHOOD TO 3023 01:50:54,760 --> 01:50:56,720 UNDERSTAND HOW CONTEXTUAL 3024 01:50:56,720 --> 01:51:01,880 FACTORS MAY ALSO IMPACT THIS 3025 01:51:01,880 --> 01:51:02,400 NEUROCIRCUITRY. 3026 01:51:02,400 --> 01:51:03,440 NEXT SLIDE, PLEASE. 3027 01:51:03,440 --> 01:51:05,000 SO THE OVERALL AIM WAS TO LOOK 3028 01:51:05,000 --> 01:51:07,080 AT THIS RELATIONSHIP WITH 3029 01:51:07,080 --> 01:51:09,840 DISPARITIES AND ADVERSITY 3030 01:51:09,840 --> 01:51:11,160 EXPOSURE AND THIS WAS USING DATA 3031 01:51:11,160 --> 01:51:15,680 FROM THE BASELINE VISIT IN ABCD, 3032 01:51:15,680 --> 01:51:18,560 SO THE AGES WERE ABOUT 9 AND 10. 3033 01:51:18,560 --> 01:51:20,520 WE LOOKED IN EXPOSURE TO 3034 01:51:20,520 --> 01:51:22,960 ADVERSITY AS A FIRST LOOK AT THE 3035 01:51:22,960 --> 01:51:23,160 DATA. 3036 01:51:23,160 --> 01:51:26,400 IT THEN RAN MODELS TO ASSESS 3037 01:51:26,400 --> 01:51:33,480 RACE RELATED DIFFERENCES IN GRAY 3038 01:51:33,480 --> 01:51:39,360 MATTERED VOLUME. 3039 01:51:39,360 --> 01:51:42,200 SO THERE WERE 14 BRAIN REGIONS 3040 01:51:42,200 --> 01:51:44,440 THAT WERE DEFINED EACH OF WHICH 3041 01:51:44,440 --> 01:51:47,000 IS ITS OWN DEPENDENT VARIABLE IN 3042 01:51:47,000 --> 01:51:49,680 EACH OF THESE MODELS AND THEN 3043 01:51:49,680 --> 01:51:51,640 WHETHER ACCOUNTING FOR CHILDHOOD 3044 01:51:51,640 --> 01:51:53,200 ADVERSITY WOULD ATTENUATE THESE 3045 01:51:53,200 --> 01:51:55,200 RACE RELATED DIFFERENCES IN 3046 01:51:55,200 --> 01:51:56,120 REGIONAL BRAIN MATTER VOLUME SO 3047 01:51:56,120 --> 01:51:58,040 THIS IS THE CRUX OF THE PAPER 3048 01:51:58,040 --> 01:52:00,320 AND THEY DID THIS BY CONDUCTING 3049 01:52:00,320 --> 01:52:03,000 PARALLEL MEDIATION MODELS. 3050 01:52:03,000 --> 01:52:04,240 NEXT SLIDE, PLEASE. 3051 01:52:04,240 --> 01:52:05,600 SO THE FIRST THING TO NOTE IS 3052 01:52:05,600 --> 01:52:07,720 THAT THEY SHOWED 3053 01:52:07,720 --> 01:52:09,960 DISPROPORTIONATE ADVERSITY 3054 01:52:09,960 --> 01:52:10,960 EXPOSURE IN BLACK YOUTH. 3055 01:52:10,960 --> 01:52:12,240 THIS IS SHOWN IN THIS TABLE. 3056 01:52:12,240 --> 01:52:13,880 THIS IS CONSISTENT ACROSS ALL 3057 01:52:13,880 --> 01:52:16,360 THE ADVERSITY METRICS. 3058 01:52:16,360 --> 01:52:19,120 CARE GIVERS OF BLACK YOUTH ALSO 3059 01:52:19,120 --> 01:52:20,800 HAD LOWER EDUCATIONAL 3060 01:52:20,800 --> 01:52:23,200 ATTAINMENT, LOWER INCOME AND 3061 01:52:23,200 --> 01:52:24,640 EMPLOYMENT COMPARED WITH THOSE 3062 01:52:24,640 --> 01:52:26,040 OF WHITE YOUTH. 3063 01:52:26,040 --> 01:52:30,320 BLACK YOUTH ALSO HAD LOWER BRAIN 3064 01:52:30,320 --> 01:52:33,480 USE, BUT CRITICALLY THE BRAIN 3065 01:52:33,480 --> 01:52:36,680 VOLUME DIFFERENCES VARIED WITH 3066 01:52:36,680 --> 01:52:39,840 ADVERSITY METRICS WITH INCOME 3067 01:52:39,840 --> 01:52:43,840 BEING THE MOST FREQUENT 3068 01:52:43,840 --> 01:52:46,880 PREDICTOR AND DISPARITIES 3069 01:52:46,880 --> 01:52:48,040 PARTIALLY MEDIATED SOME OF THESE 3070 01:52:48,040 --> 01:52:49,040 DIFFERENCES. SO ACCOUNTING FOR 3071 01:52:49,040 --> 01:52:51,240 DIFFERENCES IN EXPOSURE TO 3072 01:52:51,240 --> 01:52:53,600 ADVERSITY PARTIALLY MEDIATED THE 3073 01:52:53,600 --> 01:52:55,480 RACE RELATED DIFFERENCE AND THIS 3074 01:52:55,480 --> 01:52:57,840 IS A GRAPHIC THAT SHOWS REGIONS 3075 01:52:57,840 --> 01:53:00,680 WITHIN THE FRONTAL LOBE THAT HAD 3076 01:53:00,680 --> 01:53:02,000 THIS PARTIAL MEDIATION EFFECT. 3077 01:53:02,000 --> 01:53:04,880 THERE ARE ALSO REGIONS HERE THAT 3078 01:53:04,880 --> 01:53:06,800 DID NOT HAVE A MEDIATION EFFECT 3079 01:53:06,800 --> 01:53:09,080 AND SO THIS KIND OF RAISES THE 3080 01:53:09,080 --> 01:53:11,640 QUESTION ABOUT FOR EXAMPLE, WHY 3081 01:53:11,640 --> 01:53:13,520 THE AMYGDALA AND THE HIPPOCAMPUS 3082 01:53:13,520 --> 01:53:16,760 WHICH ARE ALSO THESE EMOTIONAL 3083 01:53:16,760 --> 01:53:18,920 AREAS, WHY THIS DID NOT SURVIVE 3084 01:53:18,920 --> 01:53:20,160 THE PARTIAL MEDIATION ANALYSIS 3085 01:53:20,160 --> 01:53:23,120 AND I PUT DOWN HERE IN THIS BOX 3086 01:53:23,120 --> 01:53:26,000 ADDITIONAL SOCIO DEMOGRAPHIC 3087 01:53:26,000 --> 01:53:27,440 VARIABLES THAT ARE AVAILABLE IN 3088 01:53:27,440 --> 01:53:30,360 ABCD BUT NOT INCLUDED IN THESE 3089 01:53:30,360 --> 01:53:30,600 ANALYSIS. 3090 01:53:30,600 --> 01:53:34,600 PERCEIVED DISCRIMINATION, SCHOOL 3091 01:53:34,600 --> 01:53:36,680 CONTEXTUAL MATTERS AND CENSUS 3092 01:53:36,680 --> 01:53:41,520 BASED MEASURES OF SYSTEMIC 3093 01:53:41,520 --> 01:53:43,000 INEQUITIES. SO THE PAPER I JUST 3094 01:53:43,000 --> 01:53:44,920 WANTED TO HIGHLIGHT SOME OF THE 3095 01:53:44,920 --> 01:53:46,960 PRESS AND THE COMMENTARIES THAT 3096 01:53:46,960 --> 01:53:48,320 HAVE FOLLOWED THE PUBLICATION OF 3097 01:53:48,320 --> 01:53:52,920 THIS PAPER, MOST NOTELY A 3098 01:53:52,920 --> 01:53:55,360 COMMENTARY WHO NOTES THAT THE 3099 01:53:55,360 --> 01:53:56,280 FINDINGS BEGIN TO CORRECT THE 3100 01:53:56,280 --> 01:53:58,560 LONG HISTORY OF REPORTING OF 3101 01:53:58,560 --> 01:54:00,360 DIFFERENCES IN HEALTH, 3102 01:54:00,360 --> 01:54:03,200 BEHAVIORAL AND NEURAL OUTCOMES 3103 01:54:03,200 --> 01:54:04,880 AATTRIBUTED TO RACE AND/OR 3104 01:54:04,880 --> 01:54:05,200 ETHNICITY. 3105 01:54:05,200 --> 01:54:09,800 YOU CAN SEE HERE A FEW OF MANY, 3106 01:54:09,800 --> 01:54:11,440 MANY NEWS ACCOUNTS OF THESE 3107 01:54:11,440 --> 01:54:13,680 FINDINGS AND EACH OF THEM REALLY 3108 01:54:13,680 --> 01:54:18,520 HIGHLIGHTS THIS NUANCED FINDING. 3109 01:54:18,520 --> 01:54:21,320 SO YOU'LL NOTE THAT NONE OF THEM 3110 01:54:21,320 --> 01:54:23,920 FOCUS ON BLACK VERSUS WHITE. 3111 01:54:23,920 --> 01:54:26,520 AND THEN SOME QUESTIONS AND 3112 01:54:26,520 --> 01:54:28,880 CHALLENGES THAT HAVE EMERGED AND 3113 01:54:28,880 --> 01:54:30,680 ONE THING THAT IS WONDERFUL 3114 01:54:30,680 --> 01:54:32,400 ABOUT A PAPER LIKE THIS, IT'S A 3115 01:54:32,400 --> 01:54:35,680 REALLY NICE EXAMPLE OF HOW ABC 3116 01:54:35,680 --> 01:54:38,680 DATA SHOULD BE USED, SHOULD BE 3117 01:54:38,680 --> 01:54:41,000 INTERPRETED, EDITORIZED AND THEN 3118 01:54:41,000 --> 01:54:42,400 REPORTED ON BY THE PRESS. I 3119 01:54:42,400 --> 01:54:43,360 HOPE IT'S SOMETHING THAT 3120 01:54:43,360 --> 01:54:44,240 CONTINUES IN THE FUTURE. 3121 01:54:44,240 --> 01:54:46,280 I THINK IT'S A GREAT EXAMPLE OF 3122 01:54:46,280 --> 01:54:49,880 HOW WE CAN HAVE RICH AND ROBUST 3123 01:54:49,880 --> 01:54:50,680 DISCUSSION ABOUT REALLY 3124 01:54:50,680 --> 01:54:51,920 DIFFICULT QUESTIONS AND 3125 01:54:51,920 --> 01:54:53,320 CHALLENGES, SOME OF WHICH ARE 3126 01:54:53,320 --> 01:54:53,920 NOTED HERE. 3127 01:54:53,920 --> 01:54:56,840 FOR EXAMPLE, IMPORTANTLY WHAT 3128 01:54:56,840 --> 01:54:59,560 HAPPENS AT COST DEVELOPMENT. 3129 01:54:59,560 --> 01:55:01,600 THIS DATA FROM BASELINE. 3130 01:55:01,600 --> 01:55:03,440 HOW MIGHT THEY CHANGE ACROSS 3131 01:55:03,440 --> 01:55:05,160 DEVELOPMENT WITH ADDITIONAL 3132 01:55:05,160 --> 01:55:06,760 ENVIRONMENT TALL CONTRIBUTIONS, 3133 01:55:06,760 --> 01:55:08,240 RACIAL DISPARITY AS I POINTED 3134 01:55:08,240 --> 01:55:12,080 OUT AND ADVERSITY ONLY PARTIALLY 3135 01:55:12,080 --> 01:55:15,800 IN GRAY MATTER VOLUME BUT IT 3136 01:55:15,800 --> 01:55:16,480 EXCLUDED OTHER CONSTRUCTS. 3137 01:55:16,480 --> 01:55:18,080 THIS IS NOT ANY KIND OF 3138 01:55:18,080 --> 01:55:19,080 INTENTIONAL EXCLUSION. 3139 01:55:19,080 --> 01:55:21,280 IT'S JUST THE KIND OF DATA 3140 01:55:21,280 --> 01:55:22,320 ANALYSIS THAT THEY CONDUCTED BUT 3141 01:55:22,320 --> 01:55:24,280 IT DOES LEAVE THE READER WITH 3142 01:55:24,280 --> 01:55:25,160 THE POTENTIAL IMPRESSION THAT 3143 01:55:25,160 --> 01:55:27,520 RACE CONTINUES TO ACCOUNT FOR 3144 01:55:27,520 --> 01:55:28,720 BRAIN VOLUME EVEN AFTER 3145 01:55:28,720 --> 01:55:31,320 CONSIDERING SOCIAL FACTORS. 3146 01:55:31,320 --> 01:55:33,360 AND THE REALLY I THINK ROBUST 3147 01:55:33,360 --> 01:55:34,760 DISCUSSION TOPIC THAT WE CAN 3148 01:55:34,760 --> 01:55:36,280 MAYBE TURN TO DURING THE 3149 01:55:36,280 --> 01:55:37,680 DISCUSSION SECTION TODAY IS 3150 01:55:37,680 --> 01:55:38,880 SHOULD WE AVOID FRAMING THIS 3151 01:55:38,880 --> 01:55:41,400 KIND OF WORK IN THE CONTEXT OF 3152 01:55:41,400 --> 01:55:43,600 RACE DIFFERENCES IN BRAIN OR 3153 01:55:43,600 --> 01:55:48,240 BEHAVIOR ALTOGETHER AND INSTEAD 3154 01:55:48,240 --> 01:55:49,320 FOCUS DIRECTLY ON SOCIAL 3155 01:55:49,320 --> 01:55:56,840 DETERMINANTS OF HEALTH AND MANY 3156 01:55:56,840 --> 01:55:59,040 OTHERS FACE MORE SOCIAL 3157 01:55:59,040 --> 01:56:00,000 DETERMINANTS OF HEALTH. 3158 01:56:00,000 --> 01:56:01,560 I WILL STOP THERE AND LOOK FOR 3159 01:56:01,560 --> 01:56:03,120 WARD TO DISCUSSION LATER. 3160 01:56:03,120 --> 01:56:04,480 >>THANK YOU. 3161 01:56:04,480 --> 01:56:06,440 SOME VERY PROVOCATIVE QUESTIONS 3162 01:56:06,440 --> 01:56:08,160 THAT WE MIGHT BE ABLE TO ADDRESS 3163 01:56:08,160 --> 01:56:10,200 IN THE DISCUSSION SESSION. I'D 3164 01:56:10,200 --> 01:56:11,760 LIKE TO CONCLUDE BY TALKING A 3165 01:56:11,760 --> 01:56:13,280 LITTLE BIT ABOUT RESEARCH 3166 01:56:13,280 --> 01:56:13,600 DISSEMINATION. 3167 01:56:13,600 --> 01:56:16,120 THESE ARE WHAT WE HOPED IN TERMS 3168 01:56:16,120 --> 01:56:17,640 OF RESEARCH THAT PEOPLE WOULD DO 3169 01:56:17,640 --> 01:56:21,120 WITH THE DATA SET AND THAT IT 3170 01:56:21,120 --> 01:56:24,120 WOULD SPUR OTHER RESEARCH IN THE 3171 01:56:24,120 --> 01:56:28,320 OTHER AREAS. 3172 01:56:28,320 --> 01:56:31,880 AND I WANT TO HIGHLIGHT A PAPER 3173 01:56:31,880 --> 01:56:33,080 THAT RECENTLY CAME OUT JUST LAST 3174 01:56:33,080 --> 01:56:34,920 WEEK THAT REALLY, THAT NORA 3175 01:56:34,920 --> 01:56:35,920 MENTIONED YESTERDAY IN HER 3176 01:56:35,920 --> 01:56:37,600 COUNCIL PRESENTATION, BUT IT 3177 01:56:37,600 --> 01:56:39,680 REALLY SPEAKS TO BEING ABLE TO 3178 01:56:39,680 --> 01:56:41,160 INFORM POLICY AND PRACTICE WHICH 3179 01:56:41,160 --> 01:56:43,040 WAS ON THAT LAST SLIDE AND YOU 3180 01:56:43,040 --> 01:56:44,440 KNOW, I DON'T HAVE A LOT OF TIME 3181 01:56:44,440 --> 01:56:47,000 TO GO INTO THE STUDY, BUT WHAT 3182 01:56:47,000 --> 01:56:51,880 IT DID WAS LOOK AT BOTH 3183 01:56:51,880 --> 01:56:52,400 HIPPOCAMPAL VOLUME AND 3184 01:56:52,400 --> 01:56:53,640 INTERNALIZING SYMPTOMS AMONG 3185 01:56:53,640 --> 01:56:54,960 YOUTH THAT WERE GROWING UP IN 3186 01:56:54,960 --> 01:56:56,640 HIGH COST OF LIVING OR LOW COST 3187 01:56:56,640 --> 01:56:58,680 OF LIVING STATES AND THE 3188 01:56:58,680 --> 01:57:00,080 DISPARITY BETWEEN LOW INCOME AND 3189 01:57:00,080 --> 01:57:01,560 HIGH INCOME YOUTH AND 3190 01:57:01,560 --> 01:57:02,800 ESSENTIALLY WHAT THEY FOUND WAS 3191 01:57:02,800 --> 01:57:04,680 THAT IN HIGH COST OF LIVING 3192 01:57:04,680 --> 01:57:08,320 STATES THAT HAD HIGH CASH 3193 01:57:08,320 --> 01:57:11,720 BENEFITS, THE DISPARITY BETWEEN 3194 01:57:11,720 --> 01:57:13,960 LOW INCOME AND HIGH INCOME YOUTH 3195 01:57:13,960 --> 01:57:16,680 BOTH IN INTERNALIZING SYMPTOMS 3196 01:57:16,680 --> 01:57:19,560 AND THE HIPPOCAMPAL VOLUME WAS 3197 01:57:19,560 --> 01:57:19,800 REDUCED. 3198 01:57:19,800 --> 01:57:21,680 THIS HAS RECEIVED QUITE A BIT OF 3199 01:57:21,680 --> 01:57:23,400 ATTENTION AND THIS IS A NICE 3200 01:57:23,400 --> 01:57:25,800 PARTNERSHIP BETWEEN THE SCIENCE 3201 01:57:25,800 --> 01:57:27,000 AND OUR PRESS TEAM WHO PUT OUT A 3202 01:57:27,000 --> 01:57:29,040 PRESS RELEASE WHEN THIS CAME OUT 3203 01:57:29,040 --> 01:57:31,240 AND IN JUST LESS THAN A WEEK 3204 01:57:31,240 --> 01:57:33,680 THERE WERE OVER 330 NEWS STORIES 3205 01:57:33,680 --> 01:57:35,800 HIGHLIGHTING THIS IMPORTANT 3206 01:57:35,800 --> 01:57:37,720 FINDING OF SOMETHING THAT IS 3207 01:57:37,720 --> 01:57:38,680 CLEARLY ACTIONABLE THAT CAN BE 3208 01:57:38,680 --> 01:57:42,360 DONE TO REDUCE SOME OF THESE 3209 01:57:42,360 --> 01:57:42,680 DISPARITIES 3210 01:57:42,680 --> 01:57:44,040 >>IN ADDITION TO THAT I 3211 01:57:44,040 --> 01:57:45,720 MENTIONED AT THE BEGINNING THAT 3212 01:57:45,720 --> 01:57:47,320 ABCD HAS BEEN DOING A LOT TO 3213 01:57:47,320 --> 01:57:49,600 ENGAGE OUR FAMILIES BETTER AND 3214 01:57:49,600 --> 01:57:53,040 REALLY TO SHOW THEM WHAT THEIR 3215 01:57:53,040 --> 01:57:54,080 CONTRIBUTIONS HAVE MADE TO 3216 01:57:54,080 --> 01:57:54,840 SCIENCE. 3217 01:57:54,840 --> 01:57:58,680 AND IN THAT RESPECT, WE LED BY 3218 01:57:58,680 --> 01:58:01,560 ELIZABETH HOFFMAN WE DEVELOPED 3219 01:58:01,560 --> 01:58:02,320 AN INTO GRAPHIC REALLY TO 3220 01:58:02,320 --> 01:58:04,800 HIGHLIGHT SOME OF FINDINGS FROM 3221 01:58:04,800 --> 01:58:06,480 ABCD IN LANGUAGE THAT EVERYBODY 3222 01:58:06,480 --> 01:58:08,640 CAN UNDERSTAND AND WE STARTED 3223 01:58:08,640 --> 01:58:10,480 WITH SCREEN TIME BECAUSE THAT'S 3224 01:58:10,480 --> 01:58:11,720 PROBABLY THE QUESTION WE GET 3225 01:58:11,720 --> 01:58:14,320 ASKED MOST IS WHAT IS THE STUDY 3226 01:58:14,320 --> 01:58:15,200 SHOWING ABOUT SCREEN TIME. 3227 01:58:15,200 --> 01:58:16,720 OUR FAMILIES ARE VERY MUCH 3228 01:58:16,720 --> 01:58:17,680 INTERESTED IN THIS. 3229 01:58:17,680 --> 01:58:19,800 SO OUR COMMUNICATIONS ENGAGEMENT 3230 01:58:19,800 --> 01:58:21,400 AND DISSEMINATION TEAM PUT 3231 01:58:21,400 --> 01:58:22,960 TOGETHER -- AND OUR RETENTION 3232 01:58:22,960 --> 01:58:24,480 WORK GROUP ACTUALLY WENT THROUGH 3233 01:58:24,480 --> 01:58:26,640 THE FINDINGS THAT ARE RELATED TO 3234 01:58:26,640 --> 01:58:28,880 SCREEN TIME, DISTILLED THEM INTO 3235 01:58:28,880 --> 01:58:34,520 MESSAGES THAT COULD BE EASILY 3236 01:58:34,520 --> 01:58:35,400 COMMUNICATED IN AN INFO GRAPHIC. 3237 01:58:35,400 --> 01:58:37,400 IT WAS DISSEMINATED TO OUR 3238 01:58:37,400 --> 01:58:39,000 FAMILIES AND ADVISORY GROUPS AND 3239 01:58:39,000 --> 01:58:45,240 IT'S GOTTEN PICKUP WITH OTHER 3240 01:58:45,240 --> 01:58:47,800 ORGANIZATIONS. MORE RECENTLY, 3241 01:58:47,800 --> 01:58:49,720 WE TRANSLATED THIS INFO GRAPHIC 3242 01:58:49,720 --> 01:58:53,200 INTO A WEBINAR FOR FAMILIES 3243 01:58:53,200 --> 01:58:56,040 WHERE WE INVITED SOME OF THE 3244 01:58:56,040 --> 01:58:57,920 RESEARCHERS WHOSE WORK WAS 3245 01:58:57,920 --> 01:58:59,160 HIGHLIGHTED IN THE INFO GRAPHIC 3246 01:58:59,160 --> 01:59:00,520 AND THIS WEBINAR WAS DESIGNED 3247 01:59:00,520 --> 01:59:03,600 FOR OUR FAMILIES SO THEY COULD 3248 01:59:03,600 --> 01:59:06,560 COME AND HEAR THE SPEAKERS TALK 3249 01:59:06,560 --> 01:59:08,320 ABOUT THEIR FINDINGS, BUT MORE 3250 01:59:08,320 --> 01:59:09,680 IMPORTANTLY WE SET ASIDE 45 3251 01:59:09,680 --> 01:59:10,760 MINUTES FOR THEM TO ASK 3252 01:59:10,760 --> 01:59:13,360 QUESTIONS OF THE SPEAKERS AS A 3253 01:59:13,360 --> 01:59:15,440 REAL OPPORTUNITY NOT ONLY TO SEE 3254 01:59:15,440 --> 01:59:17,400 WHAT WAS COMING OUT OF THEIR 3255 01:59:17,400 --> 01:59:18,520 PARTICIPATION IN THE STUDY BUT 3256 01:59:18,520 --> 01:59:20,320 ALSO TO GET THEIR OWN QUESTIONS 3257 01:59:20,320 --> 01:59:22,240 ANSWERED ABOUT WHAT IS OF 3258 01:59:22,240 --> 01:59:23,000 INTEREST DO THEM. 3259 01:59:23,000 --> 01:59:23,960 AND THIS ALL HAPPENED LAST 3260 01:59:23,960 --> 01:59:24,320 THURSDAY. 3261 01:59:24,320 --> 01:59:27,840 SO IT'S KIND OF HOT OFF THE 3262 01:59:27,840 --> 01:59:28,720 PRESSES. 3263 01:59:28,720 --> 01:59:32,200 AND WE HAD ABOUT 250 NONFEDERAL 3264 01:59:32,200 --> 01:59:34,160 EMPLOYEES OR WEBINAR STAFF 3265 01:59:34,160 --> 01:59:37,080 PARTICIPATE IN THIS FIRST 3266 01:59:37,080 --> 01:59:38,320 WEBINAR AND NEARLY 3267 01:59:38,320 --> 01:59:43,280 (INDISCERNIBLE) OF THOSE WERE -- 3268 01:59:43,280 --> 01:59:43,920 IDENTIFIED THEMSELVES AS PARENTS 3269 01:59:43,920 --> 01:59:46,840 OR CARE GIVERS OF ABCD USE. 3270 01:59:46,840 --> 01:59:49,360 I'M GUESSING PEOPLE IN THE OTHER 3271 01:59:49,360 --> 01:59:50,680 CATEGORY ARE ALSO PARTICIPANTS 3272 01:59:50,680 --> 01:59:52,160 BUT THIS IS WHAT WE WANTED TO 3273 01:59:52,160 --> 01:59:52,320 SEE. 3274 01:59:52,320 --> 01:59:54,320 WE WANT TO GIVE BACK TO OUR 3275 01:59:54,320 --> 01:59:56,000 FAMILIES THE INFORMATION THAT WE 3276 01:59:56,000 --> 01:59:57,520 ARE LEARNING FROM ALL OF THE -- 3277 01:59:57,520 --> 01:59:59,080 ALL THAT THEY CONTRIBUTE TO THE 3278 01:59:59,080 --> 01:59:59,560 STUDY. 3279 01:59:59,560 --> 02:00:01,440 SO THIS WAS OUR FIRST FORAY INTO 3280 02:00:01,440 --> 02:00:01,960 THIS. 3281 02:00:01,960 --> 02:00:04,920 WE'VE GOT OTHER INFO GRAPHICS 3282 02:00:04,920 --> 02:00:05,160 PLANNED. 3283 02:00:05,160 --> 02:00:07,400 ONE ON SLEEP, ONE ON COVID AND 3284 02:00:07,400 --> 02:00:09,800 WE PLAN TO DO THESE WEBINARS AND 3285 02:00:09,800 --> 02:00:11,080 I'LL SPEAK FOR ELIZABETH WHERE 3286 02:00:11,080 --> 02:00:12,640 THIS IS ONE OF THE HIGHLIGHTS 3287 02:00:12,640 --> 02:00:14,040 CERTAINLY OF THE WORK THAT WE'VE 3288 02:00:14,040 --> 02:00:15,640 DONE IN THE LAST COUPLE OF WEEKS 3289 02:00:15,640 --> 02:00:18,440 SO WE'RE REALLY EXCITED ABOUT 3290 02:00:18,440 --> 02:00:18,760 THAT. 3291 02:00:18,760 --> 02:00:20,640 SO WITH THAT I'D JUST LIKE TO 3292 02:00:20,640 --> 02:00:21,240 THANK EVERYBODY. 3293 02:00:21,240 --> 02:00:23,240 THANK ALL OF THE PARTNERS. 3294 02:00:23,240 --> 02:00:25,080 THIS IS A HUGE COLLABORATION 3295 02:00:25,080 --> 02:00:27,080 ACROSS NIH AND OTHER FEDERAL 3296 02:00:27,080 --> 02:00:27,320 STAFF. 3297 02:00:27,320 --> 02:00:29,520 THANK THE RESEARCHERS AT THE 3298 02:00:29,520 --> 02:00:31,320 SITES, THE DATA CENTER, HUNDREDS 3299 02:00:31,320 --> 02:00:34,440 OF INVESTIGATORS AND TRAINEES 3300 02:00:34,440 --> 02:00:40,680 BUT MORE IMPORTANTLY ID I'D LIKE 3301 02:00:40,680 --> 02:00:42,000 TO THANK ALL OF THE RESEARCH 3302 02:00:42,000 --> 02:00:43,320 ASSISTANTS AND STAFF AND ALSO 3303 02:00:43,320 --> 02:00:44,200 GETTING EVERYBODY BACK ON TRACK 3304 02:00:44,200 --> 02:00:45,840 AS WE ARE EMERGING FROM THE 3305 02:00:45,840 --> 02:00:48,040 PANDEMIC AND THEN TO THE NEARLY 3306 02:00:48,040 --> 02:00:49,440 12,000 PARTICIPANTS AND FAMILIES 3307 02:00:49,440 --> 02:00:52,480 WHO HAVE GIVEN US SO MUCH OVER 3308 02:00:52,480 --> 02:00:53,080 THE YEARS AND CONTINUE TO BE 3309 02:00:53,080 --> 02:00:55,040 REALLY DEDICATED TO THE STUDY 3310 02:00:55,040 --> 02:00:56,280 MOVING FORWARD. 3311 02:00:56,280 --> 02:01:03,720 SO THANK YOU. 3312 02:01:03,720 --> 02:01:05,960 >>I BASICALLY REALIZED THAT WE 3313 02:01:05,960 --> 02:01:07,160 ARE RUNNING LATE BUT I DON'T 3314 02:01:07,160 --> 02:01:09,000 WANT TO CUT OFF THE OPPORTUNITY 3315 02:01:09,000 --> 02:01:10,160 TO HAVE SOME QUESTIONS. 3316 02:01:10,160 --> 02:01:15,120 IS THAT OKAY, MICHELLE? 3317 02:01:15,120 --> 02:01:15,840 >>[ AWAY FROM MICROPHONE ]. 3318 02:01:15,840 --> 02:01:20,160 >>NO, BUT I THINK THAT THIS IS 3319 02:01:20,160 --> 02:01:22,440 SUCH A SPECTACULAR PROGRESS AND 3320 02:01:22,440 --> 02:01:25,120 IT COVERS SO MANY ISSUES THAT I 3321 02:01:25,120 --> 02:01:28,680 DON'T WANT TO -- SO PLEASE, IF 3322 02:01:28,680 --> 02:01:30,400 YOU HAVE QUESTIONS, ASK GAYATHRI 3323 02:01:30,400 --> 02:01:32,240 AND SHE CAN HELP ADDRESS. 3324 02:01:32,240 --> 02:01:36,360 >>THAT WAS JUST AMAZING FOR YOU 3325 02:01:36,360 --> 02:01:37,400 AND ALL THE TEAM. 3326 02:01:37,400 --> 02:01:40,680 IT REALLY I THINK HIGHLIGHTS 3327 02:01:40,680 --> 02:01:43,360 THE -- SOMETHING THAT WE'VE BEEN 3328 02:01:43,360 --> 02:01:46,960 IGNORING WHICH HAS BEEN THE 3329 02:01:46,960 --> 02:01:55,440 SOCIAL DETERMINANTS BUT IMBEDDED 3330 02:01:55,440 --> 02:01:57,360 IS THE TRAUMA PIECE AND ALL THE 3331 02:01:57,360 --> 02:01:59,080 THINGS THAT REALLY STRETCH OUR 3332 02:01:59,080 --> 02:01:59,360 FAMILIES. 3333 02:01:59,360 --> 02:02:01,560 YOU KNOW, AND SO THE -- I GUESS 3334 02:02:01,560 --> 02:02:05,680 THE ONE THING THAT IS REALLY 3335 02:02:05,680 --> 02:02:06,560 JARRING AND COMING AT IT, WE'VE 3336 02:02:06,560 --> 02:02:07,960 KNOWN SOME OF THESE THINGS AND 3337 02:02:07,960 --> 02:02:10,720 LOOKING AT IT IN TERMS OF THE 3338 02:02:10,720 --> 02:02:13,320 ABCD STUDY IS REALLY IMPORTANT 3339 02:02:13,320 --> 02:02:16,440 IN DRIVING HOME THE POINT THAT 3340 02:02:16,440 --> 02:02:19,720 WE'RE JUST NOT SET UP TO START 3341 02:02:19,720 --> 02:02:21,640 THINKING ABOUT PREVENTION OR 3342 02:02:21,640 --> 02:02:22,200 ADDRESSING THIS. 3343 02:02:22,200 --> 02:02:23,400 AND THERE FINDS TO BE A 3344 02:02:23,400 --> 02:02:24,840 FRAMEWORK BASED ON THESE DATA 3345 02:02:24,840 --> 02:02:26,240 AND THESE ARE NOT COMPLETELY 3346 02:02:26,240 --> 02:02:27,160 NEW. 3347 02:02:27,160 --> 02:02:28,600 THEY'RE NOT SURPRISING. 3348 02:02:28,600 --> 02:02:33,000 SO I THINK THAT IS ONE BIG, BIG 3349 02:02:33,000 --> 02:02:34,760 THING THAT IS JUST, YOU KNOW, 3350 02:02:34,760 --> 02:02:36,320 JUMPING OUT AT ME, BUT THE OTHER 3351 02:02:36,320 --> 02:02:38,800 PIECE I THINK THAT I WOULD LIKE 3352 02:02:38,800 --> 02:02:40,320 TO ASK A QUESTION ABOUT AND I 3353 02:02:40,320 --> 02:02:41,920 KNOW WE'VE TALKED ABOUT THIS 3354 02:02:41,920 --> 02:02:43,160 OVER THE YEARS ABOUT HOW TRAUMA 3355 02:02:43,160 --> 02:02:45,640 IS BEING ASSESSED AND HOW 3356 02:02:45,640 --> 02:02:47,360 TREATMENT IS BEING ASSESSED AND 3357 02:02:47,360 --> 02:02:49,360 THERE WERE SOME ISSUES EARLY ON 3358 02:02:49,360 --> 02:02:51,720 ABOUT HOW MUCH ASSESSMENT TO DO 3359 02:02:51,720 --> 02:02:54,880 AND SO I'VE COME BACK TO THAT 3360 02:02:54,880 --> 02:02:56,200 BECAUSE YOU'RE SEE THG AS A VERY 3361 02:02:56,200 --> 02:02:58,080 IMPORTANT KEY FINDING OR KEY 3362 02:02:58,080 --> 02:02:59,640 RISK FACTOR, AND SO COULD YOU 3363 02:02:59,640 --> 02:03:01,760 SPEAK A LITTLE BIT TO WHETHER 3364 02:03:01,760 --> 02:03:04,360 THOSE ASSESSMENTS HAVE 3365 02:03:04,360 --> 02:03:06,680 BROADENED, WHETHER YOU'RE SEEING 3366 02:03:06,680 --> 02:03:08,840 THE ABILITY TO LOOK AT 3367 02:03:08,840 --> 02:03:13,160 MALTREATMENT OR EVEN EMOTIONAL 3368 02:03:13,160 --> 02:03:13,960 DISREGULATION IN MULTIPLE WAYS 3369 02:03:13,960 --> 02:03:16,080 AS THE CHILDREN ARE GROWING 3370 02:03:16,080 --> 02:03:17,120 EARLIER AND, YOU KNOW, AROUND 3371 02:03:17,120 --> 02:03:17,760 THAT ISSUE. 3372 02:03:17,760 --> 02:03:18,760 >>CERTAINLY. 3373 02:03:18,760 --> 02:03:19,160 YEAH. 3374 02:03:19,160 --> 02:03:20,360 YOU KNOW, ONE OF THE THINGS I 3375 02:03:20,360 --> 02:03:22,160 THINK WE TALKED ABOUT A FEW 3376 02:03:22,160 --> 02:03:23,360 YEARS AGO WHEN WE WERE 3377 02:03:23,360 --> 02:03:24,680 DISCUSSING THAT WERE THAT THE 3378 02:03:24,680 --> 02:03:26,000 YOUTH WERE SO YOUNG THAT WE WERE 3379 02:03:26,000 --> 02:03:26,840 GETTING A LOT OF THE INFORMATION 3380 02:03:26,840 --> 02:03:28,880 FROM THE CARE GIVERS AND THAT 3381 02:03:28,880 --> 02:03:31,080 MIGHT NOT BE THE BEST TO GET AT 3382 02:03:31,080 --> 02:03:32,240 SOME OF THIS INFORMATION. 3383 02:03:32,240 --> 02:03:35,360 SO NOW THAT THE YOUTH HAVE 3384 02:03:35,360 --> 02:03:36,680 GOTTEN OLDER WE ARE ASKING THEM 3385 02:03:36,680 --> 02:03:38,680 MORE QUESTIONING DIRECTLY WHERE 3386 02:03:38,680 --> 02:03:40,520 WE ARE ASKING THEM -- YOU KNOW, 3387 02:03:40,520 --> 02:03:42,760 THE PTSD MODULE TO GET AT LEAST 3388 02:03:42,760 --> 02:03:45,400 SOME OF THE REPORTING DIRECTLY 3389 02:03:45,400 --> 02:03:46,560 FROM THE YOUTH. 3390 02:03:46,560 --> 02:03:47,600 BUT YOU'RE RIGHT. 3391 02:03:47,600 --> 02:03:50,960 IT'S A COMPLICATED AREA THAT -- 3392 02:03:50,960 --> 02:03:53,040 FOR US TO BE ABLE TO COLLECT 3393 02:03:53,040 --> 02:03:54,480 THAT INFORMATION, BUT THAT'S 3394 02:03:54,480 --> 02:03:57,360 BEEN MORE HOW WE'VE EXPANDED IT. 3395 02:03:57,360 --> 02:03:59,560 I DON'T KNOW, KIM, IF YOU KNOW 3396 02:03:59,560 --> 02:04:01,640 THERE ARE OTHER AREAS IN THE 3397 02:04:01,640 --> 02:04:02,840 MENTAL HEALTH SPACE THAT WE'VE 3398 02:04:02,840 --> 02:04:05,320 ADDED IN THAT RESPECT? 3399 02:04:05,320 --> 02:04:06,000 >>I JUST WANT TO FOLLOW UP 3400 02:04:06,000 --> 02:04:08,320 BECAUSE WE ARE SO PROGRAMMED TO 3401 02:04:08,320 --> 02:04:10,360 THINK ABOUT ILLNESS, PTSD. 3402 02:04:10,360 --> 02:04:13,400 BUT TRAUMA IS NOT ONLY RISK 3403 02:04:13,400 --> 02:04:16,600 FACTOR FOR PTSD AND IN FACT 3404 02:04:16,600 --> 02:04:19,520 IT'S -- FOR CRAN IT'S A RISK 3405 02:04:19,520 --> 02:04:21,240 FACTOR FOR CANCER, PHYSICAL, ALL 3406 02:04:21,240 --> 02:04:23,400 OUR HEALTH BEHAVIORS, 3407 02:04:23,400 --> 02:04:25,840 ALCOHOLISM, AND SO I THINK THE 3408 02:04:25,840 --> 02:04:29,160 ABILITY TO REALLY SORT OF CALL 3409 02:04:29,160 --> 02:04:31,520 TRAUMA IN DIFFERENT WAYS AS WELL 3410 02:04:31,520 --> 02:04:32,320 AS -- 3411 02:04:32,320 --> 02:04:36,680 >>SO THE MODEL DOES ASK ABOUT 3412 02:04:36,680 --> 02:04:40,560 SPECIFIC EVENTS. 3413 02:04:40,560 --> 02:04:42,920 WE ALSO HAVE A MEASURE THAT IS 3414 02:04:42,920 --> 02:04:44,840 CALLED LIFE EVENTS AND WE'RE NOW 3415 02:04:44,840 --> 02:04:46,520 ASKING THE YOUTHS ABOUT THESE 3416 02:04:46,520 --> 02:04:48,120 EVENTS IN THEIR LIVES RATHER 3417 02:04:48,120 --> 02:04:49,800 THAN GETTING THE INFORMATION 3418 02:04:49,800 --> 02:04:50,680 JUST FROM THE PARENTS. 3419 02:04:50,680 --> 02:04:53,640 >>I THINK IT COMES BACK TO YOUR 3420 02:04:53,640 --> 02:04:54,960 ISSUE OF RACE AND WHETHER RACE 3421 02:04:54,960 --> 02:04:56,200 SHOULD BE PULLED OUT BECAUSE 3422 02:04:56,200 --> 02:04:57,880 ACTUALLY THERE'S A LOT THAT RACE 3423 02:04:57,880 --> 02:05:01,080 IS JUST REALLY A PROXY FOR -- 3424 02:05:01,080 --> 02:05:01,360 >>RIGHT. 3425 02:05:01,360 --> 02:05:03,160 AND ONE THING I DIDN'T MENTION 3426 02:05:03,160 --> 02:05:04,040 THAT WE HAVE BEEN DOING MORE OF 3427 02:05:04,040 --> 02:05:06,080 IN THE LAST COUPLE OF DATA 3428 02:05:06,080 --> 02:05:08,080 RELEASES IS BRINGING DATA IN 3429 02:05:08,080 --> 02:05:09,360 FROM EXTERNAL DATA SETS THAT 3430 02:05:09,360 --> 02:05:11,400 SPEAK TO THINGS THAT ARE THERE 3431 02:05:11,400 --> 02:05:14,040 THE ENVIRONMENT THAT MAY BE 3432 02:05:14,040 --> 02:05:16,640 CONTEXTUALIZING, SO EXPOSURE TO 3433 02:05:16,640 --> 02:05:19,000 POLLUTIONS, EXPOSURE TO CRIME, 3434 02:05:19,000 --> 02:05:20,240 EXPOSURE TO A LOT OF DIFFERENT 3435 02:05:20,240 --> 02:05:21,560 AREAS THAT ARE IN THE 3436 02:05:21,560 --> 02:05:22,880 ENVIRONMENT THAT REALLY -- THAT 3437 02:05:22,880 --> 02:05:24,440 CAN ENHANCE THE DATA SET WITHOUT 3438 02:05:24,440 --> 02:05:26,680 ADDING BURDEN TO THE 3439 02:05:26,680 --> 02:05:28,080 PARTICIPANTS BUT REALLY SPEAK TO 3440 02:05:28,080 --> 02:05:29,800 SOME OF THOSE MOD FINAL FACTORS 3441 02:05:29,800 --> 02:05:31,440 BECAUSE AGAIN, THAT'S REALLY 3442 02:05:31,440 --> 02:05:34,600 WHERE WE WANT TO BE IS IDENTIFY 3443 02:05:34,600 --> 02:05:35,520 THOSE FACTORS THAT WE CAN 3444 02:05:35,520 --> 02:05:37,200 CHANGE, YOU FLOW, IF WE'RE NOT 3445 02:05:37,200 --> 02:05:39,040 ABLE TO ELIMINATE POVERTY, WHAT 3446 02:05:39,040 --> 02:05:40,720 CAN WE DO TO RELIEVE SOME OF 3447 02:05:40,720 --> 02:05:45,720 THOSE BURDENS TO IMPROVE THE 3448 02:05:45,720 --> 02:05:46,800 LIVES OF (INDISCERNIBLE). 3449 02:05:46,800 --> 02:05:49,240 >>THAT WAS JUST A GREAT 3450 02:05:49,240 --> 02:05:50,440 PRESENTATION. THANK YOU SO 3451 02:05:50,440 --> 02:05:50,760 MUCH. 3452 02:05:50,760 --> 02:05:52,680 JUST QUICKLY, I'M SURE YOU'RE 3453 02:05:52,680 --> 02:05:55,880 DOING THIS, BUT I'M INTERESTED 3454 02:05:55,880 --> 02:05:57,480 TO KNOW ABOUT WHAT YOU ARE 3455 02:05:57,480 --> 02:05:58,880 LEARNING ABOUT GENDER 3456 02:05:58,880 --> 02:05:59,160 DIFFERENCES. 3457 02:05:59,160 --> 02:06:02,320 THIS IS AN INCREDIBLY IMPORTANT 3458 02:06:02,320 --> 02:06:03,240 OPPORTUNITY FOR US TO UNDERSTAND 3459 02:06:03,240 --> 02:06:07,760 A RANGE OF FACTORS BIOLOGICAL 3460 02:06:07,760 --> 02:06:11,040 AND SOCIO DEMOGRAPHICS, SDOH 3461 02:06:11,040 --> 02:06:11,360 FACTORS. 3462 02:06:11,360 --> 02:06:13,320 WE HAVE HAD SO MUCH CURIOSITY 3463 02:06:13,320 --> 02:06:15,480 ABOUT ALL OF THESE THINGS IN 3464 02:06:15,480 --> 02:06:17,000 TERMS OF NEURODEVELOPMENT AND 3465 02:06:17,000 --> 02:06:18,880 ALSO THE EXPRESSION OF MENTAL 3466 02:06:18,880 --> 02:06:20,160 HEALTH AND SUBSTANCE USE 3467 02:06:20,160 --> 02:06:22,600 DISORDERS IN GIRLS AND BOYS AND 3468 02:06:22,600 --> 02:06:24,760 THIS IS LIKE SUCH A UNBELIEVABLE 3469 02:06:24,760 --> 02:06:26,760 OPPORTUNITY, SO I'M CURIOUS IF 3470 02:06:26,760 --> 02:06:28,680 YOU'RE ALREADY SEEING OR 3471 02:06:28,680 --> 02:06:29,880 EXPLORING WHAT SOME OF THOSE 3472 02:06:29,880 --> 02:06:31,320 LOOK LIKE AND I'M HOPING YOU'RE 3473 02:06:31,320 --> 02:06:33,520 DOING A LOT OF THINGS AROUND 3474 02:06:33,520 --> 02:06:35,040 MENSTRUAL CYCLE AND OTHER THINGS 3475 02:06:35,040 --> 02:06:37,760 IN THIS STUDY JUST BECAUSE WE 3476 02:06:37,760 --> 02:06:39,360 DON'T KNOW A LOT ABOUT THAT AS 3477 02:06:39,360 --> 02:06:39,800 WELL. 3478 02:06:39,800 --> 02:06:41,920 >>YEAH. 3479 02:06:41,920 --> 02:06:43,440 SO WE OF COURSE AGGREGATE THE 3480 02:06:43,440 --> 02:06:44,840 DATA BY SEX SO WE HAVE A NUMBER 3481 02:06:44,840 --> 02:06:47,760 OF PAPERS AND I'M HAPPY TO GIVE 3482 02:06:47,760 --> 02:06:49,760 YOU KIND OF A SUMMARY OF THAT. 3483 02:06:49,760 --> 02:06:51,600 THERE ARE TOO MANY TO KIND OF GO 3484 02:06:51,600 --> 02:06:53,360 INTO NOW BUT THERE ARE A NUMBER 3485 02:06:53,360 --> 02:06:55,120 OF AREAS THAT PEOPLE ARE LOOKING 3486 02:06:55,120 --> 02:06:56,240 AT SEX DIFFERENCES. 3487 02:06:56,240 --> 02:06:57,200 WE DO COLLECT INFORMATION 3488 02:06:57,200 --> 02:07:00,680 ABOUT -- WE HAVE A WORK SGRUP 3489 02:07:00,680 --> 02:07:01,680 THAT'S FOCUSED ON GENDER DIETTY 3490 02:07:01,680 --> 02:07:04,600 AND SEXUAL HEALTH WHICH HAS BEEN 3491 02:07:04,600 --> 02:07:07,000 INCREASING THE NUMBER OF 3492 02:07:07,000 --> 02:07:08,160 QUESTIONS SO WE'RE ALSO GETTING 3493 02:07:08,160 --> 02:07:10,560 AT ISSUES SUCH AS CONTRACEPTIVE 3494 02:07:10,560 --> 02:07:13,280 USE AND OTHER THINGS THAT ARE 3495 02:07:13,280 --> 02:07:14,560 CONTRIBUTING TO OUTCOMES. SO 3496 02:07:14,560 --> 02:07:16,240 THAT IS DEFINITELY A FOCUS FOR 3497 02:07:16,240 --> 02:07:18,480 US AND I'M HAPPY TO FOLLOW UP 3498 02:07:18,480 --> 02:07:20,280 WITH YOU ABOUT SPECIFIC AREAS 3499 02:07:20,280 --> 02:07:21,440 THAT WE HAVE SOME PAPERS THAT 3500 02:07:21,440 --> 02:07:23,080 ARE DOING THAT. 3501 02:07:23,080 --> 02:07:23,440 >>SURE. 3502 02:07:23,440 --> 02:07:24,480 >>THANK YOU SO MUCH. 3503 02:07:24,480 --> 02:07:25,880 THIS IS GREAT. 3504 02:07:25,880 --> 02:07:30,640 AS A PEDIATRICIAN, THIS IS VERY 3505 02:07:30,640 --> 02:07:32,240 IMPACTFUL AND SOME DATA THAT WE 3506 02:07:32,240 --> 02:07:33,760 CAN ACTUALLY USE IN PRACTICE. 3507 02:07:33,760 --> 02:07:37,280 AS A FORMER POLICY PERSON, I 3508 02:07:37,280 --> 02:07:37,880 HAVE A RECOMMENDATION IF YOU 3509 02:07:37,880 --> 02:07:38,680 HAVEN'T ALREADY DONE THIS. 3510 02:07:38,680 --> 02:07:40,920 THE CENTER FOR MEDICAID AND CHIP 3511 02:07:40,920 --> 02:07:42,600 SERVICES, THE NATIONAL MEDICAID 3512 02:07:42,600 --> 02:07:45,200 PROGRAM, I BELIEVE DOES NOT HAVE 3513 02:07:45,200 --> 02:07:46,680 A -- I THINK THEY ONLY HAVE TWO 3514 02:07:46,680 --> 02:07:47,640 CLINICIANS WORKING WITHIN THE 3515 02:07:47,640 --> 02:07:48,040 ENTIRE PROGRAM. 3516 02:07:48,040 --> 02:07:56,320 THEY DON'T HAVE A LOT OF BAND 3517 02:07:56,320 --> 02:07:58,040 WIDTH COMPARE LITERATURE. 3518 02:07:58,040 --> 02:08:00,280 THERE'S A NETWORK OF STATE 3519 02:08:00,280 --> 02:08:02,960 MEDICAID MEDICAL DIRECTORS, 3520 02:08:02,960 --> 02:08:07,160 ACADEMY HEALTH ORGANIZES THAT, 3521 02:08:07,160 --> 02:08:09,120 I'M HAPPY TO CONNECT YOU WITH 3522 02:08:09,120 --> 02:08:09,360 THEM. 3523 02:08:09,360 --> 02:08:15,520 AND I THINK AT THE POLICY LEVEL 3524 02:08:15,520 --> 02:08:16,120 THE STATE MEDICAID DIRECTOR 3525 02:08:16,120 --> 02:08:17,800 LEVEL, THEIR ANNUAL CONFERENCE 3526 02:08:17,800 --> 02:08:19,840 IN THE FALL TO HAVE YOU KEYNOTE 3527 02:08:19,840 --> 02:08:21,760 WITH THESE DATA WOULD BE 3528 02:08:21,760 --> 02:08:22,040 TREMENDOUS. 3529 02:08:22,040 --> 02:08:23,160 THEY DO NOT KNOW THESE DATA. 3530 02:08:23,160 --> 02:08:24,760 THEY ARE NOT UP TO DATE. 3531 02:08:24,760 --> 02:08:27,440 KIDS ARE IGNORED UNFORTUNATELY 3532 02:08:27,440 --> 02:08:28,560 AND MEDICAID AND CHIP COVERS 3533 02:08:28,560 --> 02:08:31,080 HALF THE KIDS IN THE COUNTRY SO 3534 02:08:31,080 --> 02:08:32,040 THIS WOULD BE VERY POLICY 3535 02:08:32,040 --> 02:08:32,400 RELEVANT. 3536 02:08:32,400 --> 02:08:35,240 THE QUESTION I HAVE FOR YOU IS 3537 02:08:35,240 --> 02:08:37,200 AS AN INVESTOR, ARE THESE DATA 3538 02:08:37,200 --> 02:08:40,360 AVAILABLE TO NONRESEARCHERS SO 3539 02:08:40,360 --> 02:08:42,560 THAT IT CAN INFORM MARKET 3540 02:08:42,560 --> 02:08:45,800 ANALYSIS OR PRUK OR SERVICE 3541 02:08:45,800 --> 02:08:46,320 DEVELOPMENT NOT JUST FOR 3542 02:08:46,320 --> 02:08:50,400 APPLYING FOR RESEARCH FUNDING 3543 02:08:50,400 --> 02:08:53,480 BUT TO FORM INNOVATIVE CARE 3544 02:08:53,480 --> 02:08:53,800 MODEL DESIGN? 3545 02:08:53,800 --> 02:08:55,440 >>ELIZABETH, DO YOU WANT TO 3546 02:08:55,440 --> 02:08:56,000 ANSWER THAT QUESTION? 3547 02:08:56,000 --> 02:08:57,760 >>SO LET'S SEE. 3548 02:08:57,760 --> 02:09:03,640 YES, SO THE DATA ARE REALLY 3549 02:09:03,640 --> 02:09:05,400 AVAILABLE TO ANYONE WHO HAS 3550 02:09:05,400 --> 02:09:08,320 AUTHORIZED USE OF THE DATA, SO 3551 02:09:08,320 --> 02:09:10,240 THEY HAVE -- THEY'RE AFFILIATED 3552 02:09:10,240 --> 02:09:14,240 WITH AN INSTITUTION THAT IS 3553 02:09:14,240 --> 02:09:17,360 RECOGNIZED BY NIH AS AN 3554 02:09:17,360 --> 02:09:19,120 AUTHORIZED -- YOU KNOW, WITH 3555 02:09:19,120 --> 02:09:20,320 FEDERAL ASSURANCE THAT THEY CAN 3556 02:09:20,320 --> 02:09:21,240 ACCESS THE DATA. 3557 02:09:21,240 --> 02:09:23,440 THERE REALLY ARE NO OTHER 3558 02:09:23,440 --> 02:09:26,000 RESTRICTIONS OTHER THAN THAT. 3559 02:09:26,000 --> 02:09:29,440 >>IF OFFLINE YOU MIGHT WANT TO 3560 02:09:29,440 --> 02:09:32,320 BRAINSTORM HOW MIGHT WE GET 3561 02:09:32,320 --> 02:09:33,480 NONACADEMIC INNOVATORS TO GET TO 3562 02:09:33,480 --> 02:09:36,680 ACCESS THAT DATA AND DO A TYPE 3563 02:09:36,680 --> 02:09:38,560 OF CERTIFICATION PROCESS SO IT'S 3564 02:09:38,560 --> 02:09:40,680 CREDIBLE USE, NONABUSE OF THE 3565 02:09:40,680 --> 02:09:44,320 DATA BUT THAT CAN DRIVE THE 3566 02:09:44,320 --> 02:09:45,720 INNOVATION ECOSYSTEM SO THAT 3567 02:09:45,720 --> 02:09:47,000 MORE CREATIVE PRODUCTS AND 3568 02:09:47,000 --> 02:09:48,320 SERVICES CAN BE BUILT OFF OF THE 3569 02:09:48,320 --> 02:09:49,880 GREAT DATA YOU ALL HAVE 3570 02:09:49,880 --> 02:09:50,160 COLLECTED. 3571 02:09:50,160 --> 02:09:51,800 THANK YOU. 3572 02:09:51,800 --> 02:09:53,360 >>LET'S TALK OFFLINE. 3573 02:09:53,360 --> 02:09:53,920 >>APPRECIATE IT. 3574 02:09:53,920 --> 02:09:57,320 >>AND I LOVE THE IDEA ABOUT 3575 02:09:57,320 --> 02:09:57,560 POLICY. 3576 02:09:57,560 --> 02:10:00,120 I HOPE THAT JAN AND TOM ARE 3577 02:10:00,120 --> 02:10:04,160 LISTENING AND CAN HELP CONNECT 3578 02:10:04,160 --> 02:10:04,560 UST 3579 02:10:04,560 --> 02:10:06,160 US, BECAUSE I THINK THAT WOULD 3580 02:10:06,160 --> 02:10:06,680 BE WONDERFUL. 3581 02:10:06,680 --> 02:10:08,680 >>A GENERAL SUGGESTION WHICH IS 3582 02:10:08,680 --> 02:10:10,800 IF YOU -- THESE INFO GRAPHICS 3583 02:10:10,800 --> 02:10:14,320 THAT YOU'RE PROVIDING THE 3584 02:10:14,320 --> 02:10:16,840 FAMILIES IS AN INSPIRED IDEA AND 3585 02:10:16,840 --> 02:10:17,440 I CAN IMAGINE SOMETHING THAT 3586 02:10:17,440 --> 02:10:19,200 SIMPLE BEING AVAILABLE IN 3587 02:10:19,200 --> 02:10:20,440 PEDIATRICIANS' WAITING ROOMS AND 3588 02:10:20,440 --> 02:10:23,080 THAT SORT OF THING SO IT'S VERY 3589 02:10:23,080 --> 02:10:25,880 WIDELY AVAILABLE TO THE PUBLIC 3590 02:10:25,880 --> 02:10:26,840 IN A SIMPLIFIED WAY, I COULD SEE 3591 02:10:26,840 --> 02:10:28,520 THAT AS EXTREMELY USEFUL. 3592 02:10:28,520 --> 02:10:29,720 >>WE DO HAVE THEM ON THE 3593 02:10:29,720 --> 02:10:30,920 WEBSITE SO WE SHOULD WORK WITH 3594 02:10:30,920 --> 02:10:32,960 OUR POLICY AND COMMUNICATIONS 3595 02:10:32,960 --> 02:10:35,200 OFFICE TO MORE BROADLY 3596 02:10:35,200 --> 02:10:36,560 DISTRIBUTE THEM, BECAUSE YEAH, 3597 02:10:36,560 --> 02:10:39,120 THAT'S A GREAT DAY. 3598 02:10:39,120 --> 02:10:45,200 >>AND SORRY, I -- [ AWAY FROM 3599 02:10:45,200 --> 02:10:47,240 MICROPHONE ]. 3600 02:10:47,240 --> 02:10:48,280 WESLEY, GO AHEAD. 3601 02:10:48,280 --> 02:10:50,320 >>GREAT. 3602 02:10:50,320 --> 02:10:52,880 THIS IS WONDERFUL. 3603 02:10:52,880 --> 02:10:58,880 IN ALIGN WITH ALL THE POLICY, 3604 02:10:58,880 --> 02:11:00,680 OTHER FEDERAL AGENCIES CAN 3605 02:11:00,680 --> 02:11:05,040 BENEFIT FROM THIS. 3606 02:11:05,040 --> 02:11:08,120 DEALING WITH STATE POLICIES, I 3607 02:11:08,120 --> 02:11:11,800 WOULD ALSO ENCOURAGE THE 3608 02:11:11,800 --> 02:11:14,120 BIPARTISAN POLICY CENTER SINCE 3609 02:11:14,120 --> 02:11:16,040 SEVERAL DECISIONS MADE AT STATE 3610 02:11:16,040 --> 02:11:17,200 LEVELS ARE MADE SHALL WE SAY 3611 02:11:17,200 --> 02:11:19,560 FROM A PARTISAN PERSPECTIVE, 3612 02:11:19,560 --> 02:11:20,280 UNDERSTANDING THE IMPACT OF 3613 02:11:20,280 --> 02:11:25,240 THESE ARE GOING TO BE VERY 3614 02:11:25,240 --> 02:11:25,520 IMPORTANT. 3615 02:11:25,520 --> 02:11:27,040 SO PLEASE CONTINUE TO TRANSLATE 3616 02:11:27,040 --> 02:11:31,720 THE DATA FROM THE ACADEMY TO THE 3617 02:11:31,720 --> 02:11:32,000 COMMUNITY. 3618 02:11:32,000 --> 02:11:32,640 THAT BECOMES VERY IMPORTANT AS 3619 02:11:32,640 --> 02:11:33,360 WAS POINTED OUT. 3620 02:11:33,360 --> 02:11:37,200 I JUST WANT TO STRESS THAT. 3621 02:11:37,200 --> 02:11:37,920 >>THANK YOU. 3622 02:11:37,920 --> 02:11:39,760 >>I WANT TO THANK YOU ON BEHALF 3623 02:11:39,760 --> 02:11:41,560 OF ALL OF US USERS FOR MAKING 3624 02:11:41,560 --> 02:11:44,360 THIS SUCH AN AMAZING RESOURCE. 3625 02:11:44,360 --> 02:11:46,440 I WONDERED TO WHAT EXTENT WE'RE 3626 02:11:46,440 --> 02:11:48,160 GOING TO FIND OUT HOW 3627 02:11:48,160 --> 02:11:49,560 PARTICIPATION IN A LONGITUDINAL 3628 02:11:49,560 --> 02:11:53,040 STUDY IMPACTS BEHAVIORS IN 3629 02:11:53,040 --> 02:11:53,360 CHILDREN. 3630 02:11:53,360 --> 02:11:55,320 THUS FAR IT SEEMS LIKE THEY'RE 3631 02:11:55,320 --> 02:11:57,080 KEEPING A PACE WITH MONITORING 3632 02:11:57,080 --> 02:11:58,960 THE FUTURE AND OTHER THINGS, BUT 3633 02:11:58,960 --> 02:12:01,080 ONE OF THE ASPECTS OF THE STUDY 3634 02:12:01,080 --> 02:12:04,640 IN WHICH WE'RE GIVING FEEDBACK 3635 02:12:04,640 --> 02:12:05,120 AND GIVING THE CHILDREN 3636 02:12:05,120 --> 02:12:06,320 OWNERSHIP OF THEIR PARTICIPATION 3637 02:12:06,320 --> 02:12:08,320 MAY RESULT IN A HEALTHIER 3638 02:12:08,320 --> 02:12:08,920 POPULATION OR NOT. 3639 02:12:08,920 --> 02:12:09,600 WHICH IS GOOD. 3640 02:12:09,600 --> 02:12:10,880 BUT WE'LL SEE. 3641 02:12:10,880 --> 02:12:12,280 >>RIGHT. THAT'S ALWAYS BEEN 3642 02:12:12,280 --> 02:12:13,480 THE INTENTION FROM THE BEGINNING 3643 02:12:13,480 --> 02:12:15,160 AND YOU KNOW, WE ARE MOVING IN A 3644 02:12:15,160 --> 02:12:17,560 DIRECTION OF GIVING MORE BACK. 3645 02:12:17,560 --> 02:12:19,880 BECAUSE THEY DESERVE IT. 3646 02:12:19,880 --> 02:12:21,720 THEY'RE PUTTING THE EFFORT IN 3647 02:12:21,720 --> 02:12:22,920 AND SO WE REALLY DON'T KNOW 3648 02:12:22,920 --> 02:12:24,120 WHETHER THERE IS GOING TO BE 3649 02:12:24,120 --> 02:12:27,040 THAT KIND OF IMPACT OR NOT. 3650 02:12:27,040 --> 02:12:28,800 BUT THAT HAS BEEN ATTENTION THAT 3651 02:12:28,800 --> 02:12:30,840 WE'VE BEEN WRESTLING WITH AND -- 3652 02:12:30,840 --> 02:12:32,240 BUT HOPEFULLY WE'LL CONTINUE TO 3653 02:12:32,240 --> 02:12:33,680 BE ABLE TO CONTINUE TO FOLLOW 3654 02:12:33,680 --> 02:12:36,320 THEM AND SEE, YOU KNOW, WHAT 3655 02:12:36,320 --> 02:12:39,680 THEY GO INTO AS ADULTS. 3656 02:12:39,680 --> 02:12:41,320 >>THANKS VERY, VERY MUCH. 3657 02:12:41,320 --> 02:12:44,240 THIS IS REALLY A SPECTACULAR 3658 02:12:44,240 --> 02:12:44,920 PROJECT AND I WANT TO THANK YOU 3659 02:12:44,920 --> 02:12:47,480 AND YOUR TEAM AND TRACI, YOU'VE 3660 02:12:47,480 --> 02:12:48,800 GOT SO MANY LAYERS OF COMPLEXITY 3661 02:12:48,800 --> 02:12:50,520 AND IT'S OPENING UP THE WORLD IN 3662 02:12:50,520 --> 02:12:53,400 TERMS OF THINGS WE CAN DO AND IT 3663 02:12:53,400 --> 02:12:56,320 BASICALLY OPENS UP FOR OUR NEXT 3664 02:12:56,320 --> 02:12:56,840 PRESENTATION BECAUSE THE 3665 02:12:56,840 --> 02:12:58,480 INSPIRATION THAT WE GET FROM THE 3666 02:12:58,480 --> 02:13:02,040 ABCD WAS WHAT ACTUALLY LED US TO 3667 02:13:02,040 --> 02:13:04,680 PROPOSE THE OTHER SIDE, THAT 3668 02:13:04,680 --> 02:13:10,640 VERY EARLY PREGNANCY, AND NEO 3669 02:13:10,640 --> 02:13:14,320 NATAL OUTCOME AND THAT WE'RE 3670 02:13:14,320 --> 02:13:18,920 VERY FORTUNATE TO HAVE MICHELLE 3671 02:13:18,920 --> 02:13:22,880 TO TAKE INITIATIVE TO GO BY THE 3672 02:13:22,880 --> 02:13:25,040 ACRONYMS OR HBCD. 3673 02:13:25,040 --> 02:13:32,000 WE USED TO BE BBCD FOR BABY. 3674 02:13:32,000 --> 02:13:33,920 SO MICHELLE, WELCOME. 3675 02:13:33,920 --> 02:13:38,120 >>THANK YOU FOR THE OPPORTUNITY 3676 02:13:38,120 --> 02:13:38,840 TO PRESENT TODAY. 3677 02:13:38,840 --> 02:13:41,960 I HOPE TO COME BACK IN A COUPLE 3678 02:13:41,960 --> 02:13:45,840 OF YEARS WITH AS AN EXCITING 3679 02:13:45,840 --> 02:13:47,520 PRESENTATION AS YOURS. 3680 02:13:47,520 --> 02:13:49,680 WE HAVE A LONG WAY TO GO. 3681 02:13:49,680 --> 02:13:56,360 AND SOON AS WE GET THE SLIDES 3682 02:13:56,360 --> 02:13:57,360 UP -- GREAT. 3683 02:13:57,360 --> 02:13:58,600 THANK YOU VERY MUCH. 3684 02:13:58,600 --> 02:14:00,160 SO ALSO FIRST I WOULD LIKE TO 3685 02:14:00,160 --> 02:14:02,280 JUST THANK THE ABCD TEAM. 3686 02:14:02,280 --> 02:14:03,480 THEY'VE BEEN WONDERFUL 3687 02:14:03,480 --> 02:14:04,280 COLLEAGUES. 3688 02:14:04,280 --> 02:14:05,200 THEY'VE SHOWN US THE WAY. 3689 02:14:05,200 --> 02:14:08,640 WE'VE COPIED THEM IN ALMOST 3690 02:14:08,640 --> 02:14:09,840 EVERY SINGLE ASPECT OF THE STUDY 3691 02:14:09,840 --> 02:14:11,440 BUT ALSO THEY CONTINUE TO SERVE 3692 02:14:11,440 --> 02:14:14,880 ON WORK GROUPS FOR HBCD WHILE 3693 02:14:14,880 --> 02:14:18,680 DOING THEIR JOB AT ABCD AND I'M 3694 02:14:18,680 --> 02:14:19,440 INTERNALLY GRATEFUL FOR THAT. 3695 02:14:19,440 --> 02:14:21,440 WE ALSO HAVE A SMALL STAFF 3696 02:14:21,440 --> 02:14:23,240 THAT'S DEDICATED TO HBCD THAT 3697 02:14:23,240 --> 02:14:33,640 AREN'T HERE TODAY BUT I WANT TO 3698 02:14:33,640 --> 02:14:37,560 THANK THEM UPFRONT TOO. 3699 02:14:37,560 --> 02:14:41,000 MOUSE? 3700 02:14:41,000 --> 02:14:42,240 NOPE. 3701 02:14:42,240 --> 02:14:47,800 I SEE. 3702 02:14:47,800 --> 02:14:49,560 NOPE. 3703 02:14:49,560 --> 02:14:52,160 SORRY, GUYS. 3704 02:14:52,160 --> 02:14:52,440 GREAT. 3705 02:14:52,440 --> 02:14:58,400 SO SIMILAR TO ABCD, THE HBCD IS 3706 02:14:58,400 --> 02:15:00,040 A LONGITUDINAL STUDY THAT WE 3707 02:15:00,040 --> 02:15:01,920 WILL PLAN TO RECRUIT 3708 02:15:01,920 --> 02:15:03,160 PARTICIPANTS IN THE SECOND 3709 02:15:03,160 --> 02:15:04,880 TRIMESTER OF PREGNANCY AND 3710 02:15:04,880 --> 02:15:07,000 FOLLOW THEM UP TO TEN YEARS AND 3711 02:15:07,000 --> 02:15:09,680 WE WILL BE COLLECTING A VAST 3712 02:15:09,680 --> 02:15:11,200 ARRAY OF INFORMATION FROM THESE 3713 02:15:11,200 --> 02:15:15,680 INDIVIDUALS. WE'LL BE DOING MRI 3714 02:15:15,680 --> 02:15:18,800 IMAGING, COLLECTING A NUMBER OF 3715 02:15:18,800 --> 02:15:20,320 BEHAVIORAL AND COGNITIVE 3716 02:15:20,320 --> 02:15:21,880 ASSESSMENTS AND ASKING OUR 3717 02:15:21,880 --> 02:15:22,960 PARTICIPANTS TO ANSWER A NUMBER 3718 02:15:22,960 --> 02:15:28,480 OF QUESTIONNAIRES THROUGHOUT THE 3719 02:15:28,480 --> 02:15:29,760 STUDY. 3720 02:15:29,760 --> 02:15:32,240 AS DR. VOLKOW MENTIONED WE HAVE 3721 02:15:32,240 --> 02:15:33,160 FUNDING FROM THE HEAL 3722 02:15:33,160 --> 02:15:34,200 INITIATIVE. 3723 02:15:34,200 --> 02:15:35,520 SORRY, I DON'T HAVE THE MOUSE 3724 02:15:35,520 --> 02:15:40,080 DOWN. 3725 02:15:40,080 --> 02:15:46,640 IT'S NOT WORKING. 3726 02:15:46,640 --> 02:15:48,680 NOPE. 3727 02:15:48,680 --> 02:15:51,080 I'M A FORMER MAC USER, SO I'M 3728 02:15:51,080 --> 02:15:52,400 CLICKING THE WRONG SIDE. 3729 02:15:52,400 --> 02:15:55,160 SO THE PROJECT OBVIOUSLY CAME 3730 02:15:55,160 --> 02:15:57,560 ABOUT BECAUSE OF THE GREAT 3731 02:15:57,560 --> 02:15:59,280 PROMISE THAT ABCD HAS BEEN 3732 02:15:59,280 --> 02:16:00,680 DEMONSTRATING BUT ALSO CAME 3733 02:16:00,680 --> 02:16:10,800 AROUND THE TIME THAT THE HEAL 3734 02:16:10,800 --> 02:16:11,160 NI 3735 02:16:11,160 --> 02:16:12,360 INITIATIVE, AND WE WERE ABLE TO 3736 02:16:12,360 --> 02:16:14,160 SECURE SOME FUND FROM THE HEAL 3737 02:16:14,160 --> 02:16:15,600 INITIATIVE BUT REALLY 3738 02:16:15,600 --> 02:16:18,400 CONTRIBUTIONS FROM A NUMBER OF 3739 02:16:18,400 --> 02:16:20,280 INSTITUTES AND CENTERS ACROSS 3740 02:16:20,280 --> 02:16:20,440 NIH. 3741 02:16:20,440 --> 02:16:22,600 THE MAJORITY OF THE WORK IS 3742 02:16:22,600 --> 02:16:24,840 MANAGED OUT OF NIDA BUT WE HAVE 3743 02:16:24,840 --> 02:16:25,960 CONTRIBUTIONS FROM THE OFFICES 3744 02:16:25,960 --> 02:16:28,160 AND CENTERS THAT ARE LISTED 3745 02:16:28,160 --> 02:16:29,080 HERE. 3746 02:16:29,080 --> 02:16:31,840 AND THE HELPING AND ADDICTION 3747 02:16:31,840 --> 02:16:34,440 LONG-TERM IS FOCUSED ON BOTH 3748 02:16:34,440 --> 02:16:36,720 ENHANCING PAIN MANAGEMENT AND 3749 02:16:36,720 --> 02:16:40,080 IMPROVING TREATMENT FOR OPIOID 3750 02:16:40,080 --> 02:16:40,240 USE. 3751 02:16:40,240 --> 02:16:42,960 MY LITTLE GROUP THAT'S PART OF 3752 02:16:42,960 --> 02:16:46,720 THAT IS THE ENHANCED OUTCOMES 3753 02:16:46,720 --> 02:16:50,320 FOR AFFECTED NEWBORNS BUT THIS 3754 02:16:50,320 --> 02:16:52,360 IS LOOKING AT DEVELOPMENT ACROSS 3755 02:16:52,360 --> 02:16:56,040 A NUMBER OF ENVIRONMENTS, NOT 3756 02:16:56,040 --> 02:16:56,440 JUST SUBSTANCE USE. 3757 02:16:56,440 --> 02:16:58,640 RIGHT CLICK. IT WORKED. 3758 02:16:58,640 --> 02:17:00,640 SO FOLLOWING A PLANNING PERIOD 3759 02:17:00,640 --> 02:17:03,080 WHERE WE WERE ALLOWED TO SORT OF 3760 02:17:03,080 --> 02:17:05,560 EXAMINE WHAT OBSTACLES WOULD BE 3761 02:17:05,560 --> 02:17:08,360 IN THE WAY OF A STUDY OF THIS 3762 02:17:08,360 --> 02:17:10,120 NATURE, WE MADE AWARDS TO A 3763 02:17:10,120 --> 02:17:12,320 NUMBER OF SITES THAT DID THIS 3764 02:17:12,320 --> 02:17:14,080 KIND OF LANDSCAPE ANALYSIS AND 3765 02:17:14,080 --> 02:17:15,400 WHAT WOULD BE -- WHAT WOULD IT 3766 02:17:15,400 --> 02:17:17,400 TAKE TO DO THIS AND THEN WE 3767 02:17:17,400 --> 02:17:18,760 ISSUED AN ANNOUNCEMENT FOR 3768 02:17:18,760 --> 02:17:20,600 APPLICATIONS FOR THE FULL STUDY. 3769 02:17:20,600 --> 02:17:24,000 IN OCTOBER OF 2020 WE MADE 3770 02:17:24,000 --> 02:17:26,320 AWARDS TO 25 RESEARCH SITES 3771 02:17:26,320 --> 02:17:29,760 ACROSS THE U.S. AS WELL AS THE 3772 02:17:29,760 --> 02:17:36,680 DATA COORDINATING CENTER AND AN 3773 02:17:36,680 --> 02:17:37,840 ADMINISTRATIVE CORE. 3774 02:17:37,840 --> 02:17:41,000 THE DAY TO COORDINATING CENTER 3775 02:17:41,000 --> 02:17:45,080 IS LED BY DR. CHRIS MISER, 3776 02:17:45,080 --> 02:17:47,720 DAMEIAN FAIR AT THE UNIVERSITY 3777 02:17:47,720 --> 02:17:51,880 OF MINNESOTA AND ANDERS IS ALSO 3778 02:17:51,880 --> 02:17:53,480 INVOLVED IN THE ABCD PROGRAM. 3779 02:17:53,480 --> 02:17:55,200 THE SITES THAT WERE SELECTED 3780 02:17:55,200 --> 02:17:56,360 WERE SELECTED FOR A NUMBER OF 3781 02:17:56,360 --> 02:17:59,280 DIFFERENT REASONS BUT ONE IN 3782 02:17:59,280 --> 02:18:00,880 PARTICULAR WAS WE WANTED TO 3783 02:18:00,880 --> 02:18:02,320 BRING IN SITES THAT WOULD BE 3784 02:18:02,320 --> 02:18:04,840 ABLE TO RECRUIT FROM VULNERABLE 3785 02:18:04,840 --> 02:18:05,920 POPULATIONS THAT AREN'T NORMALLY 3786 02:18:05,920 --> 02:18:08,320 NECESSARILY INVOLVED IN LARGE 3787 02:18:08,320 --> 02:18:09,720 RESEARCH PROGRAMS AT LARGE 3788 02:18:09,720 --> 02:18:10,920 ACADEMIC INSTITUTIONS AND YOU'LL 3789 02:18:10,920 --> 02:18:12,480 NOTICE SOME OF THOSE IN THE 3790 02:18:12,480 --> 02:18:16,680 SOUTH, ALABAMA, TENNESSEE, 3791 02:18:16,680 --> 02:18:17,560 GEORGIA. 3792 02:18:17,560 --> 02:18:18,120 OKAY. 3793 02:18:18,120 --> 02:18:21,640 SO THE HBCD STUDY HAS A NUMBER 3794 02:18:21,640 --> 02:18:22,280 OF AIMS. 3795 02:18:22,280 --> 02:18:23,480 I WON'T READ ALL OF THEM HERE 3796 02:18:23,480 --> 02:18:25,840 BUT WE'RE INTERESTED IN 3797 02:18:25,840 --> 02:18:27,280 UNDERSTANDING THE NEURAL 3798 02:18:27,280 --> 02:18:35,520 TRAJECTORIES, WHAT'S THE NORMAL 3799 02:18:35,520 --> 02:18:37,600 RANGE OF VARIABILITY THROUGHOUT 3800 02:18:37,600 --> 02:18:39,680 CHILD AND HOW DO OTHER 3801 02:18:39,680 --> 02:18:41,800 INFLUENCES CHANGE THOSE 3802 02:18:41,800 --> 02:18:42,240 TRAJECTORIES. 3803 02:18:42,240 --> 02:18:43,600 ADVERSE ENVIRONMENTS, ETC. AND 3804 02:18:43,600 --> 02:18:45,680 ARE THERE KEY AREAS WHERE 3805 02:18:45,680 --> 02:18:47,880 INTERVENTIONS MAY BE HELPFUL IN 3806 02:18:47,880 --> 02:18:49,760 CHANGING THOSE TRAJECTORIES. 3807 02:18:49,760 --> 02:18:51,520 AN WITH A STUDY WITH THIS NUMBER 3808 02:18:51,520 --> 02:18:53,440 OF PARTICIPANTS WE AIM TO 3809 02:18:53,440 --> 02:18:55,560 RECRUIT 7,500. WE HOPE TO BE 3810 02:18:55,560 --> 02:18:58,160 ABLE TO TEASE OUT SOME OF THOSE 3811 02:18:58,160 --> 02:19:00,240 CONTRIBUTING FACTORS. 3812 02:19:00,240 --> 02:19:03,160 AND IN THE SAMPLES DESIGN, THIS 3813 02:19:03,160 --> 02:19:04,200 HAS A LOT OF CLICKS. 3814 02:19:04,200 --> 02:19:05,720 WE WANTED TO MAKE SURE THAT 3815 02:19:05,720 --> 02:19:08,680 WE'RE ADDRESSING BOTH EXTERNAL 3816 02:19:08,680 --> 02:19:09,920 VALIDITY AND INTERNAL VALIDITY 3817 02:19:09,920 --> 02:19:13,880 SO WE WANT THE RESULTS TO BE 3818 02:19:13,880 --> 02:19:14,440 GENERALIZABLE ACROSS THE 3819 02:19:14,440 --> 02:19:16,280 POPULATION IN THE U.S. BUT WE 3820 02:19:16,280 --> 02:19:20,320 ALSO WANT TO BE ABLE TO TEASE 3821 02:19:20,320 --> 02:19:21,720 OUT CAUSAL INFERENCE, SO MAKING 3822 02:19:21,720 --> 02:19:23,640 SURE THAT WE HAVE THE 3823 02:19:23,640 --> 02:19:26,760 APPROPRIATE CONTROLS TO MAKE OUR 3824 02:19:26,760 --> 02:19:27,040 COMPARISONS. 3825 02:19:27,040 --> 02:19:30,920 SO WE'RE LOOKING AT QUESTIONS 3826 02:19:30,920 --> 02:19:32,240 SPECIFICALLY ABOUT SUBSTANCE USE 3827 02:19:32,240 --> 02:19:33,440 AFFECTS BUT ALSO QUESTIONS ABOUT 3828 02:19:33,440 --> 02:19:39,400 OTHER EXPOSURES AND HOW THOSE 3829 02:19:39,400 --> 02:19:39,880 MAY INTERACT. 3830 02:19:39,880 --> 02:19:42,560 SO AS I MENTIONED, WE'RE GOING 3831 02:19:42,560 --> 02:19:46,240 TO BE RECRUITING 7,500 PREGNANT 3832 02:19:46,240 --> 02:19:47,720 WOMEN IN THEIR SECOND TRIMESTER 3833 02:19:47,720 --> 02:19:49,920 IS THE TARGET ALTHOUGH WE DO 3834 02:19:49,920 --> 02:19:51,800 ALLOW FOR SOME RECRUITMENT TO 3835 02:19:51,800 --> 02:19:55,280 HAPPEN IN THIRD TRIMESTER AND A 3836 02:19:55,280 --> 02:19:56,320 SMALL PERCENTAGE THAT COULD 3837 02:19:56,320 --> 02:19:57,320 HAPPEN RIGHT AFTER BIRTH. 3838 02:19:57,320 --> 02:20:00,480 WE ARE OVERSAMPLING FOR 3839 02:20:00,480 --> 02:20:01,960 SUBSTANCE EXPOSURE BECAUSE THE 3840 02:20:01,960 --> 02:20:03,360 INCIDENTS OF SUBSTANCE USE IN 3841 02:20:03,360 --> 02:20:05,440 PREGNANCY IN THE POPULATION IS 3842 02:20:05,440 --> 02:20:06,240 ABOUT 8%. 3843 02:20:06,240 --> 02:20:10,880 WE'RE TARGETING A 25% GROUP FOR 3844 02:20:10,880 --> 02:20:12,200 SUBSTANCE USE DURING PREGNANCY 3845 02:20:12,200 --> 02:20:16,200 AND THEN MATCHING THAT WITH 25% 3846 02:20:16,200 --> 02:20:17,040 POPULATION THAT HAS SIMILAR 3847 02:20:17,040 --> 02:20:19,160 ENVIRONMENTS AND RISK FACTORS, 3848 02:20:19,160 --> 02:20:21,520 BUT NOT USING SUBSTANCES AND 3849 02:20:21,520 --> 02:20:24,280 THEN THAT COMPARED WITH THE 3850 02:20:24,280 --> 02:20:24,840 GENERAL POPULATION. 3851 02:20:24,840 --> 02:20:28,600 AND THE SAMPLE THAT WE'RE 3852 02:20:28,600 --> 02:20:29,640 RECRUITING FROM OUR WOMEN THAT 3853 02:20:29,640 --> 02:20:32,320 ARE OF CHILDBEARING AGE IN THE 3854 02:20:32,320 --> 02:20:38,160 U.S. AND MATCHES THE U.S. 3855 02:20:38,160 --> 02:20:38,480 DEMOGRAPHICS. 3856 02:20:38,480 --> 02:20:40,680 SO MANY THINGS NEED TO BE 3857 02:20:40,680 --> 02:20:44,000 CONSIDERED IN DESIGNING THE 3858 02:20:44,000 --> 02:20:45,400 VISIT STRUCTURE. 3859 02:20:45,400 --> 02:20:47,480 ONE, THE ABILITY TO RETAIN 3860 02:20:47,480 --> 02:20:49,680 PARTICIPANTS IN A STUDY OF THIS 3861 02:20:49,680 --> 02:20:50,280 LENGTH. 3862 02:20:50,280 --> 02:20:52,680 WE WANT TO BE VERY CAUTIOUS AND 3863 02:20:52,680 --> 02:20:53,920 CAREFUL ABOUT THE BURDEN WE 3864 02:20:53,920 --> 02:20:55,360 PLACE ON PARTICIPANT FAMILIES 3865 02:20:55,360 --> 02:20:59,280 BUT YET WE WANT TO HAVE A WIDE 3866 02:20:59,280 --> 02:21:00,960 RANGE OF DATA THAT WE CAN 3867 02:21:00,960 --> 02:21:02,200 COLLECT FROM THEM AND SO 3868 02:21:02,200 --> 02:21:03,680 BALANCING WHAT ASSESSMENTS WE 3869 02:21:03,680 --> 02:21:05,680 ASK THEM TO DO, HOW OFTEN WE ASK 3870 02:21:05,680 --> 02:21:08,360 THEM TO COME IN, AND THE BURDEN 3871 02:21:08,360 --> 02:21:11,720 ON THE FAMILIES. 3872 02:21:11,720 --> 02:21:14,400 MY SLIDES ARE OUT OF ORDER. 3873 02:21:14,400 --> 02:21:14,720 OKAY. 3874 02:21:14,720 --> 02:21:18,800 I'M GOING TO SKIP AHEAD. 3875 02:21:18,800 --> 02:21:22,240 JUST WANTED TO SHOW YOU HERE THE 3876 02:21:22,240 --> 02:21:25,440 TIMELINE FOR THE GENERAL VISIT 3877 02:21:25,440 --> 02:21:25,720 STRUCTURE. 3878 02:21:25,720 --> 02:21:26,360 WE HAVE FIVE VISITS THAT WILL BE 3879 02:21:26,360 --> 02:21:27,880 IN PERSON AND THEN THREE VISITS 3880 02:21:27,880 --> 02:21:29,760 THAT ARE CONDUCTED REMOTELY. 3881 02:21:29,760 --> 02:21:32,320 THIS IS TO LIMIT HOW MUCH TIME 3882 02:21:32,320 --> 02:21:33,520 THEY HAVE TO COME IN. 3883 02:21:33,520 --> 02:21:36,720 IN THE FIRST VISIT WE'LL BE 3884 02:21:36,720 --> 02:21:38,200 DOING ASSESSMENTS OF THE 3885 02:21:38,200 --> 02:21:40,440 BIRTHING PARENT, TAKING BIO 3886 02:21:40,440 --> 02:21:41,000 SPECIMENS. 3887 02:21:41,000 --> 02:21:43,080 WE'LL BE TAKING BLOOD AND URINE 3888 02:21:43,080 --> 02:21:44,760 SAMPLES AT THE FIRST VISIT. AND 3889 02:21:44,760 --> 02:21:47,520 THEN WE HOPE TO HAVE THE FAMILY 3890 02:21:47,520 --> 02:21:48,880 COME BACK AFTER THE BABY IS BORN 3891 02:21:48,880 --> 02:21:52,880 AND THAT WOULD BE THE FIRST TIME 3892 02:21:52,880 --> 02:21:55,800 FOR AN MRI AND THAT IS EXPECTED 3893 02:21:55,800 --> 02:21:57,760 TO OCCUR IN THE FIRST MONTH 3894 02:21:57,760 --> 02:21:59,360 AFTER BIRTH. 3895 02:21:59,360 --> 02:22:00,920 WE'LL BE COLLECTING -- CONTINUE 3896 02:22:00,920 --> 02:22:03,680 COLLECTING BIO SPECIMENS, DOING 3897 02:22:03,680 --> 02:22:05,160 ASSESSMENTS OF THE PARENT AND 3898 02:22:05,160 --> 02:22:07,680 THEN WE'RE ALSO SENDING HOME THE 3899 02:22:07,680 --> 02:22:10,960 BABY WITH MOTION SENSORS AND 3900 02:22:10,960 --> 02:22:13,320 THERE'S A BAND THAT THE BABY 3901 02:22:13,320 --> 02:22:16,680 WILL WEAR TO MONITOR HEART RATE 3902 02:22:16,680 --> 02:22:17,680 IN SLEEP. 3903 02:22:17,680 --> 02:22:20,200 THEY'LL COME BACK AT 3 TO 9 3904 02:22:20,200 --> 02:22:22,800 MONTHS, 9 TO 15 MONTHS AND 15 TO 3905 02:22:22,800 --> 02:22:24,600 48 MONTHS AND INTERSPERSED IN 3906 02:22:24,600 --> 02:22:26,000 THERE ARE THESE REMOTE 3907 02:22:26,000 --> 02:22:28,680 ASSESSMENTS THEY CAN DO AT HOME. 3908 02:22:28,680 --> 02:22:34,720 IN ORDER TO GET ALL OF THOSE 3909 02:22:34,720 --> 02:22:37,960 VISITS IN WITH 7,500 3910 02:22:37,960 --> 02:22:41,400 INDIVIDUALS, THE FIRST TWO 3911 02:22:41,400 --> 02:22:43,560 VISITS ARE ALL AT THE SAME TIME 3912 02:22:43,560 --> 02:22:44,040 POINTS. 3913 02:22:44,040 --> 02:22:46,680 SO IN THE THREE MONTH RANGE, 3914 02:22:46,680 --> 02:22:48,280 OVER THAT VISIT THREE, SIMILAR 3915 02:22:48,280 --> 02:22:50,520 FOR VISIT FOUR AND SO ON. 3916 02:22:50,520 --> 02:22:52,680 AND THEY WILL BE -- THE 3917 02:22:52,680 --> 02:22:53,840 PARTICIPANTS WILL BE RANDOMIZED 3918 02:22:53,840 --> 02:22:58,520 WHEN THEY ARE ENROLLED IN THE 3919 02:22:58,520 --> 02:22:58,800 STUDY. 3920 02:22:58,800 --> 02:23:05,320 AND THEN THE REMOTE VISITS ARE 3921 02:23:05,320 --> 02:23:07,840 YOKED TO THE PREVIOUS VISITS. 3922 02:23:07,840 --> 02:23:10,280 IT'S HAD A LOT OF INPUT FROM A 3923 02:23:10,280 --> 02:23:12,440 NUMBER OF INDIVIDUALS IN THE 3924 02:23:12,440 --> 02:23:12,880 CONSORTIUM. 3925 02:23:12,880 --> 02:23:15,280 ONE THING IMPORTANT TO NOTE 3926 02:23:15,280 --> 02:23:18,720 ABOUT THE VISIT STRUCTURE IS -- 3927 02:23:18,720 --> 02:23:19,960 WELL, I FORGET WHAT I WAS GOING 3928 02:23:19,960 --> 02:23:22,720 TO SAY HERE. 3929 02:23:22,720 --> 02:23:22,920 SORRY. 3930 02:23:22,920 --> 02:23:24,800 LET ME JUST MOVE ON. 3931 02:23:24,800 --> 02:23:27,680 SO I'VE OUTLINED HERE THE VISIT 3932 02:23:27,680 --> 02:23:28,680 ASSESSMENTS, WHAT WILL -- I KNOW 3933 02:23:28,680 --> 02:23:30,120 WHAT I WANTED TO SAY. 3934 02:23:30,120 --> 02:23:33,080 SO A VISIT ONE OR VISIT TWO, 3935 02:23:33,080 --> 02:23:35,240 THREE, SO ON, CAN HAPPEN OVER A 3936 02:23:35,240 --> 02:23:36,840 COUPLE OF WEEKS. 3937 02:23:36,840 --> 02:23:39,240 SO THE TOTAL VISITS CAN TAKE UP 3938 02:23:39,240 --> 02:23:40,760 TO EIGHT HOURS DEPENDING ON WHAT 3939 02:23:40,760 --> 02:23:42,480 ALL IS INCLUDED SO WE ARE 3940 02:23:42,480 --> 02:23:44,560 ALLOWING THE SITES TO BRING THE 3941 02:23:44,560 --> 02:23:45,880 PARTICIPANTS BACK AS LONG AS 3942 02:23:45,880 --> 02:23:47,720 IT'S IN A SHORT AMOUNT OF TIME. 3943 02:23:47,720 --> 02:23:49,560 AS YOU'LL SEE HERE VISIT ONE, 3944 02:23:49,560 --> 02:23:51,120 THERE'S A NUMBER OF ASSESSMENTS. 3945 02:23:51,120 --> 02:23:52,680 THIS ONE IS PROBABLY SHORTER 3946 02:23:52,680 --> 02:23:54,360 JUST BECAUSE THE BABY ISN'T IN 3947 02:23:54,360 --> 02:24:00,720 THE PICTURE YET. 3948 02:24:00,720 --> 02:24:02,360 TAKING BLOOD, URINE AND SALIVA 3949 02:24:02,360 --> 02:24:03,720 SAMPLE FROM THE MOM AND ASKING 3950 02:24:03,720 --> 02:24:04,880 ABOUT THEIR HISTORY. 3951 02:24:04,880 --> 02:24:06,200 THE SUBSTANCE USE EXPOSURE WILL 3952 02:24:06,200 --> 02:24:09,400 BE TRIGGERED IF THE INDIVIDUAL 3953 02:24:09,400 --> 02:24:10,840 FILLS OUT THE ASSIST ASSESSMENT 3954 02:24:10,840 --> 02:24:12,560 AND INDICATES SUBSTANCE USE. 3955 02:24:12,560 --> 02:24:14,320 THAT WILL THEN SET UP A TIMELINE 3956 02:24:14,320 --> 02:24:16,120 TO FOLLOW BACK ASSESSMENT SO WE 3957 02:24:16,120 --> 02:24:18,280 GET A BETTER INDICATION OF HOW 3958 02:24:18,280 --> 02:24:19,760 MUCH SUBSTANCES WERE USED. 3959 02:24:19,760 --> 02:24:24,520 AND THEN THAT WILL BE VALIDATED 3960 02:24:24,520 --> 02:24:27,600 OR VERIFIED WITH THE URINE AND 3961 02:24:27,600 --> 02:24:28,000 BLOOD SAMPLES. 3962 02:24:28,000 --> 02:24:32,160 SO WE ARE COLLECTING A NUMBER OF 3963 02:24:32,160 --> 02:24:32,640 BIO 3964 02:24:32,640 --> 02:24:35,240 BIO SPECIMENS ACROSS THE STUDY. 3965 02:24:35,240 --> 02:24:37,720 WE'RE ONLY DOING URINALYSIS OF 3966 02:24:37,720 --> 02:24:38,920 THE MOM'S FIRST AND SECOND 3967 02:24:38,920 --> 02:24:43,560 VISIT. 3968 02:24:43,560 --> 02:24:51,520 WE'RE ALSO COLLECTING NAIL 3969 02:24:51,520 --> 02:24:52,320 SPECIMENS. 3970 02:24:52,320 --> 02:24:54,360 THE DATA WILL BE ABLE TO BE USED 3971 02:24:54,360 --> 02:24:57,080 BY THE RESEARCH COMMUNITY. 3972 02:24:57,080 --> 02:24:59,320 VISIT 2, THESE ARE INCLUDING 3973 02:24:59,320 --> 02:25:01,280 MEASURES OF THE CHILDREN, SO 3974 02:25:01,280 --> 02:25:03,040 INFANT HEIGHT, WEIGHT, HEAD 3975 02:25:03,040 --> 02:25:03,560 CIRCUMFERENCE. 3976 02:25:03,560 --> 02:25:05,080 WE'LL BE SENDING THEM HOME WITH 3977 02:25:05,080 --> 02:25:07,920 THE BIO SENSORS, WE'LL DO AN MRI 3978 02:25:07,920 --> 02:25:09,680 AND THEN AT THE THIRD VISIT IS 3979 02:25:09,680 --> 02:25:11,800 WHEN WE BRING IN THE EEG 3980 02:25:11,800 --> 02:25:13,160 MEASUREMENT AS WELL AND SOME OF 3981 02:25:13,160 --> 02:25:15,520 THE SAME ASSESSMENTS ARE GIVEN 3982 02:25:15,520 --> 02:25:17,400 AGAIN AND THERE WILL BE SOME NEW 3983 02:25:17,400 --> 02:25:21,040 ONES BROUGHT IN FOR CHILD PARENT 3984 02:25:21,040 --> 02:25:23,040 INTERACTION AND SOME LANGUAGE IN 3985 02:25:23,040 --> 02:25:25,200 COGNITIVE DEVELOPMENT 3986 02:25:25,200 --> 02:25:25,480 ASSESSMENTS. 3987 02:25:25,480 --> 02:25:27,840 SO I'D LIKE TO JUST NOW TELL YOU 3988 02:25:27,840 --> 02:25:28,560 WHERE WE ARE TODAY. 3989 02:25:28,560 --> 02:25:30,120 THIS HAS BEEN ABOUT A YEAR AND A 3990 02:25:30,120 --> 02:25:31,520 HALF OF PLANNING. 3991 02:25:31,520 --> 02:25:33,920 WE'VE DONE A LOT OF DEVELOPMENT 3992 02:25:33,920 --> 02:25:35,600 OF THE PROTOCOL AND BEGAN AT THE 3993 02:25:35,600 --> 02:25:38,640 BEGINNING OF THE YEAR TO DO 3994 02:25:38,640 --> 02:25:39,280 PILOT WORK TO MAKE SURE THAT THE 3995 02:25:39,280 --> 02:25:42,920 PROTOCOL WE DEVELOPED IS 3996 02:25:42,920 --> 02:25:44,320 ACTUALLY DOABLE AND HOW MUCH 3997 02:25:44,320 --> 02:25:45,600 BURDEN IT IS ON THE FAMILIES, 3998 02:25:45,600 --> 02:25:47,200 HOW MUCH BURDEN IT IS ON THE 3999 02:25:47,200 --> 02:25:50,040 RESEARCH SITES ETC. SO THIS 4000 02:25:50,040 --> 02:25:52,400 GRAPH ILLUSTRATES THE 4001 02:25:52,400 --> 02:25:52,840 RECRUITMENT OF PILOT 4002 02:25:52,840 --> 02:25:54,480 PARTICIPANTS ACROSS THE FIRST 4003 02:25:54,480 --> 02:25:56,160 THREE VISITS, SO WE HAVE 4004 02:25:56,160 --> 02:26:00,680 CURRENTLY ENROLLED 345 PARENTS 4005 02:26:00,680 --> 02:26:02,120 AND 244 CHILDREN. 4006 02:26:02,120 --> 02:26:05,400 THE 20 -- IT'S ACTUALLY 27 SITES 4007 02:26:05,400 --> 02:26:06,840 LISTED ON THE BOTTOM. 4008 02:26:06,840 --> 02:26:09,360 TWO OF THE AWARDS HAVE 4009 02:26:09,360 --> 02:26:11,040 RECRUITMENT SITES AT DIFFERENT 4010 02:26:11,040 --> 02:26:14,760 LOCATIONS AND EACH SITE WAS 4011 02:26:14,760 --> 02:26:16,680 EXPECTED TO COLLECT THREE 4012 02:26:16,680 --> 02:26:22,120 PARTICIPANTS AT EACH TIME POINT. 4013 02:26:22,120 --> 02:26:24,240 AND I WANTED TO HIGHLIGHT THIS 4014 02:26:24,240 --> 02:26:27,640 IN THE -- IN THE PILOT -- IN THE 4015 02:26:27,640 --> 02:26:29,120 PILOT DATA THAT WE HAVE GATHERED 4016 02:26:29,120 --> 02:26:31,840 SO FAR, WE'VE BEEN VERY 4017 02:26:31,840 --> 02:26:33,440 SUCCESSFUL AT APPROACHING THE 4018 02:26:33,440 --> 02:26:35,280 TARGETS THAT WERE SET OUT AT THE 4019 02:26:35,280 --> 02:26:36,840 INITIAL START OF THE STUDY. 4020 02:26:36,840 --> 02:26:39,360 SO THOSE DEMOGRAPHICS ON THE 4021 02:26:39,360 --> 02:26:42,600 LEFT REFER TO THOSE 344 INITIAL 4022 02:26:42,600 --> 02:26:44,320 PILOT PARTICIPANTS AND THEN THE 4023 02:26:44,320 --> 02:26:46,560 CHART IS ON THE RIGHT. 4024 02:26:46,560 --> 02:26:48,280 AND YOU MAY NOTICE THE LEGEND IS 4025 02:26:48,280 --> 02:26:49,520 A LITTLE BIT DIFFERENT BETWEEN 4026 02:26:49,520 --> 02:26:50,760 THE TWO GRAPHS. 4027 02:26:50,760 --> 02:26:53,640 THIS IS THE HBCD TARGETS WAS 4028 02:26:53,640 --> 02:26:56,040 BASED ON THE NIH REPORTABLE 4029 02:26:56,040 --> 02:26:57,040 CATEGORIES THAT WE COLLECT. 4030 02:26:57,040 --> 02:26:59,400 BUT THE DATA THAT ARE SHOWN ON 4031 02:26:59,400 --> 02:27:02,200 THE LEFT COME FROM ONE OF THE 4032 02:27:02,200 --> 02:27:03,960 DEMOGRAPHIC ASSESSMENTS THAT WE 4033 02:27:03,960 --> 02:27:05,760 USED IN THE STUDY AND IT HAS 4034 02:27:05,760 --> 02:27:06,640 DIFFERENT OPTIONS. 4035 02:27:06,640 --> 02:27:09,920 SO WE -- WE'LL BE GATHERING MORE 4036 02:27:09,920 --> 02:27:12,680 DETAILED INFORMATION THROUGH 4037 02:27:12,680 --> 02:27:15,880 THOSE ASSESSMENTS. 4038 02:27:15,880 --> 02:27:18,040 WE'VE BEEN ABLE TO COLLECT MRI 4039 02:27:18,040 --> 02:27:21,720 FROM A NUMBER OF THE 4040 02:27:21,720 --> 02:27:24,080 PARTICIPANTS SO FAR, SO THE 0 TO 4041 02:27:24,080 --> 02:27:25,840 1 MONTH IS A HARD GROUP TO GET 4042 02:27:25,840 --> 02:27:27,760 MOMS TO COME IN, ESPECIALLY FOR 4043 02:27:27,760 --> 02:27:30,240 A PILOT STUDY BUT WE'RE PLEASED 4044 02:27:30,240 --> 02:27:31,640 TO SHOW THAT WE'VE BEEN ABLE TO 4045 02:27:31,640 --> 02:27:33,680 DO THAT AND WE'VE ALSO HAD THE 4046 02:27:33,680 --> 02:27:35,480 BABIES COME IN AT THE SECOND -- 4047 02:27:35,480 --> 02:27:37,800 THE THIRD TIME POINT AS WELL. 4048 02:27:37,800 --> 02:27:39,120 THIS IS NOT COMPLETE ACROSS ALL 4049 02:27:39,120 --> 02:27:40,440 OF THE SITES YET. 4050 02:27:40,440 --> 02:27:42,520 IT GOT A LATER START THAN SOME 4051 02:27:42,520 --> 02:27:44,320 OF THE OTHER ASPECTS OF PROTOCOL 4052 02:27:44,320 --> 02:27:48,680 BUT WE'RE ENCOURAGED TO SEE THAT 4053 02:27:48,680 --> 02:27:49,920 THEY ARE HAVING SUCCESS. 4054 02:27:49,920 --> 02:27:52,560 THERE WILL BE IN THE PROTOCOL A 4055 02:27:52,560 --> 02:27:54,440 NUMBER OF DIFFERENT MEASURES AND 4056 02:27:54,440 --> 02:27:56,360 THEY WILL BE -- I THINK THEY 4057 02:27:56,360 --> 02:27:57,880 WILL BE RANDOMIZED IN THE ORDER 4058 02:27:57,880 --> 02:27:59,400 OF DIRECTION BECAUSE SOME OF THE 4059 02:27:59,400 --> 02:28:00,840 DIFFERENT SEQUENCES TEND TO WAKE 4060 02:28:00,840 --> 02:28:04,440 THE BABY UP AND SO WE MAY BE NOT 4061 02:28:04,440 --> 02:28:06,880 ABLE TO COLLECT THAT FOR ALL OF 4062 02:28:06,880 --> 02:28:07,640 THEM. 4063 02:28:07,640 --> 02:28:10,280 AND THEN WE ALSO HAVE RESULTS 4064 02:28:10,280 --> 02:28:12,280 FROM THE EEG DATA COLLECTION, 4065 02:28:12,280 --> 02:28:13,720 ABOUT HALF OF THE SITES ALREADY 4066 02:28:13,720 --> 02:28:16,680 HAD PRETTY DECENT EXPERIENCE 4067 02:28:16,680 --> 02:28:18,240 COLLECTING EEG FROM PRIOR 4068 02:28:18,240 --> 02:28:20,360 STUDIES AND THEN THE OTHER HALF 4069 02:28:20,360 --> 02:28:22,680 HAD TO -- WELL, THEY ALL HAD TO 4070 02:28:22,680 --> 02:28:23,800 BUY THE EQUIPMENT AND THEY HAD 4071 02:28:23,800 --> 02:28:27,040 TO LEARN HOW TO DO THIS AND SO 4072 02:28:27,040 --> 02:28:29,000 THIS GRAPH IS SHOWING THE 4073 02:28:29,000 --> 02:28:30,440 SUCCESS RATE ACROSS THOSE 4074 02:28:30,440 --> 02:28:31,200 DIFFERENT SITES AS WELL. 4075 02:28:31,200 --> 02:28:32,880 SO THE THE BLUE BARS ARE SUCCESS 4076 02:28:32,880 --> 02:28:35,880 AND THE ORANGE BARS ARE ONES 4077 02:28:35,880 --> 02:28:37,240 THAT HAD FAILED. 4078 02:28:37,240 --> 02:28:39,760 AND THEY CONTINUE TO DO THIS IN 4079 02:28:39,760 --> 02:28:41,200 THE PILOT PHASE UNTIL WE ARE 4080 02:28:41,200 --> 02:28:42,240 READY FOR LAUNCH. 4081 02:28:42,240 --> 02:28:45,680 THEY'RE GOING TO KEEP 4082 02:28:45,680 --> 02:28:45,960 PRACTICING. 4083 02:28:45,960 --> 02:28:47,320 THE WEARABLE TECHNOLOGY AS I 4084 02:28:47,320 --> 02:28:48,680 MENTIONED, THE BABIES ARE SENT 4085 02:28:48,680 --> 02:28:50,320 HOME WITH SENSORS THAT GO ON 4086 02:28:50,320 --> 02:28:52,360 THEIR ANKLES. THEY'RE PUT IN 4087 02:28:52,360 --> 02:28:53,760 THESE LITTLE SLEEVES THAT GO 4088 02:28:53,760 --> 02:28:55,160 OVER THE LEG AND THEY'RE TO WEAR 4089 02:28:55,160 --> 02:28:57,080 THESE FOR 72 HOURS AND THEY WILL 4090 02:28:57,080 --> 02:28:58,920 TAKE THE SENSORS OFF THEN AND 4091 02:28:58,920 --> 02:29:00,360 MAIL THEM BACK TO THE RESEARCH 4092 02:29:00,360 --> 02:29:01,400 SITE WHEN THEY'RE DONE. 4093 02:29:01,400 --> 02:29:03,240 THEY WILL ALSO BE WEARING THIS 4094 02:29:03,240 --> 02:29:07,040 BAND. IT'S CALLED THE GABBY 4095 02:29:07,040 --> 02:29:08,320 BAND AND THAT MEASURES HEART 4096 02:29:08,320 --> 02:29:10,000 RATE AND THEY'RE ABLE TO GET 4097 02:29:10,000 --> 02:29:11,840 SOME INDEX OF SLEEP AS WELL. 4098 02:29:11,840 --> 02:29:14,080 THE GABBY IS A NEW PRODUCT THAT 4099 02:29:14,080 --> 02:29:15,400 HAS JUST BEEN DEVELOPED AND SO 4100 02:29:15,400 --> 02:29:17,160 WE'RE A LITTLE BIT BEHIND IN THE 4101 02:29:17,160 --> 02:29:19,200 COLLECTION OF THOSE DATA, BUT 4102 02:29:19,200 --> 02:29:22,560 HOPEFULLY THAT WILL CATCH UP 4103 02:29:22,560 --> 02:29:23,080 WITH US VERY QUICK. 4104 02:29:23,080 --> 02:29:26,320 THE MOMS WILL ALSO BE FILLING 4105 02:29:26,320 --> 02:29:27,320 OUT QUESTIONNAIRE DURING THAT 72 4106 02:29:27,320 --> 02:29:29,160 HOURS WHETHER THE DAY WAS A 4107 02:29:29,160 --> 02:29:30,720 TYPICAL DAY OR IF, YOU KNOW, 4108 02:29:30,720 --> 02:29:32,080 THEY WERE TRAVELING, THERE MAY 4109 02:29:32,080 --> 02:29:35,000 BE A REASON WHY THE MOVEMENT IS 4110 02:29:35,000 --> 02:29:37,080 LESS, ETC. ON THIS SLIDE I HAVE 4111 02:29:37,080 --> 02:29:40,280 PUT SOME OF THE PILOT DATA FROM 4112 02:29:40,280 --> 02:29:45,680 THE BIO SPECIMEN COLLECTION. 4113 02:29:45,680 --> 02:29:46,880 WE ARE COLLECTING A VIAL OF 4114 02:29:46,880 --> 02:29:50,720 BLOOD FROM THE PREGNANT PERSON 4115 02:29:50,720 --> 02:29:53,600 AND THEN THEY ALLOCATE THAT OUT 4116 02:29:53,600 --> 02:29:56,040 AND SEND THOSE ON TO THE 4117 02:29:56,040 --> 02:29:58,280 REPOSITORY AS WELL AS 4118 02:29:58,280 --> 02:29:58,920 EXPECTATION TO COLLECT URINE AND 4119 02:29:58,920 --> 02:30:00,480 SCHOOL FROM THE BABIES. 4120 02:30:00,480 --> 02:30:04,360 THOSE WILL ALSO BE SENT TO THE 4121 02:30:04,360 --> 02:30:07,520 BIO REPOSITORY AND SALIVA IS 4122 02:30:07,520 --> 02:30:10,400 SELECTED AND DNA IS BEING 4123 02:30:10,400 --> 02:30:10,880 EXTRACTED. 4124 02:30:10,880 --> 02:30:12,360 SO THE BOTTOM GRAPH SHOWS ACROSS 4125 02:30:12,360 --> 02:30:15,160 THE SITES AND THE TYPES OF 4126 02:30:15,160 --> 02:30:16,640 SAMPLES THEY'VE SENT IN SO FAR. 4127 02:30:16,640 --> 02:30:18,840 THESE DATA ARE LAGGING BEHIND 4128 02:30:18,840 --> 02:30:20,320 WHAT HAVE BEEN COLLECTED. 4129 02:30:20,320 --> 02:30:22,480 I WOULD IMAGINE THE SPECIMENS 4130 02:30:22,480 --> 02:30:24,040 RECEIVED WILL INCREASE GREATLY. 4131 02:30:24,040 --> 02:30:25,400 BUT WHAT'S MOST INTERESTING TO 4132 02:30:25,400 --> 02:30:28,320 ME ON THIS SLIDE IS THE 4133 02:30:28,320 --> 02:30:29,720 SUBSTANCE USE FROM THE ANALYSIS 4134 02:30:29,720 --> 02:30:32,240 OF THE URINE SAMPLES THAT WERE 4135 02:30:32,240 --> 02:30:36,440 SENT TO USDTL AND THE ABILITY TO 4136 02:30:36,440 --> 02:30:38,360 COMBINE THAT WITH DATA WE 4137 02:30:38,360 --> 02:30:40,440 COLLECTED FROM THE TIMELINE 4138 02:30:40,440 --> 02:30:41,480 FOLLOW BACK. 4139 02:30:41,480 --> 02:30:43,800 SO ON THE TOP IS POSITIVE FOR 4140 02:30:43,800 --> 02:30:45,360 USE ON THE TIMELINE FOLLOW BACK. 4141 02:30:45,360 --> 02:30:47,360 SO AN INDIVIDUAL FILLS OUT WHEN 4142 02:30:47,360 --> 02:30:50,000 AND WHERE OR HOW OFTEN THEY'VE 4143 02:30:50,000 --> 02:30:51,880 USED AND THEN THE PINK BAR SHOWS 4144 02:30:51,880 --> 02:30:55,920 A POSITIVE BIO SPECIMEN, AND 4145 02:30:55,920 --> 02:30:57,880 THEN ON THE BOTTOM GRAPH, THE 4146 02:30:57,880 --> 02:30:59,720 YELLOW BAR INDICATES WHERE THOSE 4147 02:30:59,720 --> 02:31:00,800 TWO HAD THAT IN COMMON. 4148 02:31:00,800 --> 02:31:03,360 SO IN SOME CASES WE DON'T HAVE 4149 02:31:03,360 --> 02:31:04,680 THE PERFECT MATCH OF DATA FROM 4150 02:31:04,680 --> 02:31:06,480 BOTH ASSESSMENTES, BUT 4151 02:31:06,480 --> 02:31:07,760 ULTIMATELY WE WILL AND THAT'S 4152 02:31:07,760 --> 02:31:11,680 HOW WE'LL BE CONFIRMING 4153 02:31:11,680 --> 02:31:12,040 SUBSTANCE USE. 4154 02:31:12,040 --> 02:31:14,400 AND THEN I THINK THIS IS MY LAST 4155 02:31:14,400 --> 02:31:14,600 SLIDE. 4156 02:31:14,600 --> 02:31:17,120 BUT THIS SHOWS THE ANALYSIS OF 4157 02:31:17,120 --> 02:31:19,320 THE URINE SAMPLE FROM USDTL. 4158 02:31:19,320 --> 02:31:22,520 ON THE LEFT IS FROM A SUBSET OF 4159 02:31:22,520 --> 02:31:24,640 63 PILOT PARTICIPANTS AND 4160 02:31:24,640 --> 02:31:27,680 SHOWING POSITIVITY IN SIX 4161 02:31:27,680 --> 02:31:29,360 CATEGORIES AND THAT'S COMPARED 4162 02:31:29,360 --> 02:31:31,440 TO THE NATIONAL POSITIVITY RATE 4163 02:31:31,440 --> 02:31:32,520 FROM THIS LAB. 4164 02:31:32,520 --> 02:31:35,080 AGAIN, IT'S A VERY SMALL NUMBER 4165 02:31:35,080 --> 02:31:37,680 BUT WE ARE REALLY PLEASED TO SEE 4166 02:31:37,680 --> 02:31:39,000 THAT WE ARE TARGETING EVEN 4167 02:31:39,000 --> 02:31:40,680 THROUGH OUR PILOT PARTICIPANTS 4168 02:31:40,680 --> 02:31:43,760 THE POPULATION WE HOPE TO 4169 02:31:43,760 --> 02:31:44,920 RECRUIT IN THE STUDY. 4170 02:31:44,920 --> 02:31:49,200 SO AN UPDATE ON WHEN WE WILL 4171 02:31:49,200 --> 02:31:51,000 ACTUALLY LAUNCH, NORA HAD AN OLD 4172 02:31:51,000 --> 02:31:52,680 SLIDE YESTERDAY AND IT SAID WE 4173 02:31:52,680 --> 02:31:53,600 WOULD LAUNCH IN MAY. 4174 02:31:53,600 --> 02:31:56,360 WE ARE ACTUALLY EXPECTING TO DO 4175 02:31:56,360 --> 02:31:58,880 A FULL LAUNCH STARTING JULY 1ST 4176 02:31:58,880 --> 02:31:59,760 OF THIS YEAR. 4177 02:31:59,760 --> 02:32:02,080 AND I'M HAPPY TO ANSWER ANY 4178 02:32:02,080 --> 02:32:02,320 QUESTIONS. 4179 02:32:02,320 --> 02:32:07,920 >>MICHELLE, THANKS VERY MUCH. 4180 02:32:07,920 --> 02:32:11,920 ANY QUESTIONS? 4181 02:32:11,920 --> 02:32:13,960 THANK YOU SO MUCH. 4182 02:32:13,960 --> 02:32:16,680 THE ONE QUESTION I WANTED TO 4183 02:32:16,680 --> 02:32:17,520 HIGHLIGHT ESPECIALLY AS THE 4184 02:32:17,520 --> 02:32:20,160 BABIES ARE GROWING AND BECOMING 4185 02:32:20,160 --> 02:32:21,600 TODDLERS IS NUTRITION DATA. 4186 02:32:21,600 --> 02:32:22,600 ARE YOU COLLECTING THAT. 4187 02:32:22,600 --> 02:32:27,360 >>SO WE'RE COLLECTING A SMALL 4188 02:32:27,360 --> 02:32:29,240 AMOUNT OF NUTRITION DATA THROUGH 4189 02:32:29,240 --> 02:32:29,640 QUESTIONNAIRE. 4190 02:32:29,640 --> 02:32:35,080 >>THERE WAS A PROPOSAL TO DO A 4191 02:32:35,080 --> 02:32:40,280 MORE IN DEPTH ONE BUT WE WOULD 4192 02:32:40,280 --> 02:32:42,720 LIKE TO GET MORE INFORMATION IF 4193 02:32:42,720 --> 02:32:46,800 POSSIBLE. 4194 02:32:46,800 --> 02:32:47,240 YEAH. 4195 02:32:47,240 --> 02:32:56,080 >>GOOD. 4196 02:32:56,080 --> 02:32:56,640 >>ARE YOU GUYS COLLECTING 4197 02:32:56,640 --> 02:32:58,440 INSURANCE TYPE AS A VARIABLE? 4198 02:32:58,440 --> 02:33:01,080 >>INSURANCE TYPE, I'M SURE 4199 02:33:01,080 --> 02:33:01,800 WE'LL HAVE THAT INFORMATION IN 4200 02:33:01,800 --> 02:33:04,320 THE MEDICAL RECORDS FOR SURE. 4201 02:33:04,320 --> 02:33:04,600 NO? 4202 02:33:04,600 --> 02:33:06,400 >>I DOUBT IT ACTUALLY IN THE 4203 02:33:06,400 --> 02:33:07,880 MEDICAL RECORD. 4204 02:33:07,880 --> 02:33:09,480 YEAH, IT MIGHT BE IN 4205 02:33:09,480 --> 02:33:11,680 ADMINISTRATIVE DATA BUT THE 4206 02:33:11,680 --> 02:33:12,680 STUFF YOU TYPICALLY CRAWL OR 4207 02:33:12,680 --> 02:33:18,880 SCRAPE IN THE DHR, WE ARE NOT 4208 02:33:18,880 --> 02:33:20,320 VERY GOOD AS CLINICIANS 4209 02:33:20,320 --> 02:33:22,360 >>THERE'S A LOT OF DEMOGRAPHIC 4210 02:33:22,360 --> 02:33:23,400 QUESTIONS THAT WOULD GET AT 4211 02:33:23,400 --> 02:33:23,600 THAT. 4212 02:33:23,600 --> 02:33:25,240 >>IF THERE'S ANY WAY TO GO 4213 02:33:25,240 --> 02:33:25,480 BACK. 4214 02:33:25,480 --> 02:33:26,960 >>YOURS DOES? 4215 02:33:26,960 --> 02:33:28,680 OKAY. THEN I GUESS IT DOES. 4216 02:33:28,680 --> 02:33:30,400 >>AMAZING. 4217 02:33:30,400 --> 02:33:32,360 THAT WILL BE RELEVANT TO TEASE 4218 02:33:32,360 --> 02:33:34,760 OUT ESPECIALLY LOOKING AT 4219 02:33:34,760 --> 02:33:36,280 ASSOCIATIONS BETWEEN INSURANCE 4220 02:33:36,280 --> 02:33:37,880 CHURN ESPECIALLY NOW AS KIDS 4221 02:33:37,880 --> 02:33:39,280 POPPING OFF OF MEDICAID, IF THEY 4222 02:33:39,280 --> 02:33:42,400 GET COVERAGE AGAIN, DO THEY GO 4223 02:33:42,400 --> 02:33:44,200 AND EXCHANGE OR EMPLOYER 4224 02:33:44,200 --> 02:33:45,640 INSURED, THAT'S GOING TO BE VERY 4225 02:33:45,640 --> 02:33:47,920 RELEVANT FOR A LOT OF THIS 4226 02:33:47,920 --> 02:33:48,200 STUFF. 4227 02:33:48,200 --> 02:33:50,240 THANK YOU. 4228 02:33:50,240 --> 02:33:51,160 >>OTHER QUESTIONS? 4229 02:33:51,160 --> 02:33:52,520 HOW LONG WILL YOU STAY IN 4230 02:33:52,520 --> 02:33:54,960 CONTACT WITH YOUR SUBJECTS HERE? 4231 02:33:54,960 --> 02:33:58,160 IS THIS ONGOING PROCESS OF 4232 02:33:58,160 --> 02:34:03,400 COLLECTING DATA AND WHAT'S THE 4233 02:34:03,400 --> 02:34:08,760 FINAL PERIOD AND WHAT WILL 4234 02:34:08,760 --> 02:34:09,160 HAPPEN WITH THEM? 4235 02:34:09,160 --> 02:34:10,640 >>WE'RE HOPING TO HAVE THEM FOR 4236 02:34:10,640 --> 02:34:11,560 TEN YEARS. 4237 02:34:11,560 --> 02:34:13,440 WE HAVE A NUMBER OF TOUCH POINTS 4238 02:34:13,440 --> 02:34:14,800 THROUGHOUT THE STUDY WHERE WE 4239 02:34:14,800 --> 02:34:16,680 WILL KEEP IN CONTACT WITH THEM 4240 02:34:16,680 --> 02:34:18,440 WITHOUT NECESSARILY BRINGING 4241 02:34:18,440 --> 02:34:22,520 THEM IN TO INCREASE RETENTION, 4242 02:34:22,520 --> 02:34:27,600 SO LIKE ABCD DOES. 4243 02:34:27,600 --> 02:34:30,720 >>WHILE WE ARE WAITING I 4244 02:34:30,720 --> 02:34:31,560 JUST -- 4245 02:34:31,560 --> 02:34:33,600 >>I JUST WANT TO CONGRATULATE 4246 02:34:33,600 --> 02:34:34,800 YOU ON AN INCREDIBLE EFFORT. 4247 02:34:34,800 --> 02:34:38,360 WE DO THIS ON A SMALL SCALE AND 4248 02:34:38,360 --> 02:34:38,800 THIS IS PHENOMENAL. 4249 02:34:38,800 --> 02:34:41,600 IT'S GOING TO BE SO MUCH WORK. 4250 02:34:41,600 --> 02:34:43,440 >>HOPEFULLY IT GETS BETTER 4251 02:34:43,440 --> 02:34:44,720 BECAUSE IT HAS BEEN TRICKY. 4252 02:34:44,720 --> 02:34:46,360 >>YOU KNOW, MOMS IN A PERIOD OF 4253 02:34:46,360 --> 02:34:48,120 TIME WHEN THEY NEED A LOT OF 4254 02:34:48,120 --> 02:34:49,520 RESOURCES, YOU'RE GETTING THEM 4255 02:34:49,520 --> 02:34:52,440 TO SCANNING, BABIES NEED TO GO 4256 02:34:52,440 --> 02:34:53,840 TO SLEEP TO GO THROUGH SEQUENCES 4257 02:34:53,840 --> 02:34:56,120 AND ALL THE BIO SPECIMENS, I 4258 02:34:56,120 --> 02:34:58,080 THINK THIS PROJECT IS GOING TO 4259 02:34:58,080 --> 02:35:01,000 BE A TREASURE FOR US. 4260 02:35:01,000 --> 02:35:02,560 >>HER HUSBAND PARTICIPATES IN 4261 02:35:02,560 --> 02:35:04,160 THIS STUDY AS ONE OF THE 4262 02:35:04,160 --> 02:35:05,680 INVESTIGATORS AND SHE'S RIGHT. 4263 02:35:05,680 --> 02:35:06,960 THERE'S A LOT THAT I DIDN'T 4264 02:35:06,960 --> 02:35:08,240 COVER AT ALL HERE THAT GOES INTO 4265 02:35:08,240 --> 02:35:10,160 HOW WE'RE GOING TO KEEP THEM IN 4266 02:35:10,160 --> 02:35:10,680 THE STUDY. 4267 02:35:10,680 --> 02:35:13,400 THERE'S A LOT OF EFFORTS AT 4268 02:35:13,400 --> 02:35:14,640 PROVIDING RESOURCES, PROVIDING 4269 02:35:14,640 --> 02:35:16,440 OUTREACH AND THOSE SORTS OF 4270 02:35:16,440 --> 02:35:18,640 THINGS THAT WILL HOPEFULLY HELP 4271 02:35:18,640 --> 02:35:21,480 THE PEOPLE WANT TO STAY IN THE 4272 02:35:21,480 --> 02:35:21,680 STUDY. 4273 02:35:21,680 --> 02:35:23,040 >>AND THAT -- SORRY. 4274 02:35:23,040 --> 02:35:24,480 YES, PLEASE. 4275 02:35:24,480 --> 02:35:26,680 >>THANK YOU. 4276 02:35:26,680 --> 02:35:29,560 I THINK WITH ANY STUDY THAT'S 4277 02:35:29,560 --> 02:35:31,840 THIS INTENSE AND THAT COVERS 4278 02:35:31,840 --> 02:35:33,960 ISSUES, YOU KNOW, OBVIOUS THAT 4279 02:35:33,960 --> 02:35:36,480 COVERS ISSUES THAT ARE 4280 02:35:36,480 --> 02:35:39,880 POTENTIALLY STIGMATIZED OR 4281 02:35:39,880 --> 02:35:40,320 LIKELY STIGMATIZED. 4282 02:35:40,320 --> 02:35:41,760 I WAS VERY HAPPY TO SEE A COUPLE 4283 02:35:41,760 --> 02:35:42,400 OF THINGS. 4284 02:35:42,400 --> 02:35:44,120 ONE IS THAT YOU'RE GETTING RATES 4285 02:35:44,120 --> 02:35:45,600 OF SUBSTANCE USE IN YOUR PILOT 4286 02:35:45,600 --> 02:35:48,560 THAT ARE SIMILAR TO WHAT YOU 4287 02:35:48,560 --> 02:35:49,640 WOULD EXPECT. 4288 02:35:49,640 --> 02:35:51,920 BECAUSE -- AND THAT AMONG THOSE 4289 02:35:51,920 --> 02:35:53,280 WHO YOU INCLUDED, THE 4290 02:35:53,280 --> 02:35:56,360 SELF-REPORT IS FAIRLY ALIGNED 4291 02:35:56,360 --> 02:35:57,800 WITH THE BIOLOGICAL SPECIMENS 4292 02:35:57,800 --> 02:35:58,960 BECAUSE I WOULD IMAGINE THAT 4293 02:35:58,960 --> 02:36:02,360 THERE'S GOING TO BE A LOT OF 4294 02:36:02,360 --> 02:36:03,200 UNDERREPORTING SUBSTANCE USE AND 4295 02:36:03,200 --> 02:36:04,640 THAT I WORRY MORE ABOUT THE 4296 02:36:04,640 --> 02:36:06,240 PEOPLE YOU DON'T GET IN THE 4297 02:36:06,240 --> 02:36:07,880 STUDY THAN THE PEOPLE WHO ARE IN 4298 02:36:07,880 --> 02:36:09,480 THE STUDY BECAUSE THEY'RE -- 4299 02:36:09,480 --> 02:36:10,520 >>MOTIVATED -- 4300 02:36:10,520 --> 02:36:10,960 >>RIGHT. 4301 02:36:10,960 --> 02:36:12,080 THE CONVERTS. 4302 02:36:12,080 --> 02:36:13,760 THEY'VE CONSENTED. 4303 02:36:13,760 --> 02:36:15,040 THEY'RE AGREEING TO PARTICIPATE, 4304 02:36:15,040 --> 02:36:16,560 THEY'RE AGREEING TO ANSWER 4305 02:36:16,560 --> 02:36:16,960 HONESTLY. 4306 02:36:16,960 --> 02:36:19,880 SO I WONDER IF YOU COULD TALK A 4307 02:36:19,880 --> 02:36:21,480 LITTLE BIT ABOUT HOW YOU MANAGE 4308 02:36:21,480 --> 02:36:28,120 THAT BECAUSE WITH ANY VULNERABLE 4309 02:36:28,120 --> 02:36:28,520 POP 4310 02:36:28,520 --> 02:36:30,280 POPULATIONS, YOU KNOW, IT CAN 4311 02:36:30,280 --> 02:36:31,480 AFFECT REPORTING, IT'S REALLY 4312 02:36:31,480 --> 02:36:33,360 CRITICAL THAT YOU ENGAGE THE 4313 02:36:33,360 --> 02:36:34,880 PARTICIPANTS REALLY WELL AND I 4314 02:36:34,880 --> 02:36:36,240 WONDER HOW YOU'VE DONE THAT. 4315 02:36:36,240 --> 02:36:37,840 >>I THINK WE WERE LUCKY IN THE 4316 02:36:37,840 --> 02:36:38,320 PIE LOT. 4317 02:36:38,320 --> 02:36:40,120 I'M NOT SURE THAT ALL OF OUR 4318 02:36:40,120 --> 02:36:41,720 RESOURCES THAT WE HAVE PLANNED 4319 02:36:41,720 --> 02:36:43,160 WERE ACTUALLY INVOKED FOR THE 4320 02:36:43,160 --> 02:36:44,680 PILOT PART BUT ONE OF THE THINGS 4321 02:36:44,680 --> 02:36:46,200 THAT I THINK WE'RE VERY PROUD OF 4322 02:36:46,200 --> 02:36:48,600 IN THE STUDY IS WE'VE INCLUDED 4323 02:36:48,600 --> 02:36:50,600 STUDY NAVIGATORS AT EACH OF THE 4324 02:36:50,600 --> 02:36:53,800 SITES. SOME OF THOSE STUDY 4325 02:36:53,800 --> 02:36:55,640 NAVIGATORS HAVE CERTIFICATION 4326 02:36:55,640 --> 02:36:56,760 PEER RECOVERY SPECIALISTS SO 4327 02:36:56,760 --> 02:36:58,680 HAVE LIVED EXPERIENCE THAT THEY 4328 02:36:58,680 --> 02:37:00,680 CAN RELATE TO, BUT REALLY EVEN 4329 02:37:00,680 --> 02:37:02,360 THE STUDY NAVIGATORS WITHOUT 4330 02:37:02,360 --> 02:37:03,680 THAT CERTIFICATION, THAT IS THE 4331 02:37:03,680 --> 02:37:06,400 GOAL OF THEIR JOB IS TO REALLY 4332 02:37:06,400 --> 02:37:07,800 WORK WITH THESE COMMUNITIES AND 4333 02:37:07,800 --> 02:37:11,520 TRY TO MAKE IT FEEL LIKE A SAFE 4334 02:37:11,520 --> 02:37:12,960 PLACE WHERE THEY BELONG AND 4335 02:37:12,960 --> 02:37:14,200 WHERE THEIR CONTRIBUTION IS 4336 02:37:14,200 --> 02:37:14,640 REALLY IMPORTANT. 4337 02:37:14,640 --> 02:37:18,000 SO I THINK THAT'S A UNIQUE 4338 02:37:18,000 --> 02:37:19,640 ASPECT OF THE STUDY. 4339 02:37:19,640 --> 02:37:21,720 AND RECRUITING FROM TREATMENT 4340 02:37:21,720 --> 02:37:22,800 CENTERS A WIDE RANGE OF 4341 02:37:22,800 --> 02:37:24,240 DIFFERENT PLACES WHERE WE'RE 4342 02:37:24,240 --> 02:37:26,080 HOPING TO REACH THESE 4343 02:37:26,080 --> 02:37:26,400 PARTICIPANTS. 4344 02:37:26,400 --> 02:37:29,200 >>I WANTED TO COMMENT ON THAT 4345 02:37:29,200 --> 02:37:32,000 BECAUSE THE CHALLENGE OF THE 4346 02:37:32,000 --> 02:37:33,240 HBCD BRINGS IT EVEN MUCH HARDER 4347 02:37:33,240 --> 02:37:37,960 THAN THE ABCD BECAUSE YOU'RE 4348 02:37:37,960 --> 02:37:39,760 HAVING PREGNANT WOMEN WHO ARE 4349 02:37:39,760 --> 02:37:41,920 TAKING DRUGS AND THAT ALSO SETS 4350 02:37:41,920 --> 02:37:45,600 IMPLICATIONS FOR STATES THAT 4351 02:37:45,600 --> 02:37:46,240 ACTUALLY CRIMINALIZE THOSE WOMEN 4352 02:37:46,240 --> 02:37:46,800 WHO ARE TAKING DRUGS. 4353 02:37:46,800 --> 02:37:49,040 SO ONE OF THE MAIN CHALLENGES IS 4354 02:37:49,040 --> 02:37:58,320 NOT TO DO ANY HARM TO THOSE 4355 02:37:58,320 --> 02:37:59,560 PAR 4356 02:37:59,560 --> 02:38:00,000 PAR 4357 02:38:00,000 --> 02:38:00,320 PARTICIPANTS. 4358 02:38:00,320 --> 02:38:01,680 I REALIZE THE ENORMOUS 4359 02:38:01,680 --> 02:38:02,880 COMPLEXITY OF RETAINING THESE 4360 02:38:02,880 --> 02:38:03,840 WOMEN AND THEIR CHILDREN BECAUSE 4361 02:38:03,840 --> 02:38:05,440 WE'RE AIMING TOWARDS ADDRESSING 4362 02:38:05,440 --> 02:38:07,960 WOMEN THAT ARE GOING TO BE 4363 02:38:07,960 --> 02:38:09,360 EXTRAORDINARILY VULNERABLE. BUT 4364 02:38:09,360 --> 02:38:10,840 WE NEED TO BITE THE BULLET AND 4365 02:38:10,840 --> 02:38:12,720 TRY TO FIGURE OUT HOW WE CAN GET 4366 02:38:12,720 --> 02:38:15,680 IT DONE AND I KNOW MICHELLE AND 4367 02:38:15,680 --> 02:38:17,800 HER TEAM HAVE BEEN WORKING 4368 02:38:17,800 --> 02:38:21,560 REALLY INCREDIBLY HARD TO MAKE 4369 02:38:21,560 --> 02:38:23,920 THIS POSSIBLE AND WE LOOK 4370 02:38:23,920 --> 02:38:25,880 FORWARD TO GET THE UPDATE NEXT 4371 02:38:25,880 --> 02:38:28,520 YEAR AND ALL ALONG, BUT YOU'RE 4372 02:38:28,520 --> 02:38:30,000 ALL VERY WELCOME TO KEEP IN 4373 02:38:30,000 --> 02:38:32,560 TOUCH AND PARTICIPATE WITH YOUR 4374 02:38:32,560 --> 02:38:33,600 SUGGESTIONS, SO MICHELLE AND 4375 02:38:33,600 --> 02:38:35,600 YOUR TEAM, THANKS VERY, VERY 4376 02:38:35,600 --> 02:38:35,800 MUCH. 4377 02:38:35,800 --> 02:38:37,640 >>THANK YOU. 4378 02:38:37,640 --> 02:38:38,560 >>FOR TAKING THE LEAD ON THIS. 4379 02:38:38,560 --> 02:38:40,280 THANKS A LOT AND I THINK THAT 4380 02:38:40,280 --> 02:38:43,480 NOW WE CAN ADJOURN FOR LUNCH. 4381 02:38:43,480 --> 02:38:43,680 GEORGE? 4382 02:38:43,680 --> 02:38:44,360 >>YEAH. 4383 02:38:44,360 --> 02:38:46,560 I JUST WANT TO ALSO OFFER MY 4384 02:38:46,560 --> 02:38:52,280 CONGRATULATIONS TO BOTH ABCD AND 4385 02:38:52,280 --> 02:38:53,640 HBCD BECAUSE I'M ASSUMING 4386 02:38:53,640 --> 02:38:55,280 EVERYBODY HERE REALIZES HOW MUCH 4387 02:38:55,280 --> 02:38:57,720 WORK GOES INTO COORDINATING AND 4388 02:38:57,720 --> 02:39:00,960 WORKING THROUGH THESE EFFORTS, 4389 02:39:00,960 --> 02:39:03,520 BUT THE RICHNESS OF THE DATABASE 4390 02:39:03,520 --> 02:39:07,680 IS EXTRAORDINARY AND SO I MAY 4391 02:39:07,680 --> 02:39:10,840 NOT BE AS PROUD AS NORA BECAUSE 4392 02:39:10,840 --> 02:39:12,600 NORA HAS BEEN PUSHING BOTH OF 4393 02:39:12,600 --> 02:39:14,640 THESE STUDIES WITH ALL OF HER 4394 02:39:14,640 --> 02:39:17,760 ENERGY, BUT I'M VERY, VERY PROUD 4395 02:39:17,760 --> 02:39:18,920 THAT WE'RE PART OF IT. 4396 02:39:18,920 --> 02:39:23,120 SO THANKS, BOTH OF YOU. 4397 02:39:23,120 --> 02:39:24,760 >>WE CAN ADJOURN FOR LUNCH. 4398 02:39:24,760 --> 02:39:27,600 >>WHEN DO YOU WANT US TO COME 4399 02:39:27,600 --> 02:39:27,800 BACK? 4400 02:39:27,800 --> 02:39:31,400 >>WE WILL BE STARTING AT 1:30. 4401 02:39:31,400 --> 02:39:32,680 SO GET HERE TEN MINUTES BEFORE 4402 02:39:32,680 --> 02:39:35,320 1:30 WE CAN GET STARTED ON TIME 4403 02:39:35,320 --> 02:39:37,760 AT 1:30. 4404 02:39:37,760 --> 02:39:38,040 OKAY. 4405 02:39:38,040 --> 02:39:40,800 >>EVERYONE, WE WILL START AT 4406 02:39:40,800 --> 02:39:41,560 1:30. 4407 02:39:41,560 --> 02:39:44,920 >>BE HERE AT 1:20 SO WE CAN 4408 02:39:44,920 --> 02:39:45,760 START AT 1:30. 4409 02:39:45,760 --> 02:39:49,120 IT'S A GREAT PLEASURE TO 4410 02:39:49,120 --> 02:39:50,320 INTRODUCE DR. JEFF BOISSONEAULT, 4411 02:39:50,320 --> 02:39:54,760 WHO IS GOING TO TALK TODAY ABOUT 4412 02:39:54,760 --> 02:39:57,920 ALCOHOL AND PAIN, SPECIFIC TITLE 4413 02:39:57,920 --> 02:39:59,120 IS DECODING BIDIRECTIONAL 4414 02:39:59,120 --> 02:40:01,920 INTERACTION BETWEEN ALCOHOL AND 4415 02:40:01,920 --> 02:40:02,120 PAIN. 4416 02:40:02,120 --> 02:40:03,800 DR. BOISSONEAULT SERVES AS 4417 02:40:03,800 --> 02:40:05,600 ASSOCIATE PROFESSOR IN 4418 02:40:05,600 --> 02:40:06,560 DEPARTMENT OF ANESTHESIOLOGY AT 4419 02:40:06,560 --> 02:40:09,160 UNIVERSITY OF MINNESOTA WHERE HE 4420 02:40:09,160 --> 02:40:12,560 DIRECTS THE MINNESOTA ALCOHOL 4421 02:40:12,560 --> 02:40:13,560 AND PAIN LAB. 4422 02:40:13,560 --> 02:40:24,240 HE WAS ASSOCIATE PROFESSOR UNTIL 4423 02:40:24,240 --> 02:40:25,960 RECENTLY, CO-DIRECTOR OF THE 4424 02:40:25,960 --> 02:40:27,480 PAIN RESEARCH AT UNIVERSITY OF 4425 02:40:27,480 --> 02:40:29,320 FLORIDA, RESEARCH INTERESTS 4426 02:40:29,320 --> 02:40:33,040 FOCUS ON NEUROPHYSIOLOGIC AND 4427 02:40:33,040 --> 02:40:34,400 PSYCHOSOCIAL MECHANISMS 4428 02:40:34,400 --> 02:40:35,560 UNDERLYING THE BIDIRECTIONAL 4429 02:40:35,560 --> 02:40:40,320 ASSOCIATION BETWEEN PAIN AND 4430 02:40:40,320 --> 02:40:45,280 SUBSTANCE USE, ALSO INVOLVED IN 4431 02:40:45,280 --> 02:40:47,360 STUDIES REGARDING CORTICAL 4432 02:40:47,360 --> 02:40:49,400 BRAINSTEM REACTION UNDERLYING 4433 02:40:49,400 --> 02:40:51,080 PLACEBO ANALGESIA AND 4434 02:40:51,080 --> 02:40:52,440 NON-PHARMACOLOGIC APPROACHES TO 4435 02:40:52,440 --> 02:41:03,080 IMPROVE PAIN MODULATORY CAPACITG 4436 02:41:36,640 --> 02:41:42,360 QUESTIONS OR SPEAKING. 4437 02:41:42,360 --> 02:41:47,920 >>NOW THAT WE HAVE THE PATENT 4438 02:41:47,920 --> 02:41:52,680 AND WE HAVE THIS IN ENGLISH AND 4439 02:41:52,680 --> 02:41:59,120 WE HAVE A PARAGRAPH FOR THE 4440 02:41:59,120 --> 02:41:59,520 PROTOCOL, -- 4441 02:41:59,520 --> 02:42:01,320 >>THANK YOU FOR THAT 4442 02:42:01,320 --> 02:42:01,680 INTRODUCTION. 4443 02:42:01,680 --> 02:42:03,240 I'M DELIGHTED TO BE ABLE TO 4444 02:42:03,240 --> 02:42:03,800 PRESENT TODAY. 4445 02:42:03,800 --> 02:42:06,760 I'M SORRY I COULDN'T BE THERE IN 4446 02:42:06,760 --> 02:42:08,520 PERSON BUT WE JUST MOVED TO 4447 02:42:08,520 --> 02:42:09,720 MINNESOTA, IT WAS NOT A GOOD 4448 02:42:09,720 --> 02:42:12,360 TIME TO GET BACK ON PLANE AND 4449 02:42:12,360 --> 02:42:12,720 TRAVEL. 4450 02:42:12,720 --> 02:42:14,600 SO, THANK YOU FOR THE 4451 02:42:14,600 --> 02:42:14,880 INVITATION. 4452 02:42:14,880 --> 02:42:17,360 I'LL BE TALKING ABOUT A RECENT 4453 02:42:17,360 --> 02:42:18,640 WORK REGARDING BIDIRECTIONAL 4454 02:42:18,640 --> 02:42:21,600 ASSOCIATIONS BETWEEN ALCOHOL AND 4455 02:42:21,600 --> 02:42:21,800 PAIN. 4456 02:42:21,800 --> 02:42:23,040 AND FIRST I WANT TO START BY 4457 02:42:23,040 --> 02:42:24,760 ACKNOWLEDGING ALL OF THE FOLKS I 4458 02:42:24,760 --> 02:42:26,680 WORK WITH TO ACTUALLY GET THIS 4459 02:42:26,680 --> 02:42:28,800 DONE, THE NUMBER OF 4460 02:42:28,800 --> 02:42:29,920 COLLABORATORS AT THE UNIVERSITY 4461 02:42:29,920 --> 02:42:33,600 OF FLORIDA ACROSS THE COUNTRY, 4462 02:42:33,600 --> 02:42:35,120 POSTDOCS, GRADUATE STUDENTS, 4463 02:42:35,120 --> 02:42:39,880 STAFF AND FUNDING SUPPORT FROM 4464 02:42:39,880 --> 02:42:42,000 NIAAA, U.S. CENTER FOR ADDICTION 4465 02:42:42,000 --> 02:42:43,240 RESEARCH HAVE ALL BEEN REALLY 4466 02:42:43,240 --> 02:42:52,040 IMPORTANT PLAYERS IN THIS WORK. 4467 02:42:52,040 --> 02:42:53,440 THANKS TO EVERYONE. 4468 02:42:53,440 --> 02:42:55,840 I'M GOING TO GIVE A BRIEF 4469 02:42:55,840 --> 02:42:57,920 DIRECTION AND STUDIES LOOKING AT 4470 02:42:57,920 --> 02:42:59,480 PAIN AS A APPROXIMATELY 4471 02:42:59,480 --> 02:43:00,960 ANTECEDENT FOR ALCOHOL USE, 4472 02:43:00,960 --> 02:43:02,400 EXPERIMENTAL STUDIES, FOLLOWED 4473 02:43:02,400 --> 02:43:04,080 BY EXPERIMENTAL STUDIES 4474 02:43:04,080 --> 02:43:05,040 REGARDING ACUTE ANALGESIC 4475 02:43:05,040 --> 02:43:07,920 EFFECTS OF ALCOHOL, AND THEN 4476 02:43:07,920 --> 02:43:12,360 FINALLY CONCLUDE WITH DISCUSSION 4477 02:43:12,360 --> 02:43:13,760 AND FUTURE DIRECTIONS. 4478 02:43:13,760 --> 02:43:16,160 I THINK EVERYBODY IS PRETTY 4479 02:43:16,160 --> 02:43:17,480 AWARE OF THE BURDEN THAT CHRONIC 4480 02:43:17,480 --> 02:43:23,120 PAIN AND PAIN IN GENERAL PLACES 4481 02:43:23,120 --> 02:43:23,800 ON SOCIETY. 4482 02:43:23,800 --> 02:43:28,640 SO ABOUT 1 IN 5 U.S. ADULTS HAVE 4483 02:43:28,640 --> 02:43:29,040 CHRONIC PAIN. 4484 02:43:29,040 --> 02:43:30,680 8% HAVE HIGH IMPACT CHRONIC PAIN 4485 02:43:30,680 --> 02:43:33,680 THAT LIMITS ACTIVITIES ON MOST 4486 02:43:33,680 --> 02:43:35,120 DAYS, ELEVATED AMONG CERTAIN 4487 02:43:35,120 --> 02:43:37,280 GROUPS INCLUDING OLDER ADULTS, 4488 02:43:37,280 --> 02:43:39,640 WOMEN, VETERANS, AND THOSE 4489 02:43:39,640 --> 02:43:41,120 LIVING IN POVERTY. 4490 02:43:41,120 --> 02:43:45,280 OVERALL COST TO THE U.S. ECONOMY 4491 02:43:45,280 --> 02:43:46,640 ARE STAGGERING OVER $600 BILLION 4492 02:43:46,640 --> 02:43:49,360 PER YEAR, JUST IN THE U.S. 4493 02:43:49,360 --> 02:43:51,480 AND UNFORTUNATELY, OUR FRONTLINE 4494 02:43:51,480 --> 02:43:53,440 TREATMENTS FOR CHRONIC PAIN HAVE 4495 02:43:53,440 --> 02:43:56,280 RELATIVELY POOR EFFICACY AND 4496 02:43:56,280 --> 02:43:59,360 SIGNIFICANT SIDE EFFECTS 4497 02:43:59,360 --> 02:44:00,560 INCLUDING OPIOIDS. 4498 02:44:00,560 --> 02:44:04,240 IN THAT CONTEXT IT'S NOT 4499 02:44:04,240 --> 02:44:06,840 SURPRISING THAT APPROXIMATELY 25 4500 02:44:06,840 --> 02:44:09,440 TO 40% OF INDIVIDUALS ENGAGE IN 4501 02:44:09,440 --> 02:44:10,440 USE OF ALCOHOL TO SELF-MANAGE 4502 02:44:10,440 --> 02:44:11,240 PAIN. 4503 02:44:11,240 --> 02:44:13,120 THIS DATA COMES FROM A 2009 4504 02:44:13,120 --> 02:44:17,040 SURVEY FROM RILEY AND KING OF 4505 02:44:17,040 --> 02:44:20,280 INDIVIDUALS WITH ORAL FACIAL OR 4506 02:44:20,280 --> 02:44:23,480 ARTHRITIS PAIN, FOUND SEVERAL 4507 02:44:23,480 --> 02:44:25,840 RISK FACTORS TENDING TO 4508 02:44:25,840 --> 02:44:26,960 PREDISPOSE FOLKS. 4509 02:44:26,960 --> 02:44:28,400 THAT INCLUDED BEING MALE, 4510 02:44:28,400 --> 02:44:31,240 YOUNGER, HAVING MORE SEVERE 4511 02:44:31,240 --> 02:44:34,160 PAIN, HIGHER SES, WHITE RACIAL 4512 02:44:34,160 --> 02:44:35,440 IDENTITY, GREATER DEPRESSION, 4513 02:44:35,440 --> 02:44:36,920 LONGER PAIN DURATION, AND 4514 02:44:36,920 --> 02:44:39,000 CONCERNINGLY GIVEN THE DATA THAT 4515 02:44:39,000 --> 02:44:41,080 DR. KOOB PRESENTED EARLIER ABOUT 4516 02:44:41,080 --> 02:44:44,440 THE ROLE OF ALCOHOL IN OPIOID 4517 02:44:44,440 --> 02:44:46,400 OVERDOSES, OPIOID CONSEQUENCES, 4518 02:44:46,400 --> 02:44:48,560 USE OF PRESCRIPTION ANALGESICS 4519 02:44:48,560 --> 02:44:49,800 WAS ASSOCIATED WITH GREATER 4520 02:44:49,800 --> 02:44:52,440 LIKELIHOOD OF USING ALCOHOL FOR 4521 02:44:52,440 --> 02:44:53,240 PAIN SELF-MANAGEMENT. 4522 02:44:53,240 --> 02:44:55,360 SO THERE ARE A NUMBER OF RISKS 4523 02:44:55,360 --> 02:44:58,880 AND CONCERNS THAT ARE ASSOCIATED 4524 02:44:58,880 --> 02:44:59,960 WITH THIS BEHAVIOR. 4525 02:44:59,960 --> 02:45:01,440 ONE IS THAT ABOUT 3/4 OF THE 4526 02:45:01,440 --> 02:45:03,400 MOST PRESCRIBED DRUGS IN THE 4527 02:45:03,400 --> 02:45:05,160 U.S. HAVE POTENTIALLY HARMFUL 4528 02:45:05,160 --> 02:45:07,440 INTERACTIONS WITH ALCOHOL THAT 4529 02:45:07,440 --> 02:45:11,680 INCLUDES ALL OPIOID ANALGESICS, 4530 02:45:11,680 --> 02:45:12,240 ANTIDEPRESSANTS, NSAIDs, 4531 02:45:12,240 --> 02:45:20,880 ACETAMINOPHEN, GABAPENTIN. 4532 02:45:20,880 --> 02:45:31,280 POLYPHARMACY IS COMMON. 4533 02:45:36,480 --> 02:45:37,640 BENZODIAZEPINES AND MUSCLE 4534 02:45:37,640 --> 02:45:39,440 RELAXANTS, EXCEEDING MODERATE 4535 02:45:39,440 --> 02:45:40,160 DRINKING GUIDELINES. 4536 02:45:40,160 --> 02:45:42,120 CHRONIC HEAVY USE OF ALCOHOL CAN 4537 02:45:42,120 --> 02:45:44,280 INCREASE RISK OF DEVELOPING A 4538 02:45:44,280 --> 02:45:47,160 PAINFUL ALCOHOL-RELATED 4539 02:45:47,160 --> 02:45:49,800 NEUROPATHY WHICH AFFECTS 25 TO 4540 02:45:49,800 --> 02:45:51,320 60% OF PEOPLE WITH ALCOHOL USE 4541 02:45:51,320 --> 02:45:52,520 DISORDER AND RELIEF FROM 4542 02:45:52,520 --> 02:46:00,640 DRINKING ALCOHOL WITH PROVIDE 4543 02:46:00,640 --> 02:46:01,920 AADDITIONAL NEGATIVE 4544 02:46:01,920 --> 02:46:02,280 REINFORCEMENT. 4545 02:46:02,280 --> 02:46:04,520 ALCOHOL WITHDRAWAL INCREASES 4546 02:46:04,520 --> 02:46:11,040 PAIN SEVERITY AND SENSITIVITY, 4547 02:46:11,040 --> 02:46:12,480 REPEATED BINGE-WITHDRAWAL CYCLES 4548 02:46:12,480 --> 02:46:13,520 INCREASE PAIN AND EXACERBATION 4549 02:46:13,520 --> 02:46:15,840 AND ALCOHOL USE IN ITSELF 4550 02:46:15,840 --> 02:46:18,480 RESULTS IN SIGNIFICANT COST 4551 02:46:18,480 --> 02:46:19,240 EVERY YEAR. 4552 02:46:19,240 --> 02:46:25,160 THIS IS A REALLY NICE SCHEMATIC 4553 02:46:25,160 --> 02:46:35,640 FIGURE FROM 2009. 4554 02:46:35,640 --> 02:46:37,920 THERE ARE ACUTE AFFECTS. 4555 02:46:37,920 --> 02:46:44,280 ANALGESIC ESPECIALLY IN SHORT 4556 02:46:44,280 --> 02:46:45,240 TERM, ABSTINENCE INDUCED 4557 02:46:45,240 --> 02:46:46,320 HYPERALGESIA, INCREASED RISK OF 4558 02:46:46,320 --> 02:46:47,440 DEVELOPING CHRONIC PAIN. 4559 02:46:47,440 --> 02:46:50,320 AT THE SAME TIME, PAIN CAN HAVE 4560 02:46:50,320 --> 02:46:51,920 SIGNIFICANT EFFECTS ON SUBSTANCE 4561 02:46:51,920 --> 02:46:53,560 USE, CAN MOTIVATE SUBSTANCE USE, 4562 02:46:53,560 --> 02:46:55,280 INCLUDING AS A MEANS OF COPING 4563 02:46:55,280 --> 02:47:00,120 WITH PAIN, CAN ACT AS BARRIER TO 4564 02:47:00,120 --> 02:47:02,000 CESSATION, INCREASE RISK OF 4565 02:47:02,000 --> 02:47:03,480 DEVELOPING SUBSTANCE USE 4566 02:47:03,480 --> 02:47:04,760 DISORDERS, A VICIOUS CYCLE WHERE 4567 02:47:04,760 --> 02:47:08,200 PAIN AND SUBSTANCE USE CAN 4568 02:47:08,200 --> 02:47:09,560 INCREASE -- CAN BE INVOLVED IN 4569 02:47:09,560 --> 02:47:10,320 MAINTENANCE AND PROGRESSION OF 4570 02:47:10,320 --> 02:47:12,600 BOTH CONDITIONS, SO IT'S 4571 02:47:12,600 --> 02:47:15,200 IMPORTANT WE DISENTANGLE AND TRY 4572 02:47:15,200 --> 02:47:17,200 TO BETTER UNDERSTAND WHAT'S 4573 02:47:17,200 --> 02:47:19,880 GOING ON HERE MECHANISTICALLY. 4574 02:47:19,880 --> 02:47:24,080 MY COLLEAGUES AND I PUT TOGETHER 4575 02:47:24,080 --> 02:47:28,120 A MODEL, THEORETICAL MODEL, 4576 02:47:28,120 --> 02:47:29,080 LOOKING AT THE PAIN SUBSTANCE 4577 02:47:29,080 --> 02:47:30,480 USE DIRECTION OF THE FIGURE I 4578 02:47:30,480 --> 02:47:31,720 SHOWED BEFORE. 4579 02:47:31,720 --> 02:47:34,000 SO REALLY TRYING TO DRILL DOWN 4580 02:47:34,000 --> 02:47:37,920 AND DEFINE A TESTABLE MODEL 4581 02:47:37,920 --> 02:47:39,320 FOCUSED ON MODIFIABLE 4582 02:47:39,320 --> 02:47:41,560 PSYCHOSOCIAL FACTORS, LOOKING AT 4583 02:47:41,560 --> 02:47:43,880 WHAT MIGHT BE DRIVING THAT 4584 02:47:43,880 --> 02:47:44,960 PROXIMAL RELATIONSHIP BETWEEN 4585 02:47:44,960 --> 02:47:48,200 PAIN AND THEN USE OF SUBSTANCES 4586 02:47:48,200 --> 02:47:49,000 INCLUDING ALCOHOL. 4587 02:47:49,000 --> 02:47:56,680 SO WE CALL THIS THE CANUE MODEL, 4588 02:47:56,680 --> 02:47:58,040 I MENTION IT BECAUSE WE'RE 4589 02:47:58,040 --> 02:47:59,400 EXCITED ABOUT TESTING THIS MODEL 4590 02:47:59,400 --> 02:48:00,600 FURTHER AND WE HAVE SOME DATA 4591 02:48:00,600 --> 02:48:02,880 THAT I'M GOING TO SHOW IN A 4592 02:48:02,880 --> 02:48:08,400 COUPLE MINUTES SHOWING THAT 4593 02:48:08,400 --> 02:48:09,920 EXPECTANCY AND PAIN-RELATED 4594 02:48:09,920 --> 02:48:12,960 NEGATIVE AFFECT ARE ALREADY 4595 02:48:12,960 --> 02:48:15,280 PLAYING A HYPOTHESIZED ROLE. 4596 02:48:15,280 --> 02:48:18,560 WE DO POINT OUT NON-MODIFIABLE 4597 02:48:18,560 --> 02:48:19,160 BIOLOGICAL AND PSYCHOSOCIAL 4598 02:48:19,160 --> 02:48:20,480 FACTORS THAT ARE IMPORTANT HERE, 4599 02:48:20,480 --> 02:48:23,800 SO THIS COULD INCLUDE RACE AND 4600 02:48:23,800 --> 02:48:26,040 ETHNICITY, SEX, GENDER IDENTITY, 4601 02:48:26,040 --> 02:48:27,400 SOCIOECONOMIC STATUS, HISTORY OF 4602 02:48:27,400 --> 02:48:29,040 SUBSTANCE USE, HISTORY OF MOOD 4603 02:48:29,040 --> 02:48:30,600 DISTURBANCE FOR MENTAL HEALTH 4604 02:48:30,600 --> 02:48:32,040 DISORDERS AND PEOPLE'S PAIN 4605 02:48:32,040 --> 02:48:34,400 CHARACTERISTICS SO DURATION OF 4606 02:48:34,400 --> 02:48:43,920 THEIR PAIN, SEVERITY AND 4607 02:48:43,920 --> 02:48:44,440 UNPLEASANTNESS, FREQUENCY, 4608 02:48:44,440 --> 02:48:45,640 MUSCULOSKELETAL OR CANCER 4609 02:48:45,640 --> 02:48:56,240 RELATED TO PLAY A ROLE. 4610 02:48:56,240 --> 02:48:59,400 THERE'S GROWING EVIDENCE IT'S A 4611 02:48:59,400 --> 02:49:00,560 PREDISPOSING FACTOR ACROSS THE 4612 02:49:00,560 --> 02:49:01,640 ADULT LIFESPAN. 4613 02:49:01,640 --> 02:49:03,960 WE'VE DONE SOME WORK IN COLLEGE 4614 02:49:03,960 --> 02:49:08,240 STUDENTS AND THERE'S PUBLISHED 4615 02:49:08,240 --> 02:49:09,960 DATA FROM MOOD IN THE MID-2000S 4616 02:49:09,960 --> 02:49:14,520 SHOWING THAT APPLIES TO OLDER 4617 02:49:14,520 --> 02:49:14,920 ADULTS. 4618 02:49:14,920 --> 02:49:17,240 KATIE HAS SHOWN USING DATA FROM 4619 02:49:17,240 --> 02:49:19,440 THE U.K. STUDY AND PROJECT 4620 02:49:19,440 --> 02:49:22,280 COMBINE THAT GREATER SEVERITY IS 4621 02:49:22,280 --> 02:49:24,040 ASSOCIATED WITH GREATER ODDS TO 4622 02:49:24,040 --> 02:49:26,400 RETURN TO DRINKING, FLIPPING 4623 02:49:26,400 --> 02:49:28,120 THIS IN A POSITIVE DIRECTION 4624 02:49:28,120 --> 02:49:31,240 WE'VE SHOWN IN RECENT DATA FROM 4625 02:49:31,240 --> 02:49:32,400 TREATMENT, RESIDENTIAL TREATMENT 4626 02:49:32,400 --> 02:49:35,080 SEEKERS IN NORTH CENTRAL FLORIDA 4627 02:49:35,080 --> 02:49:36,120 THAT REDUCTION IN PAIN SEVERITY 4628 02:49:36,120 --> 02:49:40,520 OVER THE COURSE OF RESIDENTIAL 4629 02:49:40,520 --> 02:49:44,440 TREATMENT OR EARLY ABSTINENCE 4630 02:49:44,440 --> 02:49:45,320 PREDICTS REDUCED CRAVINGS, 4631 02:49:45,320 --> 02:49:46,400 GETTING TO EFFECTIVE PAIN 4632 02:49:46,400 --> 02:49:47,720 MANAGEMENT AND TREATMENT MAY BE 4633 02:49:47,720 --> 02:49:50,040 AN IMPORTANT WAY TO HELP IMPROVE 4634 02:49:50,040 --> 02:49:52,520 OUTCOMES FOR FOLKS. 4635 02:49:52,520 --> 02:49:54,360 EXPERIMENTALLY, IT'S BEEN SHOWN 4636 02:49:54,360 --> 02:49:55,840 THAT PAIN INCREASES URGE AND 4637 02:49:55,840 --> 02:49:58,480 INTENTION TO DRINK IN HEALTHY 4638 02:49:58,480 --> 02:49:59,600 YOUNG ADULTS. 4639 02:49:59,600 --> 02:50:02,200 WE HAVE -- WANTED TO BUILD OFF 4640 02:50:02,200 --> 02:50:03,560 FINDINGS SHOWING PAIN WAS 4641 02:50:03,560 --> 02:50:04,480 INCREASING URGENT INTENTION TO 4642 02:50:04,480 --> 02:50:08,360 DRINK BY GETTING INTO OTHER 4643 02:50:08,360 --> 02:50:10,240 ASPECTS OF THAT CONSTRUCT. 4644 02:50:10,240 --> 02:50:13,920 SO OUR FIRST ATTEMPT WAS THE 4645 02:50:13,920 --> 02:50:19,640 STRENGTH TRAINING AND ALCOHOL 4646 02:50:19,640 --> 02:50:22,560 CONSUMPTION STUDY, TAKING A 4647 02:50:22,560 --> 02:50:25,160 BEHAVIORAL ECONOMIC APPROACH TO 4648 02:50:25,160 --> 02:50:25,360 THIS. 4649 02:50:25,360 --> 02:50:28,560 THIS STUDY WE HAD 53 4650 02:50:28,560 --> 02:50:33,960 PARTICIPANTS, 30 WERE WOMEN, 4651 02:50:33,960 --> 02:50:35,640 COMPLETE E-CENTRIC EXERCISE OF 4652 02:50:35,640 --> 02:50:41,880 THE BICEP, OR LOW INTENSITY 4653 02:50:41,880 --> 02:50:46,720 CONCENTRIC, SHAM DOMES, DOES NOT 4654 02:50:46,720 --> 02:50:49,560 PRODUCE MUSCLE SORENESS. 4655 02:50:49,560 --> 02:50:53,120 e-CENTRIC PEAKS 24-48 HOURS 4656 02:50:53,120 --> 02:50:54,920 AFTER EXERCISE. 4657 02:50:54,920 --> 02:50:56,320 WE ASSESSED DEMAND FOR ALCOHOL 4658 02:50:56,320 --> 02:50:57,560 BEFORE EXERCISE AND 48 HOURS 4659 02:50:57,560 --> 02:50:59,040 AFTER EXERCISE WHEN WE EXPECTED 4660 02:50:59,040 --> 02:51:01,960 PAIN TO PEAK. 4661 02:51:01,960 --> 02:51:05,000 AND WE LOOKED AT SEVERAL 4662 02:51:05,000 --> 02:51:06,480 MEASURES DERIVED FROM ALCOHOL 4663 02:51:06,480 --> 02:51:07,000 PURCHASE TASK INCLUDING 4664 02:51:07,000 --> 02:51:08,320 INTENSITY, NUMBER OF DRINKS THAT 4665 02:51:08,320 --> 02:51:09,280 AN INDIVIDUAL WOULD DRINK IF 4666 02:51:09,280 --> 02:51:12,040 THEY WERE FREE IN A HYPOTHETICAL 4667 02:51:12,040 --> 02:51:12,960 SCENARIO, BREAK POINT WHICH IS 4668 02:51:12,960 --> 02:51:17,160 PRICE OF A DRINK WHERE AN 4669 02:51:17,160 --> 02:51:18,440 INDIVIDUAL REPORTS NO 4670 02:51:18,440 --> 02:51:19,680 CONSUMPTION, O-MAX, THE MAXIMUM 4671 02:51:19,680 --> 02:51:23,200 AMOUNT AN INDIVIDUAL WOULD SPEND 4672 02:51:23,200 --> 02:51:25,280 ON ALCOHOL, PMAX, PRICE FOR 4673 02:51:25,280 --> 02:51:26,720 DEMAND BECOMES ELASTIC IN 4674 02:51:26,720 --> 02:51:28,720 ESSENTIAL VALUE WHICH REFLECTS 4675 02:51:28,720 --> 02:51:30,520 THE INDIVIDUAL'S OVERALL 4676 02:51:30,520 --> 02:51:32,560 SENSITIVITY TO PRICE OF ALCOHOL. 4677 02:51:32,560 --> 02:51:35,800 SO IT REFLECTS ITS MORE GENERAL 4678 02:51:35,800 --> 02:51:36,920 INDEX OF DEMAND. 4679 02:51:36,920 --> 02:51:38,240 SO STARTING WITH THE SANITY 4680 02:51:38,240 --> 02:51:46,040 CHECK WE DID FIND THAT THE 4681 02:51:46,040 --> 02:51:47,040 E-CENTRIC INTERVENTION OR DOMES 4682 02:51:47,040 --> 02:51:47,640 PRODUCED PAIN. 4683 02:51:47,640 --> 02:51:49,760 WE SEE A VERY LARGE DIFFERENCE 4684 02:51:49,760 --> 02:51:55,640 BETWEEN OUR DOMES GROUP AND SHAM 4685 02:51:55,640 --> 02:51:56,640 DOMS GROUP. 4686 02:51:56,640 --> 02:52:00,280 AND WE FOUND A PATTERN OF 4687 02:52:00,280 --> 02:52:00,920 INTERESTING GENDER DIFFERENCES 4688 02:52:00,920 --> 02:52:03,560 IN THE RESPONSE OF ALCOHOL 4689 02:52:03,560 --> 02:52:06,160 DEMAND TO MUSCULOSKELETAL PAIN 4690 02:52:06,160 --> 02:52:09,240 AND FOUND FOR MEN INTENSITY FOR 4691 02:52:09,240 --> 02:52:12,120 MEN IN THE DOMS GROUP TENDED TO 4692 02:52:12,120 --> 02:52:12,880 INCREASE FROM PRE-TO POST 4693 02:52:12,880 --> 02:52:13,240 EXERCISE. 4694 02:52:13,240 --> 02:52:17,600 BUT THAT WAS NOT THE CASE FOR 4695 02:52:17,600 --> 02:52:18,080 WOMEN. 4696 02:52:18,080 --> 02:52:19,960 FOR BREAK POINT WE FOUND 4697 02:52:19,960 --> 02:52:21,920 DIVERGENT PATTERN. 4698 02:52:21,920 --> 02:52:25,440 MEN, AGAIN, INCREASED IN BREAK 4699 02:52:25,440 --> 02:52:26,800 POINT AFTER THAT INDUCTION 4700 02:52:26,800 --> 02:52:28,080 MUSCULOSKELETAL PAIN BUT WOMEN 4701 02:52:28,080 --> 02:52:32,560 DECREASED IN BREAK POINT WHICH 4702 02:52:32,560 --> 02:52:34,320 WAS VERY INTERESTING. 4703 02:52:34,320 --> 02:52:36,240 SO, WE WANTED TO FOLLOW UP BY 4704 02:52:36,240 --> 02:52:40,040 LOOKING NOT JUST AT WHAT IS THE 4705 02:52:40,040 --> 02:52:42,240 EFFECT ON ALCOHOL OF PAIN ON 4706 02:52:42,240 --> 02:52:44,560 MOTIVATION TO USE ALCOHOL OR 4707 02:52:44,560 --> 02:52:46,600 REINFORCING EFFECT OF ALCOHOL 4708 02:52:46,600 --> 02:52:48,320 BUT ALSO THE EFFECT OF PAIN ON 4709 02:52:48,320 --> 02:52:51,600 THE WAY THAT PEOPLE CONSUME 4710 02:52:51,600 --> 02:52:56,120 ALCOHOL OR DRINKING TOPOGRAPHY. 4711 02:52:56,120 --> 02:53:00,680 DRINKING TOPOGRAPHY REFLECTS THE 4712 02:53:00,680 --> 02:53:01,680 MICROSTRUCTURE LIKE SIP 4713 02:53:01,680 --> 02:53:03,080 INTERVAL, SIP VOLUME, TOTAL 4714 02:53:03,080 --> 02:53:04,880 AMOUNT CONSUMED, WHICH CAN 4715 02:53:04,880 --> 02:53:07,120 AFFECT THE PHARMACOKINETICS OF 4716 02:53:07,120 --> 02:53:08,400 ALCOHOL DURING THE 4717 02:53:08,400 --> 02:53:09,360 SELF-ADMINISTRATION SESSION WITH 4718 02:53:09,360 --> 02:53:11,840 THE IDEA PEOPLE DRINKING MORE 4719 02:53:11,840 --> 02:53:15,080 RAPIDLY WILL HAVE GREATER AND 4720 02:53:15,080 --> 02:53:19,280 FASTER RISES IN BAC, WHICH CAN 4721 02:53:19,280 --> 02:53:21,040 INCREASE ALCOHOL-RELATED RISK. 4722 02:53:21,040 --> 02:53:24,440 WE HAD FOLKS COME INTO THE LAB, 4723 02:53:24,440 --> 02:53:27,960 20 PARTICIPANTS, HALF WOMEN, AND 4724 02:53:27,960 --> 02:53:28,600 COMPLETED TWO 4725 02:53:28,600 --> 02:53:30,280 SELF-ADMINISTRATION SESSIONS, UP 4726 02:53:30,280 --> 02:53:32,640 TO ONE DRINK IN VIRTUAL REALITY 4727 02:53:32,640 --> 02:53:34,840 WHICH I'LL SAY MORE ABOUT IN A 4728 02:53:34,840 --> 02:53:38,320 MINUTE, WHILE DRINKING THEY 4729 02:53:38,320 --> 02:53:42,960 EITHER EXPERIENCED HEAT PAIN, , 4730 02:53:42,960 --> 02:53:53,040 YOU CAN SEE ON THE THERMODE, AND 4731 02:53:53,040 --> 02:53:55,040 OR NON-NOXIOUS, COMPARED BETWEEN 4732 02:53:55,040 --> 02:53:56,360 HEAT PAIN AND WARMTH. 4733 02:53:56,360 --> 02:54:06,880 TO SAY MORE ABOUT THIS PLATFORM, 4734 02:54:08,360 --> 02:54:11,080 VIRTUAL REALITY PLATFORM, 4735 02:54:11,080 --> 02:54:12,880 RESEMBLING A TYPICAL BAR. 4736 02:54:12,880 --> 02:54:13,920 WE'VE STRAPPED A TRACKER TO THE 4737 02:54:13,920 --> 02:54:17,120 DRINK SO IT'S REPRESENTED IN THE 4738 02:54:17,120 --> 02:54:18,200 VIRTUAL SPACE, THEY ARE ABLE TO 4739 02:54:18,200 --> 02:54:22,720 PICK IT UP, DRINK IT AND PUT IT 4740 02:54:22,720 --> 02:54:25,440 DOWN ON THE COASTER, ALSO A 4741 02:54:25,440 --> 02:54:26,640 SCALE, TRANSMITTING WEIGHT DATA 4742 02:54:26,640 --> 02:54:28,000 REMOTELY TO A COMPUTER WHICH YOU 4743 02:54:28,000 --> 02:54:29,880 CAN'T SEE IN THE SHOT. 4744 02:54:29,880 --> 02:54:32,040 WE KNOW THE VOLUME OF EACH 4745 02:54:32,040 --> 02:54:35,840 INDIVIDUAL SIP AND TIME THAT 4746 02:54:35,840 --> 02:54:37,040 BETWEEN SIPS, SIP INTERVALS. 4747 02:54:37,040 --> 02:54:38,240 WE HAVE A TRACKER ON THE WRIST 4748 02:54:38,240 --> 02:54:40,280 SO THEY KNOW WHERE THEIR HAND IS 4749 02:54:40,280 --> 02:54:42,880 IN SPACE AND THAT FACILITATES 4750 02:54:42,880 --> 02:54:43,560 THE DRINKING. 4751 02:54:43,560 --> 02:54:47,400 THIS IS A SCREEN CAPTURE OF WHAT 4752 02:54:47,400 --> 02:54:49,240 THE BAR LOOKS LIKE. 4753 02:54:49,240 --> 02:54:50,960 IT'S A PRETTY TYPICAL BAR 4754 02:54:50,960 --> 02:54:51,320 ENVIRONMENT. 4755 02:54:51,320 --> 02:54:53,120 THE ONLY THING I'LL POINT OUT 4756 02:54:53,120 --> 02:54:54,680 THERE'S A VIRTUAL DRINKER 4757 02:54:54,680 --> 02:54:55,880 PRESENT IN THE SCREEN SHOT IT 4758 02:54:55,880 --> 02:55:03,200 WAS NOT HERE FOR THE STUDY. 4759 02:55:03,200 --> 02:55:05,920 HEAT PAIN CONDITION DID PRODUCE 4760 02:55:05,920 --> 02:55:07,600 GREATER PAIN INTENSITY THAN 4761 02:55:07,600 --> 02:55:09,720 NON-NOXIOUS CONDITION, AND THIS 4762 02:55:09,720 --> 02:55:11,080 IS JUST ANOTHER ILLUSTRATION OF 4763 02:55:11,080 --> 02:55:13,200 HOW WE DEFINE SIP INTERVAL AND 4764 02:55:13,200 --> 02:55:14,320 SIP VOLUME USING TIME SERIES 4765 02:55:14,320 --> 02:55:16,040 DATA THAT WE DERIVED FROM OUR 4766 02:55:16,040 --> 02:55:21,840 SCALE IN THE VIRTUAL REALITY 4767 02:55:21,840 --> 02:55:24,280 ENVIRONMENT. 4768 02:55:24,280 --> 02:55:26,320 A REPRESENTS SIP INTERVAL, AND 4769 02:55:26,320 --> 02:55:27,800 -- I'M SORRY FROM WHEN THEY PUT 4770 02:55:27,800 --> 02:55:29,600 THE DRINK DOWN TO PICK IT UP 4771 02:55:29,600 --> 02:55:31,160 AGAIN, AND B IS DIFFERENCE IN 4772 02:55:31,160 --> 02:55:32,400 WEIGHT BETWEEN SIPS. 4773 02:55:32,400 --> 02:55:33,600 WE CAN TAKE THAT DIFFERENCE AND 4774 02:55:33,600 --> 02:55:40,240 KNOW THAT THAT WAS THE VOLUME OF 4775 02:55:40,240 --> 02:55:42,000 AN INDIVIDUAL SIP. 4776 02:55:42,000 --> 02:55:44,720 WE FOUND PAIN AFFECTED DRINKING 4777 02:55:44,720 --> 02:55:46,280 TOPOGRAPHY OF MEN BUT NOT WOMEN. 4778 02:55:46,280 --> 02:55:48,440 THE RED LINE IS SIP INTERVAL IN 4779 02:55:48,440 --> 02:55:50,640 WOMEN, YOU CAN SEE BETWEEN THE 4780 02:55:50,640 --> 02:55:51,920 PAINFUL HEAT CONDITION AND WARM 4781 02:55:51,920 --> 02:55:56,880 CONDITION THERE WAS NO 4782 02:55:56,880 --> 02:55:58,120 DIFFERENCE. 4783 02:55:58,120 --> 02:56:01,320 MEN DRINK FASTER IN THE HEAT 4784 02:56:01,320 --> 02:56:01,560 CONDITION. 4785 02:56:01,560 --> 02:56:04,760 WE WANTED OFFED TO LOOK AT 4786 02:56:04,760 --> 02:56:05,760 PUTATIVE RISK FACTORS IN THE 4787 02:56:05,760 --> 02:56:08,520 CANUE MODEL. 4788 02:56:08,520 --> 02:56:09,520 NEGATIVE URGENCY IS HIGHLIGHTED, 4789 02:56:09,520 --> 02:56:12,840 WHAT WE FOUND THROUGH LINEAR 4790 02:56:12,840 --> 02:56:14,200 REGRESSION ANALYSIS IS THAT 4791 02:56:14,200 --> 02:56:15,400 INDIVIDUALS REGARDLESS OF GENDER 4792 02:56:15,400 --> 02:56:19,960 WHO HAD HIGHER NEGATIVE URGENCY 4793 02:56:19,960 --> 02:56:22,080 EXPERIENCED GREATER DECLINE IN 4794 02:56:22,080 --> 02:56:24,560 SIP INTERVAL FROM PAINFUL -- 4795 02:56:24,560 --> 02:56:25,520 WARM CONDITIONS TO HEAT 4796 02:56:25,520 --> 02:56:27,240 CONDITION, IN OTHER WORDS HEAT 4797 02:56:27,240 --> 02:56:28,160 WAS SHORTENING SIP INTERVALS 4798 02:56:28,160 --> 02:56:30,800 MORE IN PEOPLE WITH GREATER 4799 02:56:30,800 --> 02:56:31,200 NEGATIVE URGENCY. 4800 02:56:31,200 --> 02:56:37,800 THAT WAS CONSISTENT WITH 4801 02:56:37,800 --> 02:56:38,920 PREDICTIONS. 4802 02:56:38,920 --> 02:56:41,080 SHIFTING GEARS, ANALGESIC 4803 02:56:41,080 --> 02:56:44,600 EFFECTS OF ALCOHOL, THERE'S A 4804 02:56:44,600 --> 02:56:47,160 LOT OF ANECDOTAL AND CLINICAL 4805 02:56:47,160 --> 02:56:52,040 REPORTS THAT DATE BACK TO 1513, 4806 02:56:52,040 --> 02:56:53,720 PUBLISHED DISSERTATION, PRETTY 4807 02:56:53,720 --> 02:56:54,400 INTERESTING, THERE'S CONSISTENT 4808 02:56:54,400 --> 02:56:56,800 LABORATORY EVIDENCE THAT WAS 4809 02:56:56,800 --> 02:57:01,920 COMPILED BY THOMPSON IN 2017 4810 02:57:01,920 --> 02:57:04,880 ALCOHOL INCREASES PAIN 4811 02:57:04,880 --> 02:57:06,760 THRESHOLDS, THE OVERALL EFFECT 4812 02:57:06,760 --> 02:57:08,040 SIZE, DECREASES PAIN INTENSITY 4813 02:57:08,040 --> 02:57:09,160 IN HEALTHY INDIVIDUALS SO THIS 4814 02:57:09,160 --> 02:57:11,880 IS IN PEOPLE WITHOUT PAIN AND 4815 02:57:11,880 --> 02:57:13,880 EXPERIMENTAL SETTINGS USING A 4816 02:57:13,880 --> 02:57:15,400 VARIETY OF PAIN INDUCTION 4817 02:57:15,400 --> 02:57:17,800 METHODS, COULD BE PRESSURE, 4818 02:57:17,800 --> 02:57:21,920 HEAT, ELECTRIC SHOCK, COLD, ALL 4819 02:57:21,920 --> 02:57:23,920 SORTS OF THINGS. 4820 02:57:23,920 --> 02:57:25,080 LIMITATIONS, THEY WERE OFTEN 4821 02:57:25,080 --> 02:57:32,520 LIMITED TO MEN ONLY, PEOPLE 4822 02:57:32,520 --> 02:57:33,400 WITHOUT CHRONIC PAIN. 4823 02:57:33,400 --> 02:57:42,560 THAT BRINGS ME TO ANALGESIC 4824 02:57:42,560 --> 02:57:45,120 EFFECTS, NIAAA FUNDED R21, THOSE 4825 02:57:45,120 --> 02:57:47,160 REPORTS ARE NOW STARTING TO COME 4826 02:57:47,160 --> 02:57:51,840 OUT, THIS WAS 48 INDIVIDUALS, 36 4827 02:57:51,840 --> 02:57:55,160 WERE WOMEN, 19 CHRONIC JAW PAIN, 4828 02:57:55,160 --> 02:57:57,880 TWO DOUBLE BLIND TESTING 4829 02:57:57,880 --> 02:58:02,280 SESSIONS, ONE RECEIVED 4830 02:58:02,280 --> 02:58:08,560 ALCOHOL-CONTAINING BEVERAGE, .08 4831 02:58:08,560 --> 02:58:10,560 PER DECILITER AFTER THEY 4832 02:58:10,560 --> 02:58:13,920 CONSUMED BEVERAGE WE WAITED 30 4833 02:58:13,920 --> 02:58:17,680 MINUTES, APPROXIMATE PEAK OF 4834 02:58:17,680 --> 02:58:22,800 BRAC, PERFORMED PRESSURE AL 4835 02:58:22,800 --> 02:58:25,560 GOMETRY, ASSESSED PAIN THRESH 4836 02:58:25,560 --> 02:58:27,000 HOLD, INTENSITY TO THREE 4837 02:58:27,000 --> 02:58:33,480 LEVELS, AS WELL AS RATINGS OF 4838 02:58:33,480 --> 02:58:34,240 PERCEIVED PAIN RELIEF. 4839 02:58:34,240 --> 02:58:37,040 THERE ARE A COUPLE TAKEAWAYS. 4840 02:58:37,040 --> 02:58:38,640 ONE, AS WE WOULD EXPECT PEOPLE 4841 02:58:38,640 --> 02:58:40,680 WITH CHRONIC JAW PAIN DID REPORT 4842 02:58:40,680 --> 02:58:51,160 GREATER PAIN INTENSITY AT ALL 4843 02:58:54,800 --> 02:58:55,880 PRESSURE LEVELS 4844 02:58:55,880 --> 02:58:59,480 THERE WAS NO INTERACTION OF 4845 02:58:59,480 --> 02:59:03,280 CHRONIC PAIN STATUS AND 4846 02:59:03,280 --> 02:59:07,080 CONDITION SO THAT'S TO SAY 4847 02:59:07,080 --> 02:59:08,000 ANALGESIC EFFECTS WEREN'T 4848 02:59:08,000 --> 02:59:08,640 SIGNIFICANTLY DIFFERENT 4849 02:59:08,640 --> 02:59:12,720 REGARDLESS OF CHRONIC PAIN OR 4850 02:59:12,720 --> 02:59:13,240 NOT. 4851 02:59:13,240 --> 02:59:14,360 THAT WAS CONTRARY TO 4852 02:59:14,360 --> 02:59:14,920 EXPECTATION. 4853 02:59:14,920 --> 02:59:16,600 WE EXPECTED SOME MODULATION OF 4854 02:59:16,600 --> 02:59:18,640 ANALGESIC EFFECTS IN PEOPLE WITH 4855 02:59:18,640 --> 02:59:20,400 CHRONIC JAW PAIN. 4856 02:59:20,400 --> 02:59:21,800 ANOTHER THING TO HIGHLIGHT IS 4857 02:59:21,800 --> 02:59:24,160 THAT THE CHANGES IN THRESHOLD 4858 02:59:24,160 --> 02:59:27,880 AND INTENSITY THAT WE NOTICED AS 4859 02:59:27,880 --> 02:59:31,200 A RESULT OF ALCOHOL INTAKE WERE 4860 02:59:31,200 --> 02:59:33,000 30% CHANGE. 4861 02:59:33,000 --> 02:59:34,840 THE EFFECT OF ALCOHOL ON 4862 02:59:34,840 --> 02:59:37,120 PERCEIVED PAIN RELIEF COMPARED 4863 02:59:37,120 --> 02:59:39,720 TO PLACEBO WAS 500% CHANGE. 4864 02:59:39,720 --> 02:59:41,280 SO A VERY SIGNIFICANT 4865 02:59:41,280 --> 02:59:43,080 DIFFERENCE, PEOPLE REPORTED 4866 02:59:43,080 --> 02:59:45,120 SIGNIFICANT PAIN RELIEF COMPARED 4867 02:59:45,120 --> 02:59:49,120 TO PLACEBO CONDITION AND ALCOHOL 4868 02:59:49,120 --> 02:59:49,760 CONDITION. 4869 02:59:49,760 --> 02:59:51,760 AND INTERESTING FACET, THAT THE 4870 02:59:51,760 --> 02:59:52,920 CHANGE IN PAIN THRESHOLD AND 4871 02:59:52,920 --> 02:59:54,440 PAIN INTENSITY WAS NOT 4872 02:59:54,440 --> 02:59:55,800 CORRELATED WITH CHANGE IN PAIN 4873 02:59:55,800 --> 02:59:57,800 RELIEF SO THEY SEEMED TO BE -- 4874 02:59:57,800 --> 02:59:58,840 THERE SEEMS TO BE SOMETHING 4875 02:59:58,840 --> 03:00:01,560 GOING ON IN THE WAY PEOPLE ARE 4876 03:00:01,560 --> 03:00:03,440 MAKING A JUDGMENT ABOUT WHETHER 4877 03:00:03,440 --> 03:00:06,200 ALCOHOL RELIEF PAIN AT LEAST IN 4878 03:00:06,200 --> 03:00:08,040 THE CONTEXT WHERE THE 4879 03:00:08,040 --> 03:00:10,120 QUANTITATIVE CHANGES IN PEOPLE'S 4880 03:00:10,120 --> 03:00:11,320 PAIN SENSITIVITY ARE NOT 4881 03:00:11,320 --> 03:00:13,880 NECESSARILY RELATED TO THEIR 4882 03:00:13,880 --> 03:00:15,360 IMPRESSION OF WHETHER IT WORKED. 4883 03:00:15,360 --> 03:00:16,800 THAT'S SOMETHING I'M VERY 4884 03:00:16,800 --> 03:00:19,720 INTERESTED IN FOLLOWING UP ON. 4885 03:00:19,720 --> 03:00:21,200 WE ALSO FOUND EXPECTANCY PLAYED 4886 03:00:21,200 --> 03:00:23,000 AN IMPORTANT ROLE HERE. 4887 03:00:23,000 --> 03:00:27,560 THIS IS A PAPER ACCEPTED IN 4888 03:00:27,560 --> 03:00:29,240 CLINICAL PHARMACOLOGY, IN THE 4889 03:00:29,240 --> 03:00:30,400 ALCOHOL CONDITION PEOPLE WITH 4890 03:00:30,400 --> 03:00:32,200 GREATER EXPECTANCY OF PAIN 4891 03:00:32,200 --> 03:00:34,600 RELIEF FROM ALCOHOL ON THE 4892 03:00:34,600 --> 03:00:36,480 X-AXIS HERE REPORTED -- TENDED 4893 03:00:36,480 --> 03:00:38,800 TO REPORT GREATER PAIN RELIEF. 4894 03:00:38,800 --> 03:00:41,480 AND THIS WAS SUCH THAT A ROUGHLY 4895 03:00:41,480 --> 03:00:42,880 10-POINT INCREASE IN EXPECTANCY 4896 03:00:42,880 --> 03:00:46,760 FROM PAIN RELIEF CORRESPOND TO 4897 03:00:46,760 --> 03:00:51,200 5% INCREASE IN PERCEIVED RELIEF. 4898 03:00:51,200 --> 03:00:55,760 NOW I WANT TO TALK ABOUT THE 4899 03:00:55,760 --> 03:00:56,360 FUNCTIONAL NEUROCORRELATES OF 4900 03:00:56,360 --> 03:00:57,520 ALCOHOL ANALGESIA, MORE OF A 4901 03:00:57,520 --> 03:00:58,880 TEASER BECAUSE WE JUST FINISHED 4902 03:00:58,880 --> 03:01:05,160 COLLECTING ALL OF THE DATA FOR 4903 03:01:05,160 --> 03:01:06,920 NIAAA-FUNDED R01 THAT'S FOCUSED 4904 03:01:06,920 --> 03:01:09,960 ON THIS QUESTION, ENDED UP WITH 4905 03:01:09,960 --> 03:01:11,200 110 PARTICIPANTS WITH GOOD 4906 03:01:11,200 --> 03:01:15,960 fMRI DATA, WHICH WAS EXCITING. 4907 03:01:15,960 --> 03:01:17,840 63 WOMEN, ABOUT 50, 40 WHO WERE 4908 03:01:17,840 --> 03:01:19,960 FAMILY HISTORY POSITIVE WITHOUT 4909 03:01:19,960 --> 03:01:22,520 CHRONIC PAIN AND COMPLETED TWO 4910 03:01:22,520 --> 03:01:25,920 DOUBLE BLIND SESSIONS LIKE THE 4911 03:01:25,920 --> 03:01:26,360 R21. 4912 03:01:26,360 --> 03:01:28,240 WE USED HEAT-BASED TESTING TO 4913 03:01:28,240 --> 03:01:30,520 CHARACTERIZE EFFECTS OF ALCOHOL 4914 03:01:30,520 --> 03:01:32,000 ON THRESHOLD, INTENSITY, PAIN 4915 03:01:32,000 --> 03:01:35,160 RELIEF, AND RESTING STATE AND 4916 03:01:35,160 --> 03:01:40,000 TASKED BASEED fMRI DATA. 4917 03:01:40,000 --> 03:01:42,400 TODAY I'M GOING TO TALK ABOUT 4918 03:01:42,400 --> 03:01:45,640 RESTING STATE FINDINGS. 4919 03:01:45,640 --> 03:01:47,080 SO ONE OF THE AREAS WE'RE 4920 03:01:47,080 --> 03:01:51,600 INTERESTED IN IS LOOKING AT 4921 03:01:51,600 --> 03:01:55,120 FUNCTIONAL CONNECTIVITY OF THE 4922 03:01:55,120 --> 03:01:59,160 MEDIAL CORTICAL SYSTEM, FOCUSING 4923 03:01:59,160 --> 03:02:00,920 ON THE NUCLEUS ACCUMBENS, 4924 03:02:00,920 --> 03:02:02,000 LOOKING AT CONNECT BETWEEN THE 4925 03:02:02,000 --> 03:02:05,240 STRUCTURES THEY HAVE BEEN SHOWN 4926 03:02:05,240 --> 03:02:07,480 TO BE RELATED TO INDIVIDUALS' 4927 03:02:07,480 --> 03:02:10,680 ABILITY TO MODULATE PAIN AS WELL 4928 03:02:10,680 --> 03:02:12,000 AS VULNERABILITY TO CHRONIC PAIN 4929 03:02:12,000 --> 03:02:13,840 AND DEVELOPMENT OF CHRONIC PAIN 4930 03:02:13,840 --> 03:02:15,920 AFTER INITIAL PRESENTATION WITH 4931 03:02:15,920 --> 03:02:18,120 ACUTE OR SUBACUTE LOW BACK PAIN. 4932 03:02:18,120 --> 03:02:19,960 AND WHAT THOSE STUDIES HAVE 4933 03:02:19,960 --> 03:02:21,240 FOUND IS PEOPLE WITH CHRONIC LOW 4934 03:02:21,240 --> 03:02:24,480 BACK PAIN TEND TO HAVE HIGHER 4935 03:02:24,480 --> 03:02:25,360 CONNECTIVITY BETWEEN STRUCTURES 4936 03:02:25,360 --> 03:02:27,000 AND PEOPLE WHO ARE BETTER ABLE 4937 03:02:27,000 --> 03:02:30,080 TO MODULATE PAIN TEND TO HAVE 4938 03:02:30,080 --> 03:02:30,840 LOWER CONNECTIVITY. 4939 03:02:30,840 --> 03:02:33,240 WHAT WE FOUND IN OUR DATA IS 4940 03:02:33,240 --> 03:02:35,160 THAT THIS IS AN INITIAL SAMPLE 4941 03:02:35,160 --> 03:02:37,720 AND WE'RE WORKING ON ACTUALLY 4942 03:02:37,720 --> 03:02:39,040 REPLICATING THIS ANALYSIS NOW 4943 03:02:39,040 --> 03:02:40,960 WITH ALMOST OUR FULL SAMPLE THAT 4944 03:02:40,960 --> 03:02:42,760 ALCOHOL TENDED TO DECREASE 4945 03:02:42,760 --> 03:02:45,560 CONNECTIVITY BETWEEN THE 4946 03:02:45,560 --> 03:02:46,000 STRUCTURES ACUTELY. 4947 03:02:46,000 --> 03:02:49,040 IT WAS A MEDIUM TO STRONG EFFECT 4948 03:02:49,040 --> 03:02:53,160 BUT CONSISTENT WITH THE 4949 03:02:53,160 --> 03:02:55,600 POSSIBILITY THAT CHANGING 4950 03:02:55,600 --> 03:02:56,120 CONNECTIVITY BETWEEN 4951 03:02:56,120 --> 03:02:59,800 MESOCORTICAL LIMBIC CIRCUITRY IS 4952 03:02:59,800 --> 03:03:03,720 ONE WAY IT IS AFFECTING FOR 4953 03:03:03,720 --> 03:03:04,240 PEOPLE SELF-MANAGING. 4954 03:03:04,240 --> 03:03:06,520 WE'VE BEEN INTERESTED IN 4955 03:03:06,520 --> 03:03:07,920 EXPLORING NOVEL METRICS OF 4956 03:03:07,920 --> 03:03:09,440 RELATED TO FUNCTIONAL OR BRAIN 4957 03:03:09,440 --> 03:03:11,760 FUNCTION, AND ONE OF THOSE IS 4958 03:03:11,760 --> 03:03:12,960 REGIONAL SIGNAL VARIABILITY, YOU 4959 03:03:12,960 --> 03:03:21,920 MAY SEE THIS AS ALF. 4960 03:03:21,920 --> 03:03:24,000 OVERSIMPLIFYING IN THE INTEREST 4961 03:03:24,000 --> 03:03:25,120 OF TIME, GREATER SIGNAL 4962 03:03:25,120 --> 03:03:28,120 VARIABILITY TENDS TO BE 4963 03:03:28,120 --> 03:03:29,240 ASSOCIATED WITH BETTER COGNITIVE 4964 03:03:29,240 --> 03:03:34,160 PERFORMANCE AND BETTER PAIN 4965 03:03:34,160 --> 03:03:37,320 MODULATION AND REFLECTING 4966 03:03:37,320 --> 03:03:38,720 GREATER CAPACITY, NOT UNLIKE 4967 03:03:38,720 --> 03:03:40,120 HEART RATE VARIABILITY 4968 03:03:40,120 --> 03:03:41,160 REFLECTING GREATER ATHLETIC 4969 03:03:41,160 --> 03:03:41,440 CAPACITY. 4970 03:03:41,440 --> 03:03:44,720 WHAT WE FOUND IS ALCOHOLEL IS 4971 03:03:44,720 --> 03:03:45,360 ACUTELY REDUCING SIGNAL 4972 03:03:45,360 --> 03:03:48,160 VARIABILITY IN A VARIETY OF 4973 03:03:48,160 --> 03:03:50,680 CORTICAL AREAS, SO I HIGHLIGHTED 4974 03:03:50,680 --> 03:03:53,000 SOME HERE THAT ARE RELATED, TEND 4975 03:03:53,000 --> 03:03:56,600 TO BE RELATED TO DORSAL AND 4976 03:03:56,600 --> 03:04:01,480 VENTRAL ATTENTION NETWORKS AND 4977 03:04:01,480 --> 03:04:03,200 PAIN MODULATION, SO THIS COMES 4978 03:04:03,200 --> 03:04:07,040 FROM A PAPER PUBLISHED IN 2020 4979 03:04:07,040 --> 03:04:08,880 WITH INITIAL SAMPLE OF 26 4980 03:04:08,880 --> 03:04:09,400 INDIVIDUALS. 4981 03:04:09,400 --> 03:04:12,680 WE JUST RECENTLY -- THIS DATA IS 4982 03:04:12,680 --> 03:04:17,600 UNPUBLISHED BUT RERUN WITH THE 4983 03:04:17,600 --> 03:04:19,560 FULL SAMPLE, REPLICATED, 4984 03:04:19,560 --> 03:04:20,920 CLUSTERS BEFORE HAVE GOTTEN 4985 03:04:20,920 --> 03:04:22,240 LARGER, NICE TO SEE. 4986 03:04:22,240 --> 03:04:23,680 BUT ONE OF THE INTERESTING 4987 03:04:23,680 --> 03:04:24,760 FINDINGS FROM THAT INITIAL 4988 03:04:24,760 --> 03:04:27,160 REPORT IS THAT WE FOUND NOTHING 4989 03:04:27,160 --> 03:04:28,200 IN THE SUBCORTICAL AREA SO ALL 4990 03:04:28,200 --> 03:04:30,840 OF THE AREAS WHERE WE FOUND 4991 03:04:30,840 --> 03:04:31,880 ALCOHOL AFFECTING SIGNAL 4992 03:04:31,880 --> 03:04:34,480 VARIABILITY WAS IN THE CORTEX. 4993 03:04:34,480 --> 03:04:36,120 THERE WAS ALWAYS DECREASING 4994 03:04:36,120 --> 03:04:37,040 SIGNAL VARIABILITY. 4995 03:04:37,040 --> 03:04:39,280 IN THE NEW LARGER SAMPLE WE'RE 4996 03:04:39,280 --> 03:04:42,200 SEEING AREAS ESPECIALLY IN 4997 03:04:42,200 --> 03:04:44,440 SUBCORTICAL AREAS LIKE BRAINSTEM 4998 03:04:44,440 --> 03:04:46,640 AND THALAMUS, THAT WE'RE 4999 03:04:46,640 --> 03:04:48,120 INCREASING SIGNAL VARIABILITY IN 5000 03:04:48,120 --> 03:04:49,400 THOSE AREAS WHICH IS VERY 5001 03:04:49,400 --> 03:04:50,320 INTERESTING AND WE'RE LOOKING 5002 03:04:50,320 --> 03:04:53,840 FORWARD TO FOLLOWING UP ON THAT. 5003 03:04:53,840 --> 03:04:54,080 OKAY. 5004 03:04:54,080 --> 03:04:55,720 SO SUMMARY AND FUTURE 5005 03:04:55,720 --> 03:04:57,080 DIRECTIONS, OUR RESULTS ARE 5006 03:04:57,080 --> 03:05:01,720 PROVIDING FURTHER EVIDENCE THAT 5007 03:05:01,720 --> 03:05:03,160 PAIN IS PROXIMAL ANTECEDENT, 5008 03:05:03,160 --> 03:05:04,080 INCREASING REINFORCING EFFICACY 5009 03:05:04,080 --> 03:05:06,440 OF ALCOHOL AT LEAST FOR SOME 5010 03:05:06,440 --> 03:05:08,200 INDIVIDUALS, ESPECIALLY MEN AND 5011 03:05:08,200 --> 03:05:09,280 INDIVIDUALS WITH HIGHER NEGATIVE 5012 03:05:09,280 --> 03:05:10,960 URGENCY AND CAN ALTER THE WAY 5013 03:05:10,960 --> 03:05:13,640 PEOPLE ARE DRINKING IN THE FIRST 5014 03:05:13,640 --> 03:05:14,240 PLACE. 5015 03:05:14,240 --> 03:05:16,000 WE'RE ALSO FINDING THAT ALCOHOL 5016 03:05:16,000 --> 03:05:17,720 DOES INCREASE PAIN THRESHOLD AND 5017 03:05:17,720 --> 03:05:19,720 PERCEIVED PAIN RELIEF AND 5018 03:05:19,720 --> 03:05:20,800 DECREASED PAIN INTENSITY BUT 5019 03:05:20,800 --> 03:05:23,000 THERE'S SOME NUANCE WHICH IS 5020 03:05:23,000 --> 03:05:24,840 THAT THE EFFECTS ON PAIN RELIEF 5021 03:05:24,840 --> 03:05:27,360 ON GREATER THAN THRESHOLD OR 5022 03:05:27,360 --> 03:05:28,240 INTENSITY AND CHANGES IN RATINGS 5023 03:05:28,240 --> 03:05:30,840 DON'T SEEM TO BE CORRELATED WITH 5024 03:05:30,840 --> 03:05:32,400 PAIN INTENSITY OR PAIN 5025 03:05:32,400 --> 03:05:32,800 THRESHOLD. 5026 03:05:32,800 --> 03:05:34,360 WHICH IS SORT OF COUNTER TO THE 5027 03:05:34,360 --> 03:05:36,400 ASSUMPTION THE FIELD HAS MADE 5028 03:05:36,400 --> 03:05:38,320 FOR A LONG TIME. 5029 03:05:38,320 --> 03:05:45,040 SO A COUPLE THINGS WE NEED TO 5030 03:05:45,040 --> 03:05:47,640 FULLY CHARACTERIZE, I JUST A FEW 5031 03:05:47,640 --> 03:05:55,720 HIGHLIGHTS, WE NEED TO FURTHER 5032 03:05:55,720 --> 03:05:56,760 CHARACTERIZE PAIN AS ANTECEDENT, 5033 03:05:56,760 --> 03:05:59,560 IN THE CANUE MODEL AND OTHERS 5034 03:05:59,560 --> 03:06:01,480 AND BE CAREFUL AND INTENTIONAL 5035 03:06:01,480 --> 03:06:02,360 ABOUT INCLUDING INDIVIDUALS WHO 5036 03:06:02,360 --> 03:06:05,760 MAY BE AT HIGHER RISK FOR 5037 03:06:05,760 --> 03:06:07,160 ALCOHOL-RELATED CONSEQUENCES 5038 03:06:07,160 --> 03:06:12,360 THAT WOULD INCLUDE OLDER ADULTS, 5039 03:06:12,360 --> 03:06:14,040 MARGINALIZED AND PEOPLE IN 5040 03:06:14,040 --> 03:06:16,200 RECOVERY, SPARSELY INCLUDED IN 5041 03:06:16,200 --> 03:06:17,640 THESE STUDIES HISTORICALLY. 5042 03:06:17,640 --> 03:06:21,480 WE ALSO NEED TO RECRUITED 5043 03:06:21,480 --> 03:06:23,240 ADEQUATELY POWERED SAMPLES TO 5044 03:06:23,240 --> 03:06:24,680 TEST PREDICTIONS OF CANUE MODEL, 5045 03:06:24,680 --> 03:06:26,880 LOOK AT EFFECT OF SEX AND FAMILY 5046 03:06:26,880 --> 03:06:30,120 HISTORY ON ANALGESIC EFFECTS ON 5047 03:06:30,120 --> 03:06:30,880 ALCOHOL AND NEUROCORRELATES. 5048 03:06:30,880 --> 03:06:32,280 THAT'S ON THE WAY. 5049 03:06:32,280 --> 03:06:35,960 WE WANT TO STUDY MECHANISMS 5050 03:06:35,960 --> 03:06:36,880 UNDERLYING NEGATIVE NEGATIVE 5051 03:06:36,880 --> 03:06:39,280 EFFECTS, IN THE CONTEXT OF PAIN 5052 03:06:39,280 --> 03:06:41,560 ESPECIALLY CONSIDERING JUST HOW 5053 03:06:41,560 --> 03:06:49,400 ENORMOUS THE EFFECTS OF ALCOHOL 5054 03:06:49,400 --> 03:06:53,920 INTAKE, HOW ARE PEOPLE 5055 03:06:53,920 --> 03:07:00,200 DETERMINING ALCOHOL POWS PAIN 5056 03:07:00,200 --> 03:07:03,600 RELIEF, TO DEVELOP INTERVENTIONS 5057 03:07:03,600 --> 03:07:05,000 TO REDUCE. 5058 03:07:05,000 --> 03:07:09,960 WITH THAT I WILL TAKE ANY 5059 03:07:09,960 --> 03:07:10,240 QUESTIONS. 5060 03:07:10,240 --> 03:07:13,000 >>JEFF, BECAUSE OF THE TIME, WE 5061 03:07:13,000 --> 03:07:14,760 HAVE ANOTHER SPEAKER, WHAT WE'RE 5062 03:07:14,760 --> 03:07:17,000 GOING TO DO IF YOU CAN HANG IN 5063 03:07:17,000 --> 03:07:19,080 FOR 30 MINUTES, WE'LL TAKE 5064 03:07:19,080 --> 03:07:19,720 QUESTIONS ON BOTH TALKS AT THE 5065 03:07:19,720 --> 03:07:21,640 END BECAUSE WE HAVE A DISCUSSION 5066 03:07:21,640 --> 03:07:22,080 PERIOD. 5067 03:07:22,080 --> 03:07:23,520 I ALREADY HAVE A QUESTION PRIMED 5068 03:07:23,520 --> 03:07:26,880 UP, SO YOU WILL NOT BE 5069 03:07:26,880 --> 03:07:27,120 NEGLECTED. 5070 03:07:27,120 --> 03:07:27,680 >>SOUND GREAT. 5071 03:07:27,680 --> 03:07:31,240 >>I'LL GIVE A HINT LIKE I DID 5072 03:07:31,240 --> 03:07:32,080 YESTERDAY TO OUR SPEAKERS. 5073 03:07:32,080 --> 03:07:35,240 IT'S GOING TO BE ABOUT EMOTIONAL 5074 03:07:35,240 --> 03:07:40,000 PAIN VERSUS PHYSICAL PAIN. 5075 03:07:40,000 --> 03:07:41,240 >>ABSOLUTELY, YEAH. 5076 03:07:41,240 --> 03:07:45,920 >>CLASSIC KOOB BRAIN WANDERING. 5077 03:07:45,920 --> 03:07:46,120 OKAY. 5078 03:07:46,120 --> 03:07:49,880 NEXT SPEAKER, ARE YOU THERE, DR. 5079 03:07:49,880 --> 03:07:50,080 SUSAN? 5080 03:07:50,080 --> 03:07:51,000 >>YES. 5081 03:07:51,000 --> 03:07:55,040 >>SUSAN, ARE YOU THERE? 5082 03:07:55,040 --> 03:07:55,240 >>YES. 5083 03:07:55,240 --> 03:08:01,760 CAN YOU HEAR ME? 5084 03:08:01,760 --> 03:08:03,680 >>YES. 5085 03:08:03,680 --> 03:08:04,280 >>FANTASTIC. 5086 03:08:04,280 --> 03:08:05,400 >>FIRST OF ALL, THANKS VERY 5087 03:08:05,400 --> 03:08:06,920 MUCH FOR AGREEING TO SPEAK WITH 5088 03:08:06,920 --> 03:08:07,480 US. 5089 03:08:07,480 --> 03:08:09,680 HOPE WE CAN MEET IN PERSON SOON. 5090 03:08:09,680 --> 03:08:12,360 WE TOOK ADVANTAGE OF THE FACT WE 5091 03:08:12,360 --> 03:08:14,600 HAVE MEMBERS ON COUNCIL FOR BOTH 5092 03:08:14,600 --> 03:08:15,720 NIDA AND ALCOHOL INSTITUTE, WHAT 5093 03:08:15,720 --> 03:08:18,960 A GREAT OPPORTUNITY TO HEAR 5094 03:08:18,960 --> 03:08:21,280 ABOUT WHAT ARPA-H WITH DO AND 5095 03:08:21,280 --> 03:08:23,400 HOW WE CAN CREATE PARTNERSHIPS 5096 03:08:23,400 --> 03:08:25,640 SO WE CAN ADVANCE TRANSLATIONAL 5097 03:08:25,640 --> 03:08:28,200 PRODUCTS THAT ARE USEFUL FOR OUR 5098 03:08:28,200 --> 03:08:28,560 FIELD. 5099 03:08:28,560 --> 03:08:29,880 THAT'S WHY WE'RE VERY GRATEFUL 5100 03:08:29,880 --> 03:08:30,680 THAT YOU'RE HERE. 5101 03:08:30,680 --> 03:08:37,920 LET ME JUST GIVE A SHORT SUMMARY 5102 03:08:37,920 --> 03:08:41,320 OF DR. NONAREZ, DEPUTY DIRECTOR 5103 03:08:41,320 --> 03:08:42,720 FOR ARPA-H, ASSISTS IN 5104 03:08:42,720 --> 03:08:43,840 DEVELOPMENT OF HIGH IMPACT 5105 03:08:43,840 --> 03:08:48,280 HEALTH AND MEDICAL SCIENCE AND 5106 03:08:48,280 --> 03:08:49,000 TECHNOLOGY. 5107 03:08:49,000 --> 03:08:51,960 PREVIOUSLY SHE DID STRATEGY 5108 03:08:51,960 --> 03:08:53,560 ANALYSIS FOR ARPA-H, ACTING 5109 03:08:53,560 --> 03:08:55,600 DEPUTY DIRECTOR. 5110 03:08:55,600 --> 03:08:57,640 PRIOR TO ARPA-H, SHE WORKED IN 5111 03:08:57,640 --> 03:08:58,400 VARIOUS POSITIONS THROUGH 5112 03:08:58,400 --> 03:08:59,440 GOVERNMENT AS A FOUNDING 5113 03:08:59,440 --> 03:09:06,280 DIRECTOR OF THE CENTER OF 5114 03:09:06,280 --> 03:09:10,200 INNOVATION, IN HHS, AND EFFORTS 5115 03:09:10,200 --> 03:09:12,000 RELATED TO ENHANCING BIOMEDICAL 5116 03:09:12,000 --> 03:09:14,200 CAPABILITY IN WHITE HOUSE OFFICE 5117 03:09:14,200 --> 03:09:16,120 OF SCIENCE AND TECHNOLOGY POLICY 5118 03:09:16,120 --> 03:09:17,760 AND NATIONAL SECURITY COUNCIL. 5119 03:09:17,760 --> 03:09:19,560 IN ADDITION TO LEADERSHIP ROLES 5120 03:09:19,560 --> 03:09:22,160 IN GOVERNMENT, SHE HAS SERVED ON 5121 03:09:22,160 --> 03:09:24,440 ADVISORY PANELS FOR NATIONAL 5122 03:09:24,440 --> 03:09:25,880 ACADEMY OF SCIENCES, NATIONAL 5123 03:09:25,880 --> 03:09:30,480 SCIENCE ADVISORY BOARD OF 5124 03:09:30,480 --> 03:09:32,200 BIOSECURITY, AND FEDERAL SCIENCE 5125 03:09:32,200 --> 03:09:33,840 ADVISORY PANEL, AMONG OTHERS. 5126 03:09:33,840 --> 03:09:38,040 SHE RECEIVED A DOCTORATE IN 5127 03:09:38,040 --> 03:09:39,080 MICROBIOLOGY AND IMMUNOLOGY FROM 5128 03:09:39,080 --> 03:09:40,040 UNIVERSITY OF WISCONSIN-MADISON, 5129 03:09:40,040 --> 03:09:42,160 AND COMPLETED HER FELLOWSHIP 5130 03:09:42,160 --> 03:09:44,280 WITH AAS AND STANFORD UNIVERSITY 5131 03:09:44,280 --> 03:09:47,400 SCHOOL OF MEDICINE. 5132 03:09:47,400 --> 03:09:47,960 SUSAN, WELCOME. 5133 03:09:47,960 --> 03:09:50,680 >>THANK YOU SO MUCH FOR HAVING 5134 03:09:50,680 --> 03:09:50,920 ME. 5135 03:09:50,920 --> 03:09:55,160 DO YOU HAVE MY SLIDES OR DO YOU 5136 03:09:55,160 --> 03:09:56,680 NEED ME TO PULL THEM. 5137 03:09:56,680 --> 03:09:57,560 >>I HAVE THEM HERE. 5138 03:09:57,560 --> 03:09:59,280 IF YOU PREFER TO RUN THEM THAT'S 5139 03:09:59,280 --> 03:09:59,480 FINE. 5140 03:09:59,480 --> 03:10:01,240 >>NO, IF YOU CAN RUN THEM ALL 5141 03:10:01,240 --> 03:10:03,120 THE BETTER. 5142 03:10:03,120 --> 03:10:03,400 >>SURE. 5143 03:10:03,400 --> 03:10:04,920 >>I HAVE THE WRONG SCREEN AND 5144 03:10:04,920 --> 03:10:05,840 -- OH, PERFECT. 5145 03:10:05,840 --> 03:10:07,640 FANTASTIC. 5146 03:10:07,640 --> 03:10:10,040 THANK YOU SO MUCH. 5147 03:10:10,040 --> 03:10:11,080 I APPRECIATE THE TIME. 5148 03:10:11,080 --> 03:10:13,000 I WANT TO MAKE SURE THAT IF 5149 03:10:13,000 --> 03:10:15,200 THERE'S ONE THING THAT YOU LEAVE 5150 03:10:15,200 --> 03:10:16,680 THIS TALK WITH, IT IS THAT WE 5151 03:10:16,680 --> 03:10:20,000 ABSOLUTELY WANT TO MAKE SURE 5152 03:10:20,000 --> 03:10:20,880 WE'RE PRIORITIZING THIS 5153 03:10:20,880 --> 03:10:21,960 PORTFOLIO WITHIN THE WORK OF 5154 03:10:21,960 --> 03:10:22,400 ARPA-H. 5155 03:10:22,400 --> 03:10:24,320 SO I'M GOING TO GIVE YOU AN 5156 03:10:24,320 --> 03:10:28,280 OVERVIEW OF WHO WE ARE, WHAT 5157 03:10:28,280 --> 03:10:30,760 WE'RE DOING, AND SUM INTO HOW WE 5158 03:10:30,760 --> 03:10:32,160 SHAPE OUR PROGRAMS, AND THE 5159 03:10:32,160 --> 03:10:35,800 PROCESS BY WHICH WE WILL BRING 5160 03:10:35,800 --> 03:10:37,960 UP MANAGERS TO RUN THOSE. 5161 03:10:37,960 --> 03:10:40,240 IT'S IMPORTANT FOR ME TO 5162 03:10:40,240 --> 03:10:41,680 COMMUNICATE OUR MODEL 5163 03:10:41,680 --> 03:10:44,400 EFFECTIVELY SO YOU UNDERSTAND 5164 03:10:44,400 --> 03:10:48,880 HOW WE WOULD INCORPORATE VARIOUS 5165 03:10:48,880 --> 03:10:50,840 PORTFOLIO ASPECTS THAT YOU WERE 5166 03:10:50,840 --> 03:10:51,960 HIGHLIGHTING IN TERMS OF 5167 03:10:51,960 --> 03:10:52,680 ADDICTION, ADDICTION MEDICINE, 5168 03:10:52,680 --> 03:10:53,320 THOSE THINGS. 5169 03:10:53,320 --> 03:10:55,080 LET'S MAKE SURE THAT I COVER ALL 5170 03:10:55,080 --> 03:10:57,600 OF THAT AND HAPPY TO TAKE SOME 5171 03:10:57,600 --> 03:10:58,840 QUESTIONS AT THE END. 5172 03:10:58,840 --> 03:11:02,960 WHY DON'T WE JUMP RIGHT IN. 5173 03:11:02,960 --> 03:11:08,800 NEXT SLIDE. 5174 03:11:08,800 --> 03:11:10,200 SO, FIRST THING, WE'RE COMMITTED 5175 03:11:10,200 --> 03:11:12,280 TO WORKING WITH OUR PARTNERS AT 5176 03:11:12,280 --> 03:11:12,720 NIH. 5177 03:11:12,720 --> 03:11:14,320 WE'RE PART OF NIH. 5178 03:11:14,320 --> 03:11:16,360 WE ARE A SEPARATE INDEPENDENT 5179 03:11:16,360 --> 03:11:19,600 AGENCY BUT FULLY RECOGNIZE THAT 5180 03:11:19,600 --> 03:11:22,360 WE HAVE SUCH GREAT COLLEAGUES 5181 03:11:22,360 --> 03:11:24,240 AND TECHNICAL EXPERTISE DERIVED 5182 03:11:24,240 --> 03:11:25,960 FROM OUR SISTER AGENCY 5183 03:11:25,960 --> 03:11:26,800 INSTITUTES. 5184 03:11:26,800 --> 03:11:28,600 I'LL TALK ABOUT THAT, I'LL GIVE 5185 03:11:28,600 --> 03:11:31,240 OVERVIEW OF THE MISSION, HOW WE 5186 03:11:31,240 --> 03:11:32,480 THINK ABOUT OURSELVES, TALK 5187 03:11:32,480 --> 03:11:34,960 EXTENSIVELY ABOUT OUR BUSINESS 5188 03:11:34,960 --> 03:11:38,160 MODELS AND THEN MORE ABOUT SOME 5189 03:11:38,160 --> 03:11:39,440 SORT OF ADMINISTRATIVE 5190 03:11:39,440 --> 03:11:43,600 ACTIVITIES IN TERMS OF HUB AND 5191 03:11:43,600 --> 03:11:45,600 SPOKE MODEL TO CREATE A DATA 5192 03:11:45,600 --> 03:11:46,720 COMMONS, TALK ABOUT PROGRAM 5193 03:11:46,720 --> 03:11:48,280 MANAGERS AND CLOSE BY GIVING YOU 5194 03:11:48,280 --> 03:11:50,680 SOME SENSE OF OUR INITIAL KEY 5195 03:11:50,680 --> 03:11:53,960 INITIATIVES THAT WE'RE WORKING 5196 03:11:53,960 --> 03:11:54,680 ON. 5197 03:11:54,680 --> 03:11:55,640 NEXT SLIDE PLEASE. 5198 03:11:55,640 --> 03:11:59,280 WE THINK OF OURSELVES AS NIH'S 5199 03:11:59,280 --> 03:12:00,000 NEWEST PARTNER. 5200 03:12:00,000 --> 03:12:01,560 WE'RE REALLY COMMITTED TO 5201 03:12:01,560 --> 03:12:03,920 WORKING TOGETHER WITH OUR 5202 03:12:03,920 --> 03:12:08,160 COLLEAGUES AT NIH. 5203 03:12:08,160 --> 03:12:08,920 NEXT SLIDE. 5204 03:12:08,920 --> 03:12:11,160 SO WE THINK ABOUT THIS AS A 5205 03:12:11,160 --> 03:12:11,760 COLLABORATION ACROSS THE 5206 03:12:11,760 --> 03:12:13,520 ENTIRETY OF THE PROGRAM LIFE 5207 03:12:13,520 --> 03:12:13,720 CYCLE. 5208 03:12:13,720 --> 03:12:15,800 WHEN WE THINK ABOUT OUR PROGRAMS 5209 03:12:15,800 --> 03:12:16,840 AND ARE DESIGNING OUR PROGRAMS 5210 03:12:16,840 --> 03:12:19,880 WE WANT TO WORK WITH OUR NIH 5211 03:12:19,880 --> 03:12:20,840 COLLEAGUES, SUBJECT MATTER 5212 03:12:20,840 --> 03:12:23,240 EXPERTED TO ENSURE WE'RE 5213 03:12:23,240 --> 03:12:24,440 VALIDATING THESE WELL-DEFINED 5214 03:12:24,440 --> 03:12:24,960 PROBLEMS IN HEALTH. 5215 03:12:24,960 --> 03:12:28,320 WE WANT TO MAKE SURE WE'RE 5216 03:12:28,320 --> 03:12:28,920 SHARING OUR CONCEPTS 5217 03:12:28,920 --> 03:12:30,480 APPROPRIATELY WITH OUR 5218 03:12:30,480 --> 03:12:31,880 COLLEAGUES AT NIH TO ENSURE 5219 03:12:31,880 --> 03:12:34,000 WE'RE VALIDATING THE EFFORTS ARE 5220 03:12:34,000 --> 03:12:36,000 NOT REDUNDANT. 5221 03:12:36,000 --> 03:12:38,040 THEY SHOULD BE COMPLEMENTARY, IF 5222 03:12:38,040 --> 03:12:38,360 POSSIBLE. 5223 03:12:38,360 --> 03:12:41,960 AND WE THINK ABOUT THESE AS 5224 03:12:41,960 --> 03:12:44,000 ARPA-H HARD, WE'RE WILLING TO 5225 03:12:44,000 --> 03:12:46,800 TAKE ON HIGH RISK, HIGH REWARD 5226 03:12:46,800 --> 03:12:50,400 ASPECTS OF A PROBLEM SET THAT 5227 03:12:50,400 --> 03:12:52,200 MAY EXTEND THE WAY NIH WOULD BE 5228 03:12:52,200 --> 03:12:54,360 TRADITIONALLY THINKING ABOUT HOW 5229 03:12:54,360 --> 03:12:57,440 WE WOULD ADDRESS A PARTICULAR 5230 03:12:57,440 --> 03:12:59,120 HEALTH CARE CHALLENGE. 5231 03:12:59,120 --> 03:13:04,600 WE WORK IN A BOTTOM UP APPROACH. 5232 03:13:04,600 --> 03:13:07,120 WE HAVE A SINGLE PROGRAM MANAGER 5233 03:13:07,120 --> 03:13:09,760 WHO OVERSEES THE PROGRAM BUT WE 5234 03:13:09,760 --> 03:13:12,320 BUILD A ROBUST PERFORMER TEAM TO 5235 03:13:12,320 --> 03:13:14,960 HELP SUPPORT THE DEVELOPMENT OF 5236 03:13:14,960 --> 03:13:16,480 WHATEVER THAT PARTICULAR PRODUCT 5237 03:13:16,480 --> 03:13:17,560 OR PROCESS OR POLICY, WHATEVER 5238 03:13:17,560 --> 03:13:20,040 IT IS THAT WE'RE SEEKING TO 5239 03:13:20,040 --> 03:13:25,560 ACHIEVE THROUGH OUR INITIATIVE. 5240 03:13:25,560 --> 03:13:29,600 BUT WE WANT TO -- NIH SME, TO 5241 03:13:29,600 --> 03:13:33,360 HAVE, YOU KNOW, FOLKS IN THEIR 5242 03:13:33,360 --> 03:13:35,920 COMMUNITIES THAT WOULD BE GREAT 5243 03:13:35,920 --> 03:13:38,160 TO BE ON OUR PERFORMER TEAMS. 5244 03:13:38,160 --> 03:13:40,520 WE ENCOURAGE NIH COLLEAGUES TO 5245 03:13:40,520 --> 03:13:42,840 ACTUALLY SHARE WITH THE R&D 5246 03:13:42,840 --> 03:13:44,480 NETWORKS TO HELP MAKE SURE WE 5247 03:13:44,480 --> 03:13:45,600 HAVE THE BEST PERFORMER TEAMS 5248 03:13:45,600 --> 03:13:46,240 OUT THERE. 5249 03:13:46,240 --> 03:13:52,920 AND WE ALSO WILL HAVE OUR NIH 5250 03:13:52,920 --> 03:13:53,880 SUBJECT MATTER COLLEAGUES 5251 03:13:53,880 --> 03:13:55,240 SUPPORT PROPOSAL EVALUATION TO 5252 03:13:55,240 --> 03:13:56,360 HOLD OURSELVES TO A HIGH 5253 03:13:56,360 --> 03:14:00,040 STANDARD AS WE LAUNCH THESE 5254 03:14:00,040 --> 03:14:01,720 REALLY BIG AND FORWARD-LEANING 5255 03:14:01,720 --> 03:14:02,000 PROGRAMS. 5256 03:14:02,000 --> 03:14:05,440 AND THEN HELPING -- BRINGING 5257 03:14:05,440 --> 03:14:07,360 COLLEAGUES ON TO HELP US -- 5258 03:14:07,360 --> 03:14:09,560 ENSURING WE'RE EXECUTING AND 5259 03:14:09,560 --> 03:14:10,920 MEASURING PROGRESS ASSOCIATED 5260 03:14:10,920 --> 03:14:12,680 WITH OUR PROGRAMS, ESSENTIALLY 5261 03:14:12,680 --> 03:14:15,720 FROM DAY 1, SO WE'RE DESIGNING 5262 03:14:15,720 --> 03:14:19,360 THE RIGHT MILESTONES AND METRICS 5263 03:14:19,360 --> 03:14:23,680 SO WE CAN MITIGATE RISK OF 5264 03:14:23,680 --> 03:14:26,200 HIGH-RISK, HIGH-REWARD PROGRAMS 5265 03:14:26,200 --> 03:14:28,200 BUT HOLDING PERFORMERS 5266 03:14:28,200 --> 03:14:29,440 ACCOUNTABLE TO CRITICAL 5267 03:14:29,440 --> 03:14:31,760 STANDARDS THERE ARE DERIVED FROM 5268 03:14:31,760 --> 03:14:32,600 SUBJECT MATTER EXPERTS. 5269 03:14:32,600 --> 03:14:35,560 AND LEARNING AND GROWING MAKING 5270 03:14:35,560 --> 03:14:37,960 SURE OUR NIH COLLEAGUES ARE 5271 03:14:37,960 --> 03:14:41,080 INVOLVED IN OUR PROGRAMS, THEY 5272 03:14:41,080 --> 03:14:44,480 MAY BE TRANSITION PARTNERS, MAY 5273 03:14:44,480 --> 03:14:48,800 BE IN TERMS OF DATA WE'RE 5274 03:14:48,800 --> 03:14:50,280 DERIVING, MAY COMBINE DATA 5275 03:14:50,280 --> 03:14:51,720 FUNDED OUT OF NIH WITH DATA THAT 5276 03:14:51,720 --> 03:14:54,800 IS DERIVED FROM OUR PROGRAMS TO 5277 03:14:54,800 --> 03:14:55,840 CREATE SOMETHING THAT HELPS 5278 03:14:55,840 --> 03:14:56,720 SUPPORT AN ENTIRELY DIFFERENT 5279 03:14:56,720 --> 03:14:57,160 WAY. 5280 03:14:57,160 --> 03:14:59,120 WE THINK OF NIH AS STAKEHOLDERS 5281 03:14:59,120 --> 03:15:01,760 THROUGHOUT THE DURATION OF OUR 5282 03:15:01,760 --> 03:15:03,320 PROGRAMS AND FINALLY 5283 03:15:03,320 --> 03:15:03,800 COMMERCIALIZATION AND 5284 03:15:03,800 --> 03:15:07,680 TRANSITION, WANT TO MAKE SURE 5285 03:15:07,680 --> 03:15:08,680 THAT NIH STAKEHOLDERS 5286 03:15:08,680 --> 03:15:09,920 APPROPRIATE FOR TECH TRANSITION 5287 03:15:09,920 --> 03:15:12,200 ARE ALSO USERS AND FUNDERS SO WE 5288 03:15:12,200 --> 03:15:17,720 THINK ABOUT THEM AS PART OF THE 5289 03:15:17,720 --> 03:15:18,480 HOLISTIC LIFE CYCLE. 5290 03:15:18,480 --> 03:15:20,040 THEN HELPING TO CONSIDER IF 5291 03:15:20,040 --> 03:15:23,600 WE'RE STARTING SOMETHING THAT IS 5292 03:15:23,600 --> 03:15:25,520 HIGH RISK, BUT APPROPRIATE FOR 5293 03:15:25,520 --> 03:15:27,760 SUCCESSFUL TRANSITION INTO NIH 5294 03:15:27,760 --> 03:15:29,240 THINKING OF NIH AS POTENTIAL 5295 03:15:29,240 --> 03:15:29,920 TRANSITION PARTNER. 5296 03:15:29,920 --> 03:15:32,520 SO THAT'S HOW WE'RE WORKING 5297 03:15:32,520 --> 03:15:33,960 DIRECTLY WITH OUR COLLEAGUES AT 5298 03:15:33,960 --> 03:15:34,840 NIH. 5299 03:15:34,840 --> 03:15:38,840 IF YOU COULD GO TO THE NEXT 5300 03:15:38,840 --> 03:15:40,040 SLIDE. 5301 03:15:40,040 --> 03:15:42,360 SO WE'VE BEEN OPERATIONALIZING 5302 03:15:42,360 --> 03:15:44,560 OUR COMMITMENT TO WORKING WITH 5303 03:15:44,560 --> 03:15:46,920 VARIOUS PARTNERS ACROSS NIH SO 5304 03:15:46,920 --> 03:15:53,840 YOU'LL SEE MY BOSS WORKING WITH 5305 03:15:53,840 --> 03:15:56,440 LEADERSHIP AND WE CONTINUE TO 5306 03:15:56,440 --> 03:15:58,760 LOOK FORWARD TO ADDITIONAL 5307 03:15:58,760 --> 03:16:00,040 OPPORTUNITIES TO COLLABORATE AT 5308 03:16:00,040 --> 03:16:01,800 THE SENIOR LEADERSHIP AS WELL AS 5309 03:16:01,800 --> 03:16:07,840 PROGRAM MANAGER AND OTHER STAFF 5310 03:16:07,840 --> 03:16:08,800 LEVEL. 5311 03:16:08,800 --> 03:16:09,680 NEXT SLIDE. 5312 03:16:09,680 --> 03:16:11,600 REINFORCING WE SEE OURSELVES 5313 03:16:11,600 --> 03:16:13,560 HAVING MANY FUTURE 5314 03:16:13,560 --> 03:16:15,520 COLLABORATIONS WITH OUR 5315 03:16:15,520 --> 03:16:17,160 COLLEAGUES WITHIN NIH AND 5316 03:16:17,160 --> 03:16:21,440 HOPEFULLY NIDA AND OTHERS WILL 5317 03:16:21,440 --> 03:16:24,280 BE JOINING US AS PART OF THE 5318 03:16:24,280 --> 03:16:25,160 COLLABORATIVE ORGANIZATION, 5319 03:16:25,160 --> 03:16:25,880 COLLABORATIVE GROUP, LOOK 5320 03:16:25,880 --> 03:16:28,720 FORWARD TO CONTINUING OUR 5321 03:16:28,720 --> 03:16:29,520 DISCUSSIONS AFTER THIS MEETING 5322 03:16:29,520 --> 03:16:30,120 AND MANY OTHERS. 5323 03:16:30,120 --> 03:16:35,160 GO TO THE NEXT SLIDE. 5324 03:16:35,160 --> 03:16:40,840 WHEN IT COMES TO OUR 5325 03:16:40,840 --> 03:16:44,800 ORGANIZATION, WHEN YOU ARE GIVEN 5326 03:16:44,800 --> 03:16:49,280 TO SOLVING THE CHALLENGES, IT'S 5327 03:16:49,280 --> 03:16:49,760 DAUNTING. 5328 03:16:49,760 --> 03:16:52,720 ONE THING WE DID EARLY ON WAS TO 5329 03:16:52,720 --> 03:16:55,040 TRY TO PARSE THAT ACROSS FOUR 5330 03:16:55,040 --> 03:16:57,080 MAJOR FOCUS AREAS, AND SO WHERE 5331 03:16:57,080 --> 03:16:58,480 WE ENDED UP LANDING IS THE FOUR 5332 03:16:58,480 --> 03:17:02,160 YOU SEE IN FRONT OF YOU. 5333 03:17:02,160 --> 03:17:03,920 HEALTH SCIENCE FUTURES, SCALABLE 5334 03:17:03,920 --> 03:17:11,440 SOLUTIONS, PRO-ACTIVE HEALTH AND 5335 03:17:11,440 --> 03:17:12,560 RESILIENT SYSTEMS. 5336 03:17:12,560 --> 03:17:13,720 HEALTH SCIENCE FUTURE IS THE 5337 03:17:13,720 --> 03:17:15,040 FAR-OFF VISION FOR WHAT THE 5338 03:17:15,040 --> 03:17:17,320 FUTURE OF HEALTH SCIENCE COULD 5339 03:17:17,320 --> 03:17:18,400 LOOK LIKE. 5340 03:17:18,400 --> 03:17:20,760 IT'S REALLY DESIGNING, YOU KNOW, 5341 03:17:20,760 --> 03:17:23,480 OVER THE HORIZON PLATFORMS, 5342 03:17:23,480 --> 03:17:24,840 NOVEL APPROACHES TO VARIOUS 5343 03:17:24,840 --> 03:17:29,200 HEALTH CARE CHALLENGES OR HEALTH 5344 03:17:29,200 --> 03:17:31,480 SCIENCE CHALLENGES THAT ARE, 5345 03:17:31,480 --> 03:17:32,440 AGAIN, POSITIONING VERY HIGH 5346 03:17:32,440 --> 03:17:33,560 RISK BECAUSE THERE'S SO MUCH 5347 03:17:33,560 --> 03:17:36,520 UNCERTAINTY THAT WE TAKE ON AS 5348 03:17:36,520 --> 03:17:38,720 WE'RE DEVELOPING THOSE VARIOUS 5349 03:17:38,720 --> 03:17:39,480 MECHANISMS OF PLATFORM 5350 03:17:39,480 --> 03:17:42,200 TECHNOLOGY DEVELOPMENT AND WHAT 5351 03:17:42,200 --> 03:17:42,680 NOT. 5352 03:17:42,680 --> 03:17:44,880 SO THAT'S WHERE WE ARE. 5353 03:17:44,880 --> 03:17:47,760 WHEN YOU'RE THINKING ABOUT THE 5354 03:17:47,760 --> 03:17:49,480 PORTFOLIO HOLISTICALLY THIS IS 5355 03:17:49,480 --> 03:17:53,840 WHERE YOU WOULD POSITION THE 5356 03:17:53,840 --> 03:17:55,400 EARLIEST TYPE DEVELOPMENT OF 5357 03:17:55,400 --> 03:17:56,320 PLATFORM AND TECHNOLOGIES AND 5358 03:17:56,320 --> 03:17:57,960 HELD SCIENCE FUTURES. 5359 03:17:57,960 --> 03:18:01,360 THE OTHER THREE SCALABLE 5360 03:18:01,360 --> 03:18:03,280 SOLUTIONS ARE CLOSER TOWARDS 5361 03:18:03,280 --> 03:18:04,320 TRADITIONAL PRODUCT DEVELOPMENT 5362 03:18:04,320 --> 03:18:05,880 AND TECH TRANSFER. 5363 03:18:05,880 --> 03:18:06,800 SCALABLE SOLUTIONS IS THINKING 5364 03:18:06,800 --> 03:18:10,320 ABOUT IF WE HAVE A SOLUTION THAT 5365 03:18:10,320 --> 03:18:11,840 WORKS FOR A LIMITED POPULATION, 5366 03:18:11,840 --> 03:18:15,160 YOU KNOW, SMALL NUMBER OF 5367 03:18:15,160 --> 03:18:17,640 INDIVIDUALS, AND IS HELD BACK 5368 03:18:17,640 --> 03:18:20,920 FOR TECHNICAL REASONS, COST 5369 03:18:20,920 --> 03:18:22,200 REASONS, LOGISTICAL REASONS, 5370 03:18:22,200 --> 03:18:23,440 ANYTHING THAT PREVENTS IT FROM 5371 03:18:23,440 --> 03:18:26,440 SCALING TO THE BROADEST SET OF 5372 03:18:26,440 --> 03:18:27,840 POPULATION THAT WOULD BENEFIT, 5373 03:18:27,840 --> 03:18:29,160 THAT'S WHERE SCALABLE SOLUTIONS 5374 03:18:29,160 --> 03:18:32,120 COME IN, MAKING SURE THAT HEALTH 5375 03:18:32,120 --> 03:18:36,360 BENEFITS ARE REACHING EVERYONE. 5376 03:18:36,360 --> 03:18:38,680 COLLECTIVE HEALTH IS ENSURING WE 5377 03:18:38,680 --> 03:18:40,600 CREATE TECHNOLOGIES THAT KEEP 5378 03:18:40,600 --> 03:18:41,280 INDIVIDUALS FROM BECOMING 5379 03:18:41,280 --> 03:18:41,920 PATIENTS. 5380 03:18:41,920 --> 03:18:45,560 OR IF THEY ARE PATIENTS, WE 5381 03:18:45,560 --> 03:18:50,680 ALLOW THEM TO NOT PROGRESS DOWN 5382 03:18:50,680 --> 03:18:51,760 THE DISEASE PATHWAY OR HAVE 5383 03:18:51,760 --> 03:18:54,120 OPPORTUNITY TO HAVE THE BEST 5384 03:18:54,120 --> 03:18:55,960 OUTCOMES AND WELLNESS ASSOCIATED 5385 03:18:55,960 --> 03:18:56,840 WITH WHATEVER CONDITION OR 5386 03:18:56,840 --> 03:19:00,840 HEALTH CHALLENGE THAT THEY FACE. 5387 03:19:00,840 --> 03:19:03,600 IT'S ABOUT HELPING US ALL THEY 5388 03:19:03,600 --> 03:19:06,240 INDIVIDUAL LEVEL OR COMMUNITY 5389 03:19:06,240 --> 03:19:09,800 LEVEL HAVE INCREASED HEALTH AND 5390 03:19:09,800 --> 03:19:10,240 WELLNESS. 5391 03:19:10,240 --> 03:19:11,800 RESILIENT SYSTEMS, WE UNDERSTAND 5392 03:19:11,800 --> 03:19:14,320 THERE ARE PERTURBATIONS IN THE 5393 03:19:14,320 --> 03:19:16,040 HEALTH ECOSYSTEM, WHETHER FROM 5394 03:19:16,040 --> 03:19:19,160 EXTERNAL SOURCES LIKE CLIMATE 5395 03:19:19,160 --> 03:19:23,760 CHANGE OR CYBERSECURITY, HEALTH 5396 03:19:23,760 --> 03:19:30,600 DATA SECURITY ISSUES OR ANY 5397 03:19:30,600 --> 03:19:31,920 ASPECT OF HEALTH ECOSYSTEM 5398 03:19:31,920 --> 03:19:33,040 THAT'S BEEN CHALLENGED WHETHER 5399 03:19:33,040 --> 03:19:39,320 IN COVID OR OTHER AREAS, THIS 5400 03:19:39,320 --> 03:19:40,920 OFFICE IS THINKING HOW DO WE 5401 03:19:40,920 --> 03:19:47,760 ENSURE THAT WE CREATE A MORE 5402 03:19:47,760 --> 03:19:49,560 RESILIENT HEALTH ECOSYSTEM. 5403 03:19:49,560 --> 03:19:52,120 WE HAVE ADDITIONAL TOPICS OF 5404 03:19:52,120 --> 03:19:53,520 INTERESTS, QUANTITATIVE MEASURES 5405 03:19:53,520 --> 03:19:55,760 OF HEALTH OUTCOMES, AS WE AS 5406 03:19:55,760 --> 03:19:58,280 ARPA-H AGENCY MAKE INVESTMENT IN 5407 03:19:58,280 --> 03:19:59,120 HEALTH ECOSYSTEM WHAT DOES 5408 03:19:59,120 --> 03:20:00,120 SUCCESS LOOK LIKE? 5409 03:20:00,120 --> 03:20:02,080 HOW DO WE ENSURE THAT THE 5410 03:20:02,080 --> 03:20:08,280 LIMITED RESOURCES WE HAVE 5411 03:20:08,280 --> 03:20:09,160 AVAILABLE TO US AND HIGH-RISK, 5412 03:20:09,160 --> 03:20:09,840 HIGH-REWARD PROGRAMS WE WANT TO 5413 03:20:09,840 --> 03:20:11,360 POSITION AND LAUNCH WHAT IS 5414 03:20:11,360 --> 03:20:13,320 DERIVED BENEFIT WE WOULD BE ABLE 5415 03:20:13,320 --> 03:20:16,920 TO SAY WE HAVE NOW HELPED 5416 03:20:16,920 --> 03:20:17,400 SUPPORT THIS TANGIBLE 5417 03:20:17,400 --> 03:20:19,240 QUANTITATIVE OUTCOME WITHIN THE 5418 03:20:19,240 --> 03:20:19,880 HEALTH ECOSYSTEM? 5419 03:20:19,880 --> 03:20:21,680 THAT'S IN THE LONG RUN. 5420 03:20:21,680 --> 03:20:23,680 WE'RE ALSO THINKING ABOUT HOW TO 5421 03:20:23,680 --> 03:20:25,960 WE HAVE SOME INTERIM 5422 03:20:25,960 --> 03:20:29,040 QUANTITATIVE MEASURES THAT WOULD 5423 03:20:29,040 --> 03:20:31,960 HELP US SUPPORT PROGRAM DESIGN. 5424 03:20:31,960 --> 03:20:33,080 WHAT DO WE CURRENTLY UNDERSTAND 5425 03:20:33,080 --> 03:20:35,040 ABOUT THE NUMBER OF INDIVIDUALS 5426 03:20:35,040 --> 03:20:40,040 WHO HAVE THIS PARTICULAR 5427 03:20:40,040 --> 03:20:40,600 DISEASE? 5428 03:20:40,600 --> 03:20:42,320 OR WHETHER THIS TECHNOLOGY NEEDS 5429 03:20:42,320 --> 03:20:44,720 TO BE DESIGNED IN A CERTAIN 5430 03:20:44,720 --> 03:20:45,840 ASPECTS OR ANOTHER BECAUSE OF 5431 03:20:45,840 --> 03:20:47,960 QUANTITATIVE MEASURES OF HEALTH 5432 03:20:47,960 --> 03:20:52,440 OUTCOMES, TAKING A DATA FORWARD 5433 03:20:52,440 --> 03:20:53,320 QUANTITATIVE APPROACH TO 5434 03:20:53,320 --> 03:20:55,640 ORGANIZATIONAL DESIGN AND 5435 03:20:55,640 --> 03:20:56,600 PROGRAM DESIGN. 5436 03:20:56,600 --> 03:20:57,920 WE ALSO ARE TAKING A HUMAN 5437 03:20:57,920 --> 03:20:59,560 CENTERED DESIGN FOR HEALTH 5438 03:20:59,560 --> 03:21:02,720 INNOVATIONS, MAKING SURE THAT AS 5439 03:21:02,720 --> 03:21:03,560 WE BUILD OUT TECHNOLOGIES, THEY 5440 03:21:03,560 --> 03:21:06,600 ARE THE ONES THAT PEOPLE WILL 5441 03:21:06,600 --> 03:21:08,480 USE THAT CLINICIANS CAN 5442 03:21:08,480 --> 03:21:09,840 INCORPORATE INTO WORKFLOWS, THAT 5443 03:21:09,840 --> 03:21:10,840 THE BROADER POPULATION WILL WANT 5444 03:21:10,840 --> 03:21:13,240 TO TAKE INTO THEIR HOMES, THAT 5445 03:21:13,240 --> 03:21:14,200 WILL LEAD TO BETTER HEALTH 5446 03:21:14,200 --> 03:21:14,600 OUTCOMES. 5447 03:21:14,600 --> 03:21:19,640 SO IT'S VERY MUCH A 5448 03:21:19,640 --> 03:21:20,680 HUMAN-CENTERED DESIGN APPROACH. 5449 03:21:20,680 --> 03:21:21,360 PARTICIPATORY RESEARCH, WE WANT 5450 03:21:21,360 --> 03:21:24,840 TO MAKE SURE THE VOICES AND TO 5451 03:21:24,840 --> 03:21:25,920 THE EXTENT IT'S APPROPRIATE 5452 03:21:25,920 --> 03:21:28,480 PATIENTS ARE BEING REFLECTED IN 5453 03:21:28,480 --> 03:21:29,280 OUR RESEARCH. 5454 03:21:29,280 --> 03:21:32,000 AND SO HOW DO WE ENSURE THAT WE 5455 03:21:32,000 --> 03:21:36,560 HAVE A REALLY STRONG APPROACH TO 5456 03:21:36,560 --> 03:21:39,160 INCENTIVIZING A RESPECTFUL 5457 03:21:39,160 --> 03:21:43,560 PARTICIPATION OF OUR PATIENT 5458 03:21:43,560 --> 03:21:44,400 POPULATIONS, PROVIDER 5459 03:21:44,400 --> 03:21:46,000 COMMUNITIES IN OUR RESEARCH 5460 03:21:46,000 --> 03:21:46,440 APPROACHES. 5461 03:21:46,440 --> 03:21:48,760 THE LAST THING WE FULLY 5462 03:21:48,760 --> 03:21:49,400 RECOGNIZE THAT WORKING AT THE 5463 03:21:49,400 --> 03:21:53,680 FAR END OF THE INNOVATION 5464 03:21:53,680 --> 03:21:56,080 SPECTRUM WE'RE PUSHING WHAT IS 5465 03:21:56,080 --> 03:21:57,080 UNDERSTOOD ABOUT THE 5466 03:21:57,080 --> 03:21:58,960 IMPLICATIONS ABOUT TECHNOLOGY SO 5467 03:21:58,960 --> 03:22:01,640 WE'RE BUILDING INTO EVERYTHING 5468 03:22:01,640 --> 03:22:05,400 WE DO WHAT WE CALL ELSI, SIMILAR 5469 03:22:05,400 --> 03:22:07,560 TO WHAT THE HUMAN GENOME PROJECT 5470 03:22:07,560 --> 03:22:10,360 ENDED UP HAVING TO CONSIDER, AS 5471 03:22:10,360 --> 03:22:12,600 IT WAS BEING BUILT OUT, WE 5472 03:22:12,600 --> 03:22:13,160 UNDERSTAND THERE ARE 5473 03:22:13,160 --> 03:22:14,120 IMPLICATIONS ASSOCIATED WITH 5474 03:22:14,120 --> 03:22:14,440 THAT. 5475 03:22:14,440 --> 03:22:15,720 WE'RE BUILDING THAT IN FROM DAY 5476 03:22:15,720 --> 03:22:18,760 1 AND WE'LL BE WORKING VERY 5477 03:22:18,760 --> 03:22:22,520 QUICKLY TO LAUNCH OUR PUBLIC 5478 03:22:22,520 --> 03:22:24,920 APPROACH TO ELSI AND THEN EVERY 5479 03:22:24,920 --> 03:22:28,800 PROGRAM THAT WE BUILD OUT WILL 5480 03:22:28,800 --> 03:22:30,520 HAVE ELSI REVIEW AND ELSI 5481 03:22:30,520 --> 03:22:31,680 ACTIVITIES ASSOCIATED WITH IT. 5482 03:22:31,680 --> 03:22:37,600 I CAN TALK MORE ABOUT ANY OF 5483 03:22:37,600 --> 03:22:38,640 THOSE. 5484 03:22:38,640 --> 03:22:39,440 NEXT SLIDE. 5485 03:22:39,440 --> 03:22:42,080 SO HOPEFULLY -- I WON'T GO INTO 5486 03:22:42,080 --> 03:22:43,160 DETAIL, HOPEFULLY THEY ARE MADE 5487 03:22:43,160 --> 03:22:45,760 AVAILABLE BECAUSE IT GOES INTO 5488 03:22:45,760 --> 03:22:46,800 ADDITIONAL DEPTH, EACH ONE OF 5489 03:22:46,800 --> 03:22:49,000 THE FOCUS AREAS I TALKED ABOUT, 5490 03:22:49,000 --> 03:22:53,240 SO THIS ONE IS HEALTH SCIENCE 5491 03:22:53,240 --> 03:22:56,040 FUTURES, AGAIN ABOUT WHAT'S 5492 03:22:56,040 --> 03:22:56,960 TECHNICALLY POSSIBLE, INNOVATIVE 5493 03:22:56,960 --> 03:22:59,320 TOOLS, TECHNOLOGIES, PLATFORMS 5494 03:22:59,320 --> 03:23:01,560 THAT ALLOW US TO THINK ABOUT 5495 03:23:01,560 --> 03:23:04,680 MODULATION OF HOST SYSTEMS, 5496 03:23:04,680 --> 03:23:05,720 DELIVERY OF TARGETS, TEMPORAL, 5497 03:23:05,720 --> 03:23:08,520 SPATIAL PRECISION AS WELL AS 5498 03:23:08,520 --> 03:23:11,280 MITIGATION OF OFF-TARGET EFFECTS 5499 03:23:11,280 --> 03:23:12,920 TO ACCELERATE INTERVENTIONS, 5500 03:23:12,920 --> 03:23:14,760 THINKING ABOUT WHAT THE OVER THE 5501 03:23:14,760 --> 03:23:16,280 HORIZON HEALTH SCIENCES THAT THE 5502 03:23:16,280 --> 03:23:19,200 FUTURE THAT WE CAN CREATE 5503 03:23:19,200 --> 03:23:22,400 THROUGH OUR PROGRAMS. 5504 03:23:22,400 --> 03:23:26,000 NEXT SLIDE PLEASE. 5505 03:23:26,000 --> 03:23:27,440 AND SCALABLE SOLUTIONS, WHERE WE 5506 03:23:27,440 --> 03:23:30,240 ARE CONSIDERING HEALTH CARE 5507 03:23:30,240 --> 03:23:30,880 ACCESS AND AFFORDABILITY, MAKING 5508 03:23:30,880 --> 03:23:31,920 SURE SOMETHING THAT IS AVAILABLE 5509 03:23:31,920 --> 03:23:34,240 TO A SMALL NUMBER OF INDIVIDUALS 5510 03:23:34,240 --> 03:23:36,080 THAT WE CAN ACTUALLY REACH THE 5511 03:23:36,080 --> 03:23:40,520 FULL BREADTH OF THOSE WHO WOULD 5512 03:23:40,520 --> 03:23:43,240 BENEFIT ACROSS DEMOGRAPHICS, 5513 03:23:43,240 --> 03:23:44,920 GEOGRAPHY, RESOURCES, EARLY ONCE 5514 03:23:44,920 --> 03:23:46,280 ARE HISTOPATHOLOGY, RARE DISEASE 5515 03:23:46,280 --> 03:23:48,120 DIAGNOSIS AND TREATMENT, AND 5516 03:23:48,120 --> 03:23:49,960 SURGICAL INTERVENTIONS AND SO 5517 03:23:49,960 --> 03:23:51,160 THOSE ARE SOME AREAS WE'RE 5518 03:23:51,160 --> 03:23:52,600 STARTING TO THINK ABOUT BUT WANT 5519 03:23:52,600 --> 03:23:56,240 TO MAKE SURE THAT WE CAN HELP 5520 03:23:56,240 --> 03:23:58,600 SUPPORT A BROAD SCALABLE IMPACT 5521 03:23:58,600 --> 03:24:02,080 OF ALL HEALTH INNOVATION. 5522 03:24:02,080 --> 03:24:03,920 NEXT SLIDE PLEASE. 5523 03:24:03,920 --> 03:24:05,360 PRO-ACTIVE HEALTH, KEEPING 5524 03:24:05,360 --> 03:24:06,960 PEOPLE FROM BECOMING PATIENTS, 5525 03:24:06,960 --> 03:24:10,000 SO IMPROVING HEALTH AND 5526 03:24:10,000 --> 03:24:11,200 WELLNESS, REALLY TRYING TO MAKE 5527 03:24:11,200 --> 03:24:15,880 SURE WE TAKE A VERY PRO-ACTIVE 5528 03:24:15,880 --> 03:24:18,400 INNOVATIVE APPROACH TO 5529 03:24:18,400 --> 03:24:21,040 SUPPORTING TECHNOLOGIES THAT CAN 5530 03:24:21,040 --> 03:24:23,080 KEEP INDIVIDUALS OR COMMUNITIES 5531 03:24:23,080 --> 03:24:26,560 OR POPULATION HEALTHIER, WHETHER 5532 03:24:26,560 --> 03:24:27,520 ROBOTICS, WEARABLES, OTHER 5533 03:24:27,520 --> 03:24:31,600 DEVICES, HELPING TO THINK 5534 03:24:31,600 --> 03:24:34,000 THROUGH WHO WOULD BENEFIT, AGING 5535 03:24:34,000 --> 03:24:35,640 POPULATION, COGNITIVE OR 5536 03:24:35,640 --> 03:24:36,520 MOVEMENT DISORDERS, HELPING 5537 03:24:36,520 --> 03:24:38,240 PEOPLE AGE IN PLACE, ALL THE 5538 03:24:38,240 --> 03:24:40,440 THINGS THAT WE'RE TRYING TO 5539 03:24:40,440 --> 03:24:40,840 INCORPORATE. 5540 03:24:40,840 --> 03:24:43,160 SO WE'RE LOOKING AT WHAT ARE THE 5541 03:24:43,160 --> 03:24:44,880 TECHNOLOGIES THAT COULD BE 5542 03:24:44,880 --> 03:24:49,120 HELPFUL, HOW DO WE ACCELERATE 5543 03:24:49,120 --> 03:24:50,000 RECOVERY, ENHANCE IMMUNE 5544 03:24:50,000 --> 03:24:52,680 FUNCTIONS, IMPROVING MENTAL 5545 03:24:52,680 --> 03:24:53,240 HEALTH, TREATING SLEEP 5546 03:24:53,240 --> 03:24:54,360 DISORDERS, THINKING ABOUT WHAT 5547 03:24:54,360 --> 03:24:59,360 IS NEW IN THIS AREA THAT WE CAN 5548 03:24:59,360 --> 03:25:01,160 BE INVESTING IN THAT'S 5549 03:25:01,160 --> 03:25:01,920 TRANSFORMATIONAL. 5550 03:25:01,920 --> 03:25:03,520 NEXT SLIDE PLEASE. 5551 03:25:03,520 --> 03:25:05,280 AND RESILIENCE SYSTEMS. 5552 03:25:05,280 --> 03:25:09,400 AS I SAID, UNDERSTANDING WHAT 5553 03:25:09,400 --> 03:25:12,320 ARE THE BLOCKERS FOR HAVING A 5554 03:25:12,320 --> 03:25:15,560 STABLE AND RELIABLE HEALTH 5555 03:25:15,560 --> 03:25:18,280 ECOSYSTEM THAT ALLOWS US TO 5556 03:25:18,280 --> 03:25:19,440 WEATHER THE CRISIS, ARPA-H 5557 03:25:19,440 --> 03:25:20,480 HAVING THE OPPORTUNITY TO 5558 03:25:20,480 --> 03:25:23,040 INNOVATE FROM THE MOLECULAR TO 5559 03:25:23,040 --> 03:25:27,760 SOCIETAL LEVELS, AND SO WE'RE 5560 03:25:27,760 --> 03:25:31,040 THINKING ABOUT ENTIRE SPECTRUM 5561 03:25:31,040 --> 03:25:33,480 WHERE WE COULD PUT ACTIVITIES IN 5562 03:25:33,480 --> 03:25:35,320 PLACE TO ADDRESS FUTURE 5563 03:25:35,320 --> 03:25:37,200 PANDEMICS, SOCIAL DISRUPTION, 5564 03:25:37,200 --> 03:25:38,640 CLIMATE CHANGE, MOLECULAR 5565 03:25:38,640 --> 03:25:39,160 DISTURBANCES, ECONOMIC 5566 03:25:39,160 --> 03:25:41,640 DISABILITY, AND MANY OTHERS. 5567 03:25:41,640 --> 03:25:42,480 AND SO REALLY THINKING, YOU 5568 03:25:42,480 --> 03:25:47,560 KNOW, WHAT DO WE DO TO MAKE SURE 5569 03:25:47,560 --> 03:25:48,720 WE'RE ADDRESSING THESE 5570 03:25:48,720 --> 03:25:52,120 CHALLENGES, USING NOVEL METHODS, 5571 03:25:52,120 --> 03:25:53,400 USING INNOVATIVE APPROACHES, 5572 03:25:53,400 --> 03:25:57,200 THINGS THAT REALLY CAN BE 5573 03:25:57,200 --> 03:25:57,800 TERRIFICALLY TRANSFORMATIONAL, 5574 03:25:57,800 --> 03:25:59,520 AND SOMEONE COULD SAY, OKAY, NOW 5575 03:25:59,520 --> 03:26:01,880 WE CAN DO BETTER NEXT TIME THIS 5576 03:26:01,880 --> 03:26:03,480 HAPPENS WHICH INVARIABLY IT WILL 5577 03:26:03,480 --> 03:26:05,840 BECAUSE WE NOW HAVE THIS 5578 03:26:05,840 --> 03:26:12,560 CAPABILITY IN PLACE. 5579 03:26:12,560 --> 03:26:13,320 NEXT SLIDE. 5580 03:26:13,320 --> 03:26:15,440 ONE EXAMPLE OF WHAT WE'RE 5581 03:26:15,440 --> 03:26:17,320 THINKING ABOUT BEFORE WE LAUNCH 5582 03:26:17,320 --> 03:26:19,240 ANY PROGRAMS, WE GET LOTS OF 5583 03:26:19,240 --> 03:26:21,720 QUESTIONS, SHOW US WHAT A 5584 03:26:21,720 --> 03:26:22,960 PROGRAM WOULD LOOK LIKE. 5585 03:26:22,960 --> 03:26:29,040 HERE IS A NOTIONAL EXAMPLE OF 5586 03:26:29,040 --> 03:26:29,960 DIGITAL HISTOPATHOLOGY 5587 03:26:29,960 --> 03:26:30,880 CAPABILITY WE WOULD POTENTIALLY 5588 03:26:30,880 --> 03:26:32,680 SUPPORT OUT OF ARPA-H. 5589 03:26:32,680 --> 03:26:36,320 WE'RE ALIGNED WITH THE 5590 03:26:36,320 --> 03:26:39,160 ADMINISTRATION CANCER MOONSHOT, 5591 03:26:39,160 --> 03:26:41,320 CANCER PRIORITIES WILL BE 5592 03:26:41,320 --> 03:26:41,640 CROSS-CUTTING. 5593 03:26:41,640 --> 03:26:44,600 THE PROGRAM PROBLEM WHEN WE TALK 5594 03:26:44,600 --> 03:26:46,360 ABOUT THE BIG CHALLENGES THAT 5595 03:26:46,360 --> 03:26:49,440 WE'RE SEEKING TO ADDRESS, WE 5596 03:26:49,440 --> 03:26:50,640 KNOW CURRENT HISTOPATHOLOGY 5597 03:26:50,640 --> 03:26:52,200 PRACTICES ARE MANUAL, REQUIRE 5598 03:26:52,200 --> 03:26:54,400 EXPERT IN THE LOOP, QUITE OFTEN 5599 03:26:54,400 --> 03:26:56,480 COSTLY, AND THE DATA IS NOT 5600 03:26:56,480 --> 03:26:59,320 ACCESSIBLE TO SHARE BROAD 5601 03:26:59,320 --> 03:27:00,560 INSIGHTS TO IMPROVE PATIENT 5602 03:27:00,560 --> 03:27:01,040 CARE. 5603 03:27:01,040 --> 03:27:02,240 SO WHEN WE THINK ABOUT LET'S 5604 03:27:02,240 --> 03:27:05,800 BREAK THAT DOWN INTO ALL THE 5605 03:27:05,800 --> 03:27:07,480 DIFFERENT SUBPROBLEMS ASSOCIATED 5606 03:27:07,480 --> 03:27:08,880 WITH THAT PROBLEM STATEMENT AND 5607 03:27:08,880 --> 03:27:11,040 COMING UP WITH APPROACH THAT 5608 03:27:11,040 --> 03:27:13,080 WOULD ALLOW US TO ADDRESS THAT 5609 03:27:13,080 --> 03:27:16,200 IN A REALLY SORT OF -- THE 5610 03:27:16,200 --> 03:27:19,040 BOLDEST MOST AMBITIOUS MOST 5611 03:27:19,040 --> 03:27:23,240 PRACTICAL WAY POSSIBLE, DESIGN 5612 03:27:23,240 --> 03:27:24,880 AND DEVELOP NOVEL MULTIOMIC 5613 03:27:24,880 --> 03:27:30,680 HISTOPATH ASSAYS THAT ARE 5614 03:27:30,680 --> 03:27:35,320 SUPPORTED THROUGH AI/ML FOR 5615 03:27:35,320 --> 03:27:36,120 DIAGNOSTICS AND 5616 03:27:36,120 --> 03:27:37,120 CHARACTERIZATION, AND DATA 5617 03:27:37,120 --> 03:27:39,120 INTEGRATION INTO CARE PATHWAYS 5618 03:27:39,120 --> 03:27:41,320 SO WE REMOVE THE BARRIERS TO 5619 03:27:41,320 --> 03:27:45,960 HAVING A SEAMLESS END TO END 5620 03:27:45,960 --> 03:27:49,800 SOLUTION TO WHAT'S CURRENTLY 5621 03:27:49,800 --> 03:27:52,720 BLOCKING IMPROVED CANCER 5622 03:27:52,720 --> 03:27:56,280 DIAGNOSIS AND DATA INSIGHTS AND 5623 03:27:56,280 --> 03:27:57,520 DATA INFORMATION SHARING. 5624 03:27:57,520 --> 03:27:59,200 THEN LOOKING AT WHAT WOULD WE 5625 03:27:59,200 --> 03:28:00,120 DO? 5626 03:28:00,120 --> 03:28:02,440 WE LOOK FOR APPLICATIONS AND 5627 03:28:02,440 --> 03:28:03,960 INDICATIONS THAT WOULD INCLUDE 5628 03:28:03,960 --> 03:28:06,880 PROOFS OF CONCEPT FOR METASTATIC 5629 03:28:06,880 --> 03:28:07,920 CANCERS, NEURODEGENERATIVE 5630 03:28:07,920 --> 03:28:09,720 DISEASES, WOUND HEALING. 5631 03:28:09,720 --> 03:28:11,840 SO EVEN BEYOND JUST A SINGLE 5632 03:28:11,840 --> 03:28:13,560 SORT OF DISEASE STATE THAT WE 5633 03:28:13,560 --> 03:28:16,760 WOULD BE THINKING, OKAY, THIS 5634 03:28:16,760 --> 03:28:19,960 WOULD SOLVE FOR CANCER, IF THE 5635 03:28:19,960 --> 03:28:21,680 APPROACH THAT WE WOULD DESIGN 5636 03:28:21,680 --> 03:28:24,520 OUT OF OUR PROGRAMS WOULD ALSO 5637 03:28:24,520 --> 03:28:27,560 EXTEND TO OTHER INDICATIONS LIKE 5638 03:28:27,560 --> 03:28:29,200 NEURODEGENERATIVE DISEASES, OR 5639 03:28:29,200 --> 03:28:30,840 WOUND HEALING, THEN IT WOULD 5640 03:28:30,840 --> 03:28:36,120 ALLOW US TO CREATE THESE STRONG 5641 03:28:36,120 --> 03:28:38,000 PLATFORMS THAT ARE ACTUALLY SORT 5642 03:28:38,000 --> 03:28:40,720 OF MORE APPROPRIATELY POSITIONED 5643 03:28:40,720 --> 03:28:42,640 TO HAVE TRANSFORMATIVE IMPACT ON 5644 03:28:42,640 --> 03:28:43,880 THE HEALTH ECOSYSTEM THAN 5645 03:28:43,880 --> 03:28:46,280 SOMETHING MORE LIMITED TO ONE 5646 03:28:46,280 --> 03:28:48,760 INDICATION OR SOLVING ONE SINGLE 5647 03:28:48,760 --> 03:28:53,560 PROBLEM WITHIN THE HEALTH 5648 03:28:53,560 --> 03:28:53,960 ECOSYSTEM. 5649 03:28:53,960 --> 03:28:55,240 NEXT SLIDE PLEASE. 5650 03:28:55,240 --> 03:28:59,480 LET ME TALK A LITTLE ABOUT OUR 5651 03:28:59,480 --> 03:29:05,440 MISSION AND BUSINESS MODEL. 5652 03:29:05,440 --> 03:29:08,840 NEXT SLIDE PLEASE. 5653 03:29:08,840 --> 03:29:09,680 WE'RE THINKING ABOUT 5654 03:29:09,680 --> 03:29:10,840 ACCELERATING BETTER HEALTH 5655 03:29:10,840 --> 03:29:13,280 OUTCOMES FOR EVERYONE. 5656 03:29:13,280 --> 03:29:16,720 WHEN WE ANCHOR OUR APPROACH TO 5657 03:29:16,720 --> 03:29:19,720 EVERYTHING THAT WE DO, WE 5658 03:29:19,720 --> 03:29:22,320 CHALLENGE OURSELVES TO NOT JUST 5659 03:29:22,320 --> 03:29:24,520 DEVELOP CAPABILITIES THAT 5660 03:29:24,520 --> 03:29:26,720 PROMISE TO DELIVER BETTER HEALTH 5661 03:29:26,720 --> 03:29:28,400 OUTCOMES FOR A SUBSET OF THE 5662 03:29:28,400 --> 03:29:28,720 POPULATION. 5663 03:29:28,720 --> 03:29:31,600 WE WANT TO MAKE SURE THAT WE ARE 5664 03:29:31,600 --> 03:29:33,000 IN ALIGNMENT WITH THIS 5665 03:29:33,000 --> 03:29:34,000 ADMINISTRATION'S PRIORITIES TO 5666 03:29:34,000 --> 03:29:37,160 HAVE HEALTH EQUITY AND INCLUSION 5667 03:29:37,160 --> 03:29:41,240 ACROSS ALL POPULATIONS AND SO AS 5668 03:29:41,240 --> 03:29:43,480 WE'RE SEEING PROGRAMS OR 5669 03:29:43,480 --> 03:29:48,280 PROJECTS THAT ARE COMING IN, OUR 5670 03:29:48,280 --> 03:29:49,880 FIRST QUESTION IS WHO BENEFITS. 5671 03:29:49,880 --> 03:29:52,880 AND HOW DO WE MAKE SURE THAT 5672 03:29:52,880 --> 03:29:56,040 ANYTHING THAT WE SUPPORT THROUGH 5673 03:29:56,040 --> 03:29:59,520 ARPA-H CAN TOUCH EVERYONE WHO 5674 03:29:59,520 --> 03:30:00,760 HAS THAT PARTICULAR CHALLENGE 5675 03:30:00,760 --> 03:30:02,720 WITHIN THE HEALTH ECOSYSTEM AND 5676 03:30:02,720 --> 03:30:04,520 COULD BENEFIT FROM A PROGRAM 5677 03:30:04,520 --> 03:30:05,880 FROM ARPA-H SO IT'S REALLY WHAT 5678 03:30:05,880 --> 03:30:06,400 WE'RE PUSHING FOR. 5679 03:30:06,400 --> 03:30:12,040 THAT IS THE PROMISE OF OUR 5680 03:30:12,040 --> 03:30:12,360 AGENCY. 5681 03:30:12,360 --> 03:30:14,720 NEXT SLIDE PLEASE. 5682 03:30:14,720 --> 03:30:15,760 WE'VE BEEN INCREDIBLY FORTUNATE 5683 03:30:15,760 --> 03:30:18,920 THIS ADMINISTRATION HAS BEEN SO 5684 03:30:18,920 --> 03:30:21,280 SUPPORTIVE ABOUT HEALTH 5685 03:30:21,280 --> 03:30:21,560 INNOVATION. 5686 03:30:21,560 --> 03:30:23,320 PRESIDENT BIDEN WHEN HE LAUNCHED 5687 03:30:23,320 --> 03:30:27,520 ARPA-H HE WAS SO CLEAR ABOUT 5688 03:30:27,520 --> 03:30:30,200 ARPA-H, YOU KNOW, WE'LL BREAK 5689 03:30:30,200 --> 03:30:33,160 THE MOLD HOW WE SUPPORT 5690 03:30:33,160 --> 03:30:34,160 FUNDAMENTAL RESEARCH AND 5691 03:30:34,160 --> 03:30:35,160 COMMERCIAL PROJECTS IN THIS 5692 03:30:35,160 --> 03:30:37,960 COUNTRY SETTING THE BAR THAT THE 5693 03:30:37,960 --> 03:30:40,600 IDEAS WOULD BE SO AUDACIOUS THAT 5694 03:30:40,600 --> 03:30:45,160 THEY MAY WORK, THEY MIGHT WORK, 5695 03:30:45,160 --> 03:30:49,000 BUT THEY ARE WIN THE HIGH RISK, 5696 03:30:49,000 --> 03:30:52,680 HIGH REWARD PARADIGM, AT THAT 5697 03:30:52,680 --> 03:30:53,920 TIMES -- AND THAT'S WHAT ARPA-H 5698 03:30:53,920 --> 03:30:56,920 IS POSITIONED TO TAKE ON. 5699 03:30:56,920 --> 03:30:58,040 INCREMENTAL IMPROVEMENTS IS NOT 5700 03:30:58,040 --> 03:31:00,960 HOW WE'RE GOING TO BE CONDUCTING 5701 03:31:00,960 --> 03:31:01,320 BUSINESS. 5702 03:31:01,320 --> 03:31:03,440 WE'RE REALLY GOING TO TAKE OUR 5703 03:31:03,440 --> 03:31:04,800 AGENCY AND PUSH OURSELVES TO THE 5704 03:31:04,800 --> 03:31:06,920 VERY FAR END OF THE HEALTH 5705 03:31:06,920 --> 03:31:07,760 INNOVATION CONTINUUM AND THAT'S 5706 03:31:07,760 --> 03:31:10,200 WHERE WE'RE GOING TO LAUNCH OUR 5707 03:31:10,200 --> 03:31:10,480 PROGRAMS. 5708 03:31:10,480 --> 03:31:12,400 SO WE'RE VERY FORTUNATE TO HAVE 5709 03:31:12,400 --> 03:31:13,800 SUCH STRONG SUPPORT FROM THIS 5710 03:31:13,800 --> 03:31:15,960 ADMINISTRATION, FROM THE WHITE 5711 03:31:15,960 --> 03:31:18,080 HOUSE, AND THEY ARE CONTINUING 5712 03:31:18,080 --> 03:31:20,160 TO DO SO, SO WE'RE VERY 5713 03:31:20,160 --> 03:31:24,640 APPRECIATIVE OF THAT. 5714 03:31:24,640 --> 03:31:25,840 NEXT SLIDE PLEASE. 5715 03:31:25,840 --> 03:31:26,640 WE HOLD OURSELVES ACCOUNTABLE. 5716 03:31:26,640 --> 03:31:30,320 ONE OF THE THINGS WE HAVE DONE 5717 03:31:30,320 --> 03:31:32,720 WITHIN THE SPACE THAT WE ARE 5718 03:31:32,720 --> 03:31:35,920 WORKING OUT OF, AND ALL OF OUR 5719 03:31:35,920 --> 03:31:40,560 SORT OF PERSONAL DEVICES, WE 5720 03:31:40,560 --> 03:31:43,040 HOLD OURSELVES ACCOUNTABLE TO 5721 03:31:43,040 --> 03:31:44,520 IMAGINE IF CHALLENGES. 5722 03:31:44,520 --> 03:31:46,320 WE HAVE GREAT POSTERS THAT ARE 5723 03:31:46,320 --> 03:31:47,320 ALL AROUND US. 5724 03:31:47,320 --> 03:31:50,360 YOU CAN GO TO OUR WEBSITE AND 5725 03:31:50,360 --> 03:31:51,840 HAVE THEM YOURSELF. 5726 03:31:51,840 --> 03:31:53,760 WHAT IF WE COULD DESIGN 5727 03:31:53,760 --> 03:31:58,880 AFFORDABLE CUSTOM CAN CER 5728 03:31:58,880 --> 03:32:00,400 VACCINES FOR EVERYONE? 5729 03:32:00,400 --> 03:32:05,960 WE CAN DO IT FOR A SMALL NUMBER 5730 03:32:05,960 --> 03:32:07,600 OF INDIVIDUALS, INCREDIBLY 5731 03:32:07,600 --> 03:32:07,840 COSTLY. 5732 03:32:07,840 --> 03:32:09,440 WHAT IF EVERYBODY COULD HAVE A 5733 03:32:09,440 --> 03:32:11,800 CUSTOM CANCER VACCINE WHO NEEDS 5734 03:32:11,800 --> 03:32:12,280 IT? 5735 03:32:12,280 --> 03:32:13,960 AND IT'S AFFORDABLE TO EVERYONE. 5736 03:32:13,960 --> 03:32:17,160 WHAT IF WE COULD DO 3D 5737 03:32:17,160 --> 03:32:18,160 BIOPRINTED REPLACEMENTS FOR 5738 03:32:18,160 --> 03:32:22,240 DAMAGE THE ORGANS? 5739 03:32:22,240 --> 03:32:26,440 RIGHT NOW WE HAVE ORGAN DONATION 5740 03:32:26,440 --> 03:32:27,240 SYSTEM IN THE UNITED STATES, 5741 03:32:27,240 --> 03:32:32,920 WHAT IF WE COULD BE SO 5742 03:32:32,920 --> 03:32:34,360 DISRUPTIVE BY CREATING ORGANS 5743 03:32:34,360 --> 03:32:35,320 THAT ARE COMPATIBLE WITH THE 5744 03:32:35,320 --> 03:32:36,600 INDIVIDUAL WHO NEEDS THEM AND 5745 03:32:36,600 --> 03:32:38,160 DON'T HAVE TO RELY ON THE SYSTEM 5746 03:32:38,160 --> 03:32:39,480 WE CURRENTLY HAVE IN PLACE? 5747 03:32:39,480 --> 03:32:42,360 WHAT IF WE COULD DO NANOROBOTIC 5748 03:32:42,360 --> 03:32:46,760 SURGERY DELIVERED BY A PILL? 5749 03:32:46,760 --> 03:32:49,000 RIGHT NOW THERE ARE SO MANY 5750 03:32:49,000 --> 03:32:50,640 IMPEDIMENTS AND CHALLENGES TO 5751 03:32:50,640 --> 03:32:53,280 THE CURRENT WAY WE TREAT 5752 03:32:53,280 --> 03:32:54,840 DISEASES, ESPECIALLY THOSE WHO 5753 03:32:54,840 --> 03:32:58,320 NEED SURGERY, WHAT IF WE COULD 5754 03:32:58,320 --> 03:32:59,920 DO SOMETHING ENTIRELY DIFFERENT 5755 03:32:59,920 --> 03:33:01,320 THAT REDUCED MORBIDITY AND 5756 03:33:01,320 --> 03:33:04,920 MORTALITY AND EVERYTHING ELSE 5757 03:33:04,920 --> 03:33:05,640 ASSOCIATED WITH SURGERY, 5758 03:33:05,640 --> 03:33:06,680 REQUIRED SURGERY? 5759 03:33:06,680 --> 03:33:09,080 AND THESE ARE NOT SCIENCE 5760 03:33:09,080 --> 03:33:09,600 FICTION. 5761 03:33:09,600 --> 03:33:10,520 WE'RE GETTING READY TO WORK 5762 03:33:10,520 --> 03:33:13,080 ACROSS ALL OF THESE AND MANY 5763 03:33:13,080 --> 03:33:13,360 MORE. 5764 03:33:13,360 --> 03:33:16,920 AND THAT IS THE BAR THAT WE'RE 5765 03:33:16,920 --> 03:33:20,400 SETTING FOR OURSELVES. 5766 03:33:20,400 --> 03:33:21,160 NEXT SLIDE. 5767 03:33:21,160 --> 03:33:24,600 WE HAVEN'T BEEN AROUND VERY 5768 03:33:24,600 --> 03:33:24,800 LONG. 5769 03:33:24,800 --> 03:33:27,960 IT WAS JUST OVER A YEAR AGO, 5770 03:33:27,960 --> 03:33:30,520 MARCH 15 OF 2022, WHEN WE CAME 5771 03:33:30,520 --> 03:33:39,200 INTO EXISTENCE. 5772 03:33:39,200 --> 03:33:41,040 DR. WEGRSZYN WAS SWORN IN 5773 03:33:41,040 --> 03:33:42,640 OCTOBER 11. 5774 03:33:42,640 --> 03:33:51,040 SWEEL BRAT - WE CELEBRATED OUR 5775 03:33:51,040 --> 03:33:52,120 FIRST BIRTHDAY. 5776 03:33:52,120 --> 03:33:53,360 EVERYONE IS ENERGIZED TO START 5777 03:33:53,360 --> 03:33:55,880 TO MAKE THE TYPE OF IMPACT WE 5778 03:33:55,880 --> 03:34:06,240 KNOW WE WANT TO MAKE. 5779 03:34:11,440 --> 03:34:15,760 DR.ER WITHING REPORTS TO THE 5780 03:34:15,760 --> 03:34:17,080 SECRETARY. 5781 03:34:17,080 --> 03:34:18,560 WE PARTNER SO CLOSELY WITH 5782 03:34:18,560 --> 03:34:20,840 SUBJECT MATTER EXPERTS AND 5783 03:34:20,840 --> 03:34:22,800 INCREDIBLE TALENT AT NIH SO WE 5784 03:34:22,800 --> 03:34:24,080 CHERISH THAT RELATIONSHIP AND WE 5785 03:34:24,080 --> 03:34:29,000 WANT TO MAKE SURE THAT WE WORK 5786 03:34:29,000 --> 03:34:30,560 CLOSELY WITH OUR COLLEAGUES AT 5787 03:34:30,560 --> 03:34:33,920 NIH, AND WE HAVE OUR PROGRAM 5788 03:34:33,920 --> 03:34:36,360 MANAGERS AND BUSINESS TEAM 5789 03:34:36,360 --> 03:34:36,840 MEMBERS. 5790 03:34:36,840 --> 03:34:38,240 WE'VE BEEN FORTUNATE, CONGRESS 5791 03:34:38,240 --> 03:34:40,200 PROVIDED $2.5 BILLION TO GET US 5792 03:34:40,200 --> 03:34:43,680 OFF THE GROUND. 5793 03:34:43,680 --> 03:34:45,920 WE TAKE THAT SERIOUSLY, THE 5794 03:34:45,920 --> 03:34:47,600 OBLIGATION TO USE EVERY PENNY IN 5795 03:34:47,600 --> 03:34:49,640 THE MOST EFFECTIVE WAY TO CREATE 5796 03:34:49,640 --> 03:34:53,200 THOSE CAPABILITIES THAT WE'VE 5797 03:34:53,200 --> 03:34:54,600 BEEN TALKING ABOUT. 5798 03:34:54,600 --> 03:34:55,760 WE DON'T HAVE INTERNAL RESEARCH 5799 03:34:55,760 --> 03:34:57,880 LABS, THAT'S NOT HOW WE WORK, 5800 03:34:57,880 --> 03:34:59,240 AND WE'RE DISEASE AGNOSTIC, 5801 03:34:59,240 --> 03:35:01,440 LOOKING FOR BIG IDEAS THAT CUT 5802 03:35:01,440 --> 03:35:03,800 ACROSS MULTIPLE CONDITIONS TO BE 5803 03:35:03,800 --> 03:35:05,400 ABLE TO CREATE THESE PLATFORMS, 5804 03:35:05,400 --> 03:35:06,920 THESE PARADIGM CHANGES IN THE 5805 03:35:06,920 --> 03:35:07,640 HEALTH ECOSYSTEM. 5806 03:35:07,640 --> 03:35:09,520 WE HAVE A LEAN AND NIMBLE 5807 03:35:09,520 --> 03:35:10,360 MANAGEMENT STRUCTURE. 5808 03:35:10,360 --> 03:35:13,480 WE WANT THE MAJORITY OF OUR 5809 03:35:13,480 --> 03:35:15,520 FUNDINGS TO GO OUT TO 5810 03:35:15,520 --> 03:35:17,040 PERFORMERS, INTO THE ECOSYSTEM, 5811 03:35:17,040 --> 03:35:24,320 NOT TO STAY WITHIN THE AGENCY. 5812 03:35:24,320 --> 03:35:25,480 WE'RE A BOTTOM-UP AGENCY. 5813 03:35:25,480 --> 03:35:28,560 WE HAVE PRIZE AUTHORITY. 5814 03:35:28,560 --> 03:35:30,840 WE'VE LAUNCHED OUR FIRST PRIZE 5815 03:35:30,840 --> 03:35:31,680 COMPETITION, NEARING COMPLETION, 5816 03:35:31,680 --> 03:35:34,000 I'LL TALK MORE ABOUT THAT. 5817 03:35:34,000 --> 03:35:34,920 WE'RE NOT GRANTS BASED. 5818 03:35:34,920 --> 03:35:36,680 WE DO NOT ISSUE GRANTS. 5819 03:35:36,680 --> 03:35:38,600 WE FOCUS ON COOPERATIVE 5820 03:35:38,600 --> 03:35:40,840 AGREEMENTS, OTHER TRANSACTIONS 5821 03:35:40,840 --> 03:35:43,840 AND CONTRACTS. 5822 03:35:43,840 --> 03:35:45,440 FINALLY WE DO THIS HIGH 5823 03:35:45,440 --> 03:35:49,280 RISK/HIGH IMPACT RESEARCH, 5824 03:35:49,280 --> 03:35:50,240 THINGS THAT, AGAIN, IN PRESIDENT 5825 03:35:50,240 --> 03:35:53,680 BIDEN'S VISION IT'S SO AUDACIOUS 5826 03:35:53,680 --> 03:35:55,760 THAT IT MIGHT WORK, JUST MIGHT 5827 03:35:55,760 --> 03:35:56,120 WORK. 5828 03:35:56,120 --> 03:35:59,080 WE'RE REALLY WILLING TO TAKE ON 5829 03:35:59,080 --> 03:36:02,600 THAT HIGH RISK PORTFOLIO. 5830 03:36:02,600 --> 03:36:04,160 NEXT SLIDE PLEASE. 5831 03:36:04,160 --> 03:36:06,600 AND WE ARE NOT ALONE IN THE 5832 03:36:06,600 --> 03:36:09,600 HEALTH ECOSYSTEM. 5833 03:36:09,600 --> 03:36:11,840 WE HAVE PARTNERS FROM ACROSS THE 5834 03:36:11,840 --> 03:36:13,720 STAKEHOLDER GROUPS, INSIDE AND 5835 03:36:13,720 --> 03:36:14,880 OUTSIDE OF GOVERNMENT. 5836 03:36:14,880 --> 03:36:16,280 AND WE'RE RUNNING SHORT ON TIME 5837 03:36:16,280 --> 03:36:19,280 SO I DON'T WANT TO GET INTO 5838 03:36:19,280 --> 03:36:23,280 DETAIL HERE BUT WE HAVE 5839 03:36:23,280 --> 03:36:23,840 RESPECTFUL APPRECIATION FOR 5840 03:36:23,840 --> 03:36:25,920 EVERY PART OF THE ECOSYSTEM, AND 5841 03:36:25,920 --> 03:36:29,120 EVERY PART WILL HAVE AN INPUT OR 5842 03:36:29,120 --> 03:36:31,440 OUTPUT OR OUTCOMES FROM ARPA-H 5843 03:36:31,440 --> 03:36:36,120 AND WE INTEND TO ENSURE WE WORK 5844 03:36:36,120 --> 03:36:40,600 TIRELESSLY ACROSS THE ECOSYSTEM. 5845 03:36:40,600 --> 03:36:42,360 NEXT SLIDE PLEASE. 5846 03:36:42,360 --> 03:36:44,560 WE'RE OPEN FOR BUSINESS. 5847 03:36:44,560 --> 03:36:47,480 SO WE LAUNCHED OUR FIRST BROAD 5848 03:36:47,480 --> 03:36:49,320 AGENCY ANNOUNCEMENT A LITTLE 5849 03:36:49,320 --> 03:36:50,480 WHILE AGO, A FEW MONTHS, ABOUT A 5850 03:36:50,480 --> 03:36:53,480 MONTH AND A HALF AGO. 5851 03:36:53,480 --> 03:36:57,040 AND WE'RE ACTIVELY SEEKING 5852 03:36:57,040 --> 03:36:58,880 REALLY AMBITIOUS PROJECTS, 5853 03:36:58,880 --> 03:37:02,640 THINGS THAT, YOU KNOW, THAT ARE 5854 03:37:02,640 --> 03:37:04,600 SO BOLD THAT REALLY NO OTHER 5855 03:37:04,600 --> 03:37:07,280 AGENCY WOULD FUND THEM BECAUSE 5856 03:37:07,280 --> 03:37:10,080 THEY ARE SO SORT OF AMBITIOUS 5857 03:37:10,080 --> 03:37:12,480 AND SO FORWARD LEANING, SO JUST 5858 03:37:12,480 --> 03:37:14,200 THINKING ABOUT PROBLEMS IN AN 5859 03:37:14,200 --> 03:37:15,600 ENTIRELY DIFFERENT WAY, ACTIVELY 5860 03:37:15,600 --> 03:37:17,880 LOOKING AT THOSE PROPOSALS TO 5861 03:37:17,880 --> 03:37:19,640 COME IN, AND SO IF YOU OR ANYONE 5862 03:37:19,640 --> 03:37:23,400 YOU KNOW HAS A BIG BOLD IDEA, 5863 03:37:23,400 --> 03:37:28,640 PLEASE FEEL FREE TO PUT IN AN 5864 03:37:28,640 --> 03:37:29,920 APPLICATION. 5865 03:37:29,920 --> 03:37:36,680 WE'VE LOWERED THE THRESHOLD, A 5866 03:37:36,680 --> 03:37:39,720 3-PAGE ABSTRACT, REQUIREMENTS 5867 03:37:39,720 --> 03:37:40,520 ARE ON OUR WEBSITE. 5868 03:37:40,520 --> 03:37:43,080 YOU CAN SEE ALL THE OTHER 5869 03:37:43,080 --> 03:37:43,960 REQUIREMENTS. 5870 03:37:43,960 --> 03:37:46,200 BE BOLD. 5871 03:37:46,200 --> 03:37:50,200 BE AMBITIOUS, SUBMIT YOUR IDEAS. 5872 03:37:50,200 --> 03:37:50,800 SITE SELECTION, MULTIPLE 5873 03:37:50,800 --> 03:37:52,680 LOCATIONS, CONGRESS REQUIRED US 5874 03:37:52,680 --> 03:37:56,440 TO HAVE THREE SITES SO WE'RE 5875 03:37:56,440 --> 03:37:59,400 CREATE BE A HUB AND SPOKE MODEL, 5876 03:37:59,400 --> 03:38:01,360 WE'LL EXTEND OUR REACH AND 5877 03:38:01,360 --> 03:38:04,160 PARTNERSHIPS AND YOU CAN FIND 5878 03:38:04,160 --> 03:38:06,480 MORE INFORMATION ABOUT THAT AND 5879 03:38:06,480 --> 03:38:08,800 THE ARPA-H DASH, OUR FIRST 5880 03:38:08,800 --> 03:38:10,120 CHALLENGE. 5881 03:38:10,120 --> 03:38:12,040 IT WAS THE DASH TO IMPROVE 5882 03:38:12,040 --> 03:38:13,840 HEALTH OUTCOMES, JUST A REALLY 5883 03:38:13,840 --> 03:38:16,520 FUN WAY TO REACH OUT TO THE 5884 03:38:16,520 --> 03:38:17,720 BROADEST STAKEHOLDER COMMUNITY 5885 03:38:17,720 --> 03:38:22,000 POSSIBLE TO ANNOUNCE WE WERE 5886 03:38:22,000 --> 03:38:26,480 HERE. 5887 03:38:26,480 --> 03:38:28,480 WE'VE HAD TENS OF THOUSANDS OF 5888 03:38:28,480 --> 03:38:29,640 INDIVIDUALS PARTICIPATE OR HAVE 5889 03:38:29,640 --> 03:38:30,840 A BETTER UNDERSTANDING WHAT 5890 03:38:30,840 --> 03:38:33,400 ARPA-H IS, DUE TO THIS 5891 03:38:33,400 --> 03:38:34,880 COMPETITION, A BRACKET CHALLENGE 5892 03:38:34,880 --> 03:38:36,960 SIMILAR TO ANOTHER FAMOUS 5893 03:38:36,960 --> 03:38:38,960 CHALLENGE THAT HAPPENS IN MARCH 5894 03:38:38,960 --> 03:38:40,880 THAT STARTS WITH 64, ENDS WITH 5895 03:38:40,880 --> 03:38:42,760 1, OVER SIX SETS OF WEEKS. 5896 03:38:42,760 --> 03:38:50,040 WE'RE HEAD TO HEAD COMPETITION 5897 03:38:50,040 --> 03:38:52,000 ALLOWS US TO SEE MOST INNOVATIVE 5898 03:38:52,000 --> 03:38:53,200 IDEAS BASED ON VOTING. 5899 03:38:53,200 --> 03:38:56,320 WE LOOK INTERNALLY AS WELL FOR 5900 03:38:56,320 --> 03:38:58,800 FINAL CONFIRMATION. 5901 03:38:58,800 --> 03:39:00,080 THAT CONTEST WILL END NEXT 5902 03:39:00,080 --> 03:39:00,400 MONDAY. 5903 03:39:00,400 --> 03:39:02,720 WE WILL ANNOUNCE THE WINNER NEXT 5904 03:39:02,720 --> 03:39:04,200 WEEK, LATER NEXT WEEK. 5905 03:39:04,200 --> 03:39:05,840 BUT IF YOU'RE INTERESTED IN WHO 5906 03:39:05,840 --> 03:39:07,920 IS CURRENTLY IN THE FINAL FOUR, 5907 03:39:07,920 --> 03:39:13,280 WE'RE AT THE FINAL FOUR, YOU CAN 5908 03:39:13,280 --> 03:39:14,880 VOTE TODAY, AND WE'LL ANNOUNCE 5909 03:39:14,880 --> 03:39:18,720 THE FINAL TWO I BELIEVE TOMORROW 5910 03:39:18,720 --> 03:39:21,360 OR ON FRIDAY. 5911 03:39:21,360 --> 03:39:23,880 WE WILL DO MORE COMPETITIONS AS 5912 03:39:23,880 --> 03:39:25,560 WE CONTINUE TO GO. 5913 03:39:25,560 --> 03:39:27,560 ALL RIGHT. 5914 03:39:27,560 --> 03:39:28,960 I THINK THAT'S ALL I HAVE TIME 5915 03:39:28,960 --> 03:39:29,320 FOR. 5916 03:39:29,320 --> 03:39:31,080 WHY DON'T I STOP THERE. 5917 03:39:31,080 --> 03:39:32,720 I COVERED ALMOST EVERYTHING ELSE 5918 03:39:32,720 --> 03:39:35,000 IN THE SLIDES, HAPPY TO ANSWER 5919 03:39:35,000 --> 03:39:37,440 ANY QUESTIONS THAT ANYONE MAY 5920 03:39:37,440 --> 03:39:40,200 HAVE ABOUT ARPA-H, OUR BUSINESS 5921 03:39:40,200 --> 03:39:41,240 MODEL, WHAT WE'RE THINKING, HOW 5922 03:39:41,240 --> 03:39:43,680 YOU CAN WORK WITH US OR ANYTHING 5923 03:39:43,680 --> 03:39:45,720 ELSE THAT WOULD BE HELPFUL. 5924 03:39:45,720 --> 03:39:47,040 I REALLY APPRECIATE THE 5925 03:39:47,040 --> 03:39:48,240 OPPORTUNITY TO MEET WITH ALL OF 5926 03:39:48,240 --> 03:39:51,520 YOU TODAY. 5927 03:39:51,520 --> 03:39:52,520 >>THANKS VERY MUCH. 5928 03:39:52,520 --> 03:39:53,600 A WONDERFUL PRESENTATION. 5929 03:39:53,600 --> 03:39:56,600 NOW WE'RE OPENING UP FOR 5930 03:39:56,600 --> 03:39:56,960 QUESTIONS. 5931 03:39:56,960 --> 03:39:58,960 WE'RE OPENING UP FOR YOUR 5932 03:39:58,960 --> 03:40:01,800 PRESENTATION AND DR. 5933 03:40:01,800 --> 03:40:02,160 BOISSONEAULT. 5934 03:40:02,160 --> 03:40:03,760 JUST FOR CLARIFICATION, I DIDN'T 5935 03:40:03,760 --> 03:40:05,800 REALLY GET IT IN MY BRAIN, 5936 03:40:05,800 --> 03:40:08,000 YOU'RE GOING TO BE SELECTING 5937 03:40:08,000 --> 03:40:08,840 PROJECTS THAT ARE MERITORIOUS 5938 03:40:08,840 --> 03:40:11,160 BUT IF IT'S GOING TO BE BASED ON 5939 03:40:11,160 --> 03:40:14,320 A VOTING SYSTEM OR HOW IS THAT 5940 03:40:14,320 --> 03:40:15,080 SELECTION MADE? 5941 03:40:15,080 --> 03:40:16,320 WHO ARE THE PEOPLE THAT ARE 5942 03:40:16,320 --> 03:40:18,800 GOING TO BE MAKING THAT 5943 03:40:18,800 --> 03:40:19,640 DECISION? 5944 03:40:19,640 --> 03:40:20,760 >>SUCH A GOOD QUESTION. 5945 03:40:20,760 --> 03:40:22,320 I RAN OUT OF TIME. 5946 03:40:22,320 --> 03:40:24,520 I WAS JUST ABOUT TO TELL YOU 5947 03:40:24,520 --> 03:40:26,320 ASPECTS OF OUR BUSINESS PROCESS. 5948 03:40:26,320 --> 03:40:32,120 WE'RE A PROGRAM MANAGER DRIVEN 5949 03:40:32,120 --> 03:40:33,800 ORGANIZATION, UNIQUELY 5950 03:40:33,800 --> 03:40:34,400 POSITIONED IN GOVERNMENT, 5951 03:40:34,400 --> 03:40:36,800 SIMILAR TO THE WAY DARPA RUNS 5952 03:40:36,800 --> 03:40:37,640 ITS PORTFOLIO. 5953 03:40:37,640 --> 03:40:39,600 WE DON'T HAVE REQUIREMENTS FROM 5954 03:40:39,600 --> 03:40:41,080 THE OUTSIDE. 5955 03:40:41,080 --> 03:40:44,080 WE RECRUIT HIGHLY TALENTED VERY 5956 03:40:44,080 --> 03:40:44,760 PASSIONATE PROGRAM MANAGERS, 5957 03:40:44,760 --> 03:40:47,720 INDIVIDUALS, WHO COME IN WITH AN 5958 03:40:47,720 --> 03:40:57,120 IDEA, AND THEY ESSENTIALLY USE 5959 03:40:57,120 --> 03:40:57,880 THE HEIDELMEYER QUESTIONS, 5960 03:40:57,880 --> 03:40:59,840 CHALLENGING QUESTIONS THAT 5961 03:40:59,840 --> 03:41:01,240 REQUIRE TECHNICAL UNDERSTANDING 5962 03:41:01,240 --> 03:41:04,000 ABOUT THE PROGRAM. 5963 03:41:04,000 --> 03:41:05,400 SETS A HIGH BAR. 5964 03:41:05,400 --> 03:41:07,120 WHAT A PROGRAM MANAGER HAS TO DO 5965 03:41:07,120 --> 03:41:09,360 TO GET A PROGRAM FUNDED. 5966 03:41:09,360 --> 03:41:11,000 WE HAVE AN INTERNAL SUBJECT 5967 03:41:11,000 --> 03:41:12,600 MATTER EXPERT SORT OF VALIDATION 5968 03:41:12,600 --> 03:41:13,800 APPROACH WHERE THE PROGRAM 5969 03:41:13,800 --> 03:41:16,480 MANAGER SAYS I WANT TO DO THIS 5970 03:41:16,480 --> 03:41:18,120 PROGRAM, AND THEY MEET OUR 5971 03:41:18,120 --> 03:41:20,040 STANDARDS FOR CREATING WHAT THAT 5972 03:41:20,040 --> 03:41:25,920 PROGRAM WILL BE AND INTERNALLY 5973 03:41:25,920 --> 03:41:34,480 VET, VALIDATE, ULTIMATELY DR. WG 5974 03:41:34,480 --> 03:41:44,160 ER WITHING -- DR. WERGRYZN HAS 5975 03:41:44,160 --> 03:41:45,760 FINAL AUTHORITY. 5976 03:41:45,760 --> 03:41:46,440 >>THAT CLARIFIES. 5977 03:41:46,440 --> 03:41:47,880 THANKS, SUSAN. 5978 03:41:47,880 --> 03:41:49,880 I'M PASSING BACK TO GEORGE WHO 5979 03:41:49,880 --> 03:41:56,800 IS GOING TO MODERATE THE 5980 03:41:56,800 --> 03:41:57,480 DISCUSSION. 5981 03:41:57,480 --> 03:41:57,880 >>THANKS, NORA. 5982 03:41:57,880 --> 03:42:01,320 I THINK I'LL LEAD WITH A 5983 03:42:01,320 --> 03:42:03,200 QUESTION FOR JEFF BOISSONEAULT. 5984 03:42:03,200 --> 03:42:05,680 IT MIGHT HAVE ARPA-H 5985 03:42:05,680 --> 03:42:06,200 IMPLICATIONS. 5986 03:42:06,200 --> 03:42:10,040 JEFF, MY QUESTION FOR YOU IS, IS 5987 03:42:10,040 --> 03:42:11,400 EMOTIONAL PAIN, CAN YOU MEASURE 5988 03:42:11,400 --> 03:42:15,200 IT IN USUAL HUMAN SUBJECTS AND 5989 03:42:15,200 --> 03:42:16,520 SOME OF THESE STUDIES? 5990 03:42:16,520 --> 03:42:19,320 ASSUMING YOU COULD, IS IT A 5991 03:42:19,320 --> 03:42:20,360 COVARIATE? 5992 03:42:20,360 --> 03:42:22,440 EXPLAIN SOME OF THE VARIANTS. 5993 03:42:22,440 --> 03:42:22,680 >>YEAH. 5994 03:42:22,680 --> 03:42:24,640 EMOTIONAL PAIN IS INTERESTING IN 5995 03:42:24,640 --> 03:42:26,600 THIS CONTEXT BECAUSE, YOU KNOW, 5996 03:42:26,600 --> 03:42:30,920 WE'RE APPLYING WHAT FOLKS CALL 5997 03:42:30,920 --> 03:42:32,480 PHYSICALLY PAINFUL STIMULI, HEAT 5998 03:42:32,480 --> 03:42:33,760 PAIN, PRESSURE PAIN, PEOPLE ARE 5999 03:42:33,760 --> 03:42:35,640 COMING IN WITH JAW PAIN, FOR 6000 03:42:35,640 --> 03:42:37,000 INSTANCE WHICH WE TEND TO THINK 6001 03:42:37,000 --> 03:42:38,360 OF AS VERY PHYSICAL. 6002 03:42:38,360 --> 03:42:40,720 BUT ALL OF THOSE PHYSICAL 6003 03:42:40,720 --> 03:42:41,800 STIMULI HAVE AN EMOTIONAL 6004 03:42:41,800 --> 03:42:42,920 COMPONENT TO IT. 6005 03:42:42,920 --> 03:42:47,840 AND ONE OF THE ASPECTS OF THE 6006 03:42:47,840 --> 03:42:50,200 CANUE MODEL AND WHAT OTHER FOLKS 6007 03:42:50,200 --> 03:42:52,560 ARE WORKING ON, NEGATIVE AFFECT 6008 03:42:52,560 --> 03:42:55,400 IS PLAYING A REALLY IMPORTANT 6009 03:42:55,400 --> 03:42:57,920 ROLE, MEDIATING ASSOCIATION 6010 03:42:57,920 --> 03:42:59,640 BETWEEN PAIN AND SUBSTANCE USE. 6011 03:42:59,640 --> 03:43:02,880 AND THE WAY I THINK OF IT IS 6012 03:43:02,880 --> 03:43:05,880 THAT PAIN OR PHYSICAL PAIN IS 6013 03:43:05,880 --> 03:43:10,160 ONE SOURCE OF THAT EMOTIONAL 6014 03:43:10,160 --> 03:43:11,320 DISTRESS OR PAIN, WHATEVER YOU 6015 03:43:11,320 --> 03:43:13,320 CALL IT, BUT IT COULD BE 6016 03:43:13,320 --> 03:43:14,800 SOMETHING ELSE. 6017 03:43:14,800 --> 03:43:17,280 IT COULD BE, YOU KNOW, 6018 03:43:17,280 --> 03:43:20,200 SOCIOECONOMIC STRESSOR, SOME 6019 03:43:20,200 --> 03:43:21,480 OTHER TRAUMA, SOCIOLEGAL ISSUE. 6020 03:43:21,480 --> 03:43:23,480 COULD BE A BREAKUP, RIGHT, 6021 03:43:23,480 --> 03:43:24,720 THAT'S CAUSING THAT DISTRESS FOR 6022 03:43:24,720 --> 03:43:25,400 SOMEBODY. 6023 03:43:25,400 --> 03:43:27,200 IT MIGHT HAVE A SIMILAR 6024 03:43:27,200 --> 03:43:28,840 RELATIONSHIP FOR THEM WITH THEIR 6025 03:43:28,840 --> 03:43:30,840 DRINKING OR THEIR SUBSTANCE USE. 6026 03:43:30,840 --> 03:43:32,320 SO TO ANSWER YOUR QUESTION, YES, 6027 03:43:32,320 --> 03:43:35,280 I THINK THAT IS SOMETHING WE CAN 6028 03:43:35,280 --> 03:43:37,920 MEASURE WELL IN AN EXPERIMENTAL 6029 03:43:37,920 --> 03:43:41,080 CONTEXT OR EVEN IN AN ECOLOGICAL 6030 03:43:41,080 --> 03:43:41,880 MOMENTARY ASSESSMENT CONTEXT IN 6031 03:43:41,880 --> 03:43:44,840 TERMS OF LOOKING AT VARIOUS 6032 03:43:44,840 --> 03:43:45,880 NEGATIVE AFFECTIVE COMPONENTS 6033 03:43:45,880 --> 03:43:47,240 THAT ARE TYPICALLY RELATED TO 6034 03:43:47,240 --> 03:43:51,720 PAIN OR DISTRESS SO THAT COULD 6035 03:43:51,720 --> 03:43:53,760 BE ANXIETY, FRUSTRATION, 6036 03:43:53,760 --> 03:43:55,360 DEPRESSION, FEAR, ANGER, ALL OF 6037 03:43:55,360 --> 03:43:57,800 WHICH ARE ASSOCIATED WITH NOT 6038 03:43:57,800 --> 03:44:00,520 JUST, YOU KNOW, CHRONIC PAIN 6039 03:44:00,520 --> 03:44:01,760 CONDITIONS BUT ALSO WITH, YOU 6040 03:44:01,760 --> 03:44:06,000 KNOW, WHAT WE THINK MORE OF 6041 03:44:06,000 --> 03:44:06,560 EMOTIONAL PAIN. 6042 03:44:06,560 --> 03:44:07,080 >>THANKS. 6043 03:44:07,080 --> 03:44:10,600 AND BEFORE I GET TO YOUR 6044 03:44:10,600 --> 03:44:19,520 QUESTION LIVE HERE, FOR SUSAN, 6045 03:44:19,520 --> 03:44:20,720 FOR YOU, A QUESTION. 6046 03:44:20,720 --> 03:44:24,960 OH, THAT'S YOU. 6047 03:44:24,960 --> 03:44:26,360 ASK YOUR QUESTION LIVE. 6048 03:44:26,360 --> 03:44:28,200 >>GOOD TO HEAR YOUR VOICE AND 6049 03:44:28,200 --> 03:44:29,680 SEE YOUR FACE. 6050 03:44:29,680 --> 03:44:31,280 >>LIKEWISE. 6051 03:44:31,280 --> 03:44:31,880 >>I'M GOING TO STATE THE 6052 03:44:31,880 --> 03:44:33,160 QUESTION AND BUILD ON IT. 6053 03:44:33,160 --> 03:44:34,520 THE QUESTION IN THE CHAT WAS 6054 03:44:34,520 --> 03:44:39,080 AROUND HOW TO AVOID UNNECESSARY 6055 03:44:39,080 --> 03:44:40,680 DUPLICATION AND THE DIGITAL 6056 03:44:40,680 --> 03:44:42,360 HISTOPATHOLOGY EXAMPLE IS ONE 6057 03:44:42,360 --> 03:44:44,360 WHERE THERE'S A LOT OF STARTUPS 6058 03:44:44,360 --> 03:44:45,640 AND NOT SO START-UP COMPANIES 6059 03:44:45,640 --> 03:44:48,040 THAT ARE DOING THAT AND SEEM TO 6060 03:44:48,040 --> 03:44:49,440 HAVE GOOD COMMERCIAL TRACTION. 6061 03:44:49,440 --> 03:44:51,720 AND SO I'M CURIOUS HOW ARPA-H IS 6062 03:44:51,720 --> 03:44:54,080 GOING TO HAVE A SUFFICIENT 6063 03:44:54,080 --> 03:44:55,680 SENSING MECHANISM TO AVOID 6064 03:44:55,680 --> 03:44:58,360 DUPLICATION OF WHAT'S IN THE 6065 03:44:58,360 --> 03:44:59,960 MARKET AND RELATED TO THAT WHAT 6066 03:44:59,960 --> 03:45:01,760 IS, OTHER THAN YOU DOING A LOT 6067 03:45:01,760 --> 03:45:03,560 OF THESE GREAT TALKS, WHAT IS 6068 03:45:03,560 --> 03:45:06,280 THE PLAN FOR ENGAGING SOME OF 6069 03:45:06,280 --> 03:45:08,440 THE TOP TIER INVESTORS OUT THERE 6070 03:45:08,440 --> 03:45:11,400 SO THAT THEY CAN BE PARTNERS IN 6071 03:45:11,400 --> 03:45:12,120 CO-INVESTING OR SCALING UP 6072 03:45:12,120 --> 03:45:16,240 THINGS THAT YOU ALL END UP BEING 6073 03:45:16,240 --> 03:45:20,040 EARLY INVESTORS IN SO THAT 6074 03:45:20,040 --> 03:45:22,200 YOU'RE CONTRIBUTING TO THAT 6075 03:45:22,200 --> 03:45:23,800 FINANCING STAC AND ACCELERATING 6076 03:45:23,800 --> 03:45:27,080 AS OPPOSED TO CREATING 6077 03:45:27,080 --> 03:45:27,800 UNNECESSARY REDUNDANCY THERE. 6078 03:45:27,800 --> 03:45:29,040 >>GREAT QUESTION. 6079 03:45:29,040 --> 03:45:30,160 ON DUPLICATION, THE GOOD NEWS 6080 03:45:30,160 --> 03:45:31,960 THERE'S A LOT GOING ON IN THE 6081 03:45:31,960 --> 03:45:33,040 HEALTH ECOSYSTEM. 6082 03:45:33,040 --> 03:45:34,240 WE FULLY UNDERSTAND THAT WE 6083 03:45:34,240 --> 03:45:36,400 FULLY APPRECIATE THAT. 6084 03:45:36,400 --> 03:45:38,040 WE'RE ACTUALLY BUILDING OUT WHAT 6085 03:45:38,040 --> 03:45:41,440 WE HOPE TO BE, OBVIOUSLY THIS 6086 03:45:41,440 --> 03:45:45,240 WILL GROW AS WE GROW, A 6087 03:45:45,240 --> 03:45:47,560 LANDSCAPE ANALYSIS CAPABILITY BY 6088 03:45:47,560 --> 03:45:52,760 WHICH WE TAKE BOTH AN AUTOMATED 6089 03:45:52,760 --> 03:45:53,880 DATA TECHNICAL APPROACH TO 6090 03:45:53,880 --> 03:45:57,840 INGEST LARGE SETS OF INFORMATION 6091 03:45:57,840 --> 03:46:00,000 RELATED TO VARIOUS PROGRAM 6092 03:46:00,000 --> 03:46:00,920 ACTIVITIES, SO THINKING ABOUT 6093 03:46:00,920 --> 03:46:03,040 EVERYTHING THAT'S IN THE PUBLIC 6094 03:46:03,040 --> 03:46:05,560 DOMAIN COUPLED WITH EVERYTHING 6095 03:46:05,560 --> 03:46:08,800 THAT WE CAN ACCESS WITHIN THE 6096 03:46:08,800 --> 03:46:10,440 GOVERNMENT DOMAIN AND INTEGRATE 6097 03:46:10,440 --> 03:46:12,800 INTO A DISCOVERABLE DATASET SO 6098 03:46:12,800 --> 03:46:14,320 WE CAN BE THOUGHTFUL. 6099 03:46:14,320 --> 03:46:16,440 WE UNDERSTAND THAT THERE IS 6100 03:46:16,440 --> 03:46:17,840 NECESSARY DUPLICATION ON 6101 03:46:17,840 --> 03:46:19,400 OCCASION, RIGHT? 6102 03:46:19,400 --> 03:46:20,280 BECAUSE SOMETHING IS, YOU KNOW, 6103 03:46:20,280 --> 03:46:24,960 TAKEN TO A CERTAIN LEVEL AND 6104 03:46:24,960 --> 03:46:25,440 WARRANTS COMPLEMENTARY 6105 03:46:25,440 --> 03:46:27,840 ACTIVITIES OR THE WAY THAT SOME 6106 03:46:27,840 --> 03:46:28,800 PARTICULAR ENTITY IS WORKING ON 6107 03:46:28,800 --> 03:46:29,920 A PROBLEM IS NOT NECESSARILY 6108 03:46:29,920 --> 03:46:32,960 GOING TO GET IT TO WHERE WE NEED 6109 03:46:32,960 --> 03:46:35,760 TO BE TO TRANSLATE TO PRODUCT 6110 03:46:35,760 --> 03:46:37,400 DEVELOPMENT CYCLE SO WE'LL TAKE 6111 03:46:37,400 --> 03:46:39,160 THAT APPROACH. 6112 03:46:39,160 --> 03:46:41,960 PLUS WE'RE BRINGING IN TECHNICAL 6113 03:46:41,960 --> 03:46:44,200 EXPERTS FROM, AGAIN, NIH AND 6114 03:46:44,200 --> 03:46:46,000 OTHER PLACES TO MAKE SURE WE 6115 03:46:46,000 --> 03:46:54,440 HAVE A BROAD SET OF INPUTS PRIOR 6116 03:46:54,440 --> 03:47:00,160 TO LAUNCHING A PROGRAM AND 6117 03:47:00,160 --> 03:47:01,680 PERFORMER DAYS, WE BRING IN 6118 03:47:01,680 --> 03:47:03,080 ANYONE INTERESTING IN RECEIVING 6119 03:47:03,080 --> 03:47:04,520 ARPA-H FUNDS FOR A PARTICULAR 6120 03:47:04,520 --> 03:47:07,680 ACTIVITY, AND WE OPEN THOSE UP 6121 03:47:07,680 --> 03:47:09,120 AS BROAD AS THERE'S NO 6122 03:47:09,120 --> 03:47:10,240 LIMITATIONS ON WHO CAN 6123 03:47:10,240 --> 03:47:12,960 PARTICIPATE, SO WE HOPE WE ALSO 6124 03:47:12,960 --> 03:47:14,440 CAN HEAR FROM THOSE THAT MAY BE 6125 03:47:14,440 --> 03:47:15,640 WORKING ON A PARTICULAR 6126 03:47:15,640 --> 03:47:17,960 TECHNOLOGY OR DOMAIN TO BE ABLE 6127 03:47:17,960 --> 03:47:19,000 TO UNDERSTAND WHAT THE STATE OF 6128 03:47:19,000 --> 03:47:20,640 THE TECHNOLOGY IS. 6129 03:47:20,640 --> 03:47:23,840 SO WE THINK BETWEEN THOSE THREE 6130 03:47:23,840 --> 03:47:26,480 SORT OF LAYERS WE'LL HAVE A 6131 03:47:26,480 --> 03:47:27,720 PRETTY SOLID UNDERSTANDING OF 6132 03:47:27,720 --> 03:47:29,440 WHO MIGHT ALREADY BE WORKING IN 6133 03:47:29,440 --> 03:47:30,680 THE SPACE. 6134 03:47:30,680 --> 03:47:33,280 IN TERMS OF THE COMMUNITY, AS 6135 03:47:33,280 --> 03:47:37,040 PART OF THE HUB AND SPOKE MODEL 6136 03:47:37,040 --> 03:47:40,800 WE'RE LAUNCHING AN INVESTOR HUB 6137 03:47:40,800 --> 03:47:43,760 SORT OF HUB, WE HAVE THREE, ONE 6138 03:47:43,760 --> 03:47:49,560 IS FOCUSED ON OUR CUSTOMERS, 6139 03:47:49,560 --> 03:47:51,920 PATIENTS, AS CLOSE TO THE 6140 03:47:51,920 --> 03:47:54,360 CUSTOMER AND PATIENT EXPERIENCE 6141 03:47:54,360 --> 03:47:59,280 AS POSSIBLE THROUGH GEOGRAPHY 6142 03:47:59,280 --> 03:48:00,480 AND ENTITIES. 6143 03:48:00,480 --> 03:48:04,720 AND INVESTOR HUB TO BRING IN 6144 03:48:04,720 --> 03:48:05,640 VENTURE CAPITALISTS, INDIVIDUALS 6145 03:48:05,640 --> 03:48:06,960 PULLING TECHNOLOGY THROUGH THE 6146 03:48:06,960 --> 03:48:08,800 DEVELOPMENT PIPELINE AND 6147 03:48:08,800 --> 03:48:09,560 ALLOWING FOR SUCCESSFUL 6148 03:48:09,560 --> 03:48:10,720 TRANSITION TO THE COMMERCIAL 6149 03:48:10,720 --> 03:48:10,960 MARKET. 6150 03:48:10,960 --> 03:48:12,520 SO YOU'RE GOING TO HEAR MORE 6151 03:48:12,520 --> 03:48:15,480 ABOUT OUR PLANS IN THAT SPACE. 6152 03:48:15,480 --> 03:48:17,000 WE FULLY UNDERSTAND THAT WE'RE 6153 03:48:17,000 --> 03:48:18,880 NOT A LONG-TERM FUNDER. 6154 03:48:18,880 --> 03:48:22,200 PRODUCTS THAT WE WILL DEVELOP WE 6155 03:48:22,200 --> 03:48:23,560 DON'T WANT THEM TO GO TO A 6156 03:48:23,560 --> 03:48:25,960 VALLEY OF DEATH WHICH HAPPENS IN 6157 03:48:25,960 --> 03:48:26,760 GOVERNMENT PIPELINES, SO WE'LL 6158 03:48:26,760 --> 03:48:28,840 START EARLY AND MEET OFTEN WITH 6159 03:48:28,840 --> 03:48:29,800 POTENTIAL TRANSITION PARTNERS OR 6160 03:48:29,800 --> 03:48:31,680 FOLKS THAT CAN HELP US WITH THE 6161 03:48:31,680 --> 03:48:32,640 VENTURE APPROACH. 6162 03:48:32,640 --> 03:48:33,480 >>GREAT. 6163 03:48:33,480 --> 03:48:33,880 THANK YOU. 6164 03:48:33,880 --> 03:48:38,480 ONE IDEA TO BUILD ON THAT 6165 03:48:38,480 --> 03:48:40,120 LANDSCAPE, BARDA HAS DONE A GOOD 6166 03:48:40,120 --> 03:48:42,000 JOB BUILDING OUT THAT ECOSYSTEM 6167 03:48:42,000 --> 03:48:44,240 OF INCUBATORS AND I BELIEVE THEY 6168 03:48:44,240 --> 03:48:45,320 STARTED THAT LANDSCAPE 6169 03:48:45,320 --> 03:48:47,120 ASSESSMENT, AND ALSO I'M HAPPY 6170 03:48:47,120 --> 03:48:49,440 TO CONNECT YOU WITH FOLKS AT 6171 03:48:49,440 --> 03:48:51,360 ORGANIZATIONS LIKE ROCK HEALTH 6172 03:48:51,360 --> 03:48:54,000 AND OTHER INCUBATORS THAT HAVE 6173 03:48:54,000 --> 03:48:55,200 QUITE ROBUST DATABASES OF 6174 03:48:55,200 --> 03:48:59,400 DIGITAL HEALTH EXCLUSIONS OUT 6175 03:48:59,400 --> 03:49:00,200 THERE. 6176 03:49:00,200 --> 03:49:04,920 I'VE DONE RESEARCH WITH ROCK 6177 03:49:04,920 --> 03:49:06,040 HEALTH AND START-UP DATABASE, 6178 03:49:06,040 --> 03:49:07,640 I'M SURE THEY WOULD OFFER THOSE, 6179 03:49:07,640 --> 03:49:08,720 HAPPY TO INTRODUCE YOU TO THOSE 6180 03:49:08,720 --> 03:49:09,080 FOLKS. 6181 03:49:09,080 --> 03:49:11,880 THANK YOU. 6182 03:49:11,880 --> 03:49:12,320 >>FANTASTIC. 6183 03:49:12,320 --> 03:49:13,280 THANK YOU. 6184 03:49:13,280 --> 03:49:16,880 >>NORA HAS A QUESTION. 6185 03:49:16,880 --> 03:49:19,760 IF YOU ALL COULD USE THE 6186 03:49:19,760 --> 03:49:20,840 REACTION AND MOVE YOUR PANEL 6187 03:49:20,840 --> 03:49:22,880 RIGHT UP FRONT AND I CAN SEE YOU 6188 03:49:22,880 --> 03:49:24,800 TO CALL ON YOU. 6189 03:49:24,800 --> 03:49:26,480 ANYONE ELSE WITH QUESTIONS, 6190 03:49:26,480 --> 03:49:30,800 PLEASE JOIN THE QUEUE. 6191 03:49:30,800 --> 03:49:32,080 NORA, YOU'RE NEXT. 6192 03:49:32,080 --> 03:49:33,840 >>I REALIZE HOW COMPLEX OF AN 6193 03:49:33,840 --> 03:49:35,360 ISSUE WHAT YOU'RE AIMING TO DO. 6194 03:49:35,360 --> 03:49:37,040 I WAS ASKING THE QUESTION ABOUT 6195 03:49:37,040 --> 03:49:39,640 THE ISSUE OF HOW DOES ONE REVIEW 6196 03:49:39,640 --> 03:49:41,280 AND EVALUATE MORE LIKELY TO HAVE 6197 03:49:41,280 --> 03:49:43,720 A LARGE IMPACT BECAUSE YOU DON'T 6198 03:49:43,720 --> 03:49:44,880 WANT TO DO PROGRESSIVE, YOU WANT 6199 03:49:44,880 --> 03:49:47,360 TO DO SOMETHING THAT BE 6200 03:49:47,360 --> 03:49:47,720 TRANSFORMATIVE. 6201 03:49:47,720 --> 03:49:49,520 THIS PERTAINS TO THE QUESTION OF 6202 03:49:49,520 --> 03:49:51,320 ANDREW, MANY THINGS THAT ARE THE 6203 03:49:51,320 --> 03:49:53,440 LOWER HANGING FRUITS ARE ALREADY 6204 03:49:53,440 --> 03:49:56,920 GOING TO BE TACKLED BY MANY 6205 03:49:56,920 --> 03:49:57,280 COMPANIES. 6206 03:49:57,280 --> 03:49:58,600 HOW TO IDENTIFY AREAS WHERE 6207 03:49:58,600 --> 03:50:00,520 THOSE COMPANIES ARE NOT KEEPING 6208 03:50:00,520 --> 03:50:01,560 THEIR EYES, OTHERWISE THEY ARE 6209 03:50:01,560 --> 03:50:02,920 GOING TO BE DEVELOPED. 6210 03:50:02,920 --> 03:50:06,600 WHAT ARE AREAS THAT HAVE 6211 03:50:06,600 --> 03:50:10,440 POTENTIAL TO ACTUALLY ADVANCE 6212 03:50:10,440 --> 03:50:13,200 THIS IN WAYS. 6213 03:50:13,200 --> 03:50:15,040 THE COMPLETE QUESTION, IN THE 6214 03:50:15,040 --> 03:50:19,320 PROCESS OF SELECTION, HOW DO YOU 6215 03:50:19,320 --> 03:50:20,440 ENTER THESE INTO YOUR VALUE OF 6216 03:50:20,440 --> 03:50:22,840 THE PROGRAM, NUMBER ONE. 6217 03:50:22,840 --> 03:50:24,720 NUMBER TWO, IN THIS ONE, IN 6218 03:50:24,720 --> 03:50:26,960 TERMS OF I GUESS THERE WOULD BE 6219 03:50:26,960 --> 03:50:28,040 FLEXIBILITY IN TERMS OF AMOUNT 6220 03:50:28,040 --> 03:50:30,440 OF FUNDS THAT YOU COULD PUT FOR 6221 03:50:30,440 --> 03:50:32,360 A GIVEN PROJECT BUT WHAT ABOUT 6222 03:50:32,360 --> 03:50:33,440 THE TIMELINE? 6223 03:50:33,440 --> 03:50:38,520 I MEAN, BECAUSE THE BOLDER THE 6224 03:50:38,520 --> 03:50:39,880 ATTEMPT TO DO SOMETHING, THE 6225 03:50:39,880 --> 03:50:41,640 TIME THAT'S NEEDED. 6226 03:50:41,640 --> 03:50:43,800 THE THIRD ONE RESONATING IN 6227 03:50:43,800 --> 03:50:45,920 TERMS OF TAKING ADVANTAGE OF 6228 03:50:45,920 --> 03:50:48,840 DATABASES THAT EXIST, I HAVE 6229 03:50:48,840 --> 03:50:51,840 BROUGHT THIS UP BEFORE, HOW DO 6230 03:50:51,840 --> 03:50:52,920 WE APPLY PREDICTION MODELING 6231 03:50:52,920 --> 03:50:55,240 EARLY ON AS YOU'RE BUILDING YOUR 6232 03:50:55,240 --> 03:50:57,360 PORTFOLIO SO THAT YOU CAN LEARN 6233 03:50:57,360 --> 03:50:59,440 ABOUT WHAT ARE SUCCESSES AND 6234 03:50:59,440 --> 03:51:03,400 WHAT ARE FAILURES, WHAT PREDICTS 6235 03:51:03,400 --> 03:51:06,880 ISSUES WHERE WE CAN MAKE 6236 03:51:06,880 --> 03:51:07,480 ADVANCE. 6237 03:51:07,480 --> 03:51:10,600 THESE ARE COMPLEX AND NOT 6238 03:51:10,600 --> 03:51:10,880 SIMPLE. 6239 03:51:10,880 --> 03:51:11,800 IF THEY WERE SIMPLE ARPA-H 6240 03:51:11,800 --> 03:51:16,440 WOULDN'T EXIST BUT WHAT ARE YOUR 6241 03:51:16,440 --> 03:51:17,160 THOUGHTS? 6242 03:51:17,160 --> 03:51:18,600 >>WELL, I'LL START THE FIRST 6243 03:51:18,600 --> 03:51:22,320 QUESTION HOW DO WE PRIORITIZE. 6244 03:51:22,320 --> 03:51:26,280 I LAID OUT THE FOUR LARGE BINS, 6245 03:51:26,280 --> 03:51:28,040 THE FOUR FOCUS AREAS. 6246 03:51:28,040 --> 03:51:30,360 RIGHT NOW THAT'S THE EXTENT OF 6247 03:51:30,360 --> 03:51:32,800 OUR PRIORITIZATION. 6248 03:51:32,800 --> 03:51:35,880 WE'RE REALLY LOOKING AT THINGS, 6249 03:51:35,880 --> 03:51:37,560 IT'S A BOTTOM-UP APPROACH. 6250 03:51:37,560 --> 03:51:40,880 SO WHEN WE GET APPLICATIONS TO 6251 03:51:40,880 --> 03:51:43,000 OPEN VAA OR HAVE A PROGRAM 6252 03:51:43,000 --> 03:51:46,880 MANAGER MAKE A PITCH, WE SAY 6253 03:51:46,880 --> 03:51:48,880 WHAT WOULD BE THE IMPACT OF 6254 03:51:48,880 --> 03:51:49,400 THIS? 6255 03:51:49,400 --> 03:51:52,920 WHAT IS THE TRANSFORMATION INTO 6256 03:51:52,920 --> 03:51:54,400 THE HEALTH ECOSYSTEM THAT 6257 03:51:54,400 --> 03:51:57,920 THROUGH THIS APPROACH YOU'RE 6258 03:51:57,920 --> 03:51:58,840 ACTUALLY ACHIEVING? 6259 03:51:58,840 --> 03:52:00,280 AND WHEN A PROGRAM MANAGER COMES 6260 03:52:00,280 --> 03:52:02,920 IN THEY HAVE ALREADY GOT A 6261 03:52:02,920 --> 03:52:05,320 STRONG SENSE FOR THE CHALLENGE 6262 03:52:05,320 --> 03:52:06,600 AND HEALTH ECOSYSTEM, HOW THEY 6263 03:52:06,600 --> 03:52:08,120 THINK IT'S GOING TO HAVE AN 6264 03:52:08,120 --> 03:52:08,360 IMPACT. 6265 03:52:08,360 --> 03:52:10,760 WE HAVE A LOT OF TECHNICAL 6266 03:52:10,760 --> 03:52:13,400 TALENT ON OUR TEAM, PLUS 6267 03:52:13,400 --> 03:52:16,200 REACHBACK FROM A NUMBER OF 6268 03:52:16,200 --> 03:52:17,240 DIFFERENT PARTNERSHIPS, PRIVATE 6269 03:52:17,240 --> 03:52:17,920 SECTOR-TYPE PARTNERSHIPS. 6270 03:52:17,920 --> 03:52:18,960 EVEN IF THEY ARE THINKING THIS 6271 03:52:18,960 --> 03:52:22,360 IS GOING TO HAVE AN IMPACT, I'M 6272 03:52:22,360 --> 03:52:25,920 MAKING THIS UP, IT'S GOING TO BE 6273 03:52:25,920 --> 03:52:28,960 IMPACTED AND BENEFIT 200,000 OR 6274 03:52:28,960 --> 03:52:30,920 400,000 INDIVIDUALS, WHAT NOT. 6275 03:52:30,920 --> 03:52:32,920 IF WE THEN ASK WHAT IF YOU DO 6276 03:52:32,920 --> 03:52:33,680 SOMETHING SLIGHTLY DIFFERENT, 6277 03:52:33,680 --> 03:52:36,600 THOUGHT ABOUT IT IN THIS WAY, 6278 03:52:36,600 --> 03:52:37,520 TOOK THAT PARTICULAR APPROACH, 6279 03:52:37,520 --> 03:52:38,640 YOU COULD SCALE SOMETHING THAT 6280 03:52:38,640 --> 03:52:42,680 WOULD HAVE AN IMPACT LESS THAN A 6281 03:52:42,680 --> 03:52:43,760 MILLION PEOPLE AND POTENTIALLY 6282 03:52:43,760 --> 03:52:45,520 IMPACT 30 TO 40 TO 50 MILLION 6283 03:52:45,520 --> 03:52:46,520 PEOPLE. 6284 03:52:46,520 --> 03:52:47,400 IF THIS ITERATIVE APPROACH, 6285 03:52:47,400 --> 03:52:50,080 WHERE IT'S A GREAT IDEA AND WE 6286 03:52:50,080 --> 03:52:53,440 MAKE IT EVEN BETTER, AND THEN 6287 03:52:53,440 --> 03:52:56,560 YOU TALK ABOUT THE TIME 6288 03:52:56,560 --> 03:52:56,920 HORIZONS. 6289 03:52:56,920 --> 03:52:57,600 IT'S COMPRESSED, RIGHT? 6290 03:52:57,600 --> 03:53:00,440 I DIDN'T GET INTO THIS BUT WE -- 6291 03:53:00,440 --> 03:53:01,680 OUR PROGRAM MANAGERS ARE ON A 6292 03:53:01,680 --> 03:53:02,680 LIMITED TIME FRAME. 6293 03:53:02,680 --> 03:53:05,160 THEY COME FOR THREE YEARS, THEY 6294 03:53:05,160 --> 03:53:05,880 CAN POTENTIALLY EXTEND FOR 6295 03:53:05,880 --> 03:53:07,360 ANOTHER THREE YEARS. 6296 03:53:07,360 --> 03:53:08,200 THEY ARE NOT LONG-TERM 6297 03:53:08,200 --> 03:53:09,000 GOVERNMENT EMPLOYEES. 6298 03:53:09,000 --> 03:53:11,560 IT'S A SPRINT FROM DAY ONE. 6299 03:53:11,560 --> 03:53:12,920 AND OUR PROGRAMS REALLY ONLY 6300 03:53:12,920 --> 03:53:14,360 LAST TWO TO FOUR YEARS. 6301 03:53:14,360 --> 03:53:18,920 SO EVERY PROGRAM MANAGER HAS TO 6302 03:53:18,920 --> 03:53:24,400 DESIGN THEIR PROGRAMS WITH 12, 6303 03:53:24,400 --> 03:53:27,000 18, 24-MONTH MILESTONES, 6304 03:53:27,000 --> 03:53:28,320 GO/NO-GO AT 24 MONTHS, 6305 03:53:28,320 --> 03:53:30,040 POTENTIALLY ANOTHER TWO YEARS 6306 03:53:30,040 --> 03:53:32,720 AFTER THAT. 6307 03:53:32,720 --> 03:53:36,080 THESE, WE'RE TAKING ON REALLY 6308 03:53:36,080 --> 03:53:38,160 BOLD CHALLENGING PROBLEMS TO AN 6309 03:53:38,160 --> 03:53:39,080 AGGRESSIVE TIME LINE. 6310 03:53:39,080 --> 03:53:40,600 WE HAVE ALL OF THOSE PARTNERS 6311 03:53:40,600 --> 03:53:42,440 THAT I TALKED ABOUT BETWEEN 6312 03:53:42,440 --> 03:53:43,520 TECHNICAL EXPERTISE AND VENTURE 6313 03:53:43,520 --> 03:53:45,400 AND COMMERCIAL PARTNERS AND WE 6314 03:53:45,400 --> 03:53:49,720 PACKAGE IT ALL TOGETHER AROUND A 6315 03:53:49,720 --> 03:53:50,880 PROGRAM, AND WE PUT REALLY HIGH 6316 03:53:50,880 --> 03:53:53,040 HARD DEMANDS ON PROGRAM MANAGERS 6317 03:53:53,040 --> 03:53:54,560 AND THEN THEY CASCADE TO THE 6318 03:53:54,560 --> 03:53:55,400 PERFORMERS. 6319 03:53:55,400 --> 03:53:57,640 THIS HAS BEEN A SUCCESSFUL MODEL 6320 03:53:57,640 --> 03:53:59,560 DARPA USED. 6321 03:53:59,560 --> 03:54:01,440 WE UNDERSTAND THE HEALTH 6322 03:54:01,440 --> 03:54:02,720 ECOSYSTEM AND DEFENSE ECOSYSTEM 6323 03:54:02,720 --> 03:54:03,840 ARE VERY DIFFERENT BUT WE'RE 6324 03:54:03,840 --> 03:54:05,840 GOING TO EMPLOY THAT MODEL. 6325 03:54:05,840 --> 03:54:08,360 WE FEEL IN THE FIRST SIX MONTHS 6326 03:54:08,360 --> 03:54:09,240 OF OPERATIONS, FIRST COUPLE 6327 03:54:09,240 --> 03:54:10,920 MONTHS NOW THAT WE'VE HAD 6328 03:54:10,920 --> 03:54:13,040 PROGRAMS BEING DESIGNED WE'RE 6329 03:54:13,040 --> 03:54:14,680 FEELING PRETTY GOOD ABOUT HOW 6330 03:54:14,680 --> 03:54:16,720 THAT'S POSITIONING US FOR 6331 03:54:16,720 --> 03:54:16,920 SUCCESS. 6332 03:54:16,920 --> 03:54:19,320 AND WHAT WE'RE SEEING, WHO WE'RE 6333 03:54:19,320 --> 03:54:23,160 HIRING, PROGRAMS WE'RE ABOUT TO 6334 03:54:23,160 --> 03:54:23,360 LAUNCH. 6335 03:54:23,360 --> 03:54:25,000 SO WE'RE PRETTY CONFIDENT THIS 6336 03:54:25,000 --> 03:54:33,480 IS GOING TO WORK. 6337 03:54:33,480 --> 03:54:35,440 >>CHUCK, DO YOU WANT TO ASK 6338 03:54:35,440 --> 03:54:36,240 YOUR QUESTION? 6339 03:54:36,240 --> 03:54:38,040 IS SOMEONE SHARING THEIR SCREEN? 6340 03:54:38,040 --> 03:54:43,920 WE LOST THE VISUAL. 6341 03:54:43,920 --> 03:54:44,280 >>SURE. 6342 03:54:44,280 --> 03:54:46,600 I DON'T KNOW WHETHER YOU CAN 6343 03:54:46,600 --> 03:54:51,160 HEAR ME, GEORGE. 6344 03:54:51,160 --> 03:54:56,960 >>GO AHEAD. 6345 03:54:56,960 --> 03:55:00,320 >>JUST SOME DoD, DR. VOLKOW 6346 03:55:00,320 --> 03:55:04,520 CITED HER STUDY, NEED FOR DRUG 6347 03:55:04,520 --> 03:55:09,640 SCREENING IN ADOLESCENTS, WE HAD 6348 03:55:09,640 --> 03:55:13,800 A LARGE ANONYMOUS SURVEY IN 6349 03:55:13,800 --> 03:55:17,680 DoD, IN THE ARMY SPECIFICALLY, 6350 03:55:17,680 --> 03:55:21,920 THAT LOOKED AT FOLKS THAT HAD 6351 03:55:21,920 --> 03:55:26,880 USED OPIATES AND WHAT WE FOUND, 6352 03:55:26,880 --> 03:55:29,000 AGAIN THESE ARE FOLKS SINCE IT'S 6353 03:55:29,000 --> 03:55:31,320 IN ILLEGAL AND WE SCREEN IN OUR 6354 03:55:31,320 --> 03:55:33,760 SYSTEM WITH DRUG DETERRENCE 6355 03:55:33,760 --> 03:55:35,680 TESTING, MY HYPOTHESIS IS OPIATE 6356 03:55:35,680 --> 03:55:41,840 USE IN OUR RANKS IS PRIMARILY 6357 03:55:41,840 --> 03:55:43,240 NOT OPIATE DEPENDENCE, REAL 6358 03:55:43,240 --> 03:55:46,440 REGULAR USERS BUT MORE 6359 03:55:46,440 --> 03:55:47,720 RECREATIONAL USERS, MORE LIKE 6360 03:55:47,720 --> 03:55:49,360 TEENAGE USERS. 6361 03:55:49,360 --> 03:55:52,240 WHAT WE FOUND IS OF THOSE WHO 6362 03:55:52,240 --> 03:55:57,760 ENDORSED OPIATE USE, OPIOID USE, 6363 03:55:57,760 --> 03:56:05,400 45% SCREENED POSITIVE ON AN 6364 03:56:05,400 --> 03:56:11,120 AUDIT FOR ALCOHOL USE PROBLEMS. 6365 03:56:11,120 --> 03:56:11,480 OVER. 6366 03:56:11,480 --> 03:56:14,120 AND I GUESS ONE OF THE QUESTIONS 6367 03:56:14,120 --> 03:56:18,160 THAT RAISES FOR ME IN A CLINICAL 6368 03:56:18,160 --> 03:56:19,800 SETTING, EVEN WITH TEENAGERS 6369 03:56:19,800 --> 03:56:24,840 BEHIND CLOSED DOORS, IT MAY BE 6370 03:56:24,840 --> 03:56:27,480 MUCH MORE ACCEPTABLE TO ASK 6371 03:56:27,480 --> 03:56:30,360 ABOUT ALCOHOL USE AND YOU 6372 03:56:30,360 --> 03:56:31,240 ACTUALLY MAY HAVE SOME USEFUL 6373 03:56:31,240 --> 03:56:34,720 DATA IN YOUR HANDS IF HE LOOK AT 6374 03:56:34,720 --> 03:56:35,800 TWELFTH GRADERS THAT TRIED 6375 03:56:35,800 --> 03:56:37,200 ALCOHOL TO LOOK AT HOW MANY OF 6376 03:56:37,200 --> 03:56:44,680 THEM ALSO ARE THE ONES WHO WERE 6377 03:56:44,680 --> 03:56:50,120 SMOKING MARIJUANA. 6378 03:56:50,120 --> 03:56:50,400 OVER. 6379 03:56:50,400 --> 03:56:52,560 >>CORRECT ME IF YOU GET THIS 6380 03:56:52,560 --> 03:56:53,840 WRONG, CHUCK, BECAUSE YOU FADED. 6381 03:56:53,840 --> 03:56:58,440 WHEN YOU SCREENED THE TROOPS FOR 6382 03:56:58,440 --> 03:57:00,720 OPIOIDS, 45% WERE ACTUALLY ALSO 6383 03:57:00,720 --> 03:57:02,880 COMING UP POSITIVE FOR ALCOHOL? 6384 03:57:02,880 --> 03:57:05,440 IS THAT CORRECT? 6385 03:57:05,440 --> 03:57:07,240 OF THE OPIOID USERS? 6386 03:57:07,240 --> 03:57:12,440 >>YEAH, AND NOT JUST ALCOHOL 6387 03:57:12,440 --> 03:57:15,080 USE BUT ALCOHOL AT A PROBLEMATIC 6388 03:57:15,080 --> 03:57:18,480 DRINKING LEVEL ON THE AUDIT C. 6389 03:57:18,480 --> 03:57:21,640 >>AUDIT LEVEL, OKAY. 6390 03:57:21,640 --> 03:57:21,920 GOT IT. 6391 03:57:21,920 --> 03:57:24,240 I DON'T KNOW WHETHER YOU WANT TO 6392 03:57:24,240 --> 03:57:25,640 RESPOND, SUSAN. 6393 03:57:25,640 --> 03:57:27,640 AND WHILE I HAVE THE FLOOR, 6394 03:57:27,640 --> 03:57:29,560 ANOTHER QUESTION CAME IN THROUGH 6395 03:57:29,560 --> 03:57:31,560 THE CHAT FROM MY DEPUTY THAT I 6396 03:57:31,560 --> 03:57:34,000 WAS ALLUDING TO EARLIER AND THEN 6397 03:57:34,000 --> 03:57:37,360 MAYBE, SUSAN, YOU COULD COMMENT 6398 03:57:37,360 --> 03:57:40,560 AND THEN JEFF BOISSONEAULT. 6399 03:57:40,560 --> 03:57:42,080 WHAT ABOUT PAIN MANAGEMENT? 6400 03:57:42,080 --> 03:57:43,920 YOU HAD SLEEP UP THERE BUT PAIN 6401 03:57:43,920 --> 03:57:45,880 IS SO PREVALENT IN OUR SOCIETY, 6402 03:57:45,880 --> 03:57:47,840 20% OF PEOPLE WITH CHRONIC PAIN 6403 03:57:47,840 --> 03:57:49,400 ACCORDING TO WHAT JEFF SHOWED. 6404 03:57:49,400 --> 03:57:53,600 SO IS THAT A TOPIC THAT COULD BE 6405 03:57:53,600 --> 03:57:56,600 UTILIZED IN AN ARPA-H PROGRAM? 6406 03:57:56,600 --> 03:57:57,520 >>ABSOLUTELY. 6407 03:57:57,520 --> 03:58:05,520 WE TALK ABOUT THAT INCESSANTLY, 6408 03:58:05,520 --> 03:58:09,520 WAITING FOR A PROGRAM MANAGER 6409 03:58:09,520 --> 03:58:17,960 WHO WANTS TO CHAMPION THAT. 6410 03:58:17,960 --> 03:58:20,520 ARE THERE ALTERNATIVES TO 6411 03:58:20,520 --> 03:58:22,000 CURRENT PHARMACEUTICAL PAIN 6412 03:58:22,000 --> 03:58:22,640 MANAGEMENT CAPABILITIES, WHAT 6413 03:58:22,640 --> 03:58:25,920 WOULD BE A SCALABLE ALTERNATIVE 6414 03:58:25,920 --> 03:58:29,000 THAT'S AS EFFECTIVE FOR THE 6415 03:58:29,000 --> 03:58:31,240 BROADEST SET OF POPULATION, SO 6416 03:58:31,240 --> 03:58:33,800 WHETHER THAT'S PEDIATRIC TO 6417 03:58:33,800 --> 03:58:35,400 GERIATRIC OR SOME SIGNIFICANT 6418 03:58:35,400 --> 03:58:37,320 SUBSET, SO WE'RE SUPER OPEN AND 6419 03:58:37,320 --> 03:58:40,200 WE FULLY RECOGNIZE WHAT A HUGE 6420 03:58:40,200 --> 03:58:42,120 CHALLENGE THIS IS IN THE HEALTH 6421 03:58:42,120 --> 03:58:43,160 ECOSYSTEM. 6422 03:58:43,160 --> 03:58:49,000 IF ANYBODY HAS IDEAS OR WANTS TO 6423 03:58:49,000 --> 03:58:50,640 BE A PROGRAM MANAGER, PLEASE 6424 03:58:50,640 --> 03:58:51,120 FOLLOW UP. 6425 03:58:51,120 --> 03:58:52,360 >>JEFF, DO YOU WANT TO QUICKLY 6426 03:58:52,360 --> 03:58:52,880 COMMENT? 6427 03:58:52,880 --> 03:58:54,160 I DON'T THINK YOU WANT TO BECOME 6428 03:58:54,160 --> 03:59:00,520 A PROGRAM MANAGER BUT WHO KNOWS. 6429 03:59:00,520 --> 03:59:01,720 >>I'LL SAY WHAT I THINK THE 6430 03:59:01,720 --> 03:59:05,480 CHALLENGES ARE IN PAIN 6431 03:59:05,480 --> 03:59:07,440 MANAGEMENT, DEVELOPING NEW 6432 03:59:07,440 --> 03:59:08,640 MANAGEMENT STRATEGIES, 6433 03:59:08,640 --> 03:59:09,200 ESPECIALLY PHARMACEUTICALS. 6434 03:59:09,200 --> 03:59:11,840 I THINK THERE'S A LACK OF 6435 03:59:11,840 --> 03:59:15,040 CROSS-TALK BETWEEN OUR CLINICAL 6436 03:59:15,040 --> 03:59:16,200 INVESTIGATORS AND OUR 6437 03:59:16,200 --> 03:59:17,120 PRE-CLINICAL AND MORE BASIC 6438 03:59:17,120 --> 03:59:18,960 SCIENTISTS, THAT'S ONE OF THE 6439 03:59:18,960 --> 03:59:20,000 REASONS I'M EXCITED TO HAVE 6440 03:59:20,000 --> 03:59:21,560 MOVED TO WHERE I JUST MOVED TO 6441 03:59:21,560 --> 03:59:23,080 START WORKING IN THAT AREA A 6442 03:59:23,080 --> 03:59:25,160 LITTLE BIT MORE ABOUT 6443 03:59:25,160 --> 03:59:26,880 BACK-TRANSLATING WHAT WE'RE 6444 03:59:26,880 --> 03:59:28,080 SEEING IN HUMANS TO RODENTS, 6445 03:59:28,080 --> 03:59:31,800 BEING MORE INTENTIONAL ABOUT 6446 03:59:31,800 --> 03:59:32,240 THAT. 6447 03:59:32,240 --> 03:59:33,840 THE PAIN MANAGEMENT DRUG 6448 03:59:33,840 --> 03:59:35,680 DEVELOPMENT PIPELINE IS TRULY 6449 03:59:35,680 --> 03:59:39,120 THE VALLEY OF DEATH, 6450 03:59:39,120 --> 03:59:39,520 UNFORTUNATELY. 6451 03:59:39,520 --> 03:59:41,760 >>I'M GOING TO INTERRUPT THE 6452 03:59:41,760 --> 03:59:44,080 QUEUE. 6453 03:59:44,080 --> 03:59:44,920 I BELIEVE I MISUNDERSTOOD 6454 03:59:44,920 --> 03:59:45,760 CHUCK'S QUESTION. 6455 03:59:45,760 --> 03:59:48,080 NORA IS GOING TO ANSWER AND 6456 03:59:48,080 --> 03:59:50,720 WE'LL MOVE THROUGH THE QUEUE OF 6457 03:59:50,720 --> 03:59:51,480 OTHER QUESTIONS. 6458 03:59:51,480 --> 03:59:54,960 >>I THINK THAT FOR THE QUESTION 6459 03:59:54,960 --> 03:59:58,760 OF PAIN TOO, THERE'S A MAJOR 6460 03:59:58,760 --> 04:00:03,240 INITIATIVE RIGHT NOW AT NIH 6461 04:00:03,240 --> 04:00:03,800 PUTTING ENORMOUS AMOUNT OF 6462 04:00:03,800 --> 04:00:05,560 RESOURCES TO BRIDGE THAT VALLEY 6463 04:00:05,560 --> 04:00:06,120 OF DEATH. 6464 04:00:06,120 --> 04:00:07,080 WE'RE COMING BACK TO THE 6465 04:00:07,080 --> 04:00:10,440 QUESTION IN TERMS OF HOW DO WE 6466 04:00:10,440 --> 04:00:11,520 SCREEN FOR TEENAGERS, EVEN IF 6467 04:00:11,520 --> 04:00:12,720 THE DOOR IS CLOSED. 6468 04:00:12,720 --> 04:00:14,360 I THINK YOU'RE ABSOLUTELY RIGHT. 6469 04:00:14,360 --> 04:00:19,600 IN FACT THERE IS DATA AS YOU 6470 04:00:19,600 --> 04:00:21,920 PROBABLY KNOW ASKING FOR WHETHER 6471 04:00:21,920 --> 04:00:23,400 YOU HAVE TRIED LEGAL DRUGS 6472 04:00:23,400 --> 04:00:25,920 FIRST, IT'S A VERY HIGH 6473 04:00:25,920 --> 04:00:27,400 PREDICTOR THAT YOU CAN THEN 6474 04:00:27,400 --> 04:00:28,760 FOCUS QUESTIONS TO DETERMINE 6475 04:00:28,760 --> 04:00:31,360 THOSE MORE LIKELY TO HAVE TAKEN 6476 04:00:31,360 --> 04:00:32,000 ILLICIT DRUGS. 6477 04:00:32,000 --> 04:00:34,960 THIS HAS LED TO SURVEYS THAT CAN 6478 04:00:34,960 --> 04:00:36,040 BE ADMINISTERED RAPIDLY SUCH 6479 04:00:36,040 --> 04:00:38,160 THAT IF YOU SAY NO THE 6480 04:00:38,160 --> 04:00:39,680 LIKELIHOOD YOU TAKE AN ILLICIT 6481 04:00:39,680 --> 04:00:43,000 DRUG IS NOT THERE. 6482 04:00:43,000 --> 04:00:47,480 SO, YEAH, THESE TYPE OF SURVEYS 6483 04:00:47,480 --> 04:00:49,040 ARE SORELY NEEDED IN CLINICAL 6484 04:00:49,040 --> 04:00:50,160 PRACTICE BECAUSE PHYSICIANS ARE 6485 04:00:50,160 --> 04:00:52,120 NOT GOING TO DO LENGTHY 6486 04:00:52,120 --> 04:00:53,760 ASSESSMENTS TO DETERMINE IF 6487 04:00:53,760 --> 04:00:56,440 SOMEONE IS TAKING DRUGS. 6488 04:00:56,440 --> 04:00:59,360 SO THE CTN THAT NIDA HAS 6489 04:00:59,360 --> 04:01:01,880 PROBABLY HAS DEVELOPED ACTUALLY 6490 04:01:01,880 --> 04:01:05,400 A STRATEGY FOR SCREENING 6491 04:01:05,400 --> 04:01:11,000 TEENAGERS AND A DOCTOR THE THE 6492 04:01:11,000 --> 04:01:12,400 AT NIDA IS LEADING THAT EFFORT. 6493 04:01:12,400 --> 04:01:16,840 WE CAN GIVE YOU MORE SPECIFICS. 6494 04:01:16,840 --> 04:01:20,000 >>PATRICIA POWELL, TRISH POWELL 6495 04:01:20,000 --> 04:01:21,760 FROM NIAAA, DEPUTY DIRECTOR, HAS 6496 04:01:21,760 --> 04:01:22,040 A QUESTION. 6497 04:01:22,040 --> 04:01:24,080 >>I WANTED TO FOLLOW UP ON YOUR 6498 04:01:24,080 --> 04:01:25,600 QUESTION ON TINY BIT. 6499 04:01:25,600 --> 04:01:30,520 I WAS STRUCK IN JEFF'S TALK, 6500 04:01:30,520 --> 04:01:31,520 DIFFERENCE BETWEEN PERCEIVED 6501 04:01:31,520 --> 04:01:34,600 PAIN RELIEF AND PAIN INTENSITY 6502 04:01:34,600 --> 04:01:34,920 SENSITIVITY. 6503 04:01:34,920 --> 04:01:36,320 I JUST WONDER IF THAT PRESENTS 6504 04:01:36,320 --> 04:01:39,960 AN OPTION, FOR EXAMPLE, IN 6505 04:01:39,960 --> 04:01:41,400 ARPA-H TYPE OF ENDEAVOR THAT 6506 04:01:41,400 --> 04:01:43,880 WOULD FOCUS NOT SO MUCH 6507 04:01:43,880 --> 04:01:45,840 NECESSARILY ON RELIEVING THE 6508 04:01:45,840 --> 04:01:51,560 PAIN INTENSITY BUT ON THE 6509 04:01:51,560 --> 04:01:54,240 PERCEPTION OF PAIN. 6510 04:01:54,240 --> 04:01:54,680 >>ABSOLUTELY. 6511 04:01:54,680 --> 04:01:58,040 I THINK WE WOULD HAVE -- BIG 6512 04:01:58,040 --> 04:02:02,080 QUESTIONS WOULD BE WHAT WOULD IT 6513 04:02:02,080 --> 04:02:03,920 TAKE FROM THE ORIGINAL 6514 04:02:03,920 --> 04:02:06,320 CONCEPTUALIZATION OF THIS AS AN 6515 04:02:06,320 --> 04:02:09,360 AREA, PERCEPTION OF PAIN, TO 6516 04:02:09,360 --> 04:02:11,160 TRANSLATING INTO PATIENTS, AND 6517 04:02:11,160 --> 04:02:13,640 THEN ARE THERE ANY LIMITATIONS 6518 04:02:13,640 --> 04:02:15,560 IN WHAT PATIENTS WOULD 6519 04:02:15,560 --> 04:02:16,640 POTENTIALLY DERIVE BENEFIT FROM 6520 04:02:16,640 --> 04:02:19,320 THIS TYPE OF NEW THINKING OR NEW 6521 04:02:19,320 --> 04:02:21,080 CAPABILITY, WHATEVER THE NEW 6522 04:02:21,080 --> 04:02:23,440 PROCESS, WHATEVER IT WOULD BE 6523 04:02:23,440 --> 04:02:25,240 BECAUSE WE REALLY WANT TO MAKE 6524 04:02:25,240 --> 04:02:28,160 SURE THAT IT WAS SOMETHING THAT 6525 04:02:28,160 --> 04:02:30,240 I DIDN'T TALK ABOUT THIS BUT WE 6526 04:02:30,240 --> 04:02:33,120 HAVE THAT SORT OF PIPELINE OF 6527 04:02:33,120 --> 04:02:36,080 OUR PROGRAMS, WITH AN 6528 04:02:36,080 --> 04:02:36,880 EXPECTATION THAT WITHIN FOUR 6529 04:02:36,880 --> 04:02:38,480 YEARS THEY ARE GOING TO MOVE 6530 04:02:38,480 --> 04:02:40,240 THROUGH THAT PIPELINE TO GET AS 6531 04:02:40,240 --> 04:02:41,840 CLOSE AS POSSIBLE TO BENEFITING 6532 04:02:41,840 --> 04:02:43,520 PATIENTS SO THAT WOULD JUST BE 6533 04:02:43,520 --> 04:02:44,720 PART OF THE ITERATIVE PROCESS 6534 04:02:44,720 --> 04:02:48,960 THAT WE WOULD TAKE WHEN THINKING 6535 04:02:48,960 --> 04:02:50,600 ABOUT THIS CONCEPTUALLY. 6536 04:02:50,600 --> 04:02:51,920 ABSOLUTELY, IT COULD BE A GAME 6537 04:02:51,920 --> 04:02:54,760 CHANGER IF IT WAS SUCCESSFUL AND 6538 04:02:54,760 --> 04:02:56,520 SCALED IT COULD BE AN ABSOLUTE 6539 04:02:56,520 --> 04:02:57,440 GAME CHANGER. 6540 04:02:57,440 --> 04:03:01,800 >>I'M GOING TO JUMP IN RAPIDLY. 6541 04:03:01,800 --> 04:03:03,080 I WAS TELLING GEORGE. 6542 04:03:03,080 --> 04:03:05,360 THERE WAS A PAPER A YEAR AGO IN 6543 04:03:05,360 --> 04:03:07,480 A PRE-CLINICAL MODEL IN RODENTS 6544 04:03:07,480 --> 04:03:10,000 THAT SHOWED IN ANIMAL MODELS YOU 6545 04:03:10,000 --> 04:03:12,960 CAN ACTUALLY INHIBIT, BY 6546 04:03:12,960 --> 04:03:14,520 INHIBITING SIGNALING TO AMYGDALA 6547 04:03:14,520 --> 04:03:15,920 DO NOT MODIFY PERCEPTION OF PAIN 6548 04:03:15,920 --> 04:03:17,520 BUT THE ANIMALS WERE ABLE TO 6549 04:03:17,520 --> 04:03:19,160 KEEP ON DOING FUNCTIONING 6550 04:03:19,160 --> 04:03:19,840 PERFECTLY NORMALLY. 6551 04:03:19,840 --> 04:03:21,800 SO IF YOU TAKE THAT FINDING AND 6552 04:03:21,800 --> 04:03:24,000 BRING IT UP WITH NEW 6553 04:03:24,000 --> 04:03:27,400 TECHNOLOGIES LIKE, FOR EXAMPLE, 6554 04:03:27,400 --> 04:03:29,320 LOW INTENSITY FOCUS ULTRASOUND 6555 04:03:29,320 --> 04:03:31,040 ALLOWS TO PENETRATE DEEP INTO 6556 04:03:31,040 --> 04:03:34,320 THE BRAIN COULD INHIBIT 6557 04:03:34,320 --> 04:03:37,480 AMYGDALA, COULD BE A PROCESS 6558 04:03:37,480 --> 04:03:38,880 POTENTIALLY TO DO IN HUMANS, 6559 04:03:38,880 --> 04:03:40,440 THERAPEUTIC INTERVENTION. 6560 04:03:40,440 --> 04:03:46,200 I BRING IT UP BECAUSE IT IS 6561 04:03:46,200 --> 04:03:46,480 PERTINENT. 6562 04:03:46,480 --> 04:03:50,040 >>YOU CAN ALWAYS BRING UP MY 6563 04:03:50,040 --> 04:03:52,440 FAVORITE BRAIN REGION, THE 6564 04:03:52,440 --> 04:03:52,840 AMYGDALA. 6565 04:03:52,840 --> 04:03:55,840 SHELLY GREENFIELD HAS A 6566 04:03:55,840 --> 04:03:56,200 QUESTION. 6567 04:03:56,200 --> 04:03:58,240 >>YEAH, MAYBE A SERIES OF 6568 04:03:58,240 --> 04:04:02,880 COMMENTS AND PERHAPS A QUESTION. 6569 04:04:02,880 --> 04:04:04,280 IT'S SOME COMMENTS FROM THE 6570 04:04:04,280 --> 04:04:08,040 MORNING AND MAYBE A QUESTION. 6571 04:04:08,040 --> 04:04:10,040 BUT YOU PRESENTED BOTH GEORGE 6572 04:04:10,040 --> 04:04:11,240 AND NORA, PRESENTED A LOT OF 6573 04:04:11,240 --> 04:04:14,000 RICH DATA, A LOT OF 6574 04:04:14,000 --> 04:04:15,040 EPIDEMIOLOGIC DATA, QUESTIONS 6575 04:04:15,040 --> 04:04:16,520 FOR US AROUND RESEARCH 6576 04:04:16,520 --> 04:04:18,800 QUESTIONS, HOW WE CAN DO MORE 6577 04:04:18,800 --> 04:04:21,440 INTERVENTIONS, ESPECIALLY I'M 6578 04:04:21,440 --> 04:04:23,560 THINKING ABOUT CLINICAL 6579 04:04:23,560 --> 04:04:24,960 INTERVENTION, SCREENING, BRIEF 6580 04:04:24,960 --> 04:04:27,440 INTERVENTION, THERE'S SOME 6581 04:04:27,440 --> 04:04:28,160 SCREENING, NOT MUCH 6582 04:04:28,160 --> 04:04:29,560 INTERVENTION, AND WE WERE 6583 04:04:29,560 --> 04:04:31,080 TALKING ABOUT TAILORED 6584 04:04:31,080 --> 04:04:32,640 TREATMENTS FOR DIFFERENT 6585 04:04:32,640 --> 04:04:33,600 POPULATIONS. 6586 04:04:33,600 --> 04:04:35,000 ONE OF THE TENSIONS IN TERMS OF 6587 04:04:35,000 --> 04:04:37,680 ADDRESSING SOME OF THE SUBSTANCE 6588 04:04:37,680 --> 04:04:39,720 USE-RELATED ISSUES THAT WE HAVE 6589 04:04:39,720 --> 04:04:44,280 IN THE U.S. IS BOTH HOW DO WE DO 6590 04:04:44,280 --> 04:04:46,520 UNIVERSAL SCREENING AND 6591 04:04:46,520 --> 04:04:47,440 INTERVENTIONS WHICH ACTUALLY 6592 04:04:47,440 --> 04:04:49,160 REPRESENT QUESTIONS AROUND TOUCH 6593 04:04:49,160 --> 04:04:52,200 POINTS WITHIN THE ENTIRE MEDICAL 6594 04:04:52,200 --> 04:04:54,320 SYSTEM, WHICH WE'RE PRETTY BAD 6595 04:04:54,320 --> 04:04:59,000 AT AT THE MOMENT, AND THEN WHEN 6596 04:04:59,000 --> 04:04:59,760 WE'R ADMINISTRATION TREATMENT 6597 04:04:59,760 --> 04:05:03,720 HOUSE DO WE TAILOR TO 6598 04:05:03,720 --> 04:05:05,160 POPULATIONS TO BRING PEOPLE INTO 6599 04:05:05,160 --> 04:05:08,320 CARE AND RETAIN THEM. 6600 04:05:08,320 --> 04:05:10,120 THERE'S RESEARCH HOW TO 6601 04:05:10,120 --> 04:05:11,440 INSTITUTE SCREENING AND 6602 04:05:11,440 --> 04:05:13,040 INTERVENTIONS AT MANY DIFFERENT 6603 04:05:13,040 --> 04:05:14,920 TOUCH POINTS IN THE HEALTH CARE 6604 04:05:14,920 --> 04:05:16,680 SYSTEM, AND RESEARCH THAT LOOKS 6605 04:05:16,680 --> 04:05:17,840 AT TAILORED TREATMENTS, AND WE 6606 04:05:17,840 --> 04:05:21,400 NEED BOTH OF THOSE THINGS BUT 6607 04:05:21,400 --> 04:05:22,960 THEY ARE RELATED AND SEPARATE 6608 04:05:22,960 --> 04:05:23,240 QUESTIONS. 6609 04:05:23,240 --> 04:05:26,160 I JUST WANTED TO BRING THAT 6610 04:05:26,160 --> 04:05:26,520 TOGETHER. 6611 04:05:26,520 --> 04:05:30,560 A LOT OF DATA THAT YOU'RE 6612 04:05:30,560 --> 04:05:31,480 SHOWING ARGUES FOR MORE RESEARCH 6613 04:05:31,480 --> 04:05:33,080 IN BOTH OF THOSE AREAS. 6614 04:05:33,080 --> 04:05:34,760 WE'RE NOT VERY GOOD AT SCREENING 6615 04:05:34,760 --> 04:05:36,400 AND NOT VERY GOOD AT ALL THE 6616 04:05:36,400 --> 04:05:38,200 TOUCH POINTS IN THE CLINICAL 6617 04:05:38,200 --> 04:05:39,800 CARE SYSTEM IN TERMS OF 6618 04:05:39,800 --> 04:05:42,040 UNDERSTANDING WHEN PEOPLE ARE 6619 04:05:42,040 --> 04:05:45,120 JUST BEGINNING TO HAVE PROBLEMS 6620 04:05:45,120 --> 04:05:46,640 WITH SUBSTANCES, ALCOHOL, BUT 6621 04:05:46,640 --> 04:05:49,480 YOU'RE LOOKING AT ADOLESCENTS, 6622 04:05:49,480 --> 04:05:52,120 WOMEN, OTHER VULNERABLE 6623 04:05:52,120 --> 04:05:55,800 POPULATION, CANNABIS, ALCOHOL, 6624 04:05:55,800 --> 04:05:57,920 VAPING, TOBACCO, YOU KNOW, 6625 04:05:57,920 --> 04:05:59,160 NCI-RELATED DATA THAT'S BEEN 6626 04:05:59,160 --> 04:06:01,920 SHOWN, THERE'S A LOT OF RESEARCH 6627 04:06:01,920 --> 04:06:03,720 TO BE DONE, HOW DO YOU 6628 04:06:03,720 --> 04:06:04,840 INCENTIVIZE TOUCH POINTS BECAUSE 6629 04:06:04,840 --> 04:06:06,360 WE'RE BAD AT THIS IN THE 6630 04:06:06,360 --> 04:06:07,560 CLINICAL CARE SYSTEM, REALLY 6631 04:06:07,560 --> 04:06:07,720 BAD. 6632 04:06:07,720 --> 04:06:08,880 WE THINK WE'RE BETTER THAN WE 6633 04:06:08,880 --> 04:06:13,440 ARE BUT WE'RE NOT VERY GOOD AT 6634 04:06:13,440 --> 04:06:13,600 IT. 6635 04:06:13,600 --> 04:06:14,800 THAT'S ONE THING. 6636 04:06:14,800 --> 04:06:19,040 I WAS GOING BACK TO DATA AROUND 6637 04:06:19,040 --> 04:06:20,920 ESCALATING ALCOHOL USE IN WOMEN, 6638 04:06:20,920 --> 04:06:24,840 THE CLEAR RELATIONSHIP BETWEEN 6639 04:06:24,840 --> 04:06:27,120 ALCOHOL USE AND BREAST CANCER, 6640 04:06:27,120 --> 04:06:28,480 WOMEN STILL DON'T KNOW THAT, 6641 04:06:28,480 --> 04:06:30,840 DATA THAT SHOWS PEOPLE DON'T 6642 04:06:30,840 --> 04:06:31,720 KNOW THAT ALCOHOL PRESENTS 6643 04:06:31,720 --> 04:06:32,440 CANCER RISKS. 6644 04:06:32,440 --> 04:06:34,840 I WAS THINKING ABOUT TODAY'S 6645 04:06:34,840 --> 04:06:39,120 U.S. PUBLIC HEALTH SERVICE TASK 6646 04:06:39,120 --> 04:06:40,560 FORCE RECOMMENDATIONS AROUND 6647 04:06:40,560 --> 04:06:41,560 MOVING MAMMOGRAPHY TO AGE 40 6648 04:06:41,560 --> 04:06:43,080 RATHER THAN 50, IT'S AN 6649 04:06:43,080 --> 04:06:46,160 OPPORTUNITY I WOULD THINK FORE 6650 04:06:46,160 --> 04:06:49,440 NIAAA TO SAY, HEY, WOMEN, YOU 6651 04:06:49,440 --> 04:06:52,120 JUST SAW THIS DECREASE TO 40 6652 04:06:52,120 --> 04:06:53,440 WHEN MAMMOGRAPHY SHOULD START, 6653 04:06:53,440 --> 04:06:55,400 AND THERE ARE OTHER MODIFIABLE 6654 04:06:55,400 --> 04:06:57,040 VARIABLES, DID YOU KNOW ABOUT 6655 04:06:57,040 --> 04:06:57,280 ALCOHOL? 6656 04:06:57,280 --> 04:06:58,880 I WOULD URGE GETTING OUT THERE 6657 04:06:58,880 --> 04:06:59,840 RIGHT NOW. 6658 04:06:59,840 --> 04:07:04,880 IN OUR RESEARCH AND STUDIES WITH 6659 04:07:04,880 --> 04:07:05,760 CLINICAL POPULATIONS, WOMEN 6660 04:07:05,760 --> 04:07:06,760 COMING FOR TREATMENT FOR 6661 04:07:06,760 --> 04:07:08,120 SUBSTANCE USE DISORDERS WE 6662 04:07:08,120 --> 04:07:15,520 PRESENT A LOT OF HEALTH RELATED 6663 04:07:15,520 --> 04:07:16,560 DATA, ALMOST ALL WOMEN NEVER 6664 04:07:16,560 --> 04:07:18,480 HEARD OF IT BEFORE. 6665 04:07:18,480 --> 04:07:19,200 ASTOUNDING. 6666 04:07:19,200 --> 04:07:21,640 WE SEE THAT WOMEN INCLUDING 6667 04:07:21,640 --> 04:07:23,960 YOUNG WOMEN, WOMEN CONSIDER IT 6668 04:07:23,960 --> 04:07:26,160 QUITE INTERESTING AND 6669 04:07:26,160 --> 04:07:26,800 MOTIVATIONAL AROUND THEIR 6670 04:07:26,800 --> 04:07:27,880 OVERARCHING HEALTH WHICH GETS ME 6671 04:07:27,880 --> 04:07:29,640 BACK TO THE TOUCH POINTS BECAUSE 6672 04:07:29,640 --> 04:07:32,360 THERE'S SO MANY TOUCH POINTS WE 6673 04:07:32,360 --> 04:07:35,440 HAVE WHERE THERE ARE MULTIPLE 6674 04:07:35,440 --> 04:07:36,080 MISSED OPPORTUNITIES DISCUSSING 6675 04:07:36,080 --> 04:07:37,920 THINGS WITH PATIENTS WHO COME IN 6676 04:07:37,920 --> 04:07:41,040 TO EVERY SINGLE -- PEDIATRICS, 6677 04:07:41,040 --> 04:07:42,960 OB, YOU KNOW, GYN, EVERY PLACE 6678 04:07:42,960 --> 04:07:44,640 PEOPLE SHOW UP, MEN AND WOMEN, 6679 04:07:44,640 --> 04:07:45,920 BUT I'M THINKING ABOUT WOMEN 6680 04:07:45,920 --> 04:07:47,760 RIGHT NOW, WE DO NOT IN MENTAL 6681 04:07:47,760 --> 04:07:49,080 HEALTH CARE, JUST THE WHOLE 6682 04:07:49,080 --> 04:07:51,400 THING, WE DON'T REALLY TALK TO 6683 04:07:51,400 --> 04:07:54,680 PATIENTS ABOUT ANY OF THIS 6684 04:07:54,680 --> 04:07:54,880 STUFF. 6685 04:07:54,880 --> 04:07:59,560 AND AROUND SCREENING WITH 6686 04:07:59,560 --> 04:08:00,480 ADOLESCENT POPULATIONS THERE'S 6687 04:08:00,480 --> 04:08:03,280 DATA THAT SHOWS KIDS, YOUNG 6688 04:08:03,280 --> 04:08:04,120 PEOPLE, TRANSITIONAL AGE YOUTH, 6689 04:08:04,120 --> 04:08:06,840 THEY ARE A LITTLE MORE HONEST 6690 04:08:06,840 --> 04:08:08,560 WHEN THEY ARE DOING DIGITAL 6691 04:08:08,560 --> 04:08:09,200 SCREENING. 6692 04:08:09,200 --> 04:08:10,280 RATHER THAN BEHIND THE CLOSED 6693 04:08:10,280 --> 04:08:12,160 DOORS, IF YOU CAN ADMINISTER 6694 04:08:12,160 --> 04:08:13,760 THESE THINGS YOU KNOW HOW YOU 6695 04:08:13,760 --> 04:08:16,720 HAVE TO GET SURVEYS BEFORE YOU 6696 04:08:16,720 --> 04:08:20,480 GO TO CARE, IF YOU CAN 6697 04:08:20,480 --> 04:08:23,280 ADMINISTER WHERE IT'S AN 6698 04:08:23,280 --> 04:08:25,120 INTERACTIVE INTERFACE ASKING, 6699 04:08:25,120 --> 04:08:30,440 YOU'RE MORE LIKELY TO GET DATA 6700 04:08:30,440 --> 04:08:32,040 ABOUT WHAT'S ACTUALLY HAPPENING 6701 04:08:32,040 --> 04:08:34,640 FORE ALL THE COMPLICATED REASONS 6702 04:08:34,640 --> 04:08:35,120 USING DIGITAL PLATFORMS. 6703 04:08:35,120 --> 04:08:36,040 THE QUESTION AFTER THAT WHAT 6704 04:08:36,040 --> 04:08:38,160 DOES THE CLINICIAN DO WITH THE 6705 04:08:38,160 --> 04:08:38,480 INFORMATION? 6706 04:08:38,480 --> 04:08:39,680 SO, ONE OF THE THINGS WE'VE BEEN 6707 04:08:39,680 --> 04:08:42,440 TRYING TO WORK ON IS TAKING LIVE 6708 04:08:42,440 --> 04:08:44,800 THINGS AND STARTING TO PUT THEM 6709 04:08:44,800 --> 04:08:47,040 ON LIKE WEB INTERFACES THAT JUST 6710 04:08:47,040 --> 04:08:50,720 DON'T TAKE VERY MUCH TIME, WHERE 6711 04:08:50,720 --> 04:08:53,080 DOCTORS OR CLINICIANS CAN 6712 04:08:53,080 --> 04:08:53,840 BASICALLY HAVE SOMETHING THAT 6713 04:08:53,840 --> 04:08:54,520 THEY CAN DO. 6714 04:08:54,520 --> 04:08:59,000 IT'S VERY HARD TO ASK A BUSY 6715 04:08:59,000 --> 04:09:00,400 CLINICIAN TO SCREEN AND FEEL AT 6716 04:09:00,400 --> 04:09:02,320 A LOSS FOR THE NEXT STEP. 6717 04:09:02,320 --> 04:09:04,120 THERE'S A TON OF STUFF WE CAN 6718 04:09:04,120 --> 04:09:07,320 DEVELOP IN THAT REGARD WHERE YOU 6719 04:09:07,320 --> 04:09:09,200 CAN SCREEN PEOPLE AND THEN THERE 6720 04:09:09,200 --> 04:09:11,360 IS SOMETHING AS A FIRST 6721 04:09:11,360 --> 04:09:12,760 INTERFACE, NOT THE PERFECT THING 6722 04:09:12,760 --> 04:09:14,000 BUT IT IS SOMETHING. 6723 04:09:14,000 --> 04:09:18,560 SO THOSE ARE JUST SOME THINGS 6724 04:09:18,560 --> 04:09:21,120 THAT I WAS THINKING ABOUT DURING 6725 04:09:21,120 --> 04:09:22,600 THIS MORNING'S PRESENTATIONS. 6726 04:09:22,600 --> 04:09:26,040 THE ONLY OTHER THING ABOUT THE 6727 04:09:26,040 --> 04:09:27,400 CORE RESOURCES, NIAAA PUT A LOT 6728 04:09:27,400 --> 04:09:29,160 OF ENERGY AND EFFORT INTO I 6729 04:09:29,160 --> 04:09:32,080 WONDER WHETHER THOSE ARE NOW 6730 04:09:32,080 --> 04:09:37,040 LINKED TO ALL THE MEDICAL 6731 04:09:37,040 --> 04:09:38,080 SOCIETIES, BECAUSE THAT'S WHERE 6732 04:09:38,080 --> 04:09:40,680 YOU NEED TO DISSEMINATE THE CORE 6733 04:09:40,680 --> 04:09:40,960 RESOURCES. 6734 04:09:40,960 --> 04:09:45,120 I MEAN, THEY SHOULD BE LINKED 6735 04:09:45,120 --> 04:09:49,360 SOMEHOW TO EVERY MEDICAL 6736 04:09:49,360 --> 04:09:50,440 SOCIETY. 6737 04:09:50,440 --> 04:09:51,080 YOU KNOW, MEDICAL, PHYSICIANS DO 6738 04:09:51,080 --> 04:09:53,880 NOT DO A GOOD JOB WITH ALCOHOL 6739 04:09:53,880 --> 04:09:55,400 RELATED, THEY JUST DON'T. 6740 04:09:55,400 --> 04:09:56,800 SO THERE ARE GREAT CORE 6741 04:09:56,800 --> 04:09:58,200 RESOURCES THAT YOU'VE DEVELOPED, 6742 04:09:58,200 --> 04:10:00,080 EXCELLENT, BUT IF NOBODY GETS ON 6743 04:10:00,080 --> 04:10:01,880 THERE AND USES THEM, YOU KNOW, 6744 04:10:01,880 --> 04:10:04,280 IT'S NOT GETTING WHERE YOU WANT 6745 04:10:04,280 --> 04:10:06,760 TO GO SO I WAS THINKING ABOUT 6746 04:10:06,760 --> 04:10:07,960 HOW TO DISSEMINATE THAT 6747 04:10:07,960 --> 04:10:08,280 INFORMATION. 6748 04:10:08,280 --> 04:10:10,200 THE OTHER THING, HOW TO URGE 6749 04:10:10,200 --> 04:10:12,360 PEOPLE TO INCENTIVIZE THE USE OF 6750 04:10:12,360 --> 04:10:13,920 THOSE RESOURCES. 6751 04:10:13,920 --> 04:10:15,480 THAT'S ANOTHER THING. 6752 04:10:15,480 --> 04:10:17,280 HOW DO YOU INCENTIVIZE. 6753 04:10:17,280 --> 04:10:18,840 I'LL STOP THERE. 6754 04:10:18,840 --> 04:10:21,920 >>THANK YOU FOR THAT. 6755 04:10:21,920 --> 04:10:22,880 WE TOTALLY AGREE. 6756 04:10:22,880 --> 04:10:24,000 STAFF IN OUR DIVISION OF 6757 04:10:24,000 --> 04:10:27,520 TREATMENT AND RECOVERY WHO LEDED 6758 04:10:27,520 --> 04:10:31,120 DEVELOPMENT OF HBCR ARE WORKING 6759 04:10:31,120 --> 04:10:33,840 HARD TO DISSEMINATE THROUGH 6760 04:10:33,840 --> 04:10:34,600 VARIOUS MEDICAL SOCIETIES, 6761 04:10:34,600 --> 04:10:35,560 DIFFERENT ORGANIZATIONS, 6762 04:10:35,560 --> 04:10:36,160 PROFESSIONAL ORGANIZATIONS. 6763 04:10:36,160 --> 04:10:38,000 SO IT'S SOMETHING WE'RE 6764 04:10:38,000 --> 04:10:39,120 REALLY -- WE RECOGNIZE THE NEED 6765 04:10:39,120 --> 04:10:40,920 AND PROBLEM AND WE'RE WORKING 6766 04:10:40,920 --> 04:10:42,400 HARD TO TRY TO DISSEMINATE. 6767 04:10:42,400 --> 04:10:49,480 IT IS A TREMENDOUS CHALLENGE. 6768 04:10:49,480 --> 04:10:52,000 >>SO, SUSAN, I WANT TO -- YOU 6769 04:10:52,000 --> 04:10:53,520 CAN REMEMBER WHAT SHELLY JUST 6770 04:10:53,520 --> 04:10:55,120 SAID BECAUSE IF I MEET WITH YOU 6771 04:10:55,120 --> 04:10:58,480 AT SOME POINT I'LL RAISE SOME 6772 04:10:58,480 --> 04:10:59,360 SAME ISSUES. 6773 04:10:59,360 --> 04:11:02,120 ONE OF THE BIG CHALLENGES. 6774 04:11:02,120 --> 04:11:04,280 THERE ARE TWO OTHER QUESTIONS SO 6775 04:11:04,280 --> 04:11:07,400 I'LL MOVE WITH THE QUESTIONS. 6776 04:11:07,400 --> 04:11:08,760 SHELLY, THANK YOU VERY MUCH. 6777 04:11:08,760 --> 04:11:11,400 I MEAN, YOU TOUCH A NERVE IN OUR 6778 04:11:11,400 --> 04:11:12,000 INSTITUTE. 6779 04:11:12,000 --> 04:11:13,560 BUT WE'RE A SMALL INSTITUTE SO 6780 04:11:13,560 --> 04:11:15,920 WE CAN ONLY DO SO MUCH. 6781 04:11:15,920 --> 04:11:21,880 WE'LL BE IN TOUCH ON SOME OF 6782 04:11:21,880 --> 04:11:22,840 THESE ISSUES. 6783 04:11:22,840 --> 04:11:25,680 WOULD ARPA-H SUPPORT -- FROM 6784 04:11:25,680 --> 04:11:27,600 DOMINIQUE LORANG, IF YOU CAN 6785 04:11:27,600 --> 04:11:30,200 TURN ON YOUR SPEAKER QUICKLY AND 6786 04:11:30,200 --> 04:11:32,360 ASK THE QUESTION YOURSELF, THAT 6787 04:11:32,360 --> 04:11:36,720 WOULD BE FINE. 6788 04:11:36,720 --> 04:11:40,160 IT'S AN ARPA-H QUESTION. 6789 04:11:40,160 --> 04:11:41,360 >>GIVEN HOW IMPORTANT PAIN IS, 6790 04:11:41,360 --> 04:11:45,800 HOW CHRONIC PAIN IS IN THE BROAD 6791 04:11:45,800 --> 04:11:47,200 POPULATION, GIVEN THE COMPLEX 6792 04:11:47,200 --> 04:11:48,720 RELATIONSHIP BETWEEN CHRONIC 6793 04:11:48,720 --> 04:11:50,840 PAIN OR EMOTIONAL PAIN WHICH 6794 04:11:50,840 --> 04:11:54,520 SUBSTANCE USE DISORDERS 6795 04:11:54,520 --> 04:11:55,840 INCLUDING ALCOHOL USE DISORDERS, 6796 04:11:55,840 --> 04:11:58,320 WOULDN'T ARPA-H SUPPORT THE 6797 04:11:58,320 --> 04:11:58,880 DEVELOPMENT OF NON-INVASIVE 6798 04:11:58,880 --> 04:12:02,080 SENSING TECHNOLOGIES THAT COULD 6799 04:12:02,080 --> 04:12:05,280 BE USED TO ASSESS PAIN LEVELS, 6800 04:12:05,280 --> 04:12:06,200 PHYSICAL OR EMOTIONAL PAIN 6801 04:12:06,200 --> 04:12:08,760 LEVELS IN THE BROAD POPULATION, 6802 04:12:08,760 --> 04:12:10,240 WOULD THAT BE SOMETHING OF 6803 04:12:10,240 --> 04:12:11,040 INTEREST IN. 6804 04:12:11,040 --> 04:12:11,360 >>ABSOLUTELY. 6805 04:12:11,360 --> 04:12:17,800 WE WERE JUST TALKING THE OTHER 6806 04:12:17,800 --> 04:12:20,200 DAY ABOUT -- HOW WOULD WE THINK 6807 04:12:20,200 --> 04:12:22,280 ABOUT A TECHNOLOGY THAT WOULD 6808 04:12:22,280 --> 04:12:24,320 ACTUALLY GO THROUGH A REGULATORY 6809 04:12:24,320 --> 04:12:26,080 APPROVAL PROCESS TO ALLOW IT TO 6810 04:12:26,080 --> 04:12:30,920 THEN BE USED IN A SORT OF 6811 04:12:30,920 --> 04:12:32,040 CLINICAL OUTPATIENT SETTING 6812 04:12:32,040 --> 04:12:37,920 GIVEN, YOU KNOW, ALLOWING 6813 04:12:37,920 --> 04:12:40,440 INDIVIDUALS TO HAVE A MORE SORT 6814 04:12:40,440 --> 04:12:41,360 OF QUANTITATIVE UNDERSTANDING OF 6815 04:12:41,360 --> 04:12:43,560 OUR OWN PAIN BUT SOMETHING THAT 6816 04:12:43,560 --> 04:12:46,240 COULD BE USED FOR CLINICIANS TO 6817 04:12:46,240 --> 04:12:47,520 HELP UNDERSTAND, YOU KNOW, AN 6818 04:12:47,520 --> 04:12:49,160 INDIVIDUAL'S PERCEPTION. 6819 04:12:49,160 --> 04:12:50,800 WE WERE THINKING ABOUT WE HAVE 6820 04:12:50,800 --> 04:12:52,800 NO PROGRESS, SO THIS IS ALL 6821 04:12:52,800 --> 04:12:55,680 SPECULATIVE, BUT IS THERE SOME 6822 04:12:55,680 --> 04:12:58,400 SORT OF WEARABLE DEVICE OR 6823 04:12:58,400 --> 04:12:59,560 BIOMONITOR YOU CORRELATE TO 6824 04:12:59,560 --> 04:13:01,240 SPECIFIC BIOMARKERS THAT WOULD 6825 04:13:01,240 --> 04:13:04,320 BE INDICATIVE OF WHEN SOMEBODY'S 6826 04:13:04,320 --> 04:13:05,640 EXPERIENCING OR FEELING A 6827 04:13:05,640 --> 04:13:07,320 CERTAIN STRESS EMOTION OR A PAIN 6828 04:13:07,320 --> 04:13:09,480 OR SOMETHING LIKE THAT, SO THAT 6829 04:13:09,480 --> 04:13:13,440 YOU ACTUALLY CAN MOVE IT FROM 6830 04:13:13,440 --> 04:13:16,200 THE VERY MUCH PERCEPTION-BASED, 6831 04:13:16,200 --> 04:13:18,520 YOU KNOW, INDIVIDUALIZED SORT OF 6832 04:13:18,520 --> 04:13:21,960 APPROACH TO SOMETHING THAT 6833 04:13:21,960 --> 04:13:23,400 ACTUALLY COULD BE A DEPLOYABLE 6834 04:13:23,400 --> 04:13:25,000 TECHNOLOGY VALIDATED IN A WAY 6835 04:13:25,000 --> 04:13:26,760 THAT THERE'S A REPRODUCIBILITY 6836 04:13:26,760 --> 04:13:29,800 THAT COULD BE TRUSTED BY 6837 04:13:29,800 --> 04:13:31,160 CLINICIANS, BY A PATIENT, AND SO 6838 04:13:31,160 --> 04:13:32,760 WHAT DID THAT ALL LOOK LIKE 6839 04:13:32,760 --> 04:13:35,440 TOGETHER AND SO THE ANSWER IS 6840 04:13:35,440 --> 04:13:37,400 YES, WE WOULD ABSOLUTELY TAKE 6841 04:13:37,400 --> 04:13:40,120 SOMETHING ON LIKE THIS, KNOWING 6842 04:13:40,120 --> 04:13:43,560 HOW CHALLENGING IT IS AND HOW 6843 04:13:43,560 --> 04:13:46,800 PREVALENT IT IS IN THE PATIENT 6844 04:13:46,800 --> 04:13:47,160 POPULATION. 6845 04:13:47,160 --> 04:13:49,520 SO, IT'S JUST A FUNCTION OF HOW 6846 04:13:49,520 --> 04:13:53,920 WOULD WE DESIGN THAT PROGRAM TO 6847 04:13:53,920 --> 04:13:55,840 ACTUALLY BUILD SOMETHING THAT 6848 04:13:55,840 --> 04:13:57,600 WOULD IMPROVE PATIENT OR 6849 04:13:57,600 --> 04:13:58,920 INDIVIDUAL EXPERIENCE THAT WOULD 6850 04:13:58,920 --> 04:14:01,000 BE VALIDATABLE, GET THROUGH 6851 04:14:01,000 --> 04:14:02,400 REGULATORY PROCESS, AND BE 6852 04:14:02,400 --> 04:14:06,960 RECOGNIZED IN SORT OF A CLINICAL 6853 04:14:06,960 --> 04:14:07,240 WORKFLOW. 6854 04:14:07,240 --> 04:14:10,240 >>YEAH, I COULD SEE COMPANIES 6855 04:14:10,240 --> 04:14:13,280 DEVELOPING SPECIALIZED SENSORS 6856 04:14:13,280 --> 04:14:19,400 THAT MIGHT PICK UP SPECIFIC 6857 04:14:19,400 --> 04:14:20,000 BIOMARKERS, COMBINATION USING 6858 04:14:20,000 --> 04:14:21,920 DIGITAL HEALTH TECHNOLOGIES TO 6859 04:14:21,920 --> 04:14:22,960 IDENTIFY POTENTIAL BIOMARKERS. 6860 04:14:22,960 --> 04:14:24,840 OKAY, GREAT. 6861 04:14:24,840 --> 04:14:26,600 THANK YOU. 6862 04:14:26,600 --> 04:14:26,960 >>ABSOLUTELY. 6863 04:14:26,960 --> 04:14:32,520 >>SO, WE HAVE A QUESTION FROM 6864 04:14:32,520 --> 04:14:32,840 MELISSA WALLS. 6865 04:14:32,840 --> 04:14:33,120 MELISSA? 6866 04:14:33,120 --> 04:14:34,240 >>YES, THANKS. 6867 04:14:34,240 --> 04:14:35,360 HI, EVERYONE. 6868 04:14:35,360 --> 04:14:36,440 HANG IN THERE, WE'RE GETTING TO 6869 04:14:36,440 --> 04:14:39,640 THE END OF A LONG DAY ON ZOOM IN 6870 04:14:39,640 --> 04:14:39,880 THE ROOM. 6871 04:14:39,880 --> 04:14:41,320 I'M GOING TO FOLLOW UP WITH A 6872 04:14:41,320 --> 04:14:45,840 LITTLE BIT OF WHAT SHELLY WAS 6873 04:14:45,840 --> 04:14:46,680 HEADED TOWARDS. 6874 04:14:46,680 --> 04:14:50,320 WE TALK OUTSIDE OF NIDA AS WELL. 6875 04:14:50,320 --> 04:14:55,480 SO MY QUESTION, I'LL GIVE THE 6876 04:14:55,480 --> 04:14:58,600 QUESTION AND CONTEXT. 6877 04:14:58,600 --> 04:14:59,840 WHAT SYNERGIES MIGHT WE CREATE 6878 04:14:59,840 --> 04:15:01,040 TO ADDRESS INTHE QUESTIONS THAT 6879 04:15:01,040 --> 04:15:02,640 YOU ALL HAVE BEEN HIGHLIGHTING 6880 04:15:02,640 --> 04:15:04,400 OVER THE MORNING? 6881 04:15:04,400 --> 04:15:06,360 AND NORA, EVERY SINGLE NIDA 6882 04:15:06,360 --> 04:15:08,200 COUNCIL MEETING I BRING THIS UP 6883 04:15:08,200 --> 04:15:10,040 BECAUSE DATA FOR BLACK WOMEN, 6884 04:15:10,040 --> 04:15:13,640 DATA FOR AMERICAN INDIAN AND 6885 04:15:13,640 --> 04:15:15,320 ALASKA NATIVE WOMEN IS JUST 6886 04:15:15,320 --> 04:15:17,560 GETTING WORSE EVERY TIME. 6887 04:15:17,560 --> 04:15:27,280 AND HOW DO WE DO TO BALANCE 6888 04:15:27,280 --> 04:15:28,480 PRAGMATISM WITH REVOLUTION? 6889 04:15:28,480 --> 04:15:29,720 I SIT IN MINNESOTA THINKING 6890 04:15:29,720 --> 04:15:32,160 ABOUT THE BEST BANG FOR THE 6891 04:15:32,160 --> 04:15:33,920 BUCK, IN THIS ONE MEETING A YEAR 6892 04:15:33,920 --> 04:15:34,960 WE HAVE. 6893 04:15:34,960 --> 04:15:36,680 AND WHERE WE SEE THE MOST 6894 04:15:36,680 --> 04:15:37,920 EXTREME PAIN AND LOSS OF COURSE 6895 04:15:37,920 --> 04:15:40,000 IS THE COMMUNITIES I JUST 6896 04:15:40,000 --> 04:15:42,200 MENTIONED, WOMEN, AS SHELLY WAS 6897 04:15:42,200 --> 04:15:43,320 TALKING ABOUT, AND THE 6898 04:15:43,320 --> 04:15:45,400 CONSEQUENCES OF ALL OF THESE 6899 04:15:45,400 --> 04:15:46,440 ISSUES, WE ALL CARE SO MUCH 6900 04:15:46,440 --> 04:15:46,840 ABOUT. 6901 04:15:46,840 --> 04:15:49,840 WE KNOW THEY ARE NOT RANDOMLY 6902 04:15:49,840 --> 04:15:50,160 DISTRIBUTED. 6903 04:15:50,160 --> 04:15:52,200 AND WHAT I'M HEARING US THINK 6904 04:15:52,200 --> 04:15:53,840 ABOUT THOUGH ARE SOLUTIONS THAT 6905 04:15:53,840 --> 04:15:57,320 FIT INTO THE CURRENT SYSTEMS OF 6906 04:15:57,320 --> 04:15:59,800 CARE OR CURRENTS RESEARCH OR 6907 04:15:59,800 --> 04:16:00,600 SCIENTIFIC PARADIGMS THAT ARE 6908 04:16:00,600 --> 04:16:04,560 NOT MAKING A MARK AT ALL, 6909 04:16:04,560 --> 04:16:05,880 NOTHING IS CHANGING, IT'S 6910 04:16:05,880 --> 04:16:06,760 GETTING ACTUALLY WORSE. 6911 04:16:06,760 --> 04:16:08,360 ONE THING TO INCLUDE, FOR 6912 04:16:08,360 --> 04:16:09,560 EXAMPLE, MORE AMERICAN INDIANS 6913 04:16:09,560 --> 04:16:14,720 AND A LARGE SCALE STUDY, BUT HOW 6914 04:16:14,720 --> 04:16:17,360 DO WE APPROACH ENGAGEMENT, USE 6915 04:16:17,360 --> 04:16:19,240 MEASURES WE KNOW MAYBE WERE 6916 04:16:19,240 --> 04:16:22,760 NEVER DEVELOPED WITH NON-WHITE 6917 04:16:22,760 --> 04:16:23,840 NON-MALE NON-MIDDLE CLASS FOLKS, 6918 04:16:23,840 --> 04:16:31,000 WE HAVE SO MUCH TO IMPROVE. 6919 04:16:31,000 --> 04:16:33,480 IT'S SO COMPELLING WE HAVE THESE 6920 04:16:33,480 --> 04:16:35,560 HIGH IMPACT JOURNALS PUBLISHING 6921 04:16:35,560 --> 04:16:36,800 ON THE ROOT CAUSES OF WHAT USED 6922 04:16:36,800 --> 04:16:39,480 TO BE THOUGHT OF AS BIOLOGICAL 6923 04:16:39,480 --> 04:16:40,880 DIFFERENCES THAT ARE REALLY 6924 04:16:40,880 --> 04:16:42,360 ABOUT RACISM, RIGHT? 6925 04:16:42,360 --> 04:16:43,320 SO I GET THAT. 6926 04:16:43,320 --> 04:16:47,200 BUT WE KNOW THAT STRESSFUL 6927 04:16:47,200 --> 04:16:48,600 SITUATIONS YIELD STRESSING 6928 04:16:48,600 --> 04:16:55,160 OUTCOMES AND WE KNOW SO LITTLE 6929 04:16:55,160 --> 04:16:56,240 ABOUT STRENGTH-BASED APPROACHES 6930 04:16:56,240 --> 04:16:57,560 TO HEALING. 6931 04:16:57,560 --> 04:16:58,440 THE RESEARCH, SPECIALLY IN 6932 04:16:58,440 --> 04:17:00,480 AMERICAN INDIAN AND ALASKA 6933 04:17:00,480 --> 04:17:01,760 NATIVE COMMUNITIES COMPELS US TO 6934 04:17:01,760 --> 04:17:03,520 THINK ABOUT MORE STRENGTH 6935 04:17:03,520 --> 04:17:05,240 ORIENTED APPROACHES TO HEALING, 6936 04:17:05,240 --> 04:17:08,720 AND JUST AS A SMALL EXAMPLE, 6937 04:17:08,720 --> 04:17:10,200 VERY PRELIMINARY STUDIES, WE 6938 04:17:10,200 --> 04:17:12,880 FIND THAT THE ROLE OF BENEVOLENT 6939 04:17:12,880 --> 04:17:14,800 OR POSITIVE CHILDHOOD 6940 04:17:14,800 --> 04:17:16,680 EXPERIENCES ACTUALLY OUTSHINE 6941 04:17:16,680 --> 04:17:17,400 ADVERSE CHILDHOOD EXPERIENCES 6942 04:17:17,400 --> 04:17:19,480 BUT WE'RE NOT MEASURING THEM AND 6943 04:17:19,480 --> 04:17:21,840 NOT MEASURING THEM WE ARE 6944 04:17:21,840 --> 04:17:26,280 PERHAPS PERPETUATING STIGMA, 6945 04:17:26,280 --> 04:17:27,480 CALLING IT STRUCTURAL RACISM, 6946 04:17:27,480 --> 04:17:29,360 STILL THE STIGMA STICKS WHEN YOU 6947 04:17:29,360 --> 04:17:30,880 SEE KIDS OF COLOR, INDIGINOUS 6948 04:17:30,880 --> 04:17:32,280 KIDS, WOMEN NOT DOING AS WELL. 6949 04:17:32,280 --> 04:17:34,720 BACK TO MY QUESTION WITH THAT 6950 04:17:34,720 --> 04:17:36,400 CONTEXT WHAT SYNERGIES MIGHT 6951 04:17:36,400 --> 04:17:41,480 EXIST OR COULD WE CREATE TO 6952 04:17:41,480 --> 04:17:42,760 BALANCE PRAGMATISM ARE 6953 04:17:42,760 --> 04:17:49,240 REVOLUTIONARY APPROACH TO 6954 04:17:49,240 --> 04:17:50,800 ADDRESSING INEQUITIES? 6955 04:17:50,800 --> 04:17:54,960 >>HOW DO WE DO PRAGMATISM AND 6956 04:17:54,960 --> 04:17:59,120 GET REVOLUTION, WHAT SUSAN WAS 6957 04:17:59,120 --> 04:18:00,120 AIMING WITH ARPA-H, 6958 04:18:00,120 --> 04:18:01,600 TRANSFORMATIONAL JUMPS WE'VE NOT 6959 04:18:01,600 --> 04:18:02,640 BEEN ABLE TO DO. 6960 04:18:02,640 --> 04:18:04,440 IF THEY WERE EASY WE WOULDN'T BE 6961 04:18:04,440 --> 04:18:05,640 HAVING THIS DISCUSSION. 6962 04:18:05,640 --> 04:18:07,360 TO START WITH, ABSOLUTELY. 6963 04:18:07,360 --> 04:18:10,200 WE START BY ACTUALLY CREATING 6964 04:18:10,200 --> 04:18:12,040 SYNERGIES BETWEEN DIFFERENT 6965 04:18:12,040 --> 04:18:13,320 INSTITUTES AND IMPORTANTLY 6966 04:18:13,320 --> 04:18:14,520 CREATING SYNERGIES IN THE 6967 04:18:14,520 --> 04:18:17,560 STRUCTURES THAT WE HAVE THAT CAN 6968 04:18:17,560 --> 04:18:21,080 ACTUALLY SERVE THESE 6969 04:18:21,080 --> 04:18:21,360 POPULATIONS. 6970 04:18:21,360 --> 04:18:27,000 AND AN ASPECT ON THE BASIS OF 6971 04:18:27,000 --> 04:18:29,920 COMMITMENT TO ADVANCE SCIENCE 6972 04:18:29,920 --> 04:18:31,440 THAT WILL ADDRESS HEALTH 6973 04:18:31,440 --> 04:18:33,280 DISPARITIES IS THE NOTION TO 6974 04:18:33,280 --> 04:18:37,160 EMPOWER THOSE POPULATIONS TO 6975 04:18:37,160 --> 04:18:38,440 ACTUALLY BE THE ONES THAT COME 6976 04:18:38,440 --> 04:18:40,400 UP WITH SOLUTIONS AND THIS IS 6977 04:18:40,400 --> 04:18:41,400 PARTICULARLY RELEVANT WITH 6978 04:18:41,400 --> 04:18:42,840 AMERICAN INDIANIAN AND ALASKA 6979 04:18:42,840 --> 04:18:45,920 NATURE I WAS BECAUSE WE CAN COME 6980 04:18:45,920 --> 04:18:48,000 UP WITH THINGS THAT ARE 6981 04:18:48,000 --> 04:18:48,600 NONSTARTERS IN THOSE 6982 04:18:48,600 --> 04:18:49,920 COMMUNITIES, THIS IS GOING TO BE 6983 04:18:49,920 --> 04:18:52,520 ONE OF THE MAIN AREAS OF FOCUS, 6984 04:18:52,520 --> 04:18:56,160 HOW DO WE TRAIN OUR RESEARCHERS 6985 04:18:56,160 --> 04:18:59,880 FROM THOSE COMMUNITIES, FROM 6986 04:18:59,880 --> 04:19:03,960 THOSE GROUPS, THAT HAVE CULTURAL 6987 04:19:03,960 --> 04:19:04,720 SENSITIVITY AND UNDERSTANDINGS 6988 04:19:04,720 --> 04:19:08,040 TO DEVELOP STRATEGIES THAT 6989 04:19:08,040 --> 04:19:12,480 PROVIDE RESILIENCE BUT ALSO CAN 6990 04:19:12,480 --> 04:19:13,320 BUFFER VULNERABILITY. 6991 04:19:13,320 --> 04:19:15,920 SO WHAT YOU'RE SAYING IS 6992 04:19:15,920 --> 04:19:19,120 CORRECT, AND I DO -- LET'S NOT 6993 04:19:19,120 --> 04:19:21,920 CREATE REDUNDANCIES WHEN NOT 6994 04:19:21,920 --> 04:19:23,600 NECESSARY, LET'S MAXIMIZE 6995 04:19:23,600 --> 04:19:25,440 STRATEGIC AND ALSO LET'S EMPOWER 6996 04:19:25,440 --> 04:19:28,040 THOSE GROUPS SO THEY ARE ACTIVE 6997 04:19:28,040 --> 04:19:30,280 PARTICIPANTS IN THE RESEARCH. 6998 04:19:30,280 --> 04:19:32,680 AND LET'S TAKE ADVANTAGE OF THE 6999 04:19:32,680 --> 04:19:34,160 AGENCIES LIKE THE ARPA-H THAT'S 7000 04:19:34,160 --> 04:19:35,520 COMING IN AND SAYS LET'S DO 7001 04:19:35,520 --> 04:19:37,840 SOMETHING BOLD AND HOW CAN WE 7002 04:19:37,840 --> 04:19:40,760 PARTNER, BECAUSE THAT'S EXACTLY 7003 04:19:40,760 --> 04:19:42,960 WHY WE WANTED SUSAN TO SPEAK 7004 04:19:42,960 --> 04:19:44,360 WITH US SO WE'RE AWARE THIS IS 7005 04:19:44,360 --> 04:19:49,360 AN OPPORTUNITY. 7006 04:19:49,360 --> 04:19:50,320 7007 04:19:50,320 --> 04:19:51,720 >>THANK YOU, NORA. 7008 04:19:51,720 --> 04:19:55,440 MELISSA, I'M SURE YOU'RE AWARE 7009 04:19:55,440 --> 04:19:58,840 OF STACY'S WORK IN ALASKA, USING 7010 04:19:58,840 --> 04:20:02,360 A CULTURAL TOOLBOX SHOWING GREAT 7011 04:20:02,360 --> 04:20:04,000 SUCCESS, CERTAINLY IN ALCOHOL 7012 04:20:04,000 --> 04:20:09,880 USE DISORDERS AND SUBSTANCE USE 7013 04:20:09,880 --> 04:20:12,240 DISORDERS. 7014 04:20:12,240 --> 04:20:13,360 SO ANY OTHER QUESTIONS? 7015 04:20:13,360 --> 04:20:15,440 JEFF, I'M GOING TO ASK ONE MORE 7016 04:20:15,440 --> 04:20:18,320 QUESTION OF YOU IN LIGHT OF THIS 7017 04:20:18,320 --> 04:20:19,080 CONVERSATION. 7018 04:20:19,080 --> 04:20:19,880 IN YOUR STUDIES HAVE YOU STARTED 7019 04:20:19,880 --> 04:20:29,320 TO PICK UP ANY DIFFERENCES YOU 7020 04:20:29,320 --> 04:20:33,760 COULD ATTRIBUTE IN DIFFERENT 7021 04:20:33,760 --> 04:20:36,080 SUBGROUPS, RACES, CULTURES, HAVE 7022 04:20:36,080 --> 04:20:38,000 YOU GUYS THOUGHT OF THAT AND 7023 04:20:38,000 --> 04:20:44,640 LADIES IN THE PAIN FIELD? 7024 04:20:44,640 --> 04:20:46,880 >>SO, WE HAVE -- I WANT TO MAKE 7025 04:20:46,880 --> 04:20:48,040 SURE I GIVE THE MOST COMPLETE 7026 04:20:48,040 --> 04:20:49,520 ANSWER I CAN. 7027 04:20:49,520 --> 04:20:51,280 WE'VE FOCUSED TO DATE MORE A 7028 04:20:51,280 --> 04:20:54,240 GENDER DIFFERENCES IN SOME 7029 04:20:54,240 --> 04:20:54,880 CASES. 7030 04:20:54,880 --> 04:20:58,760 I WILL SAY ACTUALLY I DID HAVE A 7031 04:20:58,760 --> 04:21:00,720 STUDENT VERY INTERESTED IN RACE 7032 04:21:00,720 --> 04:21:03,040 AS A POTENTIAL MODERATOR OF 7033 04:21:03,040 --> 04:21:05,640 EFFECT OF PAIN ON DEMAND FOR 7034 04:21:05,640 --> 04:21:09,440 BOTH CANNABIS AND ALCOHOL. 7035 04:21:09,440 --> 04:21:10,800 AND THAT BASICALLY TURNED OUT TO 7036 04:21:10,800 --> 04:21:14,240 BE SORT OF A NULL THING, IT DID 7037 04:21:14,240 --> 04:21:15,480 NOT -- SHE RECRUITED EQUAL 7038 04:21:15,480 --> 04:21:17,080 NUMBERS OF BLACK AND WHITE 7039 04:21:17,080 --> 04:21:18,080 RESIDENTS OF NORTH CENTRAL 7040 04:21:18,080 --> 04:21:20,080 FLORIDA FOR THAT STUDY AND 7041 04:21:20,080 --> 04:21:22,560 BASICALLY FOUND VERY SIMILAR 7042 04:21:22,560 --> 04:21:24,320 RESULTS IN BOTH. 7043 04:21:24,320 --> 04:21:26,760 SYSTEMATICALLY I DON'T KNOW HOW 7044 04:21:26,760 --> 04:21:28,600 MUCH IT'S HANG IN THE SUBFIELD 7045 04:21:28,600 --> 04:21:29,680 OF SUBSTANCE USE PAIN 7046 04:21:29,680 --> 04:21:30,840 INTERACTIONS BUT I DO THINK IT'S 7047 04:21:30,840 --> 04:21:34,480 VERY IMPORTANT. 7048 04:21:34,480 --> 04:21:36,240 7049 04:21:36,240 --> 04:21:36,600 >>OKAY. 7050 04:21:36,600 --> 04:21:40,040 WE HAVE 13 MINUTES LEFT OF OUR 7051 04:21:40,040 --> 04:21:41,560 OFFICIAL TIME. 7052 04:21:41,560 --> 04:21:42,960 WIDE OPEN FOR ANY QUESTIONS. 7053 04:21:42,960 --> 04:21:48,040 DOESN'T HAVE TO BE TO OUR 7054 04:21:48,040 --> 04:21:48,800 SPEAKERS TODAY. 7055 04:21:48,800 --> 04:21:50,040 IS THERE ANYTHING YOU WANT TO 7056 04:21:50,040 --> 04:21:52,240 KNOW THAT WE HAVEN'T TOLD YOU SO 7057 04:21:52,240 --> 04:21:54,880 FAR OR -- OH, WE DO. 7058 04:21:54,880 --> 04:21:55,960 TINA? 7059 04:21:55,960 --> 04:21:58,200 >>THIS IS FOR JEFF, IN THE 7060 04:21:58,200 --> 04:21:58,880 WEEDS. 7061 04:21:58,880 --> 04:22:01,880 I'M INTRIGUED BY THE GENDER 7062 04:22:01,880 --> 04:22:04,600 DIFFERENCES IN PAIN AND 7063 04:22:04,600 --> 04:22:08,360 WONDERING IF PERCEPTION OF PAIN 7064 04:22:08,360 --> 04:22:09,840 OR RESPONSE TO INCREASED USE OF 7065 04:22:09,840 --> 04:22:13,120 ALCOHOL VARIES ACROSS THE 7066 04:22:13,120 --> 04:22:16,400 MENSTRUAL CYCLE FOR WOMEN? 7067 04:22:16,400 --> 04:22:17,560 >>GREAT QUESTION. 7068 04:22:17,560 --> 04:22:19,160 MY UNDERSTANDING OF THAT 7069 04:22:19,160 --> 04:22:20,800 LITERATURE IS THERE ARE SOME 7070 04:22:20,800 --> 04:22:23,400 SMALL EFFECTS OF THE MENSTRUAL 7071 04:22:23,400 --> 04:22:25,920 CYCLE ON PAIN RESPONSE AND 7072 04:22:25,920 --> 04:22:27,880 EXPERIMENTAL PAIN LITERATURE. 7073 04:22:27,880 --> 04:22:29,240 THEY ARE NOT HUGE. 7074 04:22:29,240 --> 04:22:32,280 I AM NOT AWARE OF DATA REGARDING 7075 04:22:32,280 --> 04:22:39,520 EFFECT OF MENSTRUAL CYCLE OR 7076 04:22:39,520 --> 04:22:40,960 ALCOHOL, ANALGESIA AS A 7077 04:22:40,960 --> 04:22:43,480 CONSEQUENCE OF MENSTRUAL CYCLE. 7078 04:22:43,480 --> 04:22:46,600 >>I WOULDN'T BE SURPRISED, 7079 04:22:46,600 --> 04:22:52,000 GIVEN THE DATA ON PRE-MENSTRUAL 7080 04:22:52,000 --> 04:22:53,480 SYNDROME AND EVEN POSTPARTUM. 7081 04:22:53,480 --> 04:22:55,800 THAT'S NOT THE MENSTRUAL CYCLE 7082 04:22:55,800 --> 04:22:57,240 OBVIOUSLY BUT POSTPARTUM I 7083 04:22:57,240 --> 04:22:58,840 SUSPECT THERE WOULD BE 7084 04:22:58,840 --> 04:22:59,840 DIFFERENCES AS WELL. 7085 04:22:59,840 --> 04:23:01,520 >>THAT IS A GREAT IDEA TO LOOK 7086 04:23:01,520 --> 04:23:02,240 AT. 7087 04:23:02,240 --> 04:23:07,800 WE DO HAVE THAT DATA IN OUR 7088 04:23:07,800 --> 04:23:09,440 LARGER STUDY OF 110 FOLKS, WE'LL 7089 04:23:09,440 --> 04:23:12,160 BE PARSING THAT OUT, DOING OUR 7090 04:23:12,160 --> 04:23:12,840 BEST. 7091 04:23:12,840 --> 04:23:14,920 >>WONDERING, JEFF, IF YOU HAD 7092 04:23:14,920 --> 04:23:17,240 EXPERIENCE WITH PEOPLE WHO HAVE 7093 04:23:17,240 --> 04:23:18,360 MIGRAINES AND CLUSTER HEADACHES 7094 04:23:18,360 --> 04:23:23,440 AND THE PAIN THAT THEY HAVE, 7095 04:23:23,440 --> 04:23:25,400 WHICH IS CONSIDERED INCREDIBLY 7096 04:23:25,400 --> 04:23:27,000 DIFFICULT. 7097 04:23:27,000 --> 04:23:32,760 I HAD A SPOUSE WHO WAS 7098 04:23:32,760 --> 04:23:33,880 COMPLETELY IMMOBILIZED BY 7099 04:23:33,880 --> 04:23:34,320 MIGRAINE HEADACHES. 7100 04:23:34,320 --> 04:23:35,560 >>I DO NOT. 7101 04:23:35,560 --> 04:23:37,120 WE HAVE NOT RECRUITED FOLKS WITH 7102 04:23:37,120 --> 04:23:38,600 MIGRAINE OR CLUSTER HEADACHES 7103 04:23:38,600 --> 04:23:39,680 FOR OUR STUDIES. 7104 04:23:39,680 --> 04:23:41,480 THERE HAVE BEEN INTERESTING 7105 04:23:41,480 --> 04:23:45,720 STUDIES LOOKING AT EFFECTS OF 7106 04:23:45,720 --> 04:23:46,800 CANNABIS ON HEADACHE, OVER THE 7107 04:23:46,800 --> 04:23:48,640 PAST FIVE TO TEN YEARS. 7108 04:23:48,640 --> 04:23:51,040 BUT, NO, NOT IN OUR WORK. 7109 04:23:51,040 --> 04:23:53,240 IT'S AN INTERESTING QUESTION. 7110 04:23:53,240 --> 04:23:56,080 BUT I CERTAINTY DON'T CONSIDER 7111 04:23:56,080 --> 04:23:58,080 MYSELF A HEADACHE EXPERT. 7112 04:23:58,080 --> 04:24:01,560 >>SHE WOULD RELATE THAT NONE OF 7113 04:24:01,560 --> 04:24:02,640 THE PAIN, CHILDBIRTH OR 7114 04:24:02,640 --> 04:24:06,680 ANYTHING, CAME NEAR THAT KIND OF 7115 04:24:06,680 --> 04:24:07,240 PAIN. 7116 04:24:07,240 --> 04:24:13,320 AND SHE DIDN'T FIND MEDICATIONS 7117 04:24:13,320 --> 04:24:14,160 THAT WERE HELPFUL EITHER. 7118 04:24:14,160 --> 04:24:16,120 >>THERE'S LOTS OF THINGS WE 7119 04:24:16,120 --> 04:24:17,600 DON'T KNOW DESPITE HAVING BEEN 7120 04:24:17,600 --> 04:24:20,480 AT NIH AS LONG AS I HAVE, I'M 7121 04:24:20,480 --> 04:24:23,040 ALWAYS AMAZED I'M STILL HERE 7122 04:24:23,040 --> 04:24:25,360 GIVEN ALL THE PATHOLOGY EACH OF 7123 04:24:25,360 --> 04:24:29,240 THE I.C. DIRECTORS BRINGS TO 7124 04:24:29,240 --> 04:24:30,560 THE REGULAR MEETINGS. 7125 04:24:30,560 --> 04:24:32,160 NORA WANTS TO MAKE A COMMENT AND 7126 04:24:32,160 --> 04:24:32,680 A QUESTION. 7127 04:24:32,680 --> 04:24:34,400 YOU HAVE A QUESTION. 7128 04:24:34,400 --> 04:24:35,000 >>A QUESTION. 7129 04:24:35,000 --> 04:24:36,960 IT HAS TO DO WITH SOME OF THE 7130 04:24:36,960 --> 04:24:38,240 POINTS BROUGHT UP. 7131 04:24:38,240 --> 04:24:41,600 I THINK WHEN JEFF, WHEN YOU WERE 7132 04:24:41,600 --> 04:24:44,680 PRESENTING THE DATA, THE 7133 04:24:44,680 --> 04:24:47,400 ENORMOUS VARIABILITY, YOU SEE 7134 04:24:47,400 --> 04:24:49,920 SIGNIFICANT DIFFERENCES, THERE'S 7135 04:24:49,920 --> 04:24:50,480 GIGANTIC DEVIATION. 7136 04:24:50,480 --> 04:24:53,120 MY QUESTION IS HAVE YOU DONE 7137 04:24:53,120 --> 04:24:55,320 STUDIES IN TERMS OF TEST 7138 04:24:55,320 --> 04:24:56,600 REPRODUCIBILITY, PARTICULARLY 7139 04:24:56,600 --> 04:24:57,760 TAKING INTO ACCOUNT, FOR 7140 04:24:57,760 --> 04:24:59,600 EXAMPLE, POTENTIAL DIFFERENCES 7141 04:24:59,600 --> 04:25:00,240 IN CIRCADIAN VARIABILITY, IN 7142 04:25:00,240 --> 04:25:02,800 OTHER WORDS ARE WE LESS 7143 04:25:02,800 --> 04:25:04,240 SENSITIVE TO PAIN ACTUALLY IN 7144 04:25:04,240 --> 04:25:09,200 THE MORNING THAN IN THE EVENING, 7145 04:25:09,200 --> 04:25:11,000 AND NUMBER TWO, THE OBVIOUS ONE 7146 04:25:11,000 --> 04:25:12,800 WE HAVEN'T DISCUSSED FOR WHICH 7147 04:25:12,800 --> 04:25:15,840 THERE'S SIGNIFICANT EVIDENCE OF 7148 04:25:15,840 --> 04:25:17,880 DATA, THAT SLEEP ACTUALLY LACK 7149 04:25:17,880 --> 04:25:20,840 OF SLEEP IS ASSOCIATED WITH 7150 04:25:20,840 --> 04:25:21,640 INCREASED ENHANCED SENSITIVITY 7151 04:25:21,640 --> 04:25:22,400 TO PAIN. 7152 04:25:22,400 --> 04:25:25,120 PUT THOSE WHO AND TWO TOGETHER, 7153 04:25:25,120 --> 04:25:26,920 YOU KNOW ALCOHOL INTERFERES WITH 7154 04:25:26,920 --> 04:25:27,920 SLEEP PATTERNS, THIS COULD BE 7155 04:25:27,920 --> 04:25:30,920 ONE OF THE FACTORS THAT ACCOUNTS 7156 04:25:30,920 --> 04:25:32,840 FOR ACTUALLY EXACERBATION OF 7157 04:25:32,840 --> 04:25:34,160 PAIN SENSITIVITY WITH CHRONIC 7158 04:25:34,160 --> 04:25:36,440 ALCOHOL AMONG THE MANY OTHERS. 7159 04:25:36,440 --> 04:25:40,560 BUT ALSO IT COULD RELATE TO THE 7160 04:25:40,560 --> 04:25:41,480 HIGHER DIFFERENCES IN RESPONSE 7161 04:25:41,480 --> 04:25:45,160 TO PAIN AMONG THE RACES BECAUSE 7162 04:25:45,160 --> 04:25:49,720 IT IS -- AND ETHNICITIES, 7163 04:25:49,720 --> 04:25:52,360 BECAUSE IF YOU LOOK AT SLEEP 7164 04:25:52,360 --> 04:25:55,680 TIME ACROSS RACES IT'S SHORTER 7165 04:25:55,680 --> 04:25:57,920 FOR PEOPLE THAT ARE BLACK, AND 7166 04:25:57,920 --> 04:25:59,600 EVEN IN TEENAGERS AND CHILDREN, 7167 04:25:59,600 --> 04:26:02,200 THIS IS ONE OF THE CONSEQUENCES 7168 04:26:02,200 --> 04:26:03,920 OF LOW INCOME. 7169 04:26:03,920 --> 04:26:06,000 HAVE YOU ENTERED INTO ACCOUNT 7170 04:26:06,000 --> 04:26:08,440 THE ISSUES OF CIRCADIAN 7171 04:26:08,440 --> 04:26:10,560 VARIABILITY, ISSUE OF SLEEP, AND 7172 04:26:10,560 --> 04:26:15,480 HOW THIS MAY BE INTERFERING 7173 04:26:15,480 --> 04:26:16,480 ULTIMATELY OR AFFECTING 7174 04:26:16,480 --> 04:26:19,480 SENSITIVITY TO PAIN? 7175 04:26:19,480 --> 04:26:20,840 >>IN OUR EXPERIMENTAL STUDIES 7176 04:26:20,840 --> 04:26:24,480 WE HAVEN'T DIRECTLY -- HAVEN'T 7177 04:26:24,480 --> 04:26:25,640 MANIPULATED CIRCADIAN PERIOD, 7178 04:26:25,640 --> 04:26:27,080 ALMOST EVERYBODY IS GETTING 7179 04:26:27,080 --> 04:26:28,400 THEIR ALCOHOL DOSE RIGHT AROUND 7180 04:26:28,400 --> 04:26:31,120 12:00, 1:00 IN THE AFTERNOON FOR 7181 04:26:31,120 --> 04:26:32,960 FEASIBILITY REASONS SO WE'RE 7182 04:26:32,960 --> 04:26:34,680 TRYING TO KEEP PEOPLE, YOU KNOW, 7183 04:26:34,680 --> 04:26:35,840 WITHIN A TYPICAL RANGE WHERE 7184 04:26:35,840 --> 04:26:38,560 THEY MIGHT BE DRINKING BUT NOT 7185 04:26:38,560 --> 04:26:41,040 SO LATE THEY HAVE TO STAY IN THE 7186 04:26:41,040 --> 04:26:43,120 LAB UNTIL TEN OR ELEVEN AT 7187 04:26:43,120 --> 04:26:43,800 NIGHT. 7188 04:26:43,800 --> 04:26:45,560 WE HAVEN'T MANIPULATED THAT BUT 7189 04:26:45,560 --> 04:26:46,520 THEY SHOULD BE AT ROUGHLY THE 7190 04:26:46,520 --> 04:26:47,960 SAME STAGE JUST BECAUSE OF WHEN 7191 04:26:47,960 --> 04:26:48,800 THEY ARE COMING IN. 7192 04:26:48,800 --> 04:26:51,920 I WILL SAY IN TERMS OF SLEEP, WE 7193 04:26:51,920 --> 04:26:53,120 DON'T TYPICALLY ASSESS SLEEP 7194 04:26:53,120 --> 04:26:54,920 QUALITY THE NIGHT BEFORE IN 7195 04:26:54,920 --> 04:26:58,760 THOSE STUDIES ALTHOUGH WE DO GET 7196 04:26:58,760 --> 04:27:00,240 TYPICAL SLEEP QUALITY THROUGH 7197 04:27:00,240 --> 04:27:01,200 THE PITTSBURGH SLEEP SCREENER 7198 04:27:01,200 --> 04:27:03,520 AND FIND THAT IS RELATED TO PAIN 7199 04:27:03,520 --> 04:27:06,200 IN AT LEAST SOME CASES. 7200 04:27:06,200 --> 04:27:08,320 IN OUR TREATMENT -- STUDIES IN 7201 04:27:08,320 --> 04:27:11,600 TREATMENT SEEKERS, WE DO FIND 7202 04:27:11,600 --> 04:27:12,400 VERY STRONG RELATIONSHIPS 7203 04:27:12,400 --> 04:27:13,560 BETWEEN THEIR CLINICAL REPORTS 7204 04:27:13,560 --> 04:27:15,560 OF PAIN AND THEIR SLEEP QUALITY 7205 04:27:15,560 --> 04:27:16,120 FOR SURE. 7206 04:27:16,120 --> 04:27:19,600 AND OVER THE COURSE OF EARLY 7207 04:27:19,600 --> 04:27:20,760 ABSTINENCE SLEEP QUALITY IS 7208 04:27:20,760 --> 04:27:24,920 IMPROVING, PAIN IS GOING DOWN, 7209 04:27:24,920 --> 04:27:26,600 CHANGES ARE STRONGLY CONNECTED. 7210 04:27:26,600 --> 04:27:29,120 >>AND YOU SHOULD SEE CIRCADIAN 7211 04:27:29,120 --> 04:27:33,480 VARIABILITY BECAUSE I BET THERE 7212 04:27:33,480 --> 04:27:34,280 IS. 7213 04:27:34,280 --> 04:27:35,640 >>THAT WOULD BE INTERESTING. 7214 04:27:35,640 --> 04:27:38,520 >>WE'VE GIVEN JEFF ENOUGH TO 7215 04:27:38,520 --> 04:27:42,400 FIGHT GRANTS FOR THE REST OF HIS 7216 04:27:42,400 --> 04:27:45,240 CAREER AND SUSAN SOME POWERFUL 7217 04:27:45,240 --> 04:27:50,160 AREAS WHERE WE SEE DEFICITS IN 7218 04:27:50,160 --> 04:27:51,800 THE SUBSTANCE USE DOMAINS. 7219 04:27:51,800 --> 04:27:54,200 ANY OTHER QUESTIONS OR COMMENTS? 7220 04:27:54,200 --> 04:27:55,040 SOMETHING IN THE CHAT. 7221 04:27:55,040 --> 04:28:02,400 ALL RIGHT. 7222 04:28:02,400 --> 04:28:09,240 ONE MORE FOR YOU, SUSAN. 7223 04:28:09,240 --> 04:28:10,720 HOWARD, CAN YOU TURN ON YOUR 7224 04:28:10,720 --> 04:28:15,400 MICROPHONE AND ASK YOUR 7225 04:28:15,400 --> 04:28:17,840 QUESTION? 7226 04:28:17,840 --> 04:28:18,840 >>SURE. 7227 04:28:18,840 --> 04:28:20,800 SO YOU BROUGHT UP THE PROJECT 7228 04:28:20,800 --> 04:28:23,760 MANAGERS THAT COME IN WITH THEIR 7229 04:28:23,760 --> 04:28:30,440 PASSION AND EXPERIENCE FROM PAST 7230 04:28:30,440 --> 04:28:33,320 YEARS, BUT HOW DOES ARPA-H 7231 04:28:33,320 --> 04:28:34,080 PROGRAM CONSIDER THE MAJOR 7232 04:28:34,080 --> 04:28:37,240 CHANGES THAT ARE GOING ON IN THE 7233 04:28:37,240 --> 04:28:40,920 RECENT THREE YEARS, IN THE R&D 7234 04:28:40,920 --> 04:28:43,120 COMMUNITY, SO I'M THINKING OF 7235 04:28:43,120 --> 04:28:47,800 TWO MAJOR THINGS, ONE IS THE 7236 04:28:47,800 --> 04:28:52,360 ONGOING LIMITATIONS OF R&D STAFF 7237 04:28:52,360 --> 04:28:55,560 TO CONDUCT TRIALS THAT'S 7238 04:28:55,560 --> 04:28:57,960 LIMITING ENROLLMENT AND SUCCESS 7239 04:28:57,960 --> 04:28:58,920 OF OTHER PROGRAMS, WHICH 7240 04:28:58,920 --> 04:29:06,560 PROBABLY RAISES THE CHALLENGE AS 7241 04:29:06,560 --> 04:29:09,840 WELL FOR THESE PHASE 1/2s TO 7242 04:29:09,840 --> 04:29:13,080 SUCCEED IN PATENT LIFE AND GET 7243 04:29:13,080 --> 04:29:15,360 FURTHER, LET'S SAY, SUPPORT BY 7244 04:29:15,360 --> 04:29:16,760 LARGER COMPANIES, AND THEN THE 7245 04:29:16,760 --> 04:29:20,320 OTHER IS WHAT'S GOING 7246 04:29:20,320 --> 04:29:21,560 REGULATORY COMMUNITY WHERE THE 7247 04:29:21,560 --> 04:29:23,640 ACCELERATED PROGRAMS ARE NOW 7248 04:29:23,640 --> 04:29:25,640 UNDER CHALLENGE BECAUSE THEY 7249 04:29:25,640 --> 04:29:28,560 HAVE NOT REALLY -- MANY HAVE NOT 7250 04:29:28,560 --> 04:29:33,080 SUCCEEDED IN GOING ON TO HAVE 7251 04:29:33,080 --> 04:29:35,160 SUCCESSFUL PHASE 3 WITHIN THE 7252 04:29:35,160 --> 04:29:37,360 TIME RANGE, YOU KNOW, THE 7253 04:29:37,360 --> 04:29:39,280 CONFIRMATORY TRIALS HAVE NOT 7254 04:29:39,280 --> 04:29:41,640 BEEN DONE. 7255 04:29:41,640 --> 04:29:47,160 AND SO THE AGENCY HAS BEEN LET'S 7256 04:29:47,160 --> 04:29:48,600 SAY MORE CONSERVATIVE ABOUT, YOU 7257 04:29:48,600 --> 04:29:51,120 KNOW, LET'S SAY SUPPORTING THE 7258 04:29:51,120 --> 04:29:55,440 ACCELERATED PROGRAMS IF THEY 7259 04:29:55,440 --> 04:29:56,840 CAN'T ALSO COINCIDENTALLY ASSURE 7260 04:29:56,840 --> 04:29:57,560 THAT THE CONFIRMATORY TRIALS 7261 04:29:57,560 --> 04:30:02,880 WILL BE DONE IN TIME. 7262 04:30:02,880 --> 04:30:04,320 >>THOSE ARE BOTH HUGE ISSUES. 7263 04:30:04,320 --> 04:30:05,200 WE FULLY UNDERSTAND THAT. 7264 04:30:05,200 --> 04:30:07,600 ONE OF THE THINGS WE'RE TRYING 7265 04:30:07,600 --> 04:30:11,640 TO DO IS THINK ABOUT INNOVATIVE 7266 04:30:11,640 --> 04:30:12,920 APPROACHES TO CLINICAL TRIAL 7267 04:30:12,920 --> 04:30:13,480 NETWORKS. 7268 04:30:13,480 --> 04:30:18,280 I TALKED ABOUT THAT INVESTOR HUB 7269 04:30:18,280 --> 04:30:19,520 AND SPOKE MODEL, CUSTOMER 7270 04:30:19,520 --> 04:30:20,400 EXPERIENCE HUB AND SPOKE MODEL 7271 04:30:20,400 --> 04:30:23,640 THAT WE'RE GOING TO EXECUTE WITH 7272 04:30:23,640 --> 04:30:25,360 THE OTHER HUB WE'RE CREATING. 7273 04:30:25,360 --> 04:30:29,480 ONE OF OUR GOALS FOR THAT IS TO 7274 04:30:29,480 --> 04:30:30,360 THINK ABOUT CREATING OR 7275 04:30:30,360 --> 04:30:33,680 REQUIRING THAT HUB AND SPOKE TO 7276 04:30:33,680 --> 04:30:35,560 HELP YOU WILLS DEVELOP THESE 7277 04:30:35,560 --> 04:30:37,760 CLINICAL TRIAL NETWORKS AND 7278 04:30:37,760 --> 04:30:40,040 ENSURE THAT THEY HAVE 7279 04:30:40,040 --> 04:30:41,600 APPROPRIATE EQUITY AND DIVERSITY 7280 04:30:41,600 --> 04:30:41,840 INCLUDED. 7281 04:30:41,840 --> 04:30:44,440 WE KNOW IT'S A HIGH BAR BUT 7282 04:30:44,440 --> 04:30:45,200 CERTAINLY THAT'S SOMETHING THAT 7283 04:30:45,200 --> 04:30:48,520 IS ON OUR MIND AND WE'RE 7284 04:30:48,520 --> 04:30:50,040 THINKING ABOUT. 7285 04:30:50,040 --> 04:30:51,600 IN TERMS OF REGULATORY PROCESS, 7286 04:30:51,600 --> 04:30:54,080 ALSO YES, BUT IT'S A CHALLENGE. 7287 04:30:54,080 --> 04:30:55,760 WE FULLY UNDERSTAND THAT. 7288 04:30:55,760 --> 04:30:58,520 ONE OF THE THINGS THAT WE'RE 7289 04:30:58,520 --> 04:31:00,720 HAPPY ABOUT IS WHEN CONGRESS, 7290 04:31:00,720 --> 04:31:02,560 YOU KNOW, CREATED ARPA-H, IT 7291 04:31:02,560 --> 04:31:05,480 ALSO GAVE US THE PERMISSION, 7292 04:31:05,480 --> 04:31:08,360 GAVE US AUTHORITY TO WORK 7293 04:31:08,360 --> 04:31:11,440 DIRECTLY WITH FDA TO ESTABLISH 7294 04:31:11,440 --> 04:31:12,120 CERTAIN PARTNERSHIP COOPERATION 7295 04:31:12,120 --> 04:31:14,720 WITH THEM, TO UNDERSTAND HOW DO 7296 04:31:14,720 --> 04:31:17,280 WE STRENGTHEN THAT REGULATORY 7297 04:31:17,280 --> 04:31:18,840 PROCESS FOR ARPA-H-LED PROGRAMS 7298 04:31:18,840 --> 04:31:20,160 AND ACTIVITIES. 7299 04:31:20,160 --> 04:31:23,240 AND WE HAVE AN RFI CURRENTLY OUT 7300 04:31:23,240 --> 04:31:25,160 ON THE STREETS THAT EVERYONE 7301 04:31:25,160 --> 04:31:28,120 HERE CAN ACCESS TO HELP US THINK 7302 04:31:28,120 --> 04:31:30,880 THROUGH INNOVATIVE APPROACH TO 7303 04:31:30,880 --> 04:31:34,120 OUR RELATIONSHIP WITH FDA AND 7304 04:31:34,120 --> 04:31:35,720 THE ACTIVITIES THAT WILL 7305 04:31:35,720 --> 04:31:41,120 INTEGRATE WITHIN ARPA-H PROGRAM 7306 04:31:41,120 --> 04:31:41,760 DEVELOPMENT AND 7307 04:31:41,760 --> 04:31:42,160 COMMERCIALIZATION. 7308 04:31:42,160 --> 04:31:45,200 SO THOSE ARE HARD PROBLEMS THAT 7309 04:31:45,200 --> 04:31:47,360 WE FULLY UNDERSTAND ARE IN THE 7310 04:31:47,360 --> 04:31:47,680 R&D. 7311 04:31:47,680 --> 04:31:48,600 WE'VE THINKING ABOUT APPROACHES 7312 04:31:48,600 --> 04:31:50,560 TO TRY TO ADDRESS THEM AND 7313 04:31:50,560 --> 04:31:53,200 MITIGATE THAT PART OF THE RISK 7314 04:31:53,200 --> 04:31:57,640 OF OUR PORTFOLIO. 7315 04:31:57,640 --> 04:32:00,560 IF ANYONE'S INTERESTED IN 7316 04:32:00,560 --> 04:32:03,120 CONTRIBUTING TO THAT RFI, YOU 7317 04:32:03,120 --> 04:32:05,600 CAN GET ACCESS ON OUR WEBSITE. 7318 04:32:05,600 --> 04:32:07,240 IT CLOSES ON MAY 30 SO YOU HAVE 7319 04:32:07,240 --> 04:32:09,680 A LITTLE BIT OF TIME TO 7320 04:32:09,680 --> 04:32:13,960 CONTRIBUTE IF YOU HAVE ANY 7321 04:32:13,960 --> 04:32:16,000 OPPORTUNITIES OR INSIGHT FOR 7322 04:32:16,000 --> 04:32:16,880 INNOVATION THAT WE SHOULD 7323 04:32:16,880 --> 04:32:18,080 CONSIDER AS WE GO ABOUT OUR 7324 04:32:18,080 --> 04:32:23,680 RELATIONSHIP WITH FDA. 7325 04:32:23,680 --> 04:32:26,760 >>IT HAS BEEN -- I'M NOT A POET 7326 04:32:26,760 --> 04:32:27,400 LIKE SHELLY IS. 7327 04:32:27,400 --> 04:32:29,640 IT'S BEEN A LONG DAY. 7328 04:32:29,640 --> 04:32:30,640 WONDERFUL DAY. 7329 04:32:30,640 --> 04:32:32,080 I SEE THAT ABOUT 60 PEOPLE HAVE 7330 04:32:32,080 --> 04:32:34,360 STUCK WITH US THROUGHOUT THE 7331 04:32:34,360 --> 04:32:35,640 WHOLE DAY TODAY ON ZOOM. 7332 04:32:35,640 --> 04:32:41,200 I WANT TO THANK OUR SPEAKERS, 7333 04:32:41,200 --> 04:32:43,120 JEFF BOISSONEAULT AND SUSAN 7334 04:32:43,120 --> 04:32:44,320 MINAREZ, FOR OUTSTANDING TALKS 7335 04:32:44,320 --> 04:32:49,640 AND WILLINGNESS TO STICK IT OUT 7336 04:32:49,640 --> 04:32:50,120 WITH OUR QUESTIONS. 7337 04:32:50,120 --> 04:32:52,000 AND SO WE'LL CALL -- NO, I DON'T 7338 04:32:52,000 --> 04:32:53,600 DO IT. 7339 04:32:53,600 --> 04:32:56,520 NORA CALLS OUT THE ADJOURNMENT. 7340 04:32:56,520 --> 04:32:59,440 I'LL STOP TALKING. 7341 04:32:59,440 --> 04:33:01,640 >>WE'VE BEEN GIVEN THIS SHEET 7342 04:33:01,640 --> 04:33:02,720 THAT TELLS WHICH PERFORMS WHAT 7343 04:33:02,720 --> 04:33:03,600 AT WHAT TIME. 7344 04:33:03,600 --> 04:33:05,480 THAT'S THE ISSUE. 7345 04:33:05,480 --> 04:33:12,480 GEORGE TENDS TO FORGET. 7346 04:33:12,480 --> 04:33:13,920 HEY, GEORGE! 7347 04:33:13,920 --> 04:33:15,120 >>STARTS RATTLING THE PAPERS. 7348 04:33:15,120 --> 04:33:15,720 >>I DON'T. 7349 04:33:15,720 --> 04:33:20,040 I JUST SAY LOOK AT THE REPORT. 7350 04:33:20,040 --> 04:33:21,600 IT'S A PLEASURE TO DOCUMENT THE 7351 04:33:21,600 --> 04:33:22,960 INTEREST AND HOW WE BOTH 7352 04:33:22,960 --> 04:33:24,880 RESONATE ON THE SAME ISSUES 7353 04:33:24,880 --> 04:33:26,520 WHICH HAPPENS ALL THE TIME. 7354 04:33:26,520 --> 04:33:28,280 I PARTICULARLY DO WANT TO THANK 7355 04:33:28,280 --> 04:33:31,400 YOU ALL THAT HAVE BEEN 7356 04:33:31,400 --> 04:33:33,440 PARTICIPATING, EITHER AS MEMBERS 7357 04:33:33,440 --> 04:33:36,560 OF COUNCILS OR AS PRESENTERS OR 7358 04:33:36,560 --> 04:33:38,240 PEOPLE THAT ARE NOT EVEN PART OF 7359 04:33:38,240 --> 04:33:40,720 COUNCIL THAT ARE IN OUR STAFF 7360 04:33:40,720 --> 04:33:42,280 AND SINCE THIS IS OPEN FOR 7361 04:33:42,280 --> 04:33:45,120 PEOPLE THAT MAY NOT BE PART OF 7362 04:33:45,120 --> 04:33:46,840 THE GOVERNMENT, BECAUSE WE 7363 04:33:46,840 --> 04:33:50,040 ACKNOWLEDGE THAT WE DO HAVE A 7364 04:33:50,040 --> 04:33:52,200 RESPONSIBILITY TO TRY TO ADDRESS 7365 04:33:52,200 --> 04:33:54,520 A VERY CHALLENGING PROBLEM THAT 7366 04:33:54,520 --> 04:33:56,960 ACTUALLY IS FACING US IN MANY 7367 04:33:56,960 --> 04:33:57,160 WAYS. 7368 04:33:57,160 --> 04:33:59,000 IN ORDER FOR US TO BE CREATIVE 7369 04:33:59,000 --> 04:34:01,760 WE NEED HAVE THE VARIOUS 7370 04:34:01,760 --> 04:34:02,080 PERSPECTIVES. 7371 04:34:02,080 --> 04:34:03,800 I VERY MUCH THANK YOU FOR THAT. 7372 04:34:03,800 --> 04:34:06,880 BUT I ALSO VERY MUCH WANT TO 7373 04:34:06,880 --> 04:34:08,760 ACKNOWLEDGE EFFORTS THAT MADE 7374 04:34:08,760 --> 04:34:14,000 THIS POSSIBLE AND IN PARTICULAR 7375 04:34:14,000 --> 04:34:15,800 DR. PAULETTE GRAY 7376 04:34:15,800 --> 04:34:21,760 EXECUTIVE SECRETARY FOR NATIONAL 7377 04:34:21,760 --> 04:34:24,240 CANCER ADVISORY BOARD, THE NCI 7378 04:34:24,240 --> 04:34:26,160 COMMITTEE OFFICE AND NATIONAL 7379 04:34:26,160 --> 04:34:30,000 INSTITUTES OF ALCOHOL ABUSE AND 7380 04:34:30,000 --> 04:34:32,000 NIDA COUNCIL MEMBERS. 7381 04:34:32,000 --> 04:34:33,600 AND EVERYBODY THAT HELPED MAKE 7382 04:34:33,600 --> 04:34:34,400 THIS POSSIBLE. 7383 04:34:34,400 --> 04:34:35,720 SO THANKS VERY MUCH. 7384 04:34:35,720 --> 04:34:39,640 AND EVEN THOUGH WE'RE GOING TO 7385 04:34:39,640 --> 04:34:44,000 BE ADJOURNING, WE ARE OPEN 7386 04:34:44,000 --> 04:34:45,080 INSTITUTES, SEND YOUR COMMENTS 7387 04:34:45,080 --> 04:34:46,600 OR SUGGESTIONS AND WE'LL ADDRESS 7388 04:34:46,600 --> 04:34:46,800 THEM. 7389 04:34:46,800 --> 04:34:47,000 THANKS VERY MUCH. 7390 04:34:47,000 --> 00:00:00,000 WE ARE ADJOURNED.