I WOULD LIKE TO
CALL TO ORDER THE OPEN SESSION
OF THE 88TH MEETING OF THE
NATIONAL ADVISORY COUNCIL FOR
COMPLEMENTARY AND INTEGRATIVE
HEALTH.
I AM DR. MARTINA SCHMIDT, AND I
SERVE AS THE EXECUTIVE SECRETARY
FOR THE NCCIH NATIONAL ADVISORY
COUNCIL.
I NOTE FOR THE RECORD THAT THIS
MEETING IS BEING HELD IN PERSON
AND IT'S BEING RECORDED AND
BROADCAST LIVE TO THE PUBLIC VIA
THE NIH VIDEOCAST.
THE COUNCIL MEETING IS CONVENED
AS IS REQUIRED BY TITLE 42 OF
THE U.S. CODE OF LAWS THAT
GOVERN THE NIH IN GENERAL AND
NCCIH SPECIFICALLY IN SECTION
287C-21.
AND IN ACCORDANCE WITH THE
FEDERAL ADVISORY COMMITTEE ACT.
I NOTE THAT THE CLOSED SESSION
TO THIS COUNCIL WAS HELD EARLIER
THIS MORNING AND WAS CLOSED TO
THE PUBLIC.
IN ACCORDANCE WITH THE
GOVERNMENT OF THE SUNSHINE ACT.
THOSE BUSINESS ITEMS COVERED,
I'M NOW GOING OVER TO ASK
DR. HELENE LANGEVIN TO GO OVER A
FEW OPENING REMARKS.
>> THANK YOU SO MUCH,
DR. SCHMIDT.
I REALLY WANT TO WELCOME ALL OF
YOU TO THIS MEETING OF THE NCCIH
ADVISORY COUNCIL.
THANK YOU ALL OF YOU WHO ARE
HERE IN PERSON AS WELL AS THOSE
THAT ARE ON VIDEOCAST.
I KNOW THAT WE'RE GOING TO FIRST
START WITH A FEW ITEMS OF
BUSINESS TO COMPLETE BEFORE I
DELIVER MY DIRECTOR'S REPORT.
>> OKAY, THANK YOU, HELENE.
SO FIRST A BRIEF OVERVIEW OF THE
MEETINGED TO.
THE OPEN SESSION WILL BEGIN AS
DR. LANGEVIN POINTED OUT WITH
HER NCCIH DIRECTOR'S REPORT TO
COUNCIL, FOLLOWED BY OUR ANNUAL
INTRAMURAL REPORT, WHICH WILL BE
GIVEN BY DR. SHURTLEFF.
WE WILL THEN BREAK FOR LUN OF LH
AROUND 1220, APPROXIMATELY, AND
RECONVENE AT 1:20.
FOLLOWING LUNCH, WE WILL MOVE TO
A SYMPOSIUM ON THE CONCEPT OF
THE NUTRITION CONTINUUM.
AFTER THE SYMPOSIUM, WE WILL
HAVE A PRESENTATION ON THE NEW
NIH INITIATIVE WHICH IS FOR
COMMUNITIES ADVANCING RESEARCH
EQUITY FOR HEALTH, THE CARE
PROGRAM.
AND THEN FINALLY, WE WILL MOVE
TO CONCEPT CLEARANCE WITH TWO
CONCEPTS BEING PRESENTED FOR
COUNCIL CONSIDERATION TODAY.
SO OUR FIRST ORDER OF BUSINESS
IS TO APPROVE THE MAY 2024
COUNCIL MEETING MINUTES WHICH
WERE PROVIDED TO ALL
COUNCILMEMBERS VIA THE
ELECTRONIC COUNCIL BOOK, AND A
COPY IS CURRENTLY DISPLAYED ON
THE SCREEN.
SO ARE THERE ANY CORRECTIONS TO
THE MAY COUNCIL MEETING MINUTES?
IF QUESTION YES, PLEASE RAISE D
VIRTUALLY OR HERE IN THE ROOM.
NO?
IF NOT, THEN MAY I HAVE A MOTION
TO APPROVE THE MINUTES FOR THE
MAY 2024 COUNCIL MEETING?
OKAY.
SO WITH THAT, ANY DISCUSSION?
OKAY, SO ALL IN FAVOR OF THE
ROOM PLEASE RAISE YOUR HANDS AND
THOSE ON ZOOM PLEASE RAISE YOUR
DIGITAL HAND SO WE CAN APPROVE
THE MINUTES.
I THINK WE HAVE EVERYBODY.
OKAY, GOOD.
PERFECT.
WITH THIS, WE CAN CONFIRM THAT
THE MOTION HAS BEEN APPROVED.
ARE THERE ANY QUESTIONS BEFORE
WE MOVE ON?
NO?
EVERYBODY IS GOOD?
PERFECT.
SO WITH THIS, I'M HANDING THE
MEETING BACK OVER TO
DR. LANGEVIN FOR HER DIRECTOR'S
REPORT.
>> GOOD MORNING.
SO IT'S MY GREAT PLEASURE TO
PRESENT TO YOU MY DIRECTOR'S
REPORT.
FOR THIS COUNCIL.
AS ALWAYS, I START WITH A FEW
ITEMS OF NEWS THAT ARE RELEVANT
EITHER AT NIH-WIDE LEVEL OR FOR
US AT NCCIH.
THE FIRST IS OUR ANNOUNCEMENT OF
A NEW DIRECTOR OF THE NIH OFFICE
OF STRATEGIC COORDINATION OR
OSC.
DR. CAROLYN HUTTER.
THE OSC OVERSEES THE NIH COMMON
FUND PROGRAM, WHICH IS QUITE
SUBSTANTIAL, HAS A $700 MILLION
BUDGET, AND WE ARE REALLY -- WE
COLLABORATE QUITE A BIT WITH THE
COMMON FUND, INCLUDING ONE OF
THE PROGRAMS THAT IS CURRENTLY
FUNDED, THE BRIDGE2AI PROGRAM
WHICH WE PARTICIPATE IN.
SO THIS IS A VERY -- SO WE
REALLY LOOK FORWARD TO WORKING
WITH DR. HUTTER ON THIS.
FOR THOSE OF YOU THAT ARE NOT
FAMILIAR, THE COMMON FUND IS A
PROGRAM WITHIN THE OFFICE OF THE
NIH DIRECTOR THAT ADDRESSES
PROGRAMS THAT ARE IMPORTANTLY
INVOLVE COLLABORATION ACROSS THE
NIH INSTITUTES.
AND ADDRESSES HIGH PRIORITY
CHALLENGES THAT WE ALL NEED TO
WORK ON TOGETHER.
ANOTHER BIG NEWS FOR US IS THIS
YEAR IT IS OUR -- IS GOING TO BE
OUR 25TH YEAR THAT NCCIH HAS
EXISTED SO WE ARE GOING TO BE
CELEBRATING THIS, THE KICKING
OFF OF OUR ANNIVERSARY YEAR IS
GOING TO BE A PRESENTATION AS
PART OF OUR STRAUSS LECTURE
SERIES ON DECEMBER 2ND.
THIS IS GOING TO BE AT THE
LIPSETT AMPHITHEATER AT THE NIH
CLINICAL CENTER AND WE'RE GOING
TO START THIS, THIS GG TO BE A
PRETTY EXTENSIVE PROGRAM WHICH
I'VE NOT YET ANNOUNCED BUT THE
KEYNOTE LECTURE IS GOING TO BE
BY DR. PATRICIA HERMAN AND SHE'S
GOING TO BE TALKING ABOUT
EXPLORE THE IMPACT OF WHOLE
PERSON HEALTH, THE ECONOMIC
IMPACT OF WHOLE PERSON HEALTH.
SO I REALLY -- WE'RE REALLY
LOOKING FORWARD TO THAT.
THERE'S GOING TO BE MORE DETAILS
SOON ABOUT THE REST OF THE
PROGRAM.
OUR OTHER BIG EVENT GOING ON IN
THE FALL, NOVEMBER 1ST, IS THE
FIRST INAUGURAL MEETING OF THE
NCCIH COALITION FOR WHOLE PERSON
HEALTH.
THIS IS A REALLY VERY IMPORTANT
LANDMARK EVENT FOR US, AS WE
HAVE BEEN TALKING ABOUT AT
SEVERAL PRECEDING COUNCIL
MEETINGS.
WE HAVE FORMED A COALITION, THIS
IS A GROUP OF EXTERNAL
ORGANIZATIONS THAT ARE GETTING
TOGETHER TO REALLY GET TOGETHER
AND HELP US TO REALLY BRING THE
FIELD OF WHOLE PERSON HEALTH
TOGETHER, AND KIND OF HELP
ADVANCE THE SCIENCE IN THIS
AREA, AND MARY BETH KESTER IS
GOING TO BE -- IS ORGANIZING
THIS MEETING.
SHE'S THE CONTACT PERSON.
AND YOU CAN SEE ON THE RIGHT THE
STEERING COMMITTEE MEETING WHICH
IS ORGANIZING THIS COLITION AS
WELL AS THE EVENT, SO YOU CAN
SEE HERE DR. AMY MACK AND
SAMANTHA SIMMONS FROM THE
INSTITUTE OF FUNCTIONAL MEDICINE
IN THE ACADEMIC CONSORTIUM FOR
INTEGRATIVE MEDICINE AND HEALTH
ARE CO-CHAIRING THE STEERING
COMMITTEE.
WE ALSO HAVE REPRESENTATIVES
FROM THE AMERICAN COLLEGE OF
LIFESTYLE MEDICINE, HOLISTIC
NURSES ASSOCIATION, ACADEMY OF
INTEGRATIVE MEDICINE & HEALTH,
CORNERSTONE COLLABORATION,
INTEGRATIVE HEALTH POLICY
CONSORTIUM, TEACHING KITCHENS
AND WHOLE HELD EDUCATION.
SO THESE ARE PEOPLE ON THE
STEERING COMMITTEE, BUT WE ARE
EXPECTING A LARGE NUMBER OF --
RIGHT NOW WE HAVE ALMOST -- OVER
45 ORGANIZATIONS THAT ARE
ALREADY SIGNED UP AND WE REALLY
HAVE -- AND WE'RE STILL OPEN FOR
REGISTRATION IN ORDER TO ATTEND
THIS MEETING, THE ORGANIZATIONS
NEED TO BE REGISTERED AND VERY
IMPORTANTLY, SO PLEASE CONTACT
MARY BETH IF YOU ARE AWARE OF AN
ORGANIZATION THAT WOULD BE
RELEVANT TO THIS, AND WE NEED
ONE REPRESENTATIVE PER
ORGANIZATION.
NEXT IS AN IMPORTANT INITIATIVE,
THE CARE FOR HEALTH PROGRAM HERE
AT NIH.
WE'RE GOING TO BE HEARING MORE
ABOUT THIS THIS AFTERNOON,
DR. AMY PATTERSON IS GOING TO BE
GIVING A PRESENTATION ON THIS.
THIS IS A REALLY INTERESTING AND
VERY, VERY IMPORTANT PROGRAM
THAT IS BEING LAUNCHED AND
SPEARHEADED BY THE NIH DIRECTOR,
DR. MONICA BERTAGNOLLI.
AND THIS IS REALLY ABOUT
EXTENDING OUR CAPACITY TO DO
RESEARCH IN PRIMARY CARE
SETTINGS.
ESPECIALLY IN UNDERSERVED AREAS.
WE'RE FOCUSING ACTUALLY FIRST ON
RURAL AREAS WHERE A LOT OF THE
HEALTHCARE IS BEING DELIVERED
IN PRIMARY CARE SETTINGS.
INCLUDING FEDERALLY QUALIFIED
HEALTHCARE SYSTEMS.
AND WHAT DR. BERTAGNOLLI IS
REALLY KIND OF ADVOCATING VERY,
VERY STRONGLY IS THAT WE NEED TO
MAKE SURE THAT OUR RESEARCH
OCCURS IN THE SETTING WHERE THE
HEALTHCARE IS DELIVERED,
ESPECIALLY IN PLACES WHERE IT IS
ACTUALLY CHALLENGING TO DO
RESEARCH.
WE SHOULDN'T -- NOT ONLY
SHOULDN'T WE SHY AWAY FROM DOING
RESEARCH IN THESE SETTINGS, WE
SHOULD PROMOTE RESEARCH IN THOSE
SETTINGS AND THAT'S WHAT THIS
CARE NETWORK IS ALL ABOUT.
YOU CAN SEE HOW THIS -- BECAUSE
THIS IS ABOUT CONDUCTING
RESEARCH IN THE REAL WORLD, THIS
HAS A LOT OF RELEVANCE TO OUR
PRAGMATIC TRIALS COLLABORATORY,
BECAUSE WE HAVE BEEN DOING
RESEARCH, WE HAVE BEEN PROMOTING
THIS KIND OF RESEARCH NOW FOR
THE LAST 10 YEARS WITH OUR
PRAGMATIC TRIALS COLLABORATORY,
SO THIS IS ONE OF THE REASONS
WHY WE ARE EXTENSIVELY INVOLVED
IN THE PLANNING OF THIS CARE FOR
HEALTH NETWORK.
I AM ONE OF THE CO-CHAIRS OF THE
OVERSIGHT COMMITTEE, ALONG WITH
DR. JOANIE RUDDER OF NCATS AND
DR. DEB TUCCI OF NIDCD AND
DR. WENDY WEBER, WHO IS OUR
DIRECTOR OF THE DIVISION OF
CLINICAL RESEARCH AT NCCIH IS ON
THE STEERING COMMITTEE FOR CARE.
SO -- EXCUSE ME, NOT STEERING
COMMITTEE, SCIENTIFIC COMMITTEE.
SO IT'S AN INITIATIVE THAT'S
VERY IMPORTANT TO US.
SO YOU'LL BE HEARING MORE ABOUT
THAT.
A QUICK REMINDER ABOUT THE
CHANGE TO GRANT APPLICATION AND
REVIEW CRITERIA AND PROCEDURES
THAT IS GOING TO BE ENACTED
STARTING JANUARY 25TH.
WE'VE BEEN TALKING A LOT ABOUT
THIS, THIS IS A SIMPLIFIED
REVIEW FRAMEWORK FOR MOST
RESEARCH PROJECT GRANTS AND SO
WE ARE BASICALLY NOW ROLLING
THIS OUT.
THIS IS THE USUAL BUDGET TABLE
THAT I SHOW YOU EVERY TIME.
BASICALLY IT'S JUST A LOT OF
NUMBERS BUT THE BOTTOM LINE IS
THAT OUR BUDGET HAS BEEN FLAT
THIS YEAR.
AS YOU ALL KNOW, THIS IS
CHALLENGING BECAUSE THE COST OF
LIVING GOES UP, SALARIES GOES
UP, EVERYTHING GOES UP BUT THE
BUDGET STAYS FLAT SO FAR THIS
YEAR.
WE DON'T KNOW WHAT THE NEXT
FISCAL YEAR WILL COME BUT THE
IMPORTANT THING TO REALIZE IS
THAT EVEN WITH A FLAT BUDGET, WE
MAKE REALLY AS GOOD OF USE OF
OUR RESOURCES AS WE CAN, AND
EVEN THOUGH NCCIH HAS A SMALL
BUDGET, WE GREATLY EXPAND OUR
REACH THROUGH MANY, MANY OF THE
PROGRAMS THAT ARE AVAILABLE THAT
ARE TRANS-NIH PROGRAMS THROUGH
COLLABORATIONS WITH OTHER
INSTITUTES SUCH AS CO-FUNDING OF
PROGRAMS AND APPLICATIONS, AS
WELL AS WE PARTICIPATE IN SO
MANY OF THESE COMMON FUND NIH
HEAL INITIATIVE, THE BRAIN
INITIATIVE, THE NEUROSCIENCE
BLUEPRINT, AND YOU KNOW, MANY
PROGRAMS WHERE WE REALLY TAKE
ADVANTAGE OF THE RESOURCES THAT
NIH AS A WHOLE HAS TO OFFER.
SO -- AND WE'RE VERY FORTUNATE
TO HAVE THE BUDGET THAT WE HAVE
SO WE MAKE THE BEST USE OF IT WE
CAN.
STAFF UPDATES.
JUST SOME -- BITTERSWEET
RETIREMENT OF DR. ROBIN BOINEAU
LEADING OUR OFFICE OF CLINICAL
AND REGULATORY AFFAIRS, WE
REALLY WISH HER WELL.
DR. BOINEAU HAS BEEN PROVIDING
GUIDANCE ON CLINICAL STUDY
DESIGN AT NIB NCCIH NOW FOR MANY
YEARS.
SHE PLAYED A VERY IMPORTANT ROLE
IN A LANDMARK STUDY, THE TACT
2 STUDY, AND I'LL SHOW THE --
THAT LOOKED AT THE EFFECT OF
CHELATION THERAPY THAT HAS
RECENTLY BEEN -- RESULTS HAVE
RECENTLY BEEN PUBLISHED, AND
ALSO SHE PLAYED A VERY IMPORTANT
ROLE IN THE PRAGMATIC TRIALS
COLLABORATORY LAUNCH INITIALLY,
10 YEARS AGO.
AND SHE REALLY HAS BEEN SUCH A
TREASURE AND WE'RE GOING TO MISS
HER GREATLY.
ALSO WE WANT TO CONGRATULATE DR.
DR. NAHIN, I HAVE TO SAY THIS,
HE IS ONE OF I THINK MAYBE
NUMBER ONE OR NUMBER TWO
EMPLOYEE AT NCCIH WAY BACK WHEN
IT USED TO BE THE OFFICE OF
ALTERNATIVE MEDICINE, BEFORE IT
WAS EVEN NCAM, DR. NAHIN WAS MY
VERY FIRST PROGRAM OFFICER BACK
IN 1997.
AND DR. NAHIN HAS BEEN THE CHIEF
EPIDEMIOLOGIST NOW, HE USED TO
BE WITHIN THE EXTRAMURAL
DIVISION BUT NOW HAS RECENTLY
MOVED TO OUR INTRAMURAL PROGRAM,
AND WE'RE VERY EXCITED ABOUT
THAT, BECAUSE IT'S GOING TO
REALLY ALLOW AN EXTENSION OF OUR
INTRAMURAL PROGRAM WHICH YOU'LL
BE HEARING MORE FROM
DR. SHURTLEFF IN A MINUTE, BUT
THAT REALLY, BECAUSE OUR
INTRAMURAL PROGRAM IS ENTIRELY
FOCUSED ON PAIN, AND DR. NAHIN
HAS BEEN REALLY AT THE FOREFRONT
OF REALLY LOOKING AT POPULATION
STUDIES TO LOOK AT THE IMPACT OF
COMPLEMENTARY INTERVENTIONS ON
PAIN, BUT ALSO INCREASINGLY
LOOKING AT THE PAIN IN THE
CONTEXT OF THE WHOLE PERSON
HEALTH.
SO WE'RE VERY EXCITED TO HAVE
DR. NAHIN IN THIS NEW ROLE.
WANT TO WELCOME ALSO -- WE HAD
REIHANEH BAHRAMALI IN THE
DIVISION OF EXTRAMURAL
ACTIVITIES.
SHE BRINGS OVER FIVE YEARS OF
EXPERIENCE INCLUDING THREE YEARS
AT THE NIH, MOST RECENTLY IN THE
OFFICE OF WOMEN'S HEALTH.
SHE HAS A MASTER'S DEGREE IN
HEALTH INFORMATICS AND
ADMINISTRATION AND A BACHELOR'S
IN COMPUTER SOFTWARE TECHNOLOGY
AND ENGINEERING.
SO SHE'S GOING TO BE INVOLVED IN
SOME REVIEW GROUPS.
NOW FOR JURIES A CO JUST A COUPF
RESEARCH SPOTLIGHT, I WANTED TO
HIGHLIGHT A COUPLE OF
INTERESTING PAPERS THAT WERE
PUBLISHED RECENTLY WITH NCCIH
FUNDING.
SO THIS FIRST PAPER WAS QUITE --
CREATED -- GENERATED A LOT OF
INTEREST RECENTLY.
THIS IS THE LAMP RANDOMIZED
CLINICAL TRIAL STUDY RESULTS ON
TELEHEALTH MINDFULNESS-BASED
INTERVENTIONS FOR CHRONIC PAIN.
BY DIANA BURGESS AND COLLEAGUES.
I WANT TO POINT OUT SOMETHING
THAT'S VERY INTERESTING GOING ON
HERE WITH THIS PAPER.
SO AS YOU CAN SEE, SO THIS IS
FIRST OF ALL A VIRTUALLY
DELIVERED INTERVENTION, AND YOU
CAN SEE FROM THE LITTLE TABLE
HERE THAT THEY LOOKED AT A LOT
OF DIFFERENT MEASURES.
THEY LOOKED AT PAIN INTENSITY
RELATED TO PAIN, PAIN RELATED
FUNCTION, BUT ALSO OTHER THINGS
LIKE PHYSICAL FUNCTION, FATIGUE,
SLEEP, SOCIAL ROLES, DEPRESSION
AND ANXIETY.
SO THEY HAD A LOT OF MEASURES.
AND SO MANY DIFFERENT -- OF
THESE DIFFERENT MEASURES WERE
IMPROVED, BUT WHEN YOU LOOK AT
THE PAPER CAREFULLY, YOU CAN SEE
THAT THE MAGNITUDE OF THE
IMPROVEMENTS WAS VERY SMALL IN
EVERY SINGLE ONE OF THESE CASES.
HOWEVER, WHAT WE'RE REALLY
STARTING TO THINK ABOUT IS, IF
YOU HAVE SMALL IMPROVEMENTS IN
10 OR 15 DIFFERENT MEASURES, DO
THESE IMPROVEMENTS ADD UP TO A
MORE INTEGRATED ASSESSMENT OF
WHAT WAS THE IMPROVEMENT OF THE
WHOLE -- OF THE EVENT EFFECT OFT
ON THE WHOLE PERSON.
SO WE'RE REALLY INTERESTED IN
DEVELOPING INSTRUMENTS THAT
WOULD ALLOW TO REALLY GET AT
THAT QUESTION.
WE THINK THAT THIS IS A VERY
IMPORTANT ASPECT OF WHOLE PERSON
RESEARCH THAT WE NEED TO REALLY
GET A GRIP ON.
SO WE REALLY LOOK FORWARD TO
FOLLOWING FURTHER THE WORK OF
THIS GROUP.
THIS IS A DIFFERENT KIND OF
APPLICATION.
IT'S A BASIC STUDY IN ANIMALS BY
DR. DU AND COLLEAGUES LOOKING AT
THE VERY IMPORTANT CONNECTION
BETWEEN WHAT'S GOING ON IN THE
NECK AND WHAT'S GOING ON IN THE
BRAIN.
AND FOR THE LONGEST TIME, YOU
KNOW, EVER SINCE THIS REALLY
GROUNDBREAKING DISCOVERY OF
CEREBROSPINAL FLUID DRAINAGE,
YOU KNOW, FROM THE BRAIN TO THE
LYMPHATIC SYSTEM, THERE WAS
ALWAYS THE THOUGHT, WELL, YOU
KNOW, IF THIS INDEED IS ALL
HAPPENING THROUGH THE LYMPHATIC
VESSELS IN THE BRAIN, CAN YOU
INFLUENCE -- WH WHAT GOES ON INE
BRAIN BY DOING AN INTERVENTION
IN THE NECK?
GOOD QUESTION, RIGHT?
AND THIS IS WHAT THESE
INVESTIGATORS DID.
THEY LOOK AT LYMPHATIC FLOW IN
THE NECK AND THEN MEASURE
CLEARANCE IN THE BRAIN AND THEN
MANIPULATED THE FLOW OF THE
LYMPHATIC VESSELS USING
PROSTAGLANDINS AND THEY FOUND
THAT, INDEED, THERE WAS A
CONNECTION THERE.
SO THIS IS I THINK VERY
IMPORTANT BECAUSE OBVIOUSLY
THERE'S WAYS IN WHICH WE
COULD -- IT'S HARD TO HAVE
ACCESS TO THE BRAIN DIRECTLY
VERY EASILY USING MANUAL
THERAPIES, FOR EXAMPLE, BUT YOU
COULD WITH THE NECK.
SO VERY INTERESTING.
THIS IS A NICE STUDY FROM ONE OF
THE INVESTIGATORS IN OUR FORCED
BASED MANIPULATION GROUP THAT
LOOKED AT A VERY CAREFULLY DONE
MODELING OF BOTH STRESSES AND
STRAINS WITHIN THE LIGAMENTS OF
THE SPINE.
FIRST OF ALL THIS IS AN
INTERESTING STUDY FOR A COUPLE
OF REASONS.
FIRST OF ALL LEG AMOUNTS IS
SOMETHING W --LIGAMENTS IS SOMEY
LESS ATTENTION TO THAN
INTERVERTEBRAL DISKS, HOWEVER
THEY'RE VERY IMPORTANT FOR
KEEPING THE SPINE IN ITS HEALTHY
CONFIGURATION.
AND WHAT THEY WERE ABLE TO MAP
HERE IN THIS MODEL IS NOT JUST
THE STRAIN, WHICH IS THE
DISPLACEMENT, THEY DID MAPPING
OF DEFAMATION THAT OCCURS IN
THESE LIGAMENTS, BUT ALSO THE
LOCAL STRESSES, WHICH IS A LOT
HARDER TO GET A AT, BECAUSE A
LOT OF TIMES WE ASSUME THAT
MECHANICAL FORCES ARE
DISTRIBUTED HOMOGENEOUSLY
THROUGH TISSUES.
THAT'S NOT TRUE.
THE ACTUAL STRESSES ARE NOT
UNIFORM AND VERY OFTEN WE HAVE
TROUBLE IN MODELING THIS.
SO THIS IS AN IMPORTANT I THINK
THAT'S GOING TO HELP US TO MOVE
ALONG IN OUR UNDERSTANDING OF
THESE IMPORTANT PIECES.
THIS PAPER HERE, THIS IS A PAPER
THAT WON AN AWARD OF THE JOURNAL
OF NATIONAL PRODUCTS SCHWARTING
AWARD.
THIS IS DR. VIDAR AND COLLEAGUES
ON THE INTERACTION METABOLOMICS
TO DISCOVER SINNER GISTS IN
NATURAL PRODUCT MIXTURES.
AND WHAT THIS PAPER SHOWS IS
THAT THEY REALLY WERE ABLE TO
CONTRAST THE EVALUATION IN
METABOLOMICS SINGLE COMPOUNDS AS
WELL AS THE INTERACTION BETWEEN
MULTIPLE COMPOUNDS TOGETHER.
AND OF COURSE THIS IS WHAT
HAPPENS WHEN COMPLEX MIXTURES
EITHER WHEN YOU EAT A PLANT OR
HAVE AN EXTRACT DERIVED FROM A
PLANT, WE'RE NOT JUST DEALING
WITH ONE MOLECULE AT A TIME.
SO THIS TYPE OF WORK IS GOING TO
BE VERY IMPORTANT FOR US TO BE
ABLE TO BETTER UNDERSTAND THESE
COMPLEX INTERACTIONS.
MOVING ON TO SOME PROGRAM NEWS,
FOR THOSE OF YOU NOT YET
FAMILIAR WITH OUR LITTLE COLORED
CIRCLE REPRESENTATION HERE, IN
THE COLORED CIRCLE THEY
REPRESENT THE SORT OF FIVE
GENERAL CATEGORIES THAT WE WERE
THINKING ABOUT IN TERMS OF WE'RE
GOING TO USE THIS TO PREPARE FOR
OUR NEXT STRATEGIC PLAN, SO
POSITIVE HEALTH PROCESSES, MIND
AND BODY CONNECTIONS, NUTRITION
AND NATURAL PRODUCTS, PAIN AND
PAIN MANAGEMENT, AND FINALLY
WHOLE PERSON RESEARCH KIND OF IN
THE MIDDLE, TYING EVERYTHING
TOGETHER.
AND THEN AT THE BOTTOM, WE HAVE
OUR WORKFORCE DEVELOPMENT AND
SPECIAL POPULATIONS AS WELL AS
METHODS AND DATA SCIENCES, WHICH
ARE VERY IMPORTANT CROSS-CUTTING
THEMES ACROSS EVERYTHING.
SO YOU CAN SEE WE USE THIS AS A
WAY NOT JUST TO B PIGEONHOLE
INITIATIVES IN ONE CATEGORY, BUT
YOU'LL FIND PROGRAMS AND EVENTS
THAT I'M GOING TO TALK ABOUT
CROSS OVER SEVERAL OF THESE
CATEGORIES, AND THAT MAKES SENSE
BECAUSE WE REALLY ARE THINKING
ABOUT A PROGRAM AS BEING VERY
INTEGRATIVE AND WE'RE VERY
INTERESTED IN LOOKING AT THE
INTERSECTIONS, FOR EXAMPLE,
BETWEEN SOMETHING LIKE SAY
NUTRITION AND NATURAL PRODUCTS
AND POSITIVE HEALTH PROCESSES.
THAT'S ONE AREA OF CONNECTION.
OR BETWEEN MINDS AND BODY
CONNECTIONS AND PAIN AND PAIN
MANAGEMENT.
YOU HAVE THESE CROSS CURRENTS
THAT GO ACROSS OUR ENTIRE
PROGRAM.
SO FIRST WE'LL START WITH WHOLE
PERSON HEALTH.
SO AT THE UPPER RIGHT CORNER OF
THE SLIDE WE PUT THE S CIRCLES D
WHAT AREAS ARE PARTICULARLY
IMPORTANT FOR THIS PARTICULAR
INITIATIVE.
SO THIS IS OUR NEW WHOLE PERSON
RESEARCH AND COORDINATING CENTER
NOFO.
SO FOR THOSE OF WHO YOU ARE NOT
FAMILIAR WITH OUR NEW JARGON,
NOFO MEANS NOTICE OF FUNDING
OPPORTUNITY.
WE USED TO TALK ABOUT ALL KINDS
OF THINGS, RFAs, PARs, BUT
NOW EVERYTHING IS A NOFO.
BUT WE STILL CAN CALL THEM
RFAs IF THE AREA IS A SPECIFIC
SETASIDE FOR THIS PARTICULAR
INITIATIVE AND IN THIS CASE,
THERE IS.
SO -- AND FUNDS, I MEAN, FUNDS
SETASIDE.
SO THIS WHOLE PERSON RESEARCH
AND COORDINATING CENTER --
COORDINATION CENTER IS SOMETHING
WE'VE BEEN TALKING ABOUT A LOT
AND WE'VE HEARD ABOUT THIS MANY
TIMES NOW AT PREVIOUS COUNCIL
MEETINGS.
BUT THIS IS A FLAGSHIP
INITIATIVE FOR US.
THIS IS AN INITIATIVE THAT WAS
PUBLISHED BACK IN JUNE AND IT
INVOLVES COLLABORATION WITH NOW
18 INSTITUTES, CENTERS AND
OFFICES AT NIH, AND NCCIH IS
LEADING THIS.
THIS IS ABOUT CREATING A
FRAMEWORK FOR UNDERSTANDING THE
WHOLE HUMAN PHYSIOME, ALL THE
ORGANS AND SYSTEMS OF THE BODY
INTERACT, AND THIS IS MEANT TO
CREATE A FUNDAMENTAL KNOWLEDGE
BASE THAT WILL BE USED IN FUTURE
STUDIES USING ARTIFICIAL
INTELLIGENCE AND TO REALLY
ORGANIZE AND ANCHOR THE
INFORMATION THAT CAN BE REALLY
FRAGMENTED ACROSS THE DIFFERENT
CARDIOVASCULAR, DIGESTIVE, ET
CETERA, BUT REALLY MAKING THIS
INTO A WHOLE.
SO THE APPLICATION DEADLINE FOR
THIS IS NOVEMBER 1.
WE'RE LOOKING FOR TEAMS OF
INVESTIGATORS, INCLUDING BOTH
DATA SCIENTISTS AS WELL AS
EXPERTS IN EVERY ONE OF THESE
AREAS, ORGANS AND SYSTEMS, SO WE
REALLY ENCOURAGE YOU TO CONTACT
LIZ AND EMRIN, WHO ARE THE LEAD
PROGRAM OFFICERS ON THIS
INITIATIVE.
THERE'S ALSO A TECHNICAL
ASSISTANCE WEBINAR ON THIS IF
YOU'RE INTERESTED THAT'S
VIDEOCAST SO YOU CAN WATCH IT.
AND THERE'S ALSO A LETTER OF
INTENT DUE NOVEMBER 1ST --
OCTOBER 1ST, IT'S NOT COMPULSORY
BUT IT'S RECOMMENDED.
SO WE REALLY HOPE THAT MANY OF
YOU WILL BE SPREADING THE WORD
AMONG PEOPLE WHO ARE INTERESTED
IN FORMING THE TEAMS.
TO SUBMIT THESE APPLICATIONS.
HERE IS ANOTHER EXAMPLE.
THIS TIME IT'S NOT A NOFO, IT'S
A NOSI.
A NOSI IS A NOTICE OF SPECIAL
INTEREST.
THAT'S WHEN WE WANT TO DRAW
ATTENTION TO ANOTHER NOFO,
SOMETHING THAT IS EXISTING
ALREADY, BUT WE WANT TO DRAW
ATTENTION TO IT FROM THE POINT
OF VIEW OF NCCIH.
THIS IS IN THE CLIMATE CHANGE
AND HEALTH SCWEER.
THE NATIONAL INSTITUTE OF
ENVIRONMENTAL HEALTH AND
SCIENCES, NIEHS, THAT WE
COLLABORATE WITH A LOT BECAUSE
THEY'RE REALLY ALSO INTERESTED
IN THE WHOLE PERSON, ESPECIALLY
IN RELATIONSHIP TO THE -- BEYOND
THE PERSON TO SOCIETY AS WELL AS
THE ENVIRONMENT.
THIS PARTICULAR NOTICE IS ABOUT
REALLY THINKING ABOUT HOW TO
PROMOTE WAYS TO MANAGE AND
MITIGATE ENVIRONMENTAL PROBLEMS
LIKE, FOR EXAMPLE, CLIMATE
CHANGE, AND HELP PEOPLE TO DEAL
WITH THE STRESS ASSOCIATED WITH,
YOU KNOW, ANXIETY ABOUT CLIMATE
CHANGE, ABOUT THE NEGATIVE
EFFECTS OF CLIMATE CHANGE,
ESPECIALLY ON VULNERABLE
POPULATIONS.
SO THIS IS -- IT SENDS PEOPLE TO
THIS PARTICULAR FUNDING
OPPORTUNITY FROM NIEHS BUT ADDS
A COMPONENT FROM NCCIH.
NEXT IS PAIN, THE PAIN CATEGORY.
THE FIRST I WANT TO POINT OUT IS
THAT THE NIH DOD VA PAIN
MANAGEMENT COLLABORATORY HAS
ISSUED A NEW ANNOUNCEMENT FOR
PRAGMATIC AND IMPLEMENTATION
SCIENCE DEMONSTRATION PROJECTS.
THIS IS THE NEXT WAVE OF FUNDING
OPPORTUNITIES FROM THE PAIN
MANAGEMENT COLLABORATORY.
IMPORTANTLY, WE HAVE A NEW
COLLABORATION WITH THE HEAL
INITIATIVE, WHICH IS VERY
EXCITING BECAUSE THE HEAL
INITIATIVE IS NOW COFUNDING PART
OF THE PMC COORDINATING CENTER.
WE THINK THIS IS VERY IMPORTANT
TO REALLY CREATE THESE
PARTNERSHIPS BECAUSE THE NCCIH
WAS REALLY A LEAD IN RESEARCH IN
THE PAIN MANAGEMENT IN THE
MILITARY, WHICH IS SO IMPORTANT,
AND TO REALLY UNDERSTAND HOW TO
DO THIS WELL, AND WE'RE JUST
VERY EXCITED THAT WE'RE GOING TO
MOVE INTO CREATING LINKS BETWEEN
THE HEAL INITIATIVE, THE
PRAGMATIC TRIALS COLLABORATORY,
AND THE PAIN MANAGEMENT
COLLABORATORY.
JUST SO THAT EVERYBODY IS
WORKING TOGETHER.
THE APPLICATION DEADLINE FOR
THIS IS NOVEMBER 7TH AND THE
CONTACT IS PETE MURRAY.
THE NEXT IS THE R15 PAIN
RESEARCH ENHANCEMENT PROGRAM, OR
PREP.
THIS IS ALSO A VERY IMPORTANT
INITIATIVE THAT IS ALSO FUNDED
BY THE HEAL INITIATIVE.
AND THIS IS TO SUPPORT BASIC AND
MECHANISTIC PAIN RESEARCH FROM
R15-ELIGIBLE UNDERGRADUATE AT
FOCUSED-SERVING INSTITUTIONS.
SO THIS APPLIES TO MANY
INSTITUTIONS THAT ARE IN THE
KIND OF COMPLEMENTARY AND
INTEGRATIVE HEALTH FIELD.
INCLUDING HEALTH PROFESSIONAL
SKOLSCHOOLS OR GRADUATE SCHOOLS.
SO THIS PARTICULAR INITIATIVE IS
TO REACH OUT TO INSTITUTIONS
THAT HAVE NOT YET BEEN MAJOR
RECIPIENTS OF NIH SUPPORT.
ESPECIALLY RESEARCHERS FROM
DIVERSE BACKGROUNDS, AND GROUPS
THAT ARE UNDERREPRESENTED IN THE
HEALTH SCIENCES.
SO FOR NCCIH SPECIFICALLY, WE
ARE THINKING ABOUT COLLEGES OF
OSTEOPATHY, CHIROPRACTOR,
ACUPUNCTURE, ET CETERA.
AND SO THIS IS A GREAT
OPPORTUNITY, AND I REALLY WANT
TO ENCOURAGE ANY OF YOU WHO ARE
IN CONTACT WITH THESE
ORGANIZATIONS TO PLEASE LET THEM
KNOW.
HERE'S ANOTHER IMPORTANT --
AGAIN, THIS IS WHAT WE CALL A
SIGN-ON, COORDINATED APPROACH TO
PAIN CARE IN HEALTHCARE SYSTEMS.
THIS IS AGAIN FROM THE HEAL
INITIATIVE.
THIS IS PART OF THE PRISSMM
COORDINATING CENTER.
SO PRISSMM, ANOTHER ACRONYM, BUT
THIS IS WITHIN THE HEAL
INITIATIVE, THE PRISSMM PROGRAM
IS SOMETHING THAT NCCIH HAS BEEN
LEADING FOR YEARS AND IT'S ABOUT
DOING PRAK MA PRAGMATIC AND
IMPLEMENTATION TRIALS ON PAIN,
USUALLY INVOLVING
NON-PHARMACOLOGICAL
INTERVENTIONS OR A COMBINATION
OF PHARMACOLOGICAL AND
NON-PHARMACOLOGICAL IN THE AREA
OF THE HEAL INITIATIVE.
SO THIS IS AN AREA WHERE WE'VE
RECEIVED MAJOR ADDITIONAL
FUNDING FOR THIS KIND OF
RESEARCH THROUGH HEAL, SO THESE
COORDINATING APPROACHES TO PAIN
CARE SOLICITS RESEARCH
APPLICATIONS THAT COMPOSE
IMPLEMENTATION SCIENCE
METHODOLOGY TO EMBED EXISTING
EVIDENCE-BASED COORDINATING --
COORDINATED PAIN CARE MODELS
INTO A VARIETY OF PUBLIC AND
PRIVATE HEALTHCARE SYSTEMS.
ESPECIALLY WHERE THIS CARE DOES
NOT CURRENTLY EXIST.
SO THIS IS REALLY ABOUT
IMPLEMENTING PRACTICES AND
THERAPIES THAT WE KNOW WORK, BUT
HOW DO YOU NOW PUT THEM INTO THE
HEALTHCARE SYSTEM AND MAKE THE
IMPLEMENTATION OF IT EFFECTIVE.
NEXT, THE N CREW PROGRAM, AGAIN
A VERY IMPORTANT PROGRAM THROUGH
HEAL.
THIS IS A LARGE NIH PROGRAM TO
ADVANCE RESEARCH LED BY NATIVE
AMERICAN COMMUNITIES ON
SUBSTANCE USE AND PAIN.
NCCIH IS PARTICIPATING IN THIS
PROGRAM.
NCCIH STAFF SEKAI CHIDEYA AND
JENNY BAUMGARTNER.
THIS IS TO ENHANCE THE CAPACITY
FOR RESEARCH THAT IS LED BY THE
TRIBES AND NATIVE AMERICAN
ORGANIZATIONS.
THERE'S A LOT OF EMPHASIS ON
MAKING SURE THAT THIS RESEARCH,
THAT THE ACTUAL RESEARCH
QUESTIONS THAT ARE ASKED COME
FROM THE TRIBES AS OPPOSED TO
THE OTHER WAY AROUND.
SO THIS IS ALSO THE OVERALL
ULTIMATE GAIN -- AIM OF THIS IS
TO IMPROVE ACCESS OF QUALITY OF
DATA ON SUBSTANCE USE, PAIN AND
RELATED FACTORS.
AND PARTICULARLY WE'RE
INTERESTED IN TRADITIONAL
HEALING PRACTICES AS THEY COME
OUT OF THE TRADITIONAL KNOWLEDGE
THAT THE AMERICAN INDIAN AND
ALASKA NATIVE TRIBES HAVE, AND
HOW THEY MANAGE -- HOW TO MANAGE
COMPLEX PROBLEMS LIKE PAIN.
NEXT WE MOVE ON TO OUR MIND AND
BODY CONNECTION.
SO THE FIRST ITEM IS -- THIS WAS
A PAST EVENT THAT WE'VE HAD THIS
SUMMER, ANNUAL FORCE-BASED
MANIPULATION INVESTIGATOR
MEETING.
SO OUR FORCE-BASED MANIPULATION,
THIS IS ONE OF OUR THREE
NETWORKS THAT WE FUND.
WE HAVE ONE ON FORCE-BASED
MANIPULATION, WE HAD ONE ON
MUSIC AND HEALTH, WE HAVE ONE ON
EMOTIONAL WELL-BEING.
THESE NETWORKS HAVE BEEN
FANTASTIC.
REALLY, WE'RE REALLY HAPPY WITH
THESE, WITH THESE -- HOW THESE
NETWORKS ARE GOING.
IN THIS MEETING WE HAD BACK IN
JUNE, IT WAS VIDEOCAST, I
ENCOURAGE ANY OF YOU WHO ARE
INTERESTED IN WATCHING THAT,
WE'VE HAD A LOT OF PEOPLE VIEW
IT.
OVER 300 ATTENDED THE LIVE EVENT
AND 400 VIEWS SINCE.
THERE WAS A RAN F FANTASTIC KEYE
LECTURE LOOKING AT THE EFFECT OF
DIETARY FATTY ACIDS, OMEGA-3
FATTY ACIDS AND OTHER TYPES OF
FATTY ACIDS ON MECHANOSENSATION,
WHICH IS REALLY A VERY, VERY
INTRIGUING TOPIC.
THAT MEETING WAS REALLY --
HIGHLIGHTED THE IMPORTANCE OF
BRINGING DIFFERENT KINDS OF
EXPERTISE IN THE ROOM TOGETHER.
YOU HAD REALLY PAIN RESEARCHERS
AND SCIENTISTS REALLY LOOKING AT
THE SENSORY ASPECTS OF PAIN, FOR
EXAMPLE, BUT ALSO TOGETHER WITH
PEOPLE WHO ARE EXPERIENCED IN
THE BIOMECHANICS OF WHAT HAPPENS
WHEN YOU ACTUALLY APPLY A
MECHANICAL FORCE TO THE BODY,
AND REALLY BRINGING THOSE
DIFFERENT KINDS OF EXPERTISE
TOGETHER TO TRANSLATE ACROSS
COMMON VOCABULARY, COMMON
KNOWLEDGE, BUT IT WAS REALLY
VERY FASCINATING, THIS IS GOING
REALLY WELL.
ANOTHER ONE OF OUR INITIATIVES
THAT'S GOING REALLY WELL IS OUR
MUSIC-BASED INTERVENTION, AND SO
THIS IS A -- NOW A NOTICE OF
FUNDING, A NOFO, AND ALSO
REQUEST FOR INFORMATION OR RFI.
FIRST THE NOFO IS ON FEASIBILITY
TRIALS OF USING THE MUSIC-BASED
INTERVENTION TOOLKIT FOR BRAIN
DISORDERS OF AGING.
AND SO THIS IS FOR EARLY PHASE
CLINICAL TRIAL TO GENERATE
EVIDENCE TO SUPPORT THE VALIDITY
OF THE TOOLKIT.
IT'S ONE THING TO DEVELOP A
TOOLKIT, YOU THEN HAVE TO USE
IT.
SO THIS IS REALLY TO SHOW HOW
HOPEFULLY THIS TOOLKIT WILL BE
USEFUL AND TO DEMONSTRATE THAT.
AND IF NECESSARY, MAKE
MODIFICATIONS.
SO THESE ARE APPLICATIONS THAT
ARE AIMED AT COLLECTING AND
ADDRESSING GAPS IN KNOWLEDGE TO
FACILITATE THE DEVELOPMENT OF
COMPETITIVE LARGER SCALE
CLINICAL TRIALS, AND THE
APPLICATION DEADLINE IS NOVEMBE.
EXCUSE ME, OCTOBER 21ST.
I KEEP GETTING THOSE MONTHS
WRONG.
ALSO WE HAVE A REQUEST FOR
COMMENTS ON MUSIC AND HEALTH
RESEARCH.
AGAIN, THAT IS DUE SOONER.
THAT IS DUE SEPTEMBER 30TH.
AND THIS IS TO REQUEST
INFORMATION TO GUIDE POTENTIAL
EFFORTS TO SUPPORT CAPACITY
BUILDING OF SCIENTISTS
INTERESTED IN UNDERSTANDING THE
RELATIONSHIP BETWEEN MUSIC AND
HEALTH.
SO WE INVITE INPUT FROM STAKE
HOARSTAKEHOLDERS, COMMUNITY MEM,
ET CETERA.
NEXT IS AN UPCOMING CONFERENCE
AT THE SOCIETY FOR NEUROSCIENCE.
NCCIH AS USUAL IS WELL
REPRESENTED.
WE'RE GOING TO HAVE A BOOTH
THERE AND NCCIH PROGRAM
DIRECTORS WILL BE THERE TO
ANSWER ANY QUESTIONS.
THERE'S ALSO GOING TO BE TWO
SESSIONS, ONE ON OCTOBER 5TH, ON
DEVELOPING PROFESSIONAL NETWORKS
FOR NEUROSCIENCE CAREER BY
DR. EDWARDS, AND ON OCTOBER 7TH,
ON EMOTIONAL WELL-BEING,
CO-CHAIRED BY ERIN QUINLAN AND
KUAN HONG WANG FROM NIA.
SO WE REALLY ENCOURAGE YOU, IF
YOU'RE IN NEUROSCIENCE, TO GO
AND ATTEND THESE.
AND YOU CAN SEE HERE ON THE
RIGHT THESE SESSIONS RELEVANT TO
MIND AND BODY CONNECTION, TO
POSITIVE HEALTH PROCESSES AND
ALSO WORKFORCE DEVELOPMENT.
NOW LET'S MOVE ON TO THE
POSITIVE HEALTH PROCESSES
THEMSELVES.
SO THE FIRST, RESILIENCE, IS
OBVIOUSLY A TOPIC THAT WE TALK A
LOT ABOUT.
THIS TIME WE ARE VERY HAPPY THAT
WE'RE GOING TO BE HAVING, AFTER
A LOT OF WORK BY THE TRANS-NIH
RESILIENCE WORKING GROUP THAT WE
PARTICIPATE IN, THIS IS A
WORKING GROUP THAT'S LED BY
DR. LAVERNE BROWN FROM THE
OFFICE OF DIETARY SUPPLEMENTS,
AND THIS IS GOING TO BE A
WORKSHOP ON ADVANCING THE
BIOMEDICAL SCIENCE OF
RESILIENCE, A DISCUSSION OF
MEASURES AND METRICS.
DEVELOPING MEASUREMENTS OF
SOMETHING AS COMPLEX AS
RESILIENCE, YOU CAN IMAGINE HOW
IMPORTANT THAT IS, AND THIS IS
GOING TO BE A VERY IMPORTANT
SESSION THAT WE'D ENCOURAGE YOU.
THIS IS GOING TO BE, AGAIN,
WEBCAST SEPTEMBER 24TH AND 25TH.
SO COMING UP.
ALSO UPCOMING, A CONFERENCE ON
THE FUTURE OF MUSIC AND ARTS IN
MEDICINE AND HEALTH AT THE JOINT
CONGRESS OF THE INTERNATIONAL
ASSOCIATION FOR MUSIC AND
MEDICINE, AND THE INTERNATIONAL
SOCIETY FOR ARTS AND MEDICINE.
SO THIS IS GOING TO BE IN --
SEPTEMBER 18TH TO THE 21ST,
THERE'S GOING TO BE A ROUNDTABLE
ON BUILDING BLOCKS FOR
MUSIC-BASED INTERVENTIONS
RESEARCH BY DR. EDWARDS AND ALSO
SHE'S GOING TO GIVE A KEYNOTE ON
SEPTEMBER 20TH ON MUSIC-BASED
INTERVENTION TOOLKIT.
THIS IS IN BERLIN, RIGHT,
EMMELINE?
YES, SHOULD MENTION THAT.
IT'S NOT AROUND THE CORNER FROM
HERE.
BERLIN, GERMANY.
SO WE'RE SO EXCITED BY HOW
DR. EDWARDS IS BEING OUR
AMBASSADOR ON MUSIC AND HEALTH
THROUGHOUT THE WORLD.
NUTRITION AND NATURAL PRODUCTS.
THAT'S OUR NEXT BIG CATEGORY BUT
AS YOU CAN SEE, IT INTERFACES
WITH A LOT OF OTHER ONES.
SO THE FIRST IS OUR NOTICE OF
FUNDING OPPORTUNITY, NOFO, ON
ENHANCING MECHANISTIC RESEARCH
ON PRECISION PROBIOTIC
THERAPIES.
THIS IS -- THE LEAD CONTACT FOR
THIS IS HYE-SOOK KIM.
APPLICATION DEADLINES ARE
OCTOBER -- THERE'S SEVERAL
DEADLINES.
OCTOBER 1ST, JUNE, ET CETERA.
YOU CAN SEE THEM HERE.
AND THERE'S NO LETTER OF INTENT
DUE ON THIS.
AGAIN, WE'VE PROVIDED THESE QR
CODES, SO IF YOU WANT, YOU CAN
GO TO THOSE AND FIND OUT ABOUT
THEM.
NOW AN NOI, WHICH IS NOTICE OF
INTEREST.
ANOTHER ACRONYM.
ADDITIONAL FUNDING PRIORITIES
FOR NCCIH NATURAL PRODUCT
CLINICAL TRIAL FUNDING
OPPORTUNITIES.
SO THIS PARTICULAR ONE IS
IMPORTANT.
SO WE ARE ISSUING THIS NOTICE OF
INFORMATION TO LET PEOPLE KNOW
OF EXPANDING THE PRIORITIES FOR
SELECT NATURAL PRODUCT CLINICAL
TRIALS TO INCLUDE STUDIES THAT
EXAMINE THE EFFECTS OF NATURAL
PRODUCTS ACROSS THE CONTINUUM OF
DIETARY INTAKE.
AND ALSO STUDIES THAT EVALUATE
WHETHER NUTRITIONAL STATUS
MODERATES THE TARGET ENGAGEMENT
OF CLINICAL OUTCOMES.
DR. EDWARD WAS MENTIONING THAT
EARLIER, WE THINK THAT IT'S
REALLY IMPORTANT THAT WE DON'T
STUDY NATURAL PRODUCTS, FOR
EXAMPLE, DIETARY SUPPLEMENT, IN
ISOLATION FROM WHAT PEOPLE ARE
EATING, OR WHATEVER ELSE, I
MEAN, IT'S NOT JUST WHAT THEY'RE
EATING, WHAT IS GOING ON IN
THEIR WHOLE PERSON.
WE'RE GOING TO HAVE A SESSION
LATER ON TODAY ON WHAT WE CALL
THE NUTRITION CONTINUUM AND
WE'RE GOING TO TALK ABOUT THIS
AGAIN LATER ON.
BUT THE INTENT OF THIS NOTICE IS
TO MAKE RESEARCHERS AWARE THAT
THIS IS SOMETHING THAT WE'RE
GOING TO BE -- WE ALREADY PAY
ATTENTION TO IT BUT WE'RE GOING
TO BE PAYING EVEN MORE ATTENTION
TO IT GOING FORWARD.
WORKFORCE DEVELOPMENT AND
SPECIAL POPULATIONS.
THIS IS OUR NEXT CATEGORY.
HERE IS A REISSUE OF A NOTICE OF
FUNDING OPPORTUNITY MAXIMIZING
OPPORTUNITIES FOR SCIENTIFIC AND
ACADEMIC INDEPENDENCE CAREERS OR
MOSAIC.
THESE ARE FOR POSTDOCS TO
TRANSITION TO INDEPENDENT
CAREER, AND TO ALSO PROMOTE
DIVERSITY AMONG THE POSTDOCTORAL
FELLOWS THAT WE ARE FUNDING.
SO CONTACT ON THIS IS LANAY
MUDD, AND THIS COVERS BOTH BASIC
AND CLINICAL RESEARCH,
IMPORTANTLY.
AND THIS IS TO SUPPORT A
CAREER -- A COHORT OF EARLY
CAREER INDEPENDENT INVESTIGATORS
TO TRANSITION TO, FOR EXAMPLE,
AN R01 TYPE GRANT.
NEXT IS OUR UPCOMING FELLOWS AND
TRAINEES WORKSHOP.
WORKSHOP ON NAVIGATING YOUR
SCIENTIFIC CAREER, EXTREMELY
IMPORTANT, SEPTEMBER 23RD AND
24TH.
AND THIS IS A CLOSED MEETING,
BUT WE WANTED COUNCIL TO BE
AWARE OF THEIR RESOURCES THAT
WE'RE OFFERING TO THE TRAINEES.
IN GENERAL, THE MEETINGS THAT I
TALK ABOUT HERE AT THIS -- IN MY
COUNCIL REPORT AT COUNCIL, WE
FOCUSED MORE ON THE OPEN
MEETINGS, THE MEETINGS THAT
EITHER ARE VIDEOCAST OR WHERE WE
WELCOME MEMBERS OF THE
COMMUNITY, BUT AS YOU CAN
IMAGINE, WE ALSO HOLD A FAIR
NUMBER OF CLOSED MEETINGS OF
JUST THE INVESTIGATORS ONLY.
WHEN
IT'S APPROPRIATE, SUCH AS THIS
ONE.
WE ALSO WANT TO DRAW YOUR
ATTENTION TO AN UPCOMING
CONFERENCE OF THE SOCIETY FOR
ADVANCEMENT OF
CHICANOS/HISPANICS AND NATIVE
AMERICANS IN SCIENCE OR SACNAS.
THIS PARTICULAR CONFERENCE IS ON
NATIONAL DIVERSITY IN STEM
CONFERENCES, IS TO REALLY
INCREASE THE -- TO BUILD THE
BASIC FOUNDATION OF -- CADRE OF
INVESTIGATORS IN THIS VERY
IMPORTANT FIELD.
SO THIS IS FOR COLLEGE AGE
THROUGH PROFESSIONAL ATTENDEES
THAT WILL BE IMMERSED IN CUTTING
EDGE STEM RESEARCH,
PROFESSIONAL -- AND JENNIFER
BAUMGARTNER FROM NCCIH WILL BE
AT THE BOOTH.
THIS IS IN PHOENIX, ARIZONA,
OCTOBER 31ST TO NOVEMBER 2ND.
NEXT IS OUR METHODS AND DATA
SCIENCE, VERY IMPORTANT HERE
STARTING WITH A.I., HARNESSING
ARTIFICIAL INTELLIGENCE TO
EXPLORE HEALTH RESTORATION IN
DIABETES.
THIS WAS A VERY NICE LECTURE
THAT'S PART OF OUR INTEGRATIVE
MEDICINE AND HEALTH LECTURE
SERIES THAT WAS VIDEOCAST BY DRN
SALUTOGENESIS.
THIS WAS IN JULY, A GREAT
LECTURE.
I ENCOURAGE YOU TO CHECK OUT THE
VIDEOCAST IF YOU'RE INTERESTED.
AGAIN, THIS IS ONE OF THOSE
CROSS-CUTTING THAT IMPACTED DATA
SCIENCE, WHOLE PERSON RESEARCH,
AS WELL AS POSITIVE HEALTH
PROCESSES.
NEXT IS A SIGN-ON, THIS AGAIN,
THIS IS WHEN WE SIGN ON TO A
FUNDING OPPORTUNITY FROM ANOTHER
INSTITUTE, CENTER OR OFFICE.
IN THIS CASE, THIS IS THE OFFICE
OF DATA SCIENCE AND STRATEGY OR
ODSS.
THIS IS ABOUT OPPORTUNITY FOR
BUILDING SUSTAINABLE SOFTWARE
TOOLS FOR OPEN SCIENCE.
THIS IS IMPORTANT BECAUSE IT'S
REALLY TO ENCOURAGE PEOPLE TO
UTILIZE CLOUD SERVICES TO LEARN
HOW TO PUT YOUR DATA IN THE
CLOUD, USE IT, INTERACT WITH IT,
ET CETERA.
SO -- AND SO ENCOURAGE YOU TO
CHECK THIS OUT.
NEXT IS NIH RESEARCH SOFTWARE
ENGINEER AWARD.
SO THIS IS AGAIN ANOTHER
OPPORTUNITY FROM THE OFFICE OF
DATA SCIENCE AND STRATEGY.
AND THIS IS TO PROVIDE SALARY
SUPPORT FOR RESEARCH SOFTWARE
ENGINEERS INVOLVED IN RESEARCH
AND POSITIONED TO MAKE
OUTSTANDING CONTRIBUTION TO NIH
FUNDED RESEARCH.
SO THIS IS KIND OF A UNIQUE
OPPORTUNITY.
I ENCOURAGE YOU TO CHECK THAT
OUT AS WELL.
FINALLY, OUR NEXT MEETING OF OUR
ADVISORY COUNCIL OF NCCIH WILL
BE ON JANUARY 24TH.
THIS WILL BE A VIRTUAL MEETING,
SO WE HAVE OUR IN-PERSON
MEETINGS NOW, WE'VE KIND OF
SETTLED ON THIS CADENCE, WE'RE
HAVING OUR IN-PERSON MEETINGS IN
MAY AND SEPTEMBER AS WE'RE
HAVING TODAY, AND THEN OUR
MEETING IN JANUARY IS VIRTUAL,
SO THAT WE DON'T GET INTO SNOW
PROBLEMS.
AND SO WE REALLY LOOK FORWARD TO
SEEING YOU THEN, JANUARY 24TH.
SO THANK YOU VERY MUCH.
GDO WE HAVE TIME FOR QUESTIONS?
WE DO.
ANY QUESTIONS OR COMMENTS FROM
OUR COUNCILMEMBERS?
>> THAT'S A LOT.
>> WE'VE BEEN WORKING REALLY
HARD ON PARRI PARING DOWN MY REO
THERE'S MORE IN YOUR ELECTRONIC
COUNCIL BOOK.
BUT YEAH, YOU'RE RIGHT, IT'S A
LOT.
IT'S A LOT.
>> AND WELL DONE.
>> THANK YOU.
IT'S BEEN CHALLENGING TO PRESENT
ALL OF THIS, AND WE JUST -- WE
WELCOME COMMENTS.
I MEAN, WE THINK THAT ORGANIZING
THE INFORMATION AROUND THE
THEMES IS GOING TO BE USEFUL
HOPEFULLY FOR PEOPLE TO
UNDERSTAND BOTH WHERE WE'RE
COMING FROM AND WHERE WE'RE
GOING.
AND SO YEAH.
>> SORRY, THIS IS BEN ONLINE.
I JUST WANT TO ECHO THAT.
PARTICULARLY EMPHASIZING THE WAY
THAT NCCIH IS NOW LEVERAGING SO
MANY OTHER INITIATIVES AROUND
NIH, WHETHER IT'S HEAL OR SOME
OF THESE OTHER MULTI-INSTITUTE
INITIATIVES.
I JUST THINK IT'S REALLY
IMPRESSIVE, THE WAY YOU ALL ARE
PARLAYING -- I KNOW $170 MILLION
DOESN'T SEEM SMALL TO MANY
PEOPLE, BUT WE KNOW THAT NIH AND
IN THE FEDERAL GOVERNMENT, IT'S
RELATIVELY SMALL, BUT YOU ALL
ARE DOING -- I DON'T KNOW IF YOU
EVEN ADD IT UP HOW MUCH THE
TOTAL SUM OF THE RESEARCH THAT
YOU'RE CONTRIBUTING TO.
DO YOU HAVE A NUMBER ON THAT?
>> YEAH, I ACTUALLY -- I USUALLY
PRESENT THIS ONCE A YEAR, I
PRESENT THIS TYPICALLY IN MAY
BECAUSE WE TOTAL THE AMOUNT THAT
WE GET FROM BOTH F FROM CO-FUND,
FROM THE OFFICE OF THE DIRECTOR
AND ALSO FROM INITIATIVES LIKE
HEAL, AND IT'S REALLY -- USUALLY
ENDS UP BEING HALF OF OUR
BUDGET, ANOTHER HALF OF OUR
BUDGET IN ADDITION TO WHAT WE
ALREADY HAVE.
SO IT'S QUITE IMPRESSIVE, AND
IT'S BEEN PRETTY CONSISTENT OVER
THE LAST SEVERAL YEARS.
SO YEAH, WE DO REALLY WELL
THERE, BUT I HAVE TO SAY, THIS
IS -- THE CREDIT GOES TO OUR
STAFF.
I MEAN, IT HARDER, RIGHT, YOU
CAN IMAGINE THE EFFORT THAT IT
TAKES TO REACH OUT TO BOTH --
IT'S A TREMENDOUS AMOUNT OF WORK
AND VERY REWARDING AND VERY
GOOD, BUT IT'S COMPLEX TO WORK
WITH THE OTHER INSTITUTES, TO
CREATE -- YOU HAVE TO CREATE
MEMORANDUMS OF UNDERSTANDING
EVERY TIME WE DO SOMETHING, TO
WORK WITH ANOTHER INSTITUTE.
WE ALSO HAVE TO PARTICIPATE IN
THESE PROGRAMS LIKE THE HEAL
INITIATIVE, THERE'S COMPLEX
ADDITIONAL LAYERS OF
ADMINISTRATION THAT ARE INVOLVED
IN THIS THAT WE HAVE TO
NAVIGATE.
SO A LOT OF CREDIT GOES TO THE
STAFF IN HOW WELL THEY'RE DOING
IN DEALING WITH THESE
CHALLENGES, AND REALLY THAT'S
HOW WE ARE ABLE TO REALLY GET
ALL OF THIS EXCITING RESEARCH TO
HAPPEN, RIGHT?
THROUGH ALL OF THAT.
SO THANK YOU, BEN.
>> ONE MORE COMMENT TOO.
IT'S INTERESTING, TOO, TO THINK
ABOUT NCCIH'S IMPACT, BUT ALSO
THE INTEGRATIVE THERAPIES AND
NON-PHARMACOLOGICAL THERAPIES
HAPPENING ACROSS ALL OF NIH THAT
AREN'T PART OF YOUR PORTFOLIO.
IF YOU LOOK AT ALL THOSE
COMBINED, THAT WOULD BE AN
AMAZING NUMBER.
NHLBI, LOOKING AT BLOOD PRESSURE
AND THINGS LIKE THAT, SO THE
IMPACT OF NON-PHARM IS REALLY --
FROM WHERE IT STARTED, IT'S
AMAZING.
>> YES, THANK YOU FOR POINTING
THIS OUT, BECAUSE THIS IS REALLY
THE CULTURE CHANGE, RIGHT, THAT
WE'RE TALKING ABOUT HERE.
CULTURE CHANGE DOESN'T HAPPEN
INSTANTLY.
IT HAPPENS IN MANY DIFFERENT
WAYS.
AT NCCIH, WE'VE BEEN TALKING
ABOUT NON-PHARMACOLOGICAL
INTERVENTIONS FOR, YOU KNOW, AS
LONG AS WE'VE BEEN IN EXISTENCE,
AND IT'S NOT LIKE THERE WAS NOT
A FOCUS ON THAT AT THE OTHER
INSTITUTES, BUT NOW I HAVE TO
SAY ESPECIALLY FOSH PROGRAMS
FOR PROGRAMS LIKETHE HEAL INITIE
NON-PHARMACOLOGICAL APPROACHES
TO MANAGING PAIN ARE NOW ALL
OVER.
I MEAN, AND SO I THINK -- I LIKE
TO SAY THAT, YOU KNOW, WE'VE
INTRODUCED KIND OF A VOCABULARY
TO TALK ABOUT THESE TYPES OF
TREATMENTS.
THERE'S NO DIFFERENCE IN THE
RIGOR OF THE SCIENCE THAT GOES
TOWARDS INVESTIGATING THE
EFFECTS OR MECHANISMS OF
SOMETHING LIKE ACUPUNCTURE OR
MASSAGE OR YOGA, BUT ALSO
CONVENTIONAL PHYSICAL THERAPY OR
HEALTH COACHING OR, YOU KNOW,
THERE'S -- I THINK PEOPLE ARE
STARTING TO UNDERSTAND THAT
THERE'S A CONTINUUM OF CARE THAT
GOES ACROSS ALL OF THESE
MODALITIES, AND SO IT'S NOT --
THERE'S NO -- A LINE IN THE SAND
ANYMORE.
I THINK THIS INTEGRATION THAT
WE'RE EXPERIENCING IS HAPPENING
EVERYWHERE.
IT'S HAPPENING AT NIH AND IT'S
ALSO HAPPENING IN HEALTHCARE.
I THINK IT'S NOT AN ACCIDENT
THAT BOTH PHENOMENA ARE
HAPPENING AT THE SAME TIME,
WHICH IS VERY GOOD.
YES.
>> I AGREE THIS IS VERY
IMPRESSIVE GIVEN THE RESOURCES,
AND SO I GUESS ONE QUESTION IS,
SINCE DEMAND AND INTEREST IN
THIS IS ONLY GOING TO GROW, THE
COMMUNICATING A LOT OF THESE
ACCOMPLISHMENTS TO THE GENERAL
PUBLIC, WHAT TYPES OF MEANS OR
PLAN IS THERE TO DO THAT?
BECAUSE I THINK THERE'S A REAL
OPPORTUNITY TO TAP THESE
ACCOMPLISHMENTS.
>> SO ONE OF THEM IS THIS, THIS
VIDEOCAST IS ARCHIVED ON OUR
WEBSITE AND SO I TRY TO GIVE AN
UPDATE EVERY COUNCIL, I REALLY
TRY TO SHOW THAT AND PEOPLE CAN
VIEW IT.
BUT THE OUTREACH, OF COURSE,
NEEDS TO BE A LOT MORE THAN
THIS.
WE HAVE OUR WEBSITE, WE HAVE
OUR -- OUR COMMUNICATIONS TEAM
AT NCCIH IS REALLY VERY, VERY
ACTIVE, AND TE AT THE FOREFRONTF
MAKING SURE INFORMATION IS
DISSEMINATED IN A WAY THAT
INFORMS RESEARCH AS WELL AS THE
PUBLIC AND PEOPLE WHO DELIVER
THE CARE, TO MAKE SURE THAT
PEOPLE UNDERSTAND THAT
COMPLEMENTARY THERAPIES ARE --
WE HAVE A LOT OF EVIDENCE BUT WE
ALSO HAVE A LOT OF
MISINFORMATION ABOUT THESE TYPES
OF THERAPIES THAT WE NEED TO
MAKE SURE THAT PEOPLE GO TO THE
RIGHT SOURCES INCLUDING OUR
WEBSITE TO GET THE INFORMATION
THAT'S REALLY BASED ON SCIENCE.
SO THAT'S KIND OF WHERE OUR
COMMUNICATION STARTED FROM IN
TERMS OF COMMUNICATING ACCURATE
FACTORIAL INFORMATION TO PEOPLE,
BUT IT GOES BEYOND THAT, BECAUSE
AS YOU'RE POINTING OUT, THE
WHOLE PHILOSOPHY REGARDING
UNDERSTANDING A PERSON AS A
WHOLE IS SOMETHING THAT WE'VE
BEEN SPEARHEADING THAT IS
CATCHING ON REALLY FAST.
WE'RE NOT THE ONLY PEOPLE WHO
OBVIOUSLY TALK ABOUT WHOLE
PERSON HEALTH, FOR EXAMPLE, THE
VA HAS BEEN A LEADER IN THIS
AREA NOW FOR MANY, MANY YEARS,
BUT I CAN SAY WE ARE REALLY
LEADING IN WHOLE PERSON
RESEARCH, BECAUSE LIKE FOR
EXAMPLE OUR NOTICE OF FUNDING
OPPORTUNITY TO DEVELOP A
FUNDAMENTAL KNOWLEDGE BASE ON
THE WHOLE PERSON, I THINK THAT'S
GOING TO BE REALLY IMPORTANT TO
REALLY ANCHOR RESEARCH IN AN
INTEGRATIVE MANNER THAT I THINK
IT'S VERY IMPORTANT THAT WE
DON'T START DOING WHOLE PERSON
RESEARCH IN A WAY THAT'S
DISORGANIZED.
AND I THINK THERE'S A REAL RISK
OF THAT.
SO WHEN WE FIRST STARTED TALKING
ABOUT WHOLE PERSON RESEARCH, THE
KINDS OF COMMENTS THAT WE WOULD
GET WAS PEOPLE LIKE, OH, YOU'RE
TRYING TO BOIL THE OCEAN, OR,
THIS IS IMPOSSIBLE, YOU KNOW,
AND THERE WAS A LOT OF
SKEPTICISM AROUND THAT.
I THINK RATE NOW WE'RE STARTING
WITH OUR WORKSHOP THAT WE HELD
THREE YEARS AGO ON WHOLE PERSON
RESEARCH METHODOLOGIES WHERE WE
CLEARLY LAID A LANDMARK ROAD
PLAN ESSENTIALLY, WHAT DO WE
NEED TO DO?
WE NEED TO DEVELOP THE
METHODOLOGY, THIS RESEARCH NEEDS
TO BE RIGOROUS, WE NEED THE
RIGHT METHODS, WE NEED TO USE A
SYSTEMS APPROACH THAT USING ALL
THE CUTTING EDGE TOOLS AND
TECHNOLOGIES AND UNDERSTANDING
THAT WE HAVE NOW, IT'S ACTUALLY
EXPLODING.
BUT APPLY THAT TO UNDERSTANDING
THE WHOLE PERSON IN A WAY THAT'S
THOUGHTFUL.
AND SO I STILL FEEL, AND
APPRECIATE YOUR COMMENT BECAUSE
I REALLY FEEL LIKE WE WANT THE
WORLD TO KNOW THAT WE'RE LEADING
THE WORLD IN THIS AREA, AND WE
WANT THIS TO BE DONE WELL.
SO WE WELCOME YOUR SUGGESTIONS
AS TO HOW WE COULD COMMUNICATE
THIS, AVENUES, I SPEAK A LOT OF
CONFERENCES BUT WHAT ELSE CAN WE
DO?
SO ANY THOUGHTS YOU MIGHT HAVE
ARE WELCOME.
>> HELENE, I'M SORRY, CAN I --
>> BRUCE, YOUR COMMENT, WE HAVE
HELEN AND THEN BEN.
>> I THINK THERE ARE REAL
OPPORTUNITIES TO LEVERAGE
EXISTING TRADITIONAL MEDIA BUT
ALSO NEWER MEDIA, SOCIAL MEDIA
AND THINGS LIKE THAT.
>> SOCIAL MEDIA FOR SURE, WE DO
A LOT OF, BUT ANY IDEAS, WE'D
LOVE TO HEAR BECAUSE YOU KNOW A
FEW THINGS ABOUT THAT.
HELEN.
>> YES, I THINK HAVING A
CROSS-NIH INITIATIVE OR INTEREST
GROUPS LIKE RESILIENCE, FOR
INSTANCE, OR SPIRITUALITY,
BRINGS IT ALL INTO FOCUS BECAUSE
EVERYBODY STARTS UNDERSTANDING
THOSE ARE MULTIFACETED DOMAINS
OF HEALTH, YOU KNOW, AND
EVERYBODY STARTS THINKING IN THE
SAME FRAMEWORK, AND I THINK THAT
FACILITATES THINKING ABOUT WHOLE
PERSON HEALTH.
AND NCCIH CAN HAVE A LIVING OR A
REALLY SIGNIFICANT CONTRIBUTING
ROLE IN THAT.
>> THAT'S A GREAT COMMENT.
YOU'RE RIGHT, THE TWO -- FOR
EXAMPLE, THEMES LIKE RESILIENCE,
IT'S SOMETIMES EASIER FOR PEOPLE
TO WRAP THEIR HEAD AROUND THAT
AS IT IS -- IT'S ALMOST A
GATEWAY TO WHOLE PERSON HEALTH,
IF I'M FOLLOWING YOUR THOUGHT,
YOU KNOW?
RIGHT?
>> I GAVE A TALK FOR THAT GROUP
NOT TOO LONG AGO, AND TO MY
SURPRISE, THEY'RE NOWHERE NEAR
UNDERSTANDING WHAT IT IS YET,
BUT WHAT THEY ARE DOING IS
LOOKING AT THIS FROM THE
MULTIPLE SYSTEM PERSPECTIVE.
>> EXACTLY.
SO IT GIVES PEOPLE AN ENTRY INTO
THE WHOLE PERSON THROUGH A
CONCEPT LIKE RESILIENCE, SO I
AGREE WITH YOU, IT'S JUST A WAY
IN, AND THIS IS WHERE I THINK IT
IMPORTANT AS WE CONTINUE TO
ANALYZE OUR PORTFOLIO, WE LOOK
AT THE APPLICATIONS COMING IN
AND IT'S REALLY ENCOURAGING TO
SEE HOW MANY PEOPLE ARE
UTILIZING THOSE TYPES OF
CONCEPTS AND INTEGRATING, FOR
EXAMPLE, USING MULTICOMPONENT
INTERVENTIONS, LOOKING AT
MULTISYSTEM OUTCOMES, IT'S
STARTING TO HAPPEN KIND OF
ORGANICALLY.
SO YEAH, THAT'S A REALLY
EXCELLENT COMMENT, THANK YOU.
WE HAD BEN AND THEN -- YES, ONE
MORE SECOND.
WE'LL DO BEN FIRST.
>> SURE.
SO THANK YOU, HELENE, AND I
THINK THIS BUILDS ON HELEN'S
COMMENTS AND THEN WHAT YOU'RE
SAYING, IN PARTICULAR IN
REFERENCE TO THE CENTER FOR THE
UNDERSTANDING OF THE WHOLE
PERSON PHYSIOME WHICH I THINK IS
A BRILLIANT STEP FORWARD AND NOW
YOU KNOW WHAT I'M GOING TO SAY,
I HOPE YOU ALL ARE ALREADY
PLANNING FOR THE NEXT ITERATION
WHICH IS GOING TO GO BEYOND THE
KIND OF -- I MEAN, THAT GRANT IS
WONDERFUL AND VERY MUCH FOCUSED
ON THE BIOME AND THE PHYSIO IN E
WHICH WE KNOW ARE CRITICALLY
IMPORTANT BUT WE ALL KNOW THAT
SPIRITUAL DIMENSION, KIND OF THE
DIMENSION WE ARE NOT GOING TO
CAPTURE IN A CENTER THAT'S
FOCUSED ON PHYSIOLOGICAL
PROCESSES.
WE'RE GOING TO NEED ONE OF THEM
TOO IN THE NEXT FEW YEARS, AND I
HOPE THAT -- I MEAN, I KNOW THAT
YOU ALL ARE ALREADY THINKING
ABOUT THAT, BUT I HOPE YOU'RE
ACTUALLY STARTING TO FORMULATE
WHAT THAT RFA, WHEN IT'S READY,
IS GOING TO LOOK LIKE, AND ALSO
JUST BECAUSE I KNOW WE'RE
GETTING CLOSE TO THINKING ABOUT
THE NEXT STRATEGIC PLAN, I HOPE
THAT WHEN WE ITERATE HOW WE'RE
TALKING ABOUT WHOLE PERSON
RESEARCH IN THE STRATEGIC PLAN,
WE REALLY INCLUDE THAT EMPHASIS.
I MEAN, I THINK WE DID THE LAST
TIME, YOU DID THE LAST TIME, BUT
I THINK JUST TO EVEN ELEVATE
THAT, IT WOULD BE EASY FOR NIH
TO FEEL IT HAD ADDRESSED THIS
ISSUE BY ADDRESSING THE
PHYSIOME.
>> NO, YOU'RE RIGHT.
SO THAT'S ALREADY STARTED WE
JUST HAD A MEETING YESTERDAY
ABOUT TH THIS WITH OTHER PARTNE.
SO THE IMPORTANT THING IS THAT
THE PHYSIOME, WE CONSIDER TO BE
THIS MIDDLE LAYER, AND THEN
CONNECTING TO THAT, YOU CAN
DRILL DOWN TO THE CELLULAR AND
MOLECULAR LEVEL.
AND THEN YOU CAN ALSO DRILL UP,
CAN GO UP TO THE BEHAVIORAL,
SOCIAL, ENVIRONMENTAL LEVEL.
BUT IMPORTANTLY, WE DON'T WANT
OUR EFFORTS IN CELL
COMMUNICATION AND OUR EFFORTS IN
SORT OF SOCIAL AND ENVIRONMENTAL
COULD DMCONNECTIONS TO BE SEPARM
THE MIDDLE PHYSIOME LAYER, WE
WANT ALL THIS TO CONNECT.
SO THE REASON WE STARTED WITH
THE PHYSIOME IS VERY
INTENTIONAL, IS BECAUSE IT'S THE
MIDDLE LAYER OF THE SANDWICH.
AND THEN WE ARE GOING TO -- YOU
KNOW, GO FROM THERE IN BOTH
DIRECTIONS.
SO IT'S VERY CLEAR THAT WE WANT
ALL OF THIS TO BE CONNECTED
TOGETHER, NOT ONLY ACROSS THE
SYSTEMS BUT ALSO WHAT WE CALL
ACROSS SCALES.
BECAUSE IT'S TOO EASY, RIGHT,
RIGHT NOW WE GOT ALL OF THIS
STUFF THAT'S GOING ON, ALL OF
THESE OMIC STUDIES, ALL THE
STUDIES ON METABOLOMICS AND
GENOMICS, LIPID OMICS, WHATEVER
ELSE, ALL CONNECTED AT THE
CELLULAR LEVEL.
THEN AT THE OTHER END OF THE
SPECTRUM, WE HAVE STUDIES ON THE
WHOLE PERSON GOING ON IN
ELECTRONIC HEALTH RECORDS AND
WHOLE PERSON MEASURES AND ALL
THAT KINE OF SKIND OF STUFF BUTT
CONNECTED.
SO THE WAY IT'S GOING TO CONNECT
IS THROUGH THE MIDDLE.
SO THAT'S WHY WE'RE STARTING
WITH THE MIDDLE.
BUT ABC LIGHT ABSOLUTELY, WE ARY
STARTING TO THINK ABOUT HOW TO
INCORPORATE ALL THESE OTHER
LAYERS AS WELL, FOR SURE.
JEFF.
>> I ALSO WANT TO THANK YOU TO
ADD MUSIC INTO THE UMBRELLA,
BECAUSE HAVING STUDIED
MEDITATION BACK IN 1999 WITH
HERB BENSON, YOGA AND OTHER
TYPES OF THINGS, ACUPUNCTURE AS
WELL, CERTAIN PEOPLE -- THE PART
OF THE CULTURE WILL GRAVITATE.
10%, 15% TO MEDITATION, 4% TO
WHATEVER IT'S GOING TO BE.
BUT I TALKED ABOUT MY RESEARCH,
I MENTION MUSIC THERAPY,
EVERYONE LIGHTS UP REGARDLESS.
SO IF IT'S NOT 10%, 20%, BUT
100%.
SO I THINK LEVERAGING THAT, HOW
IT INTERACTS WITH RELAXATION AND
OTHER THINGS.
SO I WANT TO WELCOME AND THANK
YOU FOR THAT BECAUSE IT REALLY
ADDS SOME BREADTH AND I THINK WE
CAN OPEN OUR TENT EVEN WIDER TO
PARTICIPANTS AND PATIENTS AND
FOLKS WHO ARE INTERESTED.
SO FOR HEALTH AND WELL-BEING.
SO I RECOMMEND THAT ADDITION.
>> YEAH, MUSIC IS UNIVERSAL, AS
YOU SAY.
WE AGAIN WANT TO THANK EMMELINE
FOR HER LEADERSHIP IN THIS.
WE WERE FORTUNATE, OUR PREVIOUS
NIH DIRECTOR, DR. COLLINS, WAS
ALSO A BIG CHAMPION OF MUSIC AND
HELPED US TO BUILD THIS
COLLABORATION WITH THE NATIONAL
ENDOWMENT FOR THE ARTS, RENEE
FLEMING FOUNDATION, AND NCCIH,
AND SO -- AND NOW WE HAVE A
STRONG PARTNERSHIP WITH THE
NATIONAL INSTITUTE ON AGING
HERE.
SO THANK YOU, WE APPRECIATE, WE
THINK THIS IS A VERY -- AGAIN,
IT'S ONE OF THOSE GATEWAYS TO
THE WHOLE PIRN.
PERSON.I'M GOING TO USE THAT ANY
ACTUALLY.
DAN.
>> YES, THANK YOU SO MUCH FOR
THE AMAZING OVERVIEW.
YOU KNOW, WITH NATIVE AMERICANS,
I'M REALLY EXCITED ABOUT THE
RESILIENCY PIECE OF YOUR
PRESENTATION.
WITH NATIVE AMERICANS, IT ALWAYS
BEEN LIKE MAYBE 20, 30 YEARS
AGO, IT WAS VERY IMPORTANT TO
SAY WE NATIVE AMERICANS HAVE THE
HIGHEST RATES OF THIS, THE
HIGHEST RATES OF THAT,
HISTORICAL TRAUMA, THE REASONS,
BLAH, BLAH, BLAH BLAH, BUT NOW
IT'S IMPORTANT WITH NATIVE
AMERICAN PROBABLY -- THE GENERAL
POPULATION, WHAT'S OUR INHERENT
STRENGTHS?
WHAT ARE OUR AVENUES TOWARDS
SOLUTIONS, AND TOWARDS ACHIEVING
GOOD HEALTH OVERALL.
SO I'M REALLY EXCITED.
AND WITH NATIVE AMERICANS, WE
PROBABLY HAVE -- WE DON'T HAVE
ENOUGH RESEARCH DRILLING DOWN.
WE HAVE A LOT OF SOCIAL
BEHAVIORAL CONCEPTS AND MODELS,
BUT I THINK WE WANT TO MEET THE
FIELD KIND OF GOING DOWN AND
LOOKING AT THE MECHANISMS,
MECHANISTIC PROCESS.
>> I SO LOVE THAT.
I REALLY FEEL LIKE FOCUSING ON
THE POSITIVE, NOT THAT WE
DON'T -- WE DON'T WANT TO
IGNORE, OF COURSE, THE HARMS AND
THE HURTS, BUT WE FEEL THAT
WHERE NCCIH BRINGS SOMETHING
REALLY IMPORTANT HERE IS TO
FOCUS ON THE POSITIVE.
WE'VE HAD A LOT OF IMPACT
ALREADY IN THE CONVERSATION ON
THIS.
FOR EXAMPLE, WHEN I MENTIONED
WITH NATIONAL INSTITUTE ON
ENVIRONMENTAL HEALTH, THROUGH
OUR CONVERSATIONS WITH NIEHS, WE
REALLY CHANGED -- CONTRIBUTE
TODAY CHANGING THE CONTRIBUTIONS
OF REALLY THINKING ABOUT
POSITIVE WAYS TO MITIGATE
PROBLEMS AND BUILD RESILIENCE
AND HELP PEOPLE BECAUSE CERTAIN
THINGS, WE CAN'T CHANGE THERE,
BUT WHAT CAN WE DO?
AND WE FEEL A LOT OF WHAT WE CAN
OFFER HERE IN TERMS OF THE
UNDERSTANDING OF HOW TO APPLY,
FOR EXAMPLE, MIND AND BODY
THERAPIES OR MUSIC OR
INTERVENTIONS THAT REALLY HELP
PEOPLE FROM A SPIRITUAL SIDE,
ANGLE, YOU KNOW, THERE'S A LOT
HERE THAT WE NEED TO LEARN HOW
TO DO THAT BETTER AND HOW TO
SUPPORT PEOPLE IN THEIR JOURNEY
TOWARDS HEALTH.
AND WE ARE THRILLED THAT WE'RE
GOING TO BE LEARNING FROM NATIVE
AMERICAN COMMUNITIES ON HOW THEY
VIEW THIS AND DO THIS AND
HOPEFULLY, YOU KNOW, SOME OF
THAT WILL HELP PEOPLE IN GENERAL
BECAUSE WE HAVE SO MUCH TO LEARN
FROM THOSE COMMUNITIES.
ESPECIALLY IN RELATIONSHIP TO
THE ENVIRONMENT.
I CAN'T THINK HOW MUCH MORE
IMPORTANT FOR US TO FIGURE OUT
RIGHT NOW.
YEAH.
THANK YOU.
SUSIE.
>> SURE.
ONE, THANKS, IT WAS REALLY
AWESOME.
I WANTED TO DRILL DOWN A LITTLE
BIT ABOUT IMPLEMENTATION AND
POLICY RESEARCH.
WHICH I SAW THAT MENTIONED ONCE
AROUND PAIN, WHICH MAKES A LOT
OF SENSE BECAUSE OF THE
STRENGTHS IN PAIN RESEARCH THAT
HAS BEEN PUSHED FORWARD.
BUT I'M ALSO WONDERING AROUND
WHAT THE THOUGHTS ARE AROUND
IMPLEMENTATION RESEARCH BECAUSE
WE IN SCIENCE SPECIFICALLY,
BECAUSE THERE'S SO MUCH THAT WE
ALREADY KNOW THAT ISN'T HAPP
HAPPENING BECAUSE OF POLICY
ISSUES AND BECAUSE OF OTHER
IMPLEMENTATION SCIENCE, AND THE
OTHER PART I WANTED TO ALSO ASK
WAS HOW WE'RE VIEWING THINGS
LIKE MIXED METHODS, AND
BRINGING THAT RICHNESS INTO THE
LANDSCAPE OF THE MANY DIFFERENT
TYPES OF PROJECTS.
BECAUSE I OFTEN DON'T SEE IT
TALKED ABOUT, AND BROUGHT
FORWARD WHEN WE'RE TALKING ABOUT
DATA SCIENCE, AND AS YOU SAID
THE OMICS AGE, BUT ALSO SUCH A
RICH AREA.
>> THANK YOU, SUSIE.
SO FIRST OF ALL, REGARDING
IMPLEMENTATION SCIENCE, YES, WE
REALLY -- WE THINK THIS IS
IMPORTANT.
WE DON'T DO RESEARCH ON POLICY,
PER SE, WE CAN'T DO THAT.
HOWEVER, WHAT WE CAN DO IS THINK
ABOUT WHAT THE IMPORTANT -- WHAT
POLICY MAKERS, INSURANCE PAYORS
AND PEOPLE WHO DECIDE, WHO MAKE
DECISIONS ABOUT HEALTHCARE LIKE
REIMBURSEMENT, FOR EXAMPLE, WHAT
INFORMATION DO THEY NEED, RIGHT?
IN FACT, OUR STRAUSS LECTURE IS
GOING TO BE ALL ABOUT THAT.
SO I REALLY ENCOURAGE YOU TO --
WE'RE GOING TO HAVE A FANTASTIC
PANEL DISCUSSION FOLLOWING THAT,
AND IT'S A VERY, VERY IMPORTANT
CONVERSATION.
WE NEED TO KNOW, WE NEED TO
BETTER UNDERSTAND, YOU KNOW,
WHAT IS THE KIND OF RESEARCH
THAT WILL INFLUENCE -- THAT WILL
GIVE THE RIGHT DATA SO THAT
POLICY CAN BE THE BEST THAT IT
CAN BE, RIGHT?
WE'VE ALREADY DONE A GOOD AMOUNT
OF PARTNERING WITH, FOR EXAMPLE,
CENTER FOR MEDICARE SERVICES,
CMS, AND STUDIES THAT ARE TIED
TO COVERAGE DETERMINATION.
OUR LANDMARK STUDY OF
ACUPUNCTURE AND CHRONIC LOW BACK
PAIN IN OLDER ADULTS HAS REALLY
LED THE WAY HERE.
AND THERE'S A LOT OF -- I HEAR
THIS BIG CONVERSATION GOING ON
AT NIH IN GENERAL ABOUT USING
THIS SAME KIND OF MODEL.
SO FOR IMPLEMENTATION.
AND SO IMPLEMENTATION IS VERY,
VERY IMPORTANT IN SO MANY OF OUR
PROGRAMS.
THE PRAGMATIC AND IMPLEMENTATION
STUDY THAT I MENTIONED, THE
PRISSMM STUDY WITHIN THE HEAL
INITIATIVE.
WE DO A LOT OF IMPLEMENTATION
STUDIES THERE TO TAKE THERAPIES
THAT WE KNOW ARE EFFECTIVE AND
UNDERSTAND HOW IT CAN BE
DEPLOYED IN HEALTHCARE SYSTEM,
FOR EXAMPLE, IN UNDERSERVED
AREAS, THOSE KINDS OF THINGS,
RURAL AREAS.
SO THIS IS AN AREA WHERE WE'RE
VERY, VERY ACTIVE.
THE SECOND PART OF YOUR QUESTION
WAS WHAT AGAIN, PLEASE?
REMIND ME.
>> IT WAS ABOUT MIXED METHODS
RESEARCH.
>> OH, MIXED METHODS, VERY
IMPORTANT.
MIXED METHODS, YOU KNOW, I THINK
WE'RE AT A POINT NOW WHERE WE
CAN NOW DO SO MUCH WITH NATURAL
LANGUAGE MODELS, RIGHT?
WE CAN TAKE NARRATIVES AND WHAT
PEOPLE ARE SAYING THAT IS
QUALITATIVE, BUT THEN EXTRACT
INFORMATION FROM THEM IN A WAY
WWERE NEVER, NEVER ABLE TO DO
BEFORE.
SO WE SHOULD NOT JUST READ THE
NARRATIVES FOR THEIR OWN SAKE,
BUT HOW DO YOU GET DATA FROM IT
THAT YOU CAN ANALYZE.
SO I THINK THE MIXED METHOD
FIELD IS GOING TOE RAOLY EXPLODE
COMING UP, YOU KNOW, WHEN WE
START TO REALLY EXTRACT AS MUCH
AS WE CAN, YOU KNOW, FROM THEM.
SO THAT'S JUST ONE WAY THAT WE
CAN USE THE -- BUT THANK YOU,
THAT'S A GREAT -- ABSOLUTELY
SOMETHING THAT NEEDS TO HAPPEN.
THANK YOU.
ERICA.
>> I'D JUST LIKE TO FOLLOW UP ON
THAT MIXED METHODS EMPHASIS.
I THINK THERE'S -- FOR ONE THING
POLICY MAKERS REALLY RELATE TO
NARRATIVE, SO EVEN IF WE HAVE
DATA, TO BE ABLE TO HAVE THAT
RESONATE WITH STORIES, WITH
PEOPLE'S ACTUAL WORDS IS REALLY
IMPORTANT.
AND USING, OF COURSE, RIGOROUS
QUALITATIVE METHODOLOGIES, WHICH
GIVE YOU THAT.
BUT ALSO IT REALLY ADDS TO THE
NUANCE OF THE WHOLE PERSON
HEALTH.
BECAUSE WE KNOW THAT OUR
MEASURES HAVE FLAWS, AND WE MAY
HAVE SOME OF THE MOST IMPORTANT
THINGS THAT WE'RE GRAPPLING WITH
FOR WHICH WE DON'T HAVE GOOD
MEASURES OR WHICH WE ARE --
OBVIOUSLY FEEL LIMITED IN OUR
MEASUREMENT, BUT THAT CUT ACROSS
THE WHOLE PERSON HEALTH KIND OF
CONCEPT.
AND QUALITATIVE WORK CAN REALLY
HELP ENRICH OUR UNDERSTANDING OF
IMPACT AND DATA AND SO I'M JUST
CLIMBING ON THE TRAIN.
>> WELL, YOU'RE RIGHT, THE POWER
OF A GOOD STORY IS LIKE PAINTING
A PICTURE, RIGHT?
AND IT CAN SPEAK TO THE ESSENCE
OF WHAT'S HAPPENING, AND I MEAN,
I THINK WE HAVE TO DO BOTH.
WE HAVE TO DO BOTH.
WE HAVE TO PAINT THE PICTURE,
AND THEN WE HAVE TO EXTRACT THE
BIT OF INFORMATION FROM THE
PICTURE THAT CAN BE ANALYZABLE
AND THAT'S WHAT PEOPLE LIKE YOU,
YOU KNOW, DO.
AND I THINK THIS IS -- YEAH,
THIS IS SO IMPORTANT, ESPECIALLY
WHEN WE'RE TRYING TO INTRODUCE A
NEW LANGUAGE OF UNDERSTANDING.
YOU REMEMBER SOME TIME AGO, IT
WASN'T THAT LONG AGO THAT PEOPLE
INTRODUCED THE WORD
PATIENT-CENTERED, RIGHT?
I MEAN, IT NOT LIKE RESEARCH
WASN'T PATIENT-CENTERED BEFORE,
BUT THAT WORD, I THINK,
PATIENT-CENTERED OR
PATIENT-REPORTED OUTCOMES, WE
STARTED TALKING ABOUT THAT, I
FORGET HOW LONG AGO IT WAS, 20
YEARS MAYBE, SOMETHING LIKE
THAT?
BUT I THINK THAT IS -- IT MADE
PEOPLE AWARE THAT IT IMPORTANT
TO LISTEN TO THE PATIENT.
AND IT SOUNDS VERY SELF-EVIDENT
NOW, BUT -- AND MAYBE WE WEREN'T
LISTENING WELL ENOUGH BEFORE FOR
SURE, RIGHT?
SO YEAH, I THINK WE NEED TO
REALLY CONTINUE TO BE AWARE HOW
IMPORTANT THAT IS.
YEAH.
>> OKAY, HELENE, I DON'T WANT TO
BE THE BAD GUY HERE, BUT --
>> WE'RE OUT OF TIME.
>> I HAVE TO REMIND PEOPLE WE
HAVE ONE MORE PRESENTATION
BEFORE LUNCH.
>> OH, MY GOSH.
I'M SO SORRY.
I WASN'T WATCHING THE CLOCK.
>> IT CUTS INTO YOUR LUNCH BREAK
AND THAT'S THE REALITY.
>> THAT WAS WONDERFUL.
I WISH YOU COULD HAVE TALKED
LONGER.
ANYWAY, I AM HERE FOR THE ANNUAL
UPDATE OF THE NCCIH DIVISION OF
INTRAMURAL RESEARCH, AND MY
THEME THIS TIME IS BUILDING THE
NCCIH INTRAMURAL PROGRAM.
AND THE REASON I SAY THAT IS,
WE'VE BEEN AROUND FOR 12 YEARS,
WHICH SEEMS LIKE A LONG TIME.
ACTUALLY EVEN AFTER 12 YEARS,
WE'RE STILL GROWING AND
EVOLVING.
WE'VE HAD SIGNIFICANT CHANGE IN
A RELATIVELY SHORT TIME, AND I
SAY SHORT TIME RELATIVELY
SPEAKING BECAUSE WE GET A LOT OF
SUPPORT FROM, FOR EXAMPLE, THE
NATIONAL INSTITUTE ON
NEUROLOGICAL DISORDERS AND
STROKE, AND THEY JUST TURNED 74
YEARS OLD.
SO JUST TO PUT THIS IN
PERSPECTIVE, WE ARE RELATIVELY
NASCENT.
AND IT STARTED UNDER THE FORMER
DIRECTOR, DR. JOSIE BRIGGS, IN
CONSULTATION AT THE TIME WITH
DR. STORY LANDIS FROM THE
NATIONAL INSTITUTE OF
NEUROLOGICAL DISORDERS AND
STROKE, AND THEY REALIZED AT
THAT TIME, AND YOU CAN SEE WHY
THIS WAS SO IMPORTANT THEN, 12
YEARS AGO, THEY DECIDED TO FOCUS
THE ENTIRE RESEARCH PROGRAM ON
PAIN.
AND YOU CAN SEE HOW THAT'S
REALLY FED INTO OUR NARRATIVE
HERE AT NCCIH, EXTRAMURALLY, AND
I THINK IT WAS A BRILLIANT IDEA
TO FOCUS THE PROGRAM ON PAIN
INTRAMURALLY.
THE OTHER THING THAT'S IMPORTANT
ABOUT PAIN AS YOU PROBABLY KNOW,
THERE'S NO PAIN INSTITUTE AT THE
NIH.
BACK TO OUR DISCUSSION ABOUT HOW
COMPLEMENTARY AND INTEGRATIVE
APPROACHES ARE USED BY THE
PUBLIC PRIMARILY OR ONE MAJOR
REASON IS FOR THE MANAGEMENT OF
PAIN.
YOU CAN SEE WHY THIS IS AN
IMPORTANT AREA.
AND AGAIN, GETTING BACK TO BASIC
MECHANISMS AND OUR UNDERSTANDING
OF PAIN, WHICH IS VERY COMPLEX,
IT'S JUST NOT NOCICEPTION,
RIGHT, IT'S MORE COMPLICATED
THAN THAT.
BUT WE HAVE VERY LITTLE
RESEARCH.
AND THAT'S WHERE THE HEAL
INITIATIVE COMES IN, AND I'LL
TALK ABOUT THAT IN A LITTLE BIT,
HOW OUR INTRAMURAL PROGRAM IS
GETTING INVOLVED WITH THE HEAL
INITIATIVE, WITH YOU BUT ALSO E
GOING WITH OUR MISSION.
SO WHAT IS OUR MISSION?
SO OUR OVER ALL MISSION OF THE
PROGRAM IS TO CONDUCT BASIC
CLINICAL AND TRANSLATIONAL
RESEARCH FOCUSING ON THE ROLE OF
THE NERVOUS SYSTEM, OTHER
PHYSIOLOGICAL SYSTEMS,
PSYCHOLOGICAL FACTORS,
APPRECIATING THAT PAIN IS,
AGAIN, NOT JUST NOCICEPTION, IN
PERCEIVING AND MODIFYING AND
MANAGING PAIN.
IMPORTANTLY, THIS IS A MISSION
OF ALL INTRAMURAL PROGRAMS AT
THE NIH, WE PROVIDE A RICH
ENVIRONMENT FOR TRAINING, AND
DEVELOPMENT OF CLINICAL AND
BASIC SCIENTISTS.
SO IN THAT SENSE, WE ARE VERY
SIMILAR TO OTHER INSTITUTES AT
THE NIH.
AND AGAIN, THE REASON WHY WE'RE
SO INTERESTED IN PAIN, IF YOU
THINK ABOUT PAIN IN THE UNITED
STATES, THERE ARE MORE PEOPLE
SUFFERING WITH CHRONIC PAIN THAN
CANCER, HEART DISEASE AND
DIABETES COMBINED.
IT A MAJOR PUBLIC HEALTH PROBLEM
AND CHALLENGE, AND AGAIN, OUR
PROGRAM CAN REALLY HELP.
SO WHAT IS OUR VISION TO HELP
ADDRESS THIS MAJOR PUBLIC HEALTH
CHALLENGE?
WE REALLY STRIVE TO BE A
MULTIDISCIPLINARY COLLABORATIVE
RESEARCH PROGRAM.
THAT'S REALLY IMPORTANT.
THE INTRAMURAL ENVIRONMENT AT
NIH IS QUITE COLLABORATIVE.
IT NOT SILOED, WE WORK
COLLABORATIVELY WITH ALL OTHER
INSTITUTES AND I'LL GET MORE
INTO THAT WHEN I TALK ABOUT THE
PAIN RESEARCH CENTER TA WE
SUPPORT.
BUT IN OUR OWN PROGRAM, WE HAVE
A VERY STRONG EPIDEMIOLOGICAL
PROGRAM, WHICH YOU HEARD ABOUT
FROM HELENE'S TALK, CLINICAL,
TRANSLATIONAL, BASIC RESEARCH
THAT FOCUSES ON ACUTE AND
CHRONIC PAIN, AND ASSOCIATED
PROCESSES OR CONDITIONS
INCLUDING THOSE THAT APPLY TO
THE CONCEPT OF WHOLE PERSON
HEALTH AND HEALTH RESTORATION,
WHICH WE'VE JUST TALKED ABOUT AS
WELL.
SO OUR PROGRAM IS REALLY
MULTIFACETED.
IT'S INVOLVED IN DOING CUTTING
EDGE PAIN RESEARCH FROM
MOLECULES TO HUMANS.
WE HAVE A ROBUST AND DIVERSE
ENVIRONMENT THAT TRAINS AND
SUPPORTS THE NEXT GENERATION OF
SCIENTISTS, WHICH IS REALLY A
KEY FACTOR FOR AN INTRAMURAL
PROGRAM.
A COMMITMENT TO EXPAND PRESENCE
OF PAIN AT THE NIH.
WHILE WE'RE DOING A VERY GOOD
JOB IN THE EXTRAMURAL COMMUNITY,
WE HAVE LITTLE -- OR WE'RE
STARTING TO GROW A MORE
COLLABORATIVE EFFORT AROUND PAIN
RESEARCH IN THE INTRAMURAL
PROGRAM, AND REALLY NCCIH IS
LEADING THAT EFFORT, WHICH I'M
VERY PROUD.
WE HAVE A STRONG COMMITMENT TO
EQUITY, DIVERSITY AND INCLUSION.
AND IMPORTANTLY WE ALSO WANT TO
SERVE THE PATIENTS THAT COME TO
THE NIH FOR VARIOUS DISORDERS,
DISEASES, THEY ALSO IN MANY
CASES HAVE CO-MORBID PAIN AND WE
DO THAT THROUGH THE PAIN
RESEARCH CENTER WHICH I'LL TALK
MORE ABOUT IN A MOMENT.
SO THIS IS SORT OF WHERE WE LIVE
ON THE NIH CAMPUS.
WE HAVE RESEARCH GOING ON IN THE
CLINICAL CENTER, IN OUR
OUTPATIENT CLINICS.
WE HAVE OUR BASIC SCIENCE
PROGRAM IS HOUSED AT THE PORTER
NEUROSCIENCE RESEARCH CENTER
HERE AGAIN ON THE MAIN CAMPUS,
AND AFTER A FEW YEARS, LET'S
SAY, WE WERE ABLE TO RENOVATE
ONE OF THE PUBLIC HEALTH SERVICE
OFFICER'S QUARTERS.
I DON'T KNOW IF YOU KNOW, BUT
PEOPLE ACTUALLY USED TO LIVE ON
CAMPUS.
THE SURGEON GENERAL WAS OFFERED
A HOUSE, THE CURRENT SURGEON
GENERAL IS OFFERED AN
OPPORTUNITY TO LIVE ON THE NIH
CAMPUS, BUT OVER TIME, THE
HOUSING IS BEING CONVERTED TO
OFFICE SPACE.
WE HAVE JUST CONVERTED ONE OF
THESE PUBLIC HEALTH SERVICE
OFFICER'S QUARTERS TOWNHOMES TO
OFFICE SPACE FOR A CLINICAL
RESEARCH PROGRAM, WHICH IS VERY
CLOSE TO THE CLINICAL CENTER SO
IT'S REALLY CONVENIENT FOR OUR
CLINICAL STAFF.
THE OTHER THING WE'VE DONE IS
WE'VE REORGANIZED OUR DIVISION.
WE'VE DONE THIS TO REALLY BUILD
OUT THE PROGRAM IN SOME WAYS,
STARTING IN THE LEFT-HAND CORNER
OVER HERE WITH THE OFFICE OF
CLINICAL DIRECTOR HERE, IT'S
SOMETHING WE JUST ADDED TO OUR
PROGRAM.
THIS IS LED BY DR. MISHA
BEJKONYA, TO DO RESEARCH WITH
PATIENTS PARTICULARLY WHO HAVE
COMPLEX PAIN DISORDERS, BUT
IMPORTANTLY, THEY SERVE AS THE
OVERSIGHT REGULATORY AND SAFETY
MONITORING FOR OUR ENTIRE
CLINICAL PROGRAM, AND THEY DO A
FABULOUS JOB OF THAT.
PART OF OUR CLINICAL PROGRAM IN
THE NEXT BOX IS THE AFFECTIVE
NEUROSCIENCE AND PAIN LABORATORY
DIRECTED BY DR. LAUREN ATLAS.
AGAIN, THEY ARE LOOKING AT PAIN
AS A COMPLEX
MULTIDISCIPLINARY -- FROM A
MULTIDISCIPLINARY APPROACH
LOOKING AT PAIN FROM BOTH
EMOTIONAL COGNITIVE MECHANISMS,
EXPECTATIONS, AFFECT AS WAYS IN
WHICH PAIN IS BEING INFLUENCED,
AND BOTH INFLUENCING PAIN BUT
ALSO EMOTIONAL EXPERIENCE AND
FOCUSED ON CLINICAL OUTCOMES.
ANOTHER PROGRAM THAT'S BEEN
AROUND FOR A WHILE IS THE
PROGRAM PAIN NEUROCIRCUITRY AND
CELLULAR PLASTICITY LABORATORY
LED BY DR. YARMAR CARISTIO.
A KEY FOCUS OF HER RESEARCH IS
FOCUSED ON THE CENTRAL AMYGDALA
AS A PAIN REOSTAT THAT MOD LATES
PAIN IN THE BRAIN BUT LOOKING
BROADLY AND DETERMINING HOW SEX
PLAYS A ROLE IN PERCEPTION OF
PAIN.
ANOTHER PROGRAM THAT'S BEEN
AROUND FOR THE 12 YEARS IS THE
SENSORY CELLS AND CIRCUITS
LABORATORY.
LED BY DR. ALEX CHESS LER, HOW
SENSORY INPUTS, PARTICULARLY
MECHANOSENSATION IS DETECTED AT
THE PERIPHERY, AND THEN IS
TRANSLATED TO THE BRAUN THAT
AFFECTS SPECIFIC BEHAVIORS.
WONDERFUL WORK IN THAT PROGRAM.
AND THEN I MENTIONED OFFICIALLY
NOW UNDER THIS REORGANIZATION
THE PAIN RESEARCH CENTER, AND
THIS IS REALLY SERVING AS A
RESEARCH CORE THAT NCCIH LEADS
TO SERVE AS A RESEARCH HUB FOR
ALL NIH -- ACTUALLY THE ENTIRE
INTRAMURAL RESEARCH PROGRAM.
IT GIVES CLINICAL RESEARCHERS
THE OPPORTUNITY FROM OUTSIDE THE
PAIN FIELD, INSIDE THE PAIN
FIELD BUT PRIMARILY OUTSIDE THE
PAIN FIELD TO STUDY PAIN AMONG
DIVERSE PATIENT POPULATIONS
COMING TO THE NIH.
SO THIS IS REALLY AN IMPORTANT
RESEARCH CENTER AT THE NIH
BECAUSE YOU CAN THINK ABOUT THE
DIVERSITY OF PATIENTS WITH
CONDITIONS RANGING FROM CANCER
TO SICKLE CELL DISEASE TO
AUTOIMMUNE DISORDERS TO
PSYCHIATRIC CONDITIONS TO RARE
GENETIC CONDITIONS, AND MANY IF
NOT ALL OF THESE CONDITIONS ARE
CO-MORBID FOR PAIN.
SO I LIKE TO SAY THAT YOU MAY BE
A PANE RESEARCHER AND YOU DON'T
EVEN KNOW IT BECAUSE THE PATIENT
POPULATION YOU'RE WORKING WITH
IS PROBABLY -- HAS CO-MORBID
PAIN.
THIS IS WHERE THE PAIN RESEARCH
CENTER CAN PROVIDE THAT
EXPERTISE AND REA SOURCE TO ANDY
PAIN AMONG THE PATIENTS THAT
COME TO THE CLINICAL CENTER.
SO REALLY EXCITED ABOUT THIS
OPPORTUNITY TO REALLY BRING PAIN
RESEARCH TOGETHER WITH THIS
CENTER.
FINALLY AS HELENE MENTIONED,
WE'VE ADDED -- WE'VE BROUGHT
OVER THE EPIDEMIOLOGY PROGRAM,
RICHARD NAHIN WHO FOR MANY YEARS
SERVED UNDER THE OFFICE OF THE
DIRECTOR UNDER DR. LANGEVIN
DIRECTLY IS NOW MOVING INTO OUR
INTRAMURAL PROGRAM, AND HE'S
RESPONSIBLE FOR THE DESIGN,
IMPLEMENTATION AND ANALYSIS OF
HIGH QUALITY SURVEYS AND
LONGITUDINAL STUDIES THAT WILL
FURTHER THE UNDERSTANDING OF
COMPLEMENTARY HEALTH APPROACHES
AND CHRONIC PAIN AS WELL AS
FACTORS THAT CONTRIBUTE TO
RESILIENCE, WELL-BEING AND
HEALTH RESTORATION.
IMPORTANTLY BY BEING IN THE
INTRAMURAL PROGRAM NOW, THIS
PROGRAM CAN NOW COLLABORATE WITH
OTHER EPIDEMIOLOGIC PROGRAMS
ACROSS THE NIH.
SO IT'S REALLY LEVERAGING THIS
PROGRAM IN WAYS THAT IT COULDN'T
DO PREVIOUSLY.
SO VERY EXCITED.
THE OTHER THING TO NOTE ABOUT
THIS NEW REORGANIZATION, WHICH
IS BECAUSE WE'RE SO SMALL IS
THAT IT'S A FLAT STRUCTURE.
SO EVERY SECTION REPORTS
DIRECTLY TO THE SA SCIENTIFIC
DIRECTOR, THERE'S NO MIDDLE
PERSON, THERE'S NO BRANCH,
THERE'S NO OTHER STRUCTURE.
SO THAT'S REALLY A NICE WAY THAT
THERE'S DIRECT ACCESS TO THE
SCIENTIFIC DIRECTOR, THE
EXCEPTION BEING UNDER NIH
POLICY, THE CLINICAL DIRECTOR,
THE OFFICE OF THE CLINICAL
DIRECTOR REPORTS DIRECTLY TO THE
INSTITUTE DIRECTOR FOR REASONS
RELATED TO POLICY AND SAFETY.
SO THAT'S OUR REORGANIZATION.
WE'RE VERY PROUD OF THE MANY
ACCOMPLISHMENTS WE'VE HAD OVER
THE YEARS.
AGAIN AS I MENTIONED, WE'RE 12
YEARS OLD SO A LOT OF GOOD NEW
CAREER CHANGING EVENTS HAVE
HAPPENED WITH OUR INVESTIGATORS.
DR. LAUREN ATLAS RECEIVED NIH
TENURE JUST ABOUT A YEAR AGO, A
LITTLE LESS THAN A YEAR AGO NOW.
DR. MISHA BACKONJA WAS RECENTLY
APPOINTED CLINICAL DIRECTOR IN
FEBRUARY THIS YEAR.
YOU MENTIONED THE REORGANIZATION
THAT JUST LITERALLY HAPPENED IN
APRIL.
DR. YARIMAR CARRASQUILLO
RECEIVED NIH TENURE IN MAY OF
THIS YEAR.
DR. RICHARD NAHIN APPOINTED
CHIEF OF THE EPIDEMIOLOGY
PROGRAM IN JUNE.
DR. CHESLER RECEI WENT THROUGH S
THIRD BOARD OF SCIENTIFIC
COUNCIL'S REVIEW.
THESE ARE EVERY FOUR YEARS.
PIs ARE REVIEWED BY OUTSIDE
EXPERTS AT THEIR SCIENCE.
HE RECEIVED AN OUTSTANDING
RATING WHICH SAYS A LOT ABOUT
HIS RESEARCH BUT ALSO ABOUT OUR
PROGRAM THAT JUST HAPPENED IN
JULY.
WE'RE VERY EXCITED ABOUT MANY
NEW STAFF HIRES AND PROMOTIONS
THAT MAY HAVE BEEN MENTIONED AT
COUNCIL, I THINK THEY'RE IN YOUR
ELECTRONIC COUNCIL BOOK SO I
ENCOURAGE UR TO L YOU TO LOOK A.
AND AGAIN GETTING BACK TO
BUILDING OUR PAIN RESEARCH
CENTER, WE'RE JUST IN THE
PROCESS NOW OF HIRING A FACILITY
HEAD.
WE HAVE A TENTATIVE OFFER, AND
IF ALL GOES WELL, YOU KNOW, IT'S
THE GOVERNMENT SO YOU NEVER SAY
IT GOING TO HAPPEN UNTIL IT
FINALLY HAPPENS, BUT WE'RE
HOPEFUL THAT OUR NEW FACILITY
HEAD WILL BE ON BOARD BY
NOVEMBER OF THIS YEAR.
SO A LOT OF EXCITING GROWTH AND
CHANGE AND AGAIN THE THEME OF
BUILDING THE PROGRAM.
THIS IS JUST TO GIVE YOU A
SNAPSHOT OF SOME OF THE REALLY
EXCITING RA RESEARCH GOING ON IN
OUR INTRAMURAL PROGRAM.
I WON'T HAVE TIME TO GO INTO IT,
BUT IT'S NICELY CAPTURED ON OUR
WEBSITE, THE RESEARCH
SPOTLIGHT'S WEBSITE, SO YOU CAN
SEE THE URL AT THE BOTTOM, BUT
YOU CAN SEE THIS IS CUTTING EDGE
RESEARCH FROM DRS. CARRASQUILLO,
ATLAS, CHESLER, NAHIN, AND I
HOPE YOU'LL HAVE AN OPPORTUNITY
TO REVIEW.
GETTING BACK TO THE HEAL
INITIATIVE, HELPING END
ADDICTION LONG TERM, THIS IS A
PROGRAM THAT CUTS ACROSS MANY
INSTITUTES AT THE NIH ON THE
EXTRAMURAL SIDE.
JUST THIS YEAR ACTUALLY, AGAIN,
VERY RECENTLY IN MAY AND WE'RE
ABOUT TO THINK ABOUT FUNDING
INTRAMURAL INVESTIGATORS UNDER
HEAL THIS MONTH, WE LAUNCHED THE
I-HEAL PROGRAM, INTRAMEUR HEAL
INITIATIVE PAIN RESEARCH
PROGRAM.
AND JUST FOR THOSE WHO MAY NOT
KNOW THE HISTORY OF THE HELPING
END ADDICTION LONG TERM HEAL
INITIATIVE, HOW WE GOT HERE, IT
REALLY STARTED A LONG TIME AGO,
IN 1999, WITH A FIRST WAVE OF
OPIOID USE THAT HAPPENED WITH
THE OVERPRESCRIBING OF OPIOID
MEDICATIONS, NEW FORMULATIONS
WERE COMING ON THE MARKET.
THERE WAS AN ADVOCACY FOR
PRESCRIBING OPIOID MEDICATIONS
TO PATIENTS TO TREAT PAIN.
WE CERTAINLY REALIZED THAT THESE
NEW FORMULATIONS WERE ADDICTIVE
AND MANY PEOPLE UNFORTUNATELY
WERE OVERDOSING ON THESE MED
KAIGS THAT RESULTED IN DEATHS.
THAT WAS THE FIRST WAVE.
AND THEN IN 2010, WE HAD A
SECOND WAVE WITH THE RISE IN
HEROIN OVERDOSE AND DEATHS, AND
THREE YEARS LATER, THE EPIDEMIC
TOOK A NEW TO THE FORM, THE
THIRD WAVE, WITH OVERDOSE AND
DEATHS STARTING WITH THE
INTRODUCTION OF FENTANYL.
WHICH IS A SYNTHETIC OPIOID.
IT'S APPROXIMATELY 100 TIMES
MORE POTENT.
THAN MORPHINE AND 50
TIMES MORE POTENT THAN HAIR ONE
ANDHEROINAND THAT REALLY ACCELEE
PROBLEM OF ADDICTION BUT
CERTAINLY ACCELERATED THE
PROBLEM OF OVERDOSE AND DEATH.
SO IN 2017, HEALTH AND -- THE
DEPARTMENT OF HEALTH AND HUMAN
SERVICES DECLARED THE OPIOID
CRISIS A PUBLIC HEALTH
EMERGENCY, AND IN 2018, THERE
WAS A SPECIAL SETASIDE AND
REPORT FROM THE CONGRESS, THE
NIH HELPING TO END ADDICTION
LONG TERM INITIATIVE WAS
LAUNCHED TO ACCELERATE
SCIENTIFIC SOLUTIONS FOR OPIOID
USE DISORDER OVERDOSE, AND
REALLY GETTING AT SOME OF THE
ROOT CAUSE OF THESE OVERDOSE
DEATHS IS TO ACCELERATE THE
RESEARCH ON MANAGEMENT OF PAIN.
AND THAT'S BEEN A VERY
SUCCESSFUL PROGRAM.
YOU CAN SEE HERE OVER 18,000
PROJECTS HAVE BEEN SUPPORTED BY
THE HEAL INITIATIVE IN THE LAST
FIVE-PLUS YEARS.
YOU CAN SEE THAT IT COVERS
EXTRAMURAL SUPPORT ACROSS ALL 50
STATES.
IT REALLY IS A GAME CHANGER IN
TERMS OF HOW WE'RE THINKING
ABOUT THE TREAT W TREATMENT OF ,
IMPROVING OUR UNDERSTANDING OF
MANAGING OPIOID USE DISORDER AND
PREVENTION AND TREATMENT OF
OPIOID MISUSE AND ADDICTION.
SO THIS HAS REALLY BEEN AS I SAY
A GAME CHANGER FOR THE
EXTRAMURAL COMMUNITY AND AS WE
MOVE THE PROGRAM FOR THE OFFICE
OF THE DIRECTOR BACK TO
NEUROLOGICAL DISEASES AND STROKE
INSTITUTE AND NIDA, LEADERSHIP
HAS RETHOUGHT THE ROLE OF THE
INTRAMURAL PROGRAM AND HAS
DECIDED THAT THE INTRAMURAL
PROGRAM SHOULD BE INVOLVED TOO.
AND SOME GOOD REASONS FOR THAT
TO BE THE CASE.
THERE ARE SOME REALLY UNIQUE
STRENGTHS WITH THE INTRAMURAL
PROGRAM.
WE HAVE THE OPPORTUNITY TO
LEVERAGE AN EXISTING RESEARCH
INFRASTRUCTURE THAT'S ALREADY
PAID FOR.
WE HAVE CORES TO CUTTING EDGE
TECHNOLOGY THAT WE CAN
MAXIMIZITY EFFICIENCY AND IMPACT
AND FOCUS SOME OF THOSE
RESOURCES TO THE MISSION OF
HEAL.
BUT AT THE SAME TIME, WE WANT TO
MAKE SURE THAT THE PROCESS IS
COMPETITIVE AND RIGOROUS SO
WE'VE ADOPTED THE EXTRAMURAL
APPROACH TO PEER REVIEW.
AND OF COURSE ALL PROJECTS
SHOULD ADDRESS THE KEY ASPECTS
OF THE HEAL INITIATIVE.
SO I-HEAL RIGHT NOW IS SOLELY
DEVOTED FOR PAIN RESEARCH, IT'S
FLEXIBLE AND SCALABLE AND WE SEE
THOSE AVAILABLE FUNDS FROM HEAL.
IT'S REALLY A SMALL PERCENTAGE
OF THE BUDGET.
IN THE END, IT WILL BE LESS THAN
1% OF THE HEAL INITIATIVE
BUDGET.
SO JUST TO SUMMARIZE, WE JUST
LAUNCHED THIS PROGRAM IN APRIL
FISCAL YEAR '24.
FOR THIS FIRST PAY L PILOT ROUNT
WILL BE PRIMARILY FOCUSED ON
PAIN RELATED RESEARCH WE HOPE AS
THIS PROGRAM DEVELOPS AND GROWS
AND EVOLVES, THAT WILL INCLUDE
NIDA, THE HEAL PORTION THAT'S
UNDER NIDA TO FOCUS ON OPIOID
USE DISORDER, SUBSTANCE USE
DISORDERS AND WE HOPE THAT WILL
HAPPEN IN FISCAL '25.
WE ALSO AGAIN HOPE TO --
INTERESTED IN DOING PAIN
RESEARCH, WE'VE PROMOTED THE
PAIN RESEARCH CENTER AS AN
OPPORTUNITY TO LEVERAGE SO
PEOPLE OUTSIDE OF THE PAIN
RESEARCH FIELD CAN GET INVOLVED
USING THE PAIN RESEARCH CENTER.
SO THAT'S WHERE YOU'RE GOING
WITH INCORPORATING HEAL INTO THE
NCCIH INTRAMURAL PROGRAM BUT
AGAIN PART OF THIS BUILDING
THEME, WE'RE HIRING.
IMPORTANTLY THIS IS REALLY A KEY
POSITION, I'VE BEEN ACTING
SCIENTIFIC DIRECTOR FOR 4 1/2
YEARS BUT WHO'S COUNTING AND
WE'LL PROBABLY BE DOING IN
ANOTHER SIX MONTHS OR SO AND I
REALLY ENJOYED MY TIME WITH THIS
GROUP, I THINK IT'S JUST A
FABULOUS DIVISION, REALLY SMART,
CREATIVE AND ENTHUSIASTIC TEAM
THAT WE HAVE.
BUT IT'S TIME TO PASS THE BATON
SO TO SPEAK.
SO WE'RE JUST NOW OPENING A
SEARCH LOOKING FOR AN
ACCOMPLISHED SCIENTIST WHO HAS A
DEMONSTRATED TRACK RECORD OF
INTERNATIONALLY RECOGNIZED BASIC
TRANSLATIONAL OR CLINICAL
RESEARCH, WE'RE REALLY BROADLY
LOOKING FOR ANYONE, THEY REALLY
DO NEED TO BE IN THE PAIN FIELD,
BUT ANY ASPECTS OF PAIN RESEARCH
WILL DO, SPO SO TO SPEAK.
OF COURSE BECAUSE THEY WILL BE
LEADING THE PROGRAM, THEY NEED
STRONG LEADERSHIP SKILLS TO
SUSTAIN THIS VIBRANT AND
COLLABORATIVE TEAM THAT WE'VE
REALLY BUILT NOW OVER THE LAST
12 YEARS, AND I THINK IT'S
REALLY COME A LONG WAY AND READY
FOR NEW LEADERSHIP.
SO IF ANY OF YOU OR IF YOU KNOW
OF ANYONE WHO'S INTERESTED IN
APPLYING, PLEASE LET THEM KNOW.
I THINK IT WILL OFFICIALLY COME
ONLINE PROBABLY BY THE END OF
THE MONTH, EARLY IN OCTOBER, AND
WE'LL BE OPEN FOR SOME TIME FOR
APPLICATIONS TO BE RECEIVED.
SO IN ADDITION BECAUSE OF MOVING
THE EPIDEMIOLOGY PROGRAM INTO
THE DIVISION OF INTRAMURAL
RESEARCH, WE NOW HAVE NEW
POSITIONS THAT WE CAN APPLY TO
THE EPIDEMIOLOGY PROGRAM, IN
THIS CASE, RESEARCH FELLOWS THAT
DR. NAHIN IS INTERESTED IN
HIRING TWO RESEARCH FELLOWS TO
BUILD OUT THE EPIDEMIOLOGY
PROGRAM TO A GREATER EXTENT, AND
THOSE APPLICATIONS ARE NOW BEING
SOLICITED, THE ANNOUNCEMENT IS
ON THE WEB, YOU CAN SEE THE QR
CODE HERE.
APPLICATIONS ARE DUE
NOVEMBER 22ND.
SO IF YOU KNOW ANYONE THAT'S
DOING EPIDEMIOLOGY RESEARCH, HAS
POSTDOCTORAL EXPERIENCE OR
ADVANCED TRAINING, AN M.P.H.,
PLEASE ENCOURAGE THEM TO APPLY,
I THINK IT'S A GREAT OPPORTUNITY
FOR THEM TO COME AS THIS PROGRAM
IS NOW IN ITS NEXT PHASE OF
WORKING IN THE INTRAMURAL
PROGRAM, SO REALLY A GREAT
OPPORTUNITY FOR PEOPLE TO GET
INVOLVED.
IT'S NOT JUST RICHARD WHO'S
HIRING, WE'RE ALWAYS LOOKING FOR
TALENTED EARLY CAREER
INVESTIGATORS.
DR. BACKONJA THROUGH THE OFFICE
OF THE CLINICAL DIRECTOR IS
LOOKING FOR CLINICAL RESEARCHERS
TO GET INVOLVED IN HIS GROUP.
WE'RE ALWAYS LOOKING FOR
TALENTED POSTBAC AND
POSTDOCTORAL INDIVIDUALS ACROSS
THE THREE LABORATORIES AT THE
NIH.
SO HERE'S THE CONTACT
INFORMATION, THE QR CODE TO
LEARN MORE.
AND TO MAKE IT EVEN EASIER,
WE'VE REFRESHED OUR DIVISION OF
INTRAMURAL WEBSITE THAT NOW,
THANKS TO OUR COMMUNICATIONS
TEAM, IT'S REALLY EASY TO FIND
INFORMATION ON EACH OF OUR
LABORATORIES, CURRENT RESEARCH,
JOB OPPORTUNITIES, HIRING
ANNOUNCEMENTS, ET CETERA.
SO I ENCOURAGE YOU TO TAKE A
LOOK AT THAT AS WELL, AND I
THINK THEY'VE DONE A FABULOUS
JOB OF REFRESHING OUR WEBPAGE
AND BUILDING IT OUT.
I JUST WANT TO SPEND THE LAST
FEW MINUTES SAYING THAT IT'S
MORE THAN OF COURSE NCCIH, WE'RE
RELATIVELY SMALL, WE DO BOX
ABOVE OUR WEIGHT CLASS AND WE DO
A LOT TO BRING THE PROGRAM
TOGETHER PRIMARILY AROUND PAIN,
BUT IF YOU THINK ABOUT WHERE NIH
WAS WHEN IT FIRST STARTED,
BEFORE THE MEDICAL SCHOOLS
AROUND THE COUNTRY BECAME
MATURE, NIH WAS THE PLACE FOR
RESEARCH TRAINING, AND IT STILL
IS.
AND THERE'S SO MANY WAYS FOR
PEOPLE TO GET INVOLVED.
JUST THINK ABOUT, THOUGH, THE
INFRASTRUCTURE WE HAVE, WHY NIH.
WE SUPPORT BIOMEDICAL,
BEHAVIORAL, SOCIAL SCIENCE
RESEARCH AT ALL LEVELS BASIC AND
TRANSLATIONAL.
26 VAI BRANDT PROGRAMS ON CAMPUS
HERE IN THIS SMALL COMMUNITY
HERE, WE HAVE A VERY UNIQUE NIH
CLINICAL CENTER THAT JUST TA THS
TRANSLATIONAL CLINICAL RESEARCH
WITH PATIENT CARE, LITERALLY
LABS RIGHT NEXT DOOR TO THE
OUTPATIENT AND INPATIENT
CLINICS.
WE ALSO PROMOTE PROFESSIONAL
CAREER AND PERSONAL DEVELOP M.
AS I MENTIONED WE HAVE
OUTSTANDING RESOURCES FOR
SCIENCE AND FOR TRAINING,
COMPREHENSIVE WELLNESS AND
RESILIENCE PROGRAMS FOR EARLY
CAREER INVESTIGATORS,
OPPORTUNITIES FOR TRAINING AND
CAREER ADVANCEMENT.
THIS IS JUST REALLY SORT OF A
SNAPSHOT OF ALL OF THE PROGRAMS
FROM EARLY STAGE, SUMMER
INTERNSHIPS FOR
COLLEGE/UNDERGRADUATES, POSTBAC,
WHICH IS -- GRADUATE
PARTNERSHIPS FOR PH.D. FOR
GRADUATE STUDENTS, POSTDOC
PROGRAM, RESEARCH FELLOWS,
CLINICAL RESEARCH PROGRAMS FOR
PEOPLE INTERESTED IN BECOMING
CLINICIAN-SCIENTISTS, SO MANY
GREAT OPPORTUNITIES AT THE NIH.
FACULTY LEVEL, I DON'T KNOW IF
PEOPLE REALIZE, WE HIRE 30 OR
MORE TENURE AND TENURE TRACK
POSITIONS EVERY YEAR ON THE NIH
CAMPUS BUT OTHER SATELLITE
CAMPUSES AROUND THE COUNTRY,
AGAIN TO PLAY AN IMPORTANT AND
MAJOR ROLE IN TRAINING AND
MENTORING THE NEXT GENERATION OF
SCIENTISTS.
WE ALSO HAVE A UNIQUE POSITION
OF THE STAFF SCIENTISTS.
THESE ARE -- WE HIRE A LOT OF
STAFF SCIENTISTS.
THEY'RE NON-TENURE TRACKED BUT
THEY HAVE A TREMENDOUS IMPACT
AND SOME INDEPENDENCE AND
WORKING ON PROJECTS BUT THEY'RE
HERE TO SUPPORT SENIOR
INVESTIGATORS AND RUNNING THE
LABORATORY OF A SENIOR
INVESTIGATOR EXISTING IN THAT,
OR ACTUALLY HEADING SPECIFIC
CORE FACILITIES AS WE'RE DOING
WITH THE PRC, THAT WILL BE A
STAFF SCIENTIST POSITION AT
NCCIH.
FINALLY AGAIN THIS IS WHERE I
THINK OUR COMMUNICATIONS GROUP
AND THE OFFICE OF THE DIRECTOR
HAS DONE A GREAT JOB.
I DON'T KNOW IF ANYBODY HAS
LOOKED AT THIS VIRTUAL TOUR OF
THE NIH, BUT IT REALLY GIVES YOU
A REAL DYNAMIC WAY OF LACKING AT
WHAT WE'RE DOING HERE ON THE NIH
CAMPUS.
ONE OF OUR STEEN YOUR
INVESTIGATORS, DR. LAUREN ATLAS,
IS FEATURED IN THIS VIRTUAL TOUR
AND I ENCOURAGE YOU TO TAKE A
LOOK AT THAT WEBSITE AS WELL.
SO WITH THAT I THINK I'LL STOP,
THANK YOU FOR YOUR TIME AND TAKE
ANY QUESTIONS YOU MAY HAVE.
SO THANK YOU.
YES, BOB.
>> I JUST WANT TO REALLY SAY HOW
GREAT IT IS THAT NCCIH IS -- IT
HAS BEEN AND IS TAKING LEAD FOR
PAIN RESEARCH ON THE CAMPUS OF
NIH.
I TRAINED HERE AT NIH WITH ROD'S
GROUP LIKE MANY, MANY, MANY PAIN
RESEARCH IN THE U.S. I HAVE THIS
WEIRD CONNECTION WITH DENTAL
DEPARTMENTS IN THE U.S. BECAUSE
THAT GROUP WAS IN NI IN.
DR AND IDCR NOW.
IT WAS AN ABSOLUTE POWERHOUSE
AND AFTER DEPARTING THE GROUP
SORT OF DISSIPATED, I'M GRAD TO
SEE THE NCCIH HAS SOME REALLY
GREAT SCIENTISTS AND I LOOK
FORWARD TO SEEING IT CONTINUE TO
GROW AND ALSO ESPECIALLY
CONTINUE TO REACH OUT AND TAP
INTO THE INCREDIBLY RICH
RESOURCES THAT ARE HERE, BOTH ON
THE BASIC SIDE AND ON THE
CLINICAL SIDE.
BECAUSE THAT'S DEFINITELY A GAP
AND I THINK THERE'S A LOT OF
ROOM FOR GROWTH TOO.
SO THAT'S ONE COMMENT.
ANOTHER QUESTION JUST THINKING
ABOUT NIH AND SOME OF THE
EXPERIENCES OF PEOPLE THAT I
KNOW.
HOW EASY IS TO GO FOR A PATH OF
COMMERCIALIZATION?
YOU FIND A COMPOUND THAT LOOKS
LIKE IT WORKS, YOU GET SOME
CLINICAL TRIALS DONE IN HOUSE
AND THEN MOVING TO A FULL BLOWN
CLINICAL TRIAL OUTSIDE --
>> WE DO HAVE CRADAs AS
ANOTHER WAY, THEY'RE NOT WELL
ADVERTISED BUT THE INTRAMURAL
PROGRAM IS HEAVILY INVOLVED IN
THAT KIND OF APPROACH.
I WILL SAY TOO, WE TEND TO RELY
ON INDUSTRY TO DO A LOT OF THAT,
BUT THERE IS ONE COMPOUND THAT I
THINK I CAN -- YEAH, I CAN TALK
ABOUT.
IT'S A DERIVATIVE OF KETAMINE,
HYDROXYNEUROKETAMINE, THAT WAS
DEVELOPED AND TAKEN THROUGH
PHASE ONE BY NIMH BECAUSE ITS
MAJOR PRIMARY FOCUS IS ON
DEPRESSION, TREATMENT OF
DEPRESSIVE DISORDER.
IT TURNS OUT IN PRE-CLINICAL
MODELS THERE'S INDICATIONS THAT
IT'S ANALGESIC.
SO WHAT WE'RE GOING TO BE DOING
IN PARTNERSHIP, AGAIN, THIS IS
WHERE YOU CAN BREAK DOWN SILOS
PRETTY EASILY AT AN INTRAMURAL
PROGRAM.
WORKING WITH THOSE INITIAL
PROGRAMS THAT COME IN,
INPATIENTS THAT COME IN TO THE
NIMH, WE WILL BE ABLE TO DO QST
TO LOOK AT SOME OF THE ANALGESIC
PROPERTY OF THIS COMPOUND.
SO THAT'S JUST AN EXAMPLE OF HOW
WE'RE LEVERAGING A DRUG
DEVELOPMENT PIPELINE FOR
DEPRESSION BUT NOW WE CAN SORT
OF TAKE IT INTO ANOTHER SPACE
FOR PAIN.
JUST BACK TO YOUR COMMENT ABOUT
NIDCR, I THINK THAT'S EXACTLY
WAS OUR MINDSET.
THAT PROGRAM WAS SO SUCCESSFUL,
IN FACT, OUR FIRST DIRECTOR,
CATHERINE BUSHNELL, WAS PART OF
THAT PROGRAM AS A POSTDOC, I
BELIEVE, BEFORE SHE WENT TO
MCGILL AND DID GREAT THINGS
THERE, AND YOU AND OTHERS.
WE WANT TO RELIVE THAT AN
REBUILD THAT.
AND FOR WHATEVER REASON, THINGS
WAX AND WANE EVERYWHERE, BUT
THAT'S EXACTLY THE MODEL WE'RE
TRYING TO BUILD OUT AGAIN, BUT
EVEN TAKING IT A STEP FURTHER
AND GOING ALL THE WAY FROM BASIC
MOLECULAR PRE-CLINICAL
TRANSLATIONAL CLINICAL, AND
FINDING A WAY NOT TO JUST SILO
IN ONE INSTITUTE BUT TO REALLY
OPEN THIS UP TO THE ENTIRE
INTRAMURAL PROGRAM, BECAUSE AS I
MENTIONED, I CAN'T THINK OF A
DISORDER WHERE PAIN IS NOT
CO-MORBID.
IT'S REALLY AN OPPORTUNITY FOR
US TO THINK THIS THROUGH.
ONE GOAL IS TO DO A NATURAL
HISTORY STUDY.
THERE MAY BE OPPORTUNITIES TO DO
EXTENSIVE GENOTYPING THROUGH THE
CLINICAL CENTER, THROUGH NIAID
THAT MAY BE FUNDED OUTSIDE OF
NCCIH, BUT COULD YOU IMAGINE
MARRYING GENOTYPE WITH EXTENSIVE
PHENOTYPING, QST AND
PATIENT-REPORTED OUTCOMES AND
OTHER MEASURES THAT WE COULD
REALLY START TO LOOK AT IT
ALMOST AS LAKE LIKE A VIRTUAL GN
THE FUTURE.
SO WE'RE VERY EXCITED ABOUT
THAT.
YES.
>> THANK YOU FOR REALLY AN
INFORMATIVE AND EXCITING TALK.
IT WAS SO NICE TO SEE ALL THE
WORK THAT'S GOING ON.
YOU MENTIONED FOSTERING
COLLABORATIONS BETWEEN THE
DIFFERENT INSTITUTES AND I
WASN'T CLEAR WHETHER THAT ALSO
WOULD INCLUDE CLAB REAT COLLABOS
WITH EXTRAMURAL RESEARCHERS.
>> THERE IS AN OPPORTUNITY TO
WORK WITH THE INTRAMURAL.
WE HAVE THEIR COOPERATIVE
AGREEMENTS PRIMARILY ARE THE
WAYS TO BRING IN THE EXTRAMURAL,
AND THAT'S REALLY -- OVER TIME
THAT'S WHERE WE WANT TO GO.
WE DON'T WANT TO KEEP THIS A
SECRET OR JUST KEEP IT FOR OUR
OWN USE, BUT I THINK AGAIN JUST
THINKING ABOUT BUILDING THE
PROGRAM, 12 YEARS SEEMS LIKE A
LONG TIME BUT HAVING BEEN ACTING
SD NOW FOR ALMOST FIVE YEARS, IT
REALLY TOOK US THAT LONG TO
BUILD OUT THE PROGRAM.
I MEAN, JUST THE FRUK TO SUPPORT
THE RESEARCH.
THERE'S A LOT OF PEOPLE WORKING
BEHIND THE SCENES.
I THINK SOME OF THEM IN THIS
ROOM AROUND THE PERIPHERY THAT
WE NEEDED TO BUILD UP AND I WANT
TO THANK GINGER, ANNE AND OTHERS
FOR SEEING HOW THAT IS JUST AS
IMPORTANT AS THE RESEARCH WE DO
BUILDING OUT THE PROFESSIONAL
STAFF THAT SUPPORT THE RESEARCH.
BUT TO YOUR POINT, WE'RE GETTING
THERE.
AND WE WILL -- AND THERE ARE
OPPORTUNITIES, IT'S JUST
RELATIONSHIPS, MANY OF OUR
RESEARCHERS HAVE LONG-STANDING
COLLABORATIONS AND ARE FORMING
NEW COLLABORATIONS WITH
EXTRAMURAL SCIENTISTS, SO IT'S
ALWAYS THOSE PERSONAL CONTEXTS
THAT GET THINGS GOING, SO IF
YOU -- AND I'M HAPPY TO
FACILITATE THOSE CONNECTIONS IF
YOU'RE INTERESTED IN WORKING
WITH SOME OF OUR INTRAMURAL
INVESTIGATORS, I'M HAPPY TO DO
THAT.
>> SO THANKS, THAT WAS VERY
INSPIRING PRESENTATION AND I
THINK IT'S REALLY MADE ME THINK
MANY TIMES WHILE YOU WERE
SPEAKING ABOUT THE IMPORTANCE OF
NUTRITION IN PAIN AND PAIN
MANAGEMENT, AND REALLY
UNDERSTANDING WHAT PEOPLE ARE
EATING AND INGESTING EITHER
INTENTIONALLY OR NOT
INTENTIONALLY AND THE
ASSOCIATION WITH PAIN, AND THEN
PERHAPS SINCE WE KNOW THAT THESE
MEDICATIONS THAT ARE BEING TAKEN
FOR PAIN CAN SPEED UP THE
METABOLISM OF ESSENTIAL
NUTRIENTS, THEY CAN BLOCK THEIR
TRANSPORT, OR INTERFERE WITH
THEIR TRANSPORT IN WAYS AND
CHANGE THEIR DISTRIBUTION, THAT
PERHAPS ONE COULD START LOOKING
AT -- WITH YOUR STUDIES AND
COLLABORATIONS, HOW COULD WE
FORMULATE A NUTRIENT COCKTAIL
THAT WOULD PERHAPS AUGMENT THE
BENEFITS OF THE DRUG TREATMENTS,
AND REVERSE SOME OF THE SIDE
EFFECTS THAT ARE ASSOCIATED WITH
DRUG TREATMENTS.
>> THAT'S A BRILLIANT
SUGGESTION.
YOU KNOW, AGAIN, THIS IS THE
VIRTUE OF BEING ON THE NIH
CAMPUS, WE HAVE A WHOLE
INSTITUTE, NIDDK, THAT, YOU
KNOW, IS INTERESTED IN NUTRITION
AND ROLE IN OBESITY AND
METABOLISM.
AGAIN, THROUGH THE PAIN RESEARCH
CENTER, SOMETHING AS YOU JUST
PROPOSED COULD BE DONE IN
COLLABORATION WITH NIDDK, FOR
EXAMPLE.
THAT'S A BRILLIANT THOUGHT THAT
WE SHOULD -- AS SOON AS WE GET
THAT FACILITY HEAD HERE, YOU
THINK THAT MIGHT BE ONE OF THE
FIRST CONVERSATIONS, TO HAVE
THEM START SPEAKING WITH NIDDK.
BUT YES, THAT SORT OF TIES IN
WITH OUR EXTRAMURAL PRIORITY
AROUND NUTRITION AS DR. LANGEVIN
MENTIONED IN HER OPENING
REMARKS.
SO I THINK THAT'S REALLY A GREAT
CONNECTION.
BUT THAT IS THE VIRTUE AGAIN --
IT'S NOT JUST INDIVIDUAL
DEPARTMENTS HERE AT NIH, IT'S
ALMOST LIKE MINI UNIVERSITIES,
RIGHT, BECAUSE THEY COVER THE
WATERFRONT, AND THEY'RE ALL
HERE, 26 OF THEM READY AND ABLE
TO HELP EACH OTHER.
SO THAT'S RE REALLY WHAT'S EXCIG
ABOUT THE INTRAMURAL PROGRAM.
>> JUST TRYING TO BE MINDFUL OF
TIME, IS THERE --
>> I JUST WANT TO JUST MAKE
SURE TO UNDERSCORE THE AMAZING
JOB THAT DAVID HAS DONE AS
SCIENTIFIC DIRECTOR.
IN ADDITION --
[APPLAUSE]
IN ADDITION TO HIS OTHER JOB,
WHICH IS DEPUTY DIRECTOR, WHICH
HE IS SO EXCELLENT AT.
SO I KNOW WHEN FOUR PLUS YEARS
AGO, WE DECIDED TO TAKE ON THE
CHALLENGE OF -- HE DIDN'T JUST
TREAD WATER, RIGHT, JUST REALLY
BUILT THIS PROGRAM IN A WAY THAT
IS JUST SO THOUGHTFUL, AND
ACCOMPLISHED SO MUCH, SO REALLY,
REALLY WANT TO THANK YOU, AND,
YOU KNOW, THIS PROGRAM IS GOING
TO BEAR YOUR STAMP ON IT FOR A
LONG TIME.
>> THANK YOU FOR THAT.
BUT REALLY, I TAKE SOME OF THE
CREDIT, PROBABLY SOME WHRA BLAM,
BUT IT'S REALLY EVERYONE, YOU
KNOW, I THINK I JUST CAN'T SAY
ENOUGH ABOUT THE TREMENDOUS
SCIENTISTS WE HAVE IN THE
PROGRAM, THE PROFESSIONAL STAFF
THAT REALLY MAKE THE PROGRAM,
YOU KNOW, IT TAKES ALL OF US TO
DO THIS.
AND I THINK WE'RE NOW UP TO LIKE
50 OR SO STAFF OVERALL IN THE
PROGRAM.
WHICH FOR A VERY SMALL CENTER IS
PRETTY LARGE.
EVERYONE IS PULLING THEIR WEIGHT
AND DOING A FABULOUS JOB, SO I'M
VERY THANKFUL AND GRATEFUL FOR
EVERYONE AND WHAT WE'VE DONE
OVER THESE LAST FOUR YEARS BUT
REALLY OVER THE LAST 12 YEARS.
SO THANK YOU.
>> OKAY, THANK YOU SO MUCH,
DAVID.
AND WE ARE NOW MOVING ON TO OUR
NEXT AGENDA ITEM, LONG EXPECTED,
WHICH IS OUR LUNCH BREAK.
SO FOR EVERYBODY EITHER BEING ON
ZOOM OR ON THE VIDEOCAST, WE ARE
RECONVENING HERE AT 1:20 EASTERN
TIME.
AND THIS IS A HARD START, SO IT
IS 1:20.
FOR EVERYBODY HERE IN THE ROOM,
WE HAVE DOWNSTAIRS THE
CAFETERIA, CAN GET FOOD THERE,
YOU CAN EAT DOWN THERE, OR YOU
CAN BRING THE FOOD UPSTAIRS WITH
YOU, WE HAVE MEETING ROOMS OVER
THERE SO YOU CAN EAT IN THERE,
BUT AGAIN, IT IS 1:20.
SO HARD START. GOOD. THANK YOU.
WELCOME BACK, EVERYBODY, FROM
LUNCH.
WE ARE NOW GOING TO RESTART THE
MEETING.
OUR FIRST ORDER OF BUSINESS WILL
BE OUR NUTRITION CONTINUUM
SYMPOSIUM, AND I AM GOING TO
TURN THINGS OVER TO
DR. LANGEVIN, WHO WILL INTRODUCE
OUR GUEST SPEAKERS FOR OUR
SYMPOSIUM, AS WELL AS OFFER SOME
OPENING REMARKS TO SET THE STAGE
FOR TODAY'S PRESENTATION AND
DISCUSSION.
THIS JUST TAKES US A SECOND.
>> THANK YOU VERY MUCH, MARTINA.
SO THIS AFTERNOON FOR OUR
SYMPOSIUM, WE'RE REALLY EXCITED
TO WELCOME TWO GUEST SPEAKERS.
DR. STEFAN PASIAKOS, DIRECTOR OF
THE OFFICE OF DIETARY
SUPPLEMENTS, AND DR. ANDREW
BREMER, DIRECTOR OF THE OFFICE
OF NUTRITION RESEARCH.
TO US, THIS PARTNERSHIP THAT WE
HAVE WITH BOTH ODS AND ONR IS
VERY, VERY IMPORTANT.
WOVE .WE'VE HAD OBVIOUSLY A
LONG-STANDING PARTNERSHIP WITH
THE OFFICE OF DIETARY
SUPPLEMENTS AND AS I WILL
EXPLAIN IN A MINUTE, WE'RE
REALLY EXTENDING NOW OUR VIEW OF
THE IMPORTANCE OF INTEGRATING
THE RESEARCH THAT WE DO ON
DIETARY SUPPLEMENTS WITH A WIDER
VIEW OF WHERE THE DIETARY
SUPPLEMENTS FIT IN THE CONTEXT
OF OVERALL NUTRITION.
SO THIS IS ONE OF THE REASONS
WHY THIS IS SO IMPORTANT FOR US
TO HAVE THIS DISCUSSION TODAY.
SO I'M JUST GOING TO BRIEFLY
INTRODUCE OUR TWO SPEAKERS AND
THEN I'M GOING TO JUST GIVE A
FEW REMARKS.
FIRST, DR. PASIAKOS, HE JOINED
THE NIH'S OFFICE OF DIETARY
SUPPLEMENTS OR O DS IN
JULY 2023.
BEFORE THAT, HE HELD MULTIPLE
POSITIONS IN THE UNITED STATES
ARMY RESEARCH INSTITUTE OF
ENVIRONMENTAL MEDICINE FROM 2008
TO 2023 AND MOST RECENTLY HE
SERVED AS CHIEF MILITARY
PERFORMANCE CA DIVISION TO DEVEP
EVIDENCE-BASED SOLUTIONS TO
LIMIT MUSCULOSKELETAL INJURIES
AND OPTIMIZE PHYSICAL AND
COGNITIVE PERFORMANCE IN
MILITARY TRAINING AND
OPERATIONAL ENVIRONMENTS.
AND FROM 2012 TO 2021,
DR. PASIAKOS WAS A RESEARCH
PHYSIOLOGIST IN THE MILITARY
NUTRITION DIVISION.
AND HE'S GOING TO BE JOINING US
ON ZOOM.
NOW DR. BREMER WAS NAMED
DIRECTOR OF THE OFFICE OF
NUTRITION RESEARCH IN
SEPTEMBER 2023.
SO BOTH RELATIVELY RECENT
ARRIVALS TO THEIR POSITION.
PRIOR TO THIS APPOINTMENT, HE
WAS THE ONR -- BEFORE BEING THE
ONR DIRECTOR, DR. BREMER WAS THE
CHIEF OF PEDIATRIC GROWTH AND
NUTRITION BRANCH AT THE EUNICE
KENNEDY SHRIVER NATIONAL
INSTITUTE OF CHILD HEALTH AND
HUMAN DEVELOPMENT.
DR. BREMER JOINED NIH IN 2013,
AFTER HOLDING ACADEMIC POSITIONS
AT UNIVERSITY OF CALIFORNIA
DAVIS AND VANDERBILT.
HE'S A CO-CHAIR OF NATIONAL
COLLABORATIVE ON CHILDHOOD
OBESITY RESEARCH STEERING
COMMITTEE, A MEMBER OF THE
SENIOR LEADERSHIP GROUP OF THE
NIH OBESITY RESEARCH TASK FORCE,
THE NIH LIAISON TO THE AMERICAN
ACADEMY OF PEDIATRICS COMMITTEE
ON NUTRITION AND SECTION ON
OBESITY, AND A MEMBER OF THE NIH
CLIMATE CHANGE AND HEALTH
RESEARCH INITIATIVE STEERING
COMMITTEE.
AS A MEMBER OF THE ONR SENIOR
LEADERSHIP GROUP, HE HELPED
DEVELOP THE 2020 TO 2030
STRATEGIC PLAN FOR NIH NUTRITION
RESEARCH.
AND AFTER THEIR PRESENTATIONS,
WE WILL MOVE TO A Q & A AND
DISCUSSION AND FOR THIS
DISCUSSION, WE WILL BE ALSO
JOINED BY DR. STEPHANIE GEORGE,
WHO IS A DEPUTY DIRECTOR OF THE
OFFICE OF DIETARY SUPPLEMENTS.
PRIOR TO -- OR ORDS.
PRYING TO JOINING ODS IN 2024,
DR. GEORGE SERVED AS NATIONAL
INSTITUTES OF ARTHRITIS AND
MUSCULOSKELETAL AND SKIN
DISEASES SINCE 2019, AS AN
EPIDEMIOLOGIST AND PROGRAM
DIRECTOR OVERSEEING NIH'S
LARGEST INVESTMENT IN PHYSICAL
ACTIVITY RESEARCH, THE MOLECULAR
TRANSDUCER OF PHYSICAL ACTIVITY
CONSORTIUM OR MTPAC.
FOCUSED ON NUTRITION RESEARCH,
DIETARY SUPPLEMENTS, OBESITY,
PHYSICAL ACTIVITY, MEDICAL
REHABILITATION, BEHAVIORAL AND
SOCIAL SCIENCES, HEALTH
DISPARITIES, SOCIAL DETERMINANTS
OF HEALTH AND HEALTH
COMMUNICATION.
SO WE HAVE A WEALTH OF EXPERTISE
IN THIS PANEL.
I'M VERY, VERY EXCITED.
SO NOW I'M JUST GOING TO GIVE
YOU A LITTLE BIT OF CONTEXT
ABOUT WHY WE ARE SO EXCITED IN
THIS IDEA OF A NUTRITION
CONTINUUM.
WITH A FEW REMARKS.
AND HOW DOES THE NUTRITION
CONTINUUM FIT WITH OUR OVERALL
CONCEPT OF WHOLE PERSON HEALTH.
SO THIS IS A SLIDE THAT MANY OF
YOU HAVE SEEN BEFORE.
THIS IS KIND OF A LITTLE BIT
LIKE OUR ORGANIZING PRINCIPLE
FOR WHY LOOKING AT THE WHOLE
PERSON.
THIS WHOLE IDEA THAT YOU NEED
BOTH ANALYSIS AND SYNTHESIS, IT
DOESN'T MATTER WHAT YOU DO, IN
SCIENCE OR EVEN IN PHILOSOPHY OR
MATHEMATICS, THERE'S ALWAYS THIS
COUNTERCURRENT OF BREAKING
THINGS DOWN AND THEN PUTTING
THEM BACK TOGETHER.
AND IN MEDICINE, AND BIOMEDICAL
SCIENCES, WE HAVE A STRONG PULL
TOWARDS ANALYSIS, RIGHT?
IT'S KIND OF INHERENT IN HOW WE
DO THINGS, WE BREAK THINGS DOWN,
WE WANT TO UNDERSTAND, WE WANT
TO GET TO ROOT CAUSES, PRECISE
MECHANISMS TO THE CELLS, TO THE
MOLECULES, ET CETERA, AND THAT'S
FINE.
IT'S JUST THAT IT TAKES AN
EFFORT TO GO THE OTHER WAY, AND
PUT THE PUZZLE BACK TOGETHER.
AND THIS IS WHERE -- PUTTING AN
EMPHASIS ON BEING MINDFUL ABOUT
THE CHALLENGES OF DOING
SYNTHESIS, OF DOING INTEGRATION,
AND THAT'S WHY WE'RE CALLED THE
NATIONAL CENTERS FOR
COMPLEMENTARY AND INTEGRATIVE
HEALTH.
THAT'S PART OF WHAT WE TRY TO
DO, IS WE TRY TO PUT THINGS
TOGETHER.
SO THE OTHER THING -- THAT'S
STILL NOT ADVANCING VERY WELL
HERE.
THERE.
PART OF UNDERSTANDING WHY IT'S
IMPORTANT TO REALLY THINK ABOUT
ALL OF THE LEVELS STARTING WITH
THE PERSON BUT THEN GOING DOWN
TO THE CELLS AND MOLECULES AND
ALSO GOING BACK UP THE OTHER
DIRECTION TO, AS WE WERE TALKING
ABOUT EARLIER TO THE PERSON, TO
THE SOCIAL ENVIRONMENT, THE
FAMILY, THE COMMUNITY, AND EVEN
ALL THE WAY OVER TO THE PLANET,
TO UNDERSTAND THAT ALL OF THIS
IS AN INTEGRATED MULTI-SCALE
INTERRELATED NETWORK.
ALL OF THIS, EVERYTHING IS
RELATED TO EVERYTHING ELSE, AND
EVERYTHING THAT HAPPENS AT A
SMALL LEVEL INFLUENCES THE WHOLE
AND THE WHOLE INFLUENCES EVERY
PART.
SO THIS IS A FUNDAMENTAL
PRINCIPLE OF ECOLOGY, THE
SCIENCE OF ECOLOGY WAS BUILT
FROM, FROM THE BEGINNING, BUT
MEDICINE WASN'T BUILT WITH THAT
PRINCIPLE.
SO WE HAVE TO LEARN FROM OTHER
MORE INTEGRATIVE AND
ECOLOGICAL-MINDED SCIENCES TO
LEARN HOW TO THINK ABOUT HUMAN
BEINGS AND HEALTH THAT WAY.
AND WHAT ABOUT NUTRITION?
WELL, THE IDEA IS YOU CAN THINK
ABOUT ALL THE VARIOUS ASPECTS OF
NUTRITION THE SAME WAY, WITHIN A
FRAMEWORK OF MULTI-SCALE
NETWORKS, ALL THE WAY FROM, YOU
KNOW, GROWING THE FOOD IN THE
SOIL TO PRODUCING AND
DISTRIBUTING THE FOOD TO COOKING
TO EATING TO UNDERSTANDING
WHAT'S IN THE FOOD AND FINALLY,
ALL THE LITTLE MOLECULES THAT
ARE IN THE FOOD.
THAT WE EAT.
UNFORTUNATELY, WHAT WE'RE SEEING
IN THIS NETWORK, IN THIS DAY AND
AGE, IS UNFORTUNATELY NOT ALWAYS
VERY GOOD.
WE SEE A LOT OF PROBLEMS THAT
ARE INTERRELATED, GOING ALL THE
WAY FROM OVERUSING FERTILIZERS,
HERBICIDES, PESTICIDES,
DEPLETING OUR SOILS TO MASS
PRODUCED FARMING FOOD DEZ ERTS,
FAT FOOD, ULTRAPROCESSED FOODS,
ADDICTING FOODS, POOR NUTRIENT
QUALITY AND FINALLY USING
DIETARY SUPPLEMENTS INSTEAD OF
FOOD.
THIS IS NOT A GOOD SITUATION.
IN ORDER TO ADDRESS THIS
PROBLEM, IT'S CLEAR WE CANNOT
JUST ADDRESS ALL THESE ISSUES
ONE AT A TIME, SEPARATELY,
BECAUSE THEY ARE SO
INTERRELATED.
SO HERE I'VE DRAWN KIND OF THE
NUTRITION CONTINUUM FROM THE
POINT OF VIEW OF THE RESEARCH
THAT WE CAN DO.
YOU CAN SEE THAT FROM UNTIL
RECENTLY, WHAT NCCIH WAS MAINLY
CONCERNED ABOUT WAS KIND OF ON
THE FAR RIGHT CORNER OF THIS,
MORE LOOKING AT NATURAL PRODUCTS
FROM THE POINT OF VIEW OF THEIR
BIOACTIVE CONSTITUENTS, LOOKING
AT, FOR EXAMPLE, INDIVIDUAL
COMPOUNDS AND THEIR POTENTIAL
FOR PERHAPS BEING DEVELOPED INTO
MEDICINES, DRUGS OR EVEN
UNDERSTANDING HOW DIFFERENT
COMPONENTS OF NATURAL PRODUCTS,
FOR EXAMPLE, INTERACT WITH ONE
ANOTHER, THE KINDS OF COMPOUNDS
THAT ARE USED, FOR EXAMPLE, IN
MMEDICINAL PLANTS, ALL OF THAT
CONTINUES TO BE OF GREAT
INTEREST TO US.
IN ADDITION, WE'VE HAD ALSO AN
INCREASING INTEREST IN MICROBES,
IN MICROBIOME, IN PRO AND
PREBIOTICS, BUT UP UNTIL
RECENTLY, WE HADN'T REALLY
INTEGRATED THAT RESEARCH INTO
THE RESEARCH ON THE ACTUAL --
WHAT PEOPLE EAT IN THEIR OVERALL
DIET, BECAUSE THAT WAS KIND OF
IN A DIFFERENT INSTITUTE,
DIFFERENT DOMAIN, USUALLY WE'D
THINK THAT'S THE DOMAIN OF THE
NIDDK, YOU KNOW.
RIGHT NOW, WE'RE THINKING THAT
BECAUSE WE HAVE A LOT OF
COLLABORATION INCLUDING WITH
NIDDK, INCLUDING WITH ONR AND
WITH ODS, WE'RE THINKING THAT WE
REALLY CAN INTEGRATE THIS
RESEARCH BETTER.
AND SO THE IDEA OF
UNDERSTANDING, FOR EXAMPLE, WHAT
IS THE IMPACT OF TAKING A
DIETARY SUPPLEMENT, DEPENDING ON
WHAT ELSE YOU'RE EATING, THAT'S
IMPORTANT.
IT'S NOT JUST WHAT IS THE EFFECT
OF THE DIETARY SUPPLEMENT IN AND
OF ITSELF.
SO THAT'S WHY WE ISSUED THE
ADDITIONAL REQUEST FOR THE
NOTICE THAT I TALKED ABOUT
EARLIER TODAY, ABOUT
INCORPORATING INFORMATION ON
DIETARY INFORMATION IN STUDIES
THAT STUDIED THE EFFECT OF A
SINGLE COMPONENT, FOR EXAMPLE,
MEGA 3 FATTY ACIDS, JUST FOR
USING AN EXAMPLE.
SO THE WHOLE WORLD OF PRECISION
NUTRITION, OF FOOD AS MEDICINE,
OF MEDICALLY TAILORED MEALS,
THESE ARE ALL AREAS WHERE WE
FEEL LIKE ALL THIS RESEARCH
NEEDS TO BE INTEGRATED AND TAKEN
IN THE CONTEXT OF WHAT WE CALL
THE NUTRITION CONTINUUM.
WE ALSO ARE VERY EXCITED ABOUT
THE SOCIAL AND ENVIRONMENTAL
ASPECTS OF NUTRITION IN
COLLABORATION, FOR EXAMPLE, WITH
THE OFFICE OF NURSING RESEARCH,
WE WERE VERY FORTUNATE TO HAVE
DR. ZENK, WHO'S THE DIRECTOR OF
NINR GIVE OUR STRAUSS LECTURE A
COUPLE OF YEARS AGO, WHERE SHE
TALKED ABOUT FOOD DESERTS AND
FOOD AVAILABILITY AND SOCIAL
DETERMINANTS OF HEALTH
REGARDING -- AROUND NUTRITION.
AND FINALLY, I WANT TO JUST ALSO
TALK ABOUT THE IMPORTANCE OF
UNDERSTANDING THAT THE
RELATIONSHIP BETWEEN WHAT WE EAT
AND THE PLACES WHERE THE FOOD IS
GROWN IS VERY -- THERE'S AN
INTERESTING RELATIONSHIP BETWEEN
WHAT IS GOING ON, FOR EXAMPLE,
IN PLANTS THAT THE SAME
MOLECULE, FOR EXAMPLE,
FLAVONOIDS, CAN CONTRIBUTE TO
HOW A PLANT IS ABLE TO BE
RESILIENT IN THE FACE OF, SAY,
DROUGHT OR EXTREME TEMPERATURES
OR OTHER STRESSORS, THE VERY
SAME MOLECULES CAN BE IMPORTANT
IN THE RESILIENCE OF HUMANS,
ANIMALS, I GUESS, WHO CONSUME
THESE MOLECULES, AND SO IT'S AT
BOTH ENDS OF THE SPECTRUM.
AND THE OTHER IMPORTANT THING IS
THAT WE'RE STARTING TO
UNDERSTAND, IS THAT THE
RELATIONSHIP OF MICROBES TO BOTH
THE SOIL AND, FOR EXAMPLE, THE
GUT HELP METABOLIZE THESE
COMPONENTS AND THESE COMPOUNDS
AND HELP THEM, FOR EXAMPLE, IN
THE GUT TO METABOLISM INTO
COMPOUNDS THAT WE ARE BETTER
ABLE TO AB SORM ABSORB AND INTT
WITH, FOR EXAMPLE, OUR BRAINS.
SO THE IDEA THAT THERE'S THIS
WONDERFUL CONNECTION BETWEEN THE
VARIOUS DIFFERENT LEVELS OF THIS
NUTRITION CONTINUUM ILLUSTRATED
IN SOME CASES LIKE THIS REALLY
UNDERSCORES THE FACT THAT --
SORRY.
IT WAS WORKING FINE EARLIER.
WHEN WE TALK ABOUT WHOLE PERSON
HEALTH, NUTRITION IS NOT
ISOLATED IN AND OF ITSELF.
NOT ONLY DO WE HAVE TO
CONTRIBUTE -- CONSIDER THE
CONTINUUM OF NUTRITION, BUT ALSO
THE RELATIONSHIP OF NUTRITION TO
OTHER ASPECTS OF HEALTH, SUCH AS
PHYSICAL ACTIVITY, SUCH AS
STRESS MANAGEMENT, SLEEP, ET
CETERA.
IT'S ALL A COMPONENT OF
SELF-CARE, AND WHAT WE CAN DO TO
SUPPORT THIS SELF-CARE AND TO
MAINTAIN THE HEALTH OF THE WHOLE
PERSON, AND THEN -- NOT ONLY
PREVENT A HOST OF CHRONIC
DISEASES, BUT ALSO HELP REVERSE
SOME OF THESE CONDITIONS IF
TAKEN AT AN EARLY ENOUGH STAGE.
INTERESTINGLY ENOUGH, A VERY
SIMILAR STORY CAN BE PAINTED FOR
OUR PLANET.
THE FACT THAT WE CAN -- THERE
ARE CERTAIN THINGS THAT WE CAN
DO AND SPECIFICALLY WHICH
REGARDING TO THE ENVIRONMENT
WHERE OUR FOOD IS GROWN, OUR
SOIL, AND SO THE KIND OF
AGRICULTURE PRACTICES THAT WE
HAVE CAN CONTRIBUTE TO US
REVERSING NOT JUST THE EFFECT
OF -- ESSENTIALLY THE HEALTH OF
EARTH AS A WHOLE.
SO WE OFTEN TALK ABOUT CLIMATE
CHANGE AS SOMETHING WE NEED TO
ADDRESS URGENTLY, BUT I WOULD
ARGUE THAT THE HEALTH OF THE
SOIL OF THE PLANET IS JUST AS
IMPORTANT.
AND THIS IS SOMETHING THAT HAS A
DIRECT LINK TO NUTRITION.
SO IN CLOSING, THIS IS OUR
FAMILIAR DIAGRAM WHERE WE TALK
ABOUT WHOLE PERSON HEALTH AS
SUPPORTING AND EMPOWERING
INDIVIDUALS, FAMILIES,
COMMUNITIES AND POPULATION, AND
HERE WE'VE ADDED THE PLANET, TO
IMPROVE HEALTH THROUGH -- IN
BIOLOGICAL, BEHAVIORAL, SOCIAL
AND ENVIRONMENTAL DOMAINS IN A
VERY INTERCONNECTED WAY.
SO I'M VERY EXCITED TO WELCOME
OUR FIRST SPEAKER, DR. PASIAKOS.
WHO IS GOING TO TALK TO US ABOUT
WHAT IS GOING ON AT ODS.
>> I AM EXTREMELY EXCITED TO BE
PART OF TODAY'S SESSION.
DR. LANGEVIN, I REALLY
APPRECIATE THE OPPORTUNITY, THE
GREAT INTRODUCTION, AND MOST
IMPORTANTLY FOR THOSE
OUTSTANDING INTRODUCTORY
COMMENTS THAT SET THE STAGE FOR
WHAT YOU'LL HEAR FROM DREW AND I
TODAY.
I'M GOING TO DO MY VERY BEST TO
HARNESS MY INNER DREW BR BREMERO
MAKE SURE I MATCH HIS ENERGY
LEVELS BECAUSE YOU'LL SEE WHEN
HE COMES ON IN A FEW MINUTES HOW
HIGH ENERGY HE IS, WHICH MEANS
HE'S STILL ENTHUSIASTIC ABOUT
THE WORK THAT WE'RE DOING.
SO THIS IS AN EXCITING SESSION
FOR US BECAUSE THE WAY I LOOK AT
SCIENCE ALWAYS THROUGH AN
INTEGRATED LINE.
I KNEW THIS WAS SOMETHING I
WANTED THE OFFICE OF DIETARY
SUPPLEMENTS TO BE A PART OF, AND
WHEN THE OPPORTUNITY CAME UP IN
DISCUSSION WITH DR. LANGEVIN,
DR. BREMER, AND NINR, I KNEW
THERE WAS AN OPPORTUNITY FOR US
TO ACTUALLY MOVE THE NEEDLE HERE
AND MAKE A MARK.
SO VERY EXCITED TO BE PART OF
THIS WORK.
I'M GOING TO START OFF TELLING
YOU REALLY WHAT YOU'RE GOING TO
HEAR OR TAKE AWAY AT THE END OF
THE PRESENTATION, THAT IS THIS
NUTRITION CONTINUUM.
IT'S A MULTI-SCALE NETWORK THAT
LINKS FOOD AND HEALTH THROUGHOUT
LIFE.
YOU'LL SEE THAT I WANT TO MAKE
IT CLEAR TO YOU THAT THE OFFICE
OF DIETARY SUPPLEMENTS, AND I'LL
EXPLAIN TO YOU WHO WE ARE, WHERE
WE'VE DONE AS AN OFFICE AND
WHERE WE ARE GOING AND MOST
IMPORTANTLY, HOW WE LOOK TO GET
FULLY BEHIND THE CONTINUUM AND
LOOK TO BUILD UPON OUR
LONG-STANDING PARTNERSHIP WITH
NCCIH AND ONR BY ADVANCING WHOLE
PERSON HEALTH.
TO DO THAT, I WILL GIVE YOU A
VERY QUICK OVERVIEW OF THE
OFFICE, WHO WE ARE, AND FOCUS
MAINLY ON WHERE WE ARE GOING.
WE'RE IN A VERY INTERESTING
TRANSITION PERIOD FOR THE OFFICE
OF DIETARY SUPPLEMENTS SO I WANT
TO MAKE SURE IT'S CLEAR TO
COUNCIL AND OTHERS FROM NCCIH
WHERE WE ARE GOING.
I WANT TO HIGHLIGHT OUR HISTORY
OF RELATIONSHIP WITH NCCIH AND
ITS PRODUCTIVITY AND END BY
WHERE I SEE THIS OPPORTUNITY,
THIS OPPORTUNITY TO MOVE THE
NEEDLE TO JOIN FORCES HERE, IF
YOU WILL, AND REALLY ATTACK THE
CONTINUUM TOGETHER TO ADVANCE
WHOLE PERSON HEALTH.
AND AS YOU CAN IMAGINE, GIVEN
THE HIGH PREVALENCE -- SO THE
OFFICE WAS ESTABLISHED IN
RESPONSE TO THE DIETARY
SUPPLEMENT HEALTH AND EDUCATION
ACT OF 1994.
THE OFFICE WAS STOOD UP IN 1995.
IN THAT LAW, IT SEPARATED OUT
THE REGULATORY ASPECTS OF
DIETARY SUPPLEMENTS, GAVE THAT
TO THE FDA WHEN THEY REALLY PUT
US IN CHARGE OF THE SCIENCE OF
DIETARY SUPPLEMENTS.
THE LAW LAID OUT A FEW KEY
OBJECTIVES FOR THE OFFICE, AND
THAT WAS TO EXPLORE THE ROLE OF
DIETARY SUPPLEMENTS AS AN EFFORT
TO IMPROVE HEALTHCARE, TO
PROMOTE DIETARY SUPPLEMENT
RESEARCH TO CONDUCT, COORDINATE,
COLLECT, COMPILE DIETARY
SUPPLEMENT RESEARCH IN THEIR
RESULTS AND REALLY TO SERVE AS
AN ADVISOR TO OTHER GOVERNMENT
AGENCIES AND HERE AT NIH ON
ISSUES RELATED TO DIETARY
SUPPLEMENTS.
THE OFFICE HAS HAD A COMPILATION
OF PROGRAMS AND ACTIVITIES AND
MANY OF THOSE HAVE BEEN HERE FOR
A VERY LONG TIME.
LONG-STANDING OBJECTIVES,
DISCRETE MISSIONS AND OUTCOMES,
AND AS MOST DPCPSI COORDINATING
OFFICES, OUR PRIMARY FUNCTION IS
TO BUT SORT RESEARCH.
WE DO THAT THROUGH GRANTS AND
COFUNDING.
WE ALSO DO IT THROUGH A VARIETY
OF OTHER MECHANISMS VIA
ADMINISTRATIVE SUPPLEMENTS,
THROUGH OUR ODS SCHOLARS PROGRAM
OR THROUGH CONTRIBUTING TO OTHER
TRANS-NIH INITIATIVES.
THE MOST RELEVANT AND NOTABLE
FOR TODAY'S PRESENTATION IS JUST
A RECOGNITION OF THE CARBON
PROGRAM, OR THE NIH CONSORTIUM
FOR ADVANCING RESEARCH ON
BOTANICALS AND OTHER NATURAL
PRODUCTS.
THAT'S A 25, GOING ON 30-YEAR
PARTNERSHIP WITH NCCIH AMONG
OTHER ICOs AND I'LL EXPLAIN
THE ADVANCES THAT WE'VE MADE BUT
REALLY FOCUS ON THE DIRECTION OF
WHERE THAT'S GOING AND HOW
THAT'S GOING TO CONTRIBUTE TO
WHOLE PERSON HEALTH.
WE HAVE SEVERAL PUBLICLY
AVAILABLE RESOURCES TO INCLUDE
DATABASES FOR ACADEMICS FOR THE
END USERS, FOR HEALTH
PROFESSIONALS TO EXPLORE WHAT'S
ON THE MARKET.
WE HAVE DATABASES THAT CONTAIN
ANALYTICAL REPORTS ON WHAT'S
ACTUALLY IN THE MOST HEAVILY
USED DIETARY SUPPLEMENTS OR
DIETARY SUPPLEMENTS WITH KNOWN
BENEFIT AND REQUIREMENTS SUCH AS
PRENATAL VITAMINS.
WE ALSO SUPPORT A VARIETY OF
EDUCATION MATERIALS AND
PROFESSIONAL DEVELOPMENT
ACTIVITY, MOST NOTABLY THE MARY
FRANCIS PICCIANO DIETARY
SUPPLEMENT RESEARCH PRACTICUM
WHICH WE ARE GEARING UP TO RUN
NEXT IN MAY 2025.
BEFORE I TRANSITION INTO THE
FUTURE WORK OF THE OFFICE, I
JUST WANT FOD GIVED TO GIVE A ST
TO A WORKSHOP COMING UP IN A
COUPLE WEEKS.
LED BY THE OFFICE OF DIETARY
SUPPLEMENTS, DR. LAVERNE BROWN,
AS WELL AS ACROSS TRANS-NIH
EFFORTS.
THERE'S A TRANS-NIH RESILIENCE
WORKING GROUP AND THAT INCLUDES
MANY DIFFERENT ICs ON THIS
EFFORT.
AND WHY AM I BRINGING THIS UP?
I RAISE THE WORKSHOP BECAUSE OF
ITS DIRECT LINK TO MUCH OF THE
WORK WE DO BETWEEN NCCIH AND OUR
OFFICE.
AND THAT'S THE STUDY OF
RESILIENCE, AND HOW RESILIENCE
IS ACTUALLY STUDIED, DEFINED,
QUALIFIED, AND ACTUALLY
QUANTIFIED IN RESEARCH.
THIS IS AN EXCITING EVENT, AND
IT PAVES THE WAY FOR FUTURE WORK
ON RESILIENCE.
IF INTERESTED IN LEARNING MORE
ABOUT WHAT THE OFFICE OF DIETARY
SUM PTS AND THE TRANS-NIH
RESILIENCE WORKING GROUP DOES, I
POINT TO YOU A SPECIAL ISSUE
THAT WAS PUBLISHED LAST YEAR IN
THE JOURNAL OF STRESS AND HEALTH
THAT REALLY OUTLINES WHERE WE
THINK RESILIENCE RESEARCH IS
GOING HERE AT NIH, AND MOST
IMPORTANTLY IT COMES UP WITH A
CONSENSUS DEFINITION THAT IS
AGREED UPON AMONGST INDIVIDUALS
THAT PARTICIPATED IN THIS EVENT
ON WHAT RESILIENCE MEANS, AND
WHAT THE RESEARCH FRAMEWORK
SHOULD BE ON HOW TO STUDY
RESILIENCE, ESPECIALLY FOR US IN
THE CONTEXT OF DIETARY
SUPPLEMENTS.
SO THAT IS HAPPENING ON THE 24TH
AND 25TH, AND IF ANYONE IS
INTERESTED, I ENCOURAGE YOU TO
REGISTER AND PARTICIPATE IN THAT
EVENT.
MOVING AHEAD, WHEN I CAME ON
BOARD IN JULY OF 2023, ONE OF
THE FIRST THINGS THAT I WAS
CHARGED TO DO WAS TO DEVELOP OR
REINVIGORATE THE OFFICE, REVAMP
IT, REALLY HAVE A NEW FRESH
START AND TO DO THAT THROUGH
DEVELOPING A NEW STRATEGIC PLAN.
THE PLAN REFLECTS THE MANY
STRENGTHS AND ACCOMPLISHMENTS OF
THE OFFICE, BUT IT ALSO SETS THE
STAGE AND FOUNDATION FOR NEW
WORK, AND NEW PRIORITIES.
THE STRATEGIC PLAN WILL BE
OFFICIALLY PUBLISHED LIKELY IN
THE NEXT TWO MONTHS, AND I'M
ACTUALLY REVIEWING THE FINAL
DRAFT AS I PREPARE FOR TODAY'S
MEETING.
THE FIRST ASPECT OF DEVELOPING
THE STRATEGIC PLAN WAS REALLY TO
COME UP WITH OUR VISION.
OUR MISSION AND REALLY COME UP
WITH WHAT ARE THE KEY VALUES WE
BELIEVE ARE IMPORTANT TO ADVANCE
THE FIELD.
THE BOTTOM LINE OF THIS SLIDE
AND WHAT I WANT TO YOU TAKE AWAY
IS THAT WE WILL PRIORITIZE
INNOVATION THROUGH
COLLABORATION, BUILT ON RESPECT,
CURIOSITY AND SCIENCE AND
CURIOSITY IN ALL WE DO, AND
THROUGH ACCOUNTABILITY, BEING
ACCOUNTABLE FOR WHAT WE DO, WHAT
WE INVEST IN AND WHAT WE WANT TO
DO TO MAKE SURE WE CAN ADVANCE
PUBLIC HEALTH.
IF YOU KNOW ABOUT THE OFFICE,
AND YOU'VE HEARD ABOUT WHAT
WE'VE DONE IN THE PAST, IF YOU
READ STRATEGIC PLAN, YOU'LL SEE
THAT IT'S A MAJOR TRANSITION AND
SHIFT FROM WHAT WE HAVE DONE IN
THE PAST, FROM DISCRETE PROJECTS
AND PROGRAMS WITH THEIR OWN
MISSION SETS, TO A BOLD VISION
THAT REALLY PULLS THE OFFICE
TOGETHER TO BE MORE
INTEROPERABLE AND COLLABORATIVE,
AND WE HOPE TO USE STRATEGIC
PRAGMATISM TO REALLY MAKE SURE
WE CAN ADDRESS CUTTING EDGY
MERGING PUBLIC HEALTH CONCERNS
BUT TO DO SO IN A SENSIBLE WAY
TO REALLY MOVE THE NEEDLE AND
MAKE A DIFFERENCE IN PUBLIC
HEALTH.
TO BUILD UPON THAT, THE OFFICE
FIRST HAS TO BE CENTERED ON
RESEARCH PRIORITIES.
SO WE DEVELOPED THREE
CROSS-CUTTING RESEARCH
PRIORITIES OR THEMES THAT
EMPHASIZE EXPLORING THE ROLE OF
DIETARY SUPPLEMENTS ON
RESILIENCE AND HEALTH ACROSS THE
LIFESPAN IN DIVERSE POPULATIONS.
IN THIS DIAGRAM, THOSE ARE
DEMONSTRATED IN THE CENTER AS
OUR CROSS-CUTTING THEMES, REALLY
WHAT OUR RESEARCH WILL FOCUS AND
HONE IN ON.
WHAT WILL ALLOW US TO BE AGILE
AND ADDRESSEE MERGING GAPS IN
THOSE AREAS ARE OUR SCIENTIFIC
DISCIPLINE PRIORITY AREAS WHICH
ARE BIOLOGICAL POPULATION AND
ANALYTICAL SCIENCES AND WE APPLY
A NUMBER OF OTHER EXPERTISE
WITHIN THE OFFICE TO REALLY MAKE
SURE THAT WE CAN DEVELOP NEW
INITIATIVES AND CONCEPTS THAT
MOVE DIETARY SUPPLEMENT SCIENCE
FORWARD AND A WAY FROM LOOKING E
BROADER PUBLIC HEALTH ISSUE ON
WHERE DIETARY SUPPLEMENTS MAY OR
MAY NOT HAVE A ROLE.
A COUPLE OF KEY THINGS I WANT
YOU TO TAKE AWAY FROM THE TENETS
THAT I LIST HERE ON THE
RIGHT-HAND SIDE IS THAT I WANT
OUR OFFICE TO BE MORE
INTRAOPERABLE, SO MORE NOT SO
SEGMENTED, I WANT US TO BE MORE
COLLABORATIVE.
WHAT I MEAN BY THAT IS MORE
TRANS-NIH ENGAGEMENT AND REALLY
LEVERAGE THE EXISTING
PARTNERSHIPS THAT WE ALREADY
HAVE.
I WANT TO SHIFT FROM A REACTIVE
POSTURE TO MORE PROACTIVE
POSTURE, AND YOU CAN SEE A LOT
OF THAT IN WHAT WE'VE DONE OVER
THE PAST YEAR, IN FACT, WE HAVE
A NUMBER OF NEW I WOULD SAY
EMERGING CONCEPTS THAT WE ARE
STARTING TO DEVELOP IN ADVANCE
OF THE STRATEGIC PLAN EVEN BEING
PUBLISHED THAT REALLY PUTS US ON
THAT PATH TO BEING MORE
PROACTIVE.
A KEY THING IN DIETARY
SUPPLEMENT SIZE IS MAKING SURE
WE FOCUS ON RIGOR,
REPRODUCIBILITY AND
TRANSPARENCY, AND THAT'S IN
EVERYTHING WE DO FROM FUNDING TO
DECISIONS, EXPERIMENTAL DESIGN
WHEN EVALUATING EXPERIMENTS ALL
THE WAY THROUGH REPORTING THE
SCIENCE IN THE LITERATURE AND
MAKING SURE THAT'S AS STRONG AS
IT CAN BE.
I THINK WHAT REALLY SETS ME --
WHAT IS ONE OF THE MAIN THINGS
THAT KIND OF HAS GOTTEN ME
THROUGH MY CAREER AT THIS POINT
IS I'M NOT ONE FOR STAGNANCE AND
STATUS QUO.
SO I'LL ALWAYS BE LOOKING TO SEE
WHAT -- THAT'S WHAT WE'RE GOING
TO BE TRYING TO DO WITH OUR NEW
STRATEGIC PLAN.
THIS SLIDE GIVES US A LITTLE
MORE INFORMATION ABOUT WHAT OUR
CROSS-CUTTING THEMES ARE.
I'M NOT GOING TO READ THESE
VERBATIM BUT WHAT I WILL SAY,
THESE PRIORITIES WITHIN THESE
THEMES AS THEY EMERGE, YOU'LL
START SEEING NEW PARTNERSHIPS
ACROSS NIH START TO COME
TOGETHER.
YOU'LL START SEEING NEW WORKING
GROUPS OR MORE PARTICIPATION IN
TRANS-NIH WORKING GROUPS, MORE
REACHING OUT TO ACADEMIA AND
OTHER GOVERNMENT AGENCIES TO
START REALLY PUTTING THE PIECES
TOGETHER OF NEW INITIATIVES AND
HOPEFULLY WE CAN START DOING
THAT IN THE NEXT COUPLE YEARS
AND I KNOW WITH MY DEPUTY ON
BOARD, STEPHANIE OVER THERE, HER
EXPERIENCE WITH MTRPC, WE ARE
EXCITED TO GET SOME NEW THINGS
OFF THE GROUND AND THE CONTINUUM
IS ONE OF THOSE EXAMPLES.
OVER THE NEXT COUPLE OF SLIDES,
I'M GOING TO DETAIL AT A VERY
HIGH LEVEL OUR RELATIONSHIP WITH
NCCIH, WHICH IS AMONGST OUR
STRONGEST PARTNERSHIPS HERE
WITHIN NIH.
AN AREA OF EMPHASIS FOR OUR
OFFICE AND FOR NCCIH AS YOU
HEARD DR. LANGEVIN MENTION IS
THE HEIGHTENED FOCUS ON
ANALYTICAL METHOD DEVELOPMENT
AND THE PROMOTION OF RESEARCH
INTEGRITY.
THE NIH CARBON PROGRAM AS I
MENTIONED IS A 25-YEAR
PARTNERSHIP WITH NCCIH.
PROGRAM GOALS HAVE BEEN TO
ENSURE THE COMPLEX FORMULATION
AND MECHANISMS OF ACTION OF
BOTANICALS AND OTHER NATURAL PRO
KUPRODUCTS CAN BE ANALYZED
EFFECTIVE SO WE NO HOW AND WHY
THEY ARE EXERTING TH A BIOLOGICL
EFFECT FOR THE EVENTUAL DESIGN
CLINICAL RESEARCH STUDIES ON
HEALTH.
THAT'S THE EVENTUAL WAY WE WOULD
LIKE TO GO WITH CARBON.
THERE ARE OTHER SUPPORTING
COMPLEMENTARY EFFORTS WITHIN OUR
OFFICE NOTABLY THE ANALYTICAL
METHODS AND REFERENCE MATERIALS
PROGRAM AND OUR EMPHASIS ON
PRODUCT INTEGRITY WHEN
EVALUATING GRANTS FOR COFUNDING.
WE REALLY WANT TO MAKE SURE
THESE ASPECTS DEPICTED IN THE
FIGURE ON THE LEFT-HAND SIDE ARE
CONSIDERED WHEN WE ARE LOOKING
AT A GRANT TO ACTUALLY CO-FUND.
LET ME TAKE YOU THROUGH THIS
FIGURE.
THIS IS A FIGURE DEVELOPED BY
BARBARA SORKIN, WHO LEADS FROM
THE ODS END THE CARBON PROGRAM.
I'M GOING TO WALK YOU THROUGH IT
BACKWARDS TO KIND OF GIVE YOU A
SENSE OF HOW I FEEL DIETARY SUM
STUSUPPLEMENT STUDIES SHOULD ALS
BE CONSIDERED.
THE BOTTOM LINE IN TERMS OF WHAT
WE WANT IN TERMS OF THE PUBLIC
AND WHAT WE WANT TO KNOW AS
SCIENTISTS OF DIETARY
SUPPLEMENTS, DO THEY HAVE AN
ACTUAL EFFECT ON HUMAN HEALTH?
WHAT ARE THE PHENOTYPIC EFFECTS
OF DIETARY SUPPLEMENTS?
YOU CAN'T DO THAT IF YOU DON'T
KNOW BIOLOGICALLY WHAT IT'S
DOING.
YOU CAN'T DO THAT IF YOU DON'T
KNOW HOW IT'S AFFECTING THE
CELLS AND KNOWING WHAT'S
ACTUALLY BIOAVAILABLE.
YOU CAN'T KNOW BIOAVAILABILITY
IF YOU DON'T KNOW
BIOACCESSIBILITY.
WHAT ARE THE ACTUAL INGREDIENTS
AND CONSTITUENTS WITHIN DIETARY
SUPPLEMENTS?
WHAT ARE THE ACTIVE INGRE INGRE,
WHAT ARE THE EXCIPIENT
INGREDIENTS, HOW ARE THEY
INTERACTING OR INTERFERING WITH
OTHER PROCESSES WITHIN THE BODY
TO AUGMENT A CELLULAR PROCESS?
AND YOU CAN'T DO ANY OF THAT IF
YOU DON'T KNOW WHAT'S IN THE
ACTUAL DIETARY SUPPLEMENT ITSELF
AND THAT'S I WOULD SAY
REPRESENTED UNDER KNE UNDERNEATD
THAT'S REALLY WHERE CARBON HAS
BEEN FOR A GOOD NUMBER OF YEARS,
REALLY DEVELOPING THOSE TOOLS
AND THOSE RESOURCES THAT
UNDERSTAND WHAT'S IN A DIETARY
SUPPLEMENT.
NOW YOU CAN'T DO ANALYTICAL
SCIENCE YOUR ENTIRE CAREER,
ESPECIALLY AS AN ORGANIZATION
THE SIZE OF MINE, WE MUST MAKE
SURE WE HAVE A COMPLETE PROGRAM
AND WE TRANSITION TO A MORE
BALANCED APPROACH TOWARDS
CLINICAL RESEARCH.
LAST YEAR THE COUNCIL APPROVED
THE 2025-2029 CARBON CONCEPT,
WHICH REALLY IS MOVING IN THAT
DIRECTION.
LESS OF A FOCUS ON ANALYTICS,
MORE OF A FOCUS ON DEVELOPING
CLINICAL AND TRANSLATIONAL WORK
AND LEVERAGING EXISTING
DATABASES TO REALLY ADDRESS
QUESTIONS, LOOK FOR UNIQUE
PHENOTYPIC SIGNATURES OF
RESILIENCE AND POTENTIALLY OTHER
METABOLIC PATHWAYS AFFECTED BY
NATURAL PRODUCTS AND THAT'S WHAT
WE LOOK TO TIE TOGETHER WITH
THESE THREE NOFOs THAT WERE
RELEASED BACK IN THE SPRING OF
2024, AND I THINK RIGHT NOW, THE
CARBON LEADS ARE STARTING TO
SIFT THROUGH THE NUMBER OF
APPLICATIONS THAT CAME THROUGH
IN RESPONSE TO THOSE FUNDING
ANNOUNCEMENTS.
OUR RELATIONSHIP WITH NCCIH GOES
WELL BEYOND CARBON.
THIS FIGURE I RECEIVED FROM
PATRICIA HAGERTY.
IT'S JUST A NUMBER OF COFUNDED
PROJECTS THAT THE OFFICE HAS
BEEN A PART OF OVER THE PAST 10
YEARS, A NUMBER OF PROJECTS, 420
OR SO WERE FUNDED, AND ABOUT 20%
OF THOSE HAVE BEEN IN
PARTNERSHIP WITH NCCIH.
SO WE HAVE A STRONG PARTNERSHIP,
AND I'VE BEEN EXCITED TO LEARN
MORE ABOUT WHAT DR. LANGEVIN
WANTS AS HER PRIORITIES SO I CAN
SEE HOW WE ALIGN GOING FORWARD.
MOST RECENTLY, NCCIH,
DR. CHIDEYA INVITED THE OFFICE
OF DIETARY SUPPLEMENTS TO
PARTICIPATE IN A VERY
INTERESTING AND
THOUGHT-PROVOKING WORKSHOP A FEW
MONTHS BACK. DIETARY
SUPPLEMENTS WAS A MAJOR
COMPONENT OF THAT.
AND IMPORTANTLY, THE ASPECTS
THAT WERE PRESENTED IN THIS
WORKSHOP REALLY GET TO THE HEART
OF WHAT DR. LANGEVIN WAS SAYING,
IS THAT WE CAN'T LOOK AT THINGS
IN ISOLATION.
THERE ARE A NUMBER OF FACTORS
THAT AFFECT HUMAN HEALTH OR
WHOLE PERSON HEALTH AND WE NEED
TO LOOK AT THAT COLLECTIVELY
BECAUSE YOU CAN'T LOOK AT THINGS
IN ISOLATION.
AND THAT WAS AN IMPORTANT PART
BECAUSE DIETARY SUPPLEMENTS WERE
FOCUSED ON DURING ONE OR TWO OF
THE MAIN SESSIONS DURING THIS
WORKSHOP, AND I REALLY LOOK
FORWARD TO SEEING WHAT THE END
RESULT OF THIS WORKSHOP IS, AND
I KNOW THAT FINAL REPORT IS
BEING WORKED ON NOW.
I WOULD SAY PROBABLY RIGHT NOW
OUR INITIAL CONVERSATION,
DR. LANGEVIN AND I WHEN I WAS
ANNOUNCED AS COMING ON AS THE
NEW DIRECTOR, I DON'T THINK I
WAS ACTUALLY ON BOARD YET, WHOLE
PERSON HEALTH CAME UP AND REALLY
HER DESIRE TO MOVE AWAY FROM
ISOLATED RESEARCH IN SILOS TO
MORE LOOKING AT THE HUMAN
COLLECTIVELY, AND EVERYTHING
THAT THAT INVOLVES.
AND I COULDN'T HAVE BEEN MORE IN
LINE WITH THAT.
I LOOK AT MYSELF AS AN
INTEGRATIVE PHYSIOLOGIST WHO'S
NOT FOCUSED IN ANY ONE AREA.
YES, MY RESEARCH WHEN I WAS A
SCIENTIST WAS REALLY FOCUSED ON
DIETARY PROTEIN, BUT BECAUSE I
WAS FOCUSING ON MILITARY AND IN
THE ENVIRONMENTS THAT THEY
OPERATED, I HAD TO LOOK AT THE
COMPLETE PICTURE.
AND THEY ALSO WERE EATING COMBAT
RATION, I KNEW I HAD TO CONSIDER
EXACTLY THAT FOOD SOURCE, HOW
THAT'S MANUFACTURED, HOW IT'S
PRODUCED, HOW IT'S METABOLIZED
IN THE BODY AND HOW THAT
ACTUALLY IMPACTS A BIOLOGICAL
EFFECT.
SO THIS CONCEPT OF WHOLE PERSON
HEALTH WAS SOMETHING THAT I GOT
ON BOARD WITH, I WOULD SAY
WITHIN MONTHS OF COMING HERE,
AND WHEN THE OPPORTUNITY CAME ON
TO SIGN ON TO THE INITIATIVE TO
BE PART OF THE WHOLE PERSON
HEALTH PROGRAM HERE AT NCCIH, I
DID SO FOR OUR OFFICE.
FUNDAMENTALLY AND A TRAINED
NUTRITION SCIENTIST AND SOMEONE
WHO HAS LED COMPLEX CLINICAL
TRIALS ON DIET OR DIETARY
SUPPLEMENT AND UNDERSTANDING THE
MANY, MANY WEAKNESSES AND
CONFOUNDERS IN SUCH STUDIES,
ESPECIALLY THOSE THAT FAIL TO
APPRECIATE THE COMPLETE PICTURE
ON ONE'S HEALTH, I
WHOLEHEARTEDLY SUPPORT THE
NUTRITION CONTINUUM.
IT'S NOT ONLY AN OPPORTUNITY FOR
NEW RESEARCH, I SEE IT AS A
NECESSITY.
I SEE IT AS A NECESSITY FOR US
AS NIH, AS A NECESSITY FOR OUR
DIFFERENT ICOs TO REALLY COME
TOGETHER AND ADDRESS THIS
CONCEPT FROM A COLLECTIVE.
AND WHY ARE DIETARY SUPPLEMENTS
SUCH AN INTEGRAL COMPONENT OF
THIS NUTRITION CONTINUUM?
WELL, THAT'S BECAUSE PEOPLE TAKE
A LOT OF DIETARY SUPPLEMENTS.
THIS IS NEW DATA.
IT'S FROM 2017 TO RIGHT BEFORE
THE PANDEMIC, AND IT JUST
REPRESENTS THE PERCENTAGE OF
PEOPLE REPORTING TAKING DIETARY
SUPPLEMENTS WITHIN THE LAST
THREE MONTHS.
AND IT LOOKS AT IT IN ADULTS 20
YEARS AND OLDER, AND IT BREAKS
IT DOWN BY SEX AND AGE.
IF YOU LOOK ALL THE WAY TO THE
LEFT-HAND SIDE OF THIS FIGURE,
YOU SEE THAT NEARLY 60% OF THE
POPULATION OR THE ADULT
POPULATION WILL REPORT USING
DIETARY SUPPLEMENTS AT LEAST
ONE, SOME, MANY DIETARY
SUPPLEMENTS.
IF YOU START LOOKING AT IT BY
SEX AND AGE, YOU CAN SEE WHEN
YOU GET TO OLDER ADULTS, 60 AND
OVER, 70% OF MALES AND 80% OF
FEMALES REPORT USING DIETARY
SUPPLEMENTS, AND AS I SAID, MANY
OF THOSE INDIVIDUALS REPORT
TAKING MANY, MANY MORE.
SO TO MAKE A LONG STORY SHORE,
DIETARY SUPPLEMENT USE IS HIGHLY
PREVALENT, THE INDUSTRY IS NOT
GOING AWAY, IN FACT, IT
CONTINUES TO INCREASE YEAR OVER
YEAR, SO I THINK IT'S FAIR TO
CONCLUDE THAT DIETARY
SUPPLEMENTS IS AN IMPORTANT
PIECE TO LOOK AT COLLECTIVELY.
DO THEY HAVE A BENEFIT, DO THEY
HAVE A DETRIMENT, ARE THEY BEING
USED EFFECTIVELY OR SHOULD THEY
NOT BE USED, AND THAT'S WHAT
WE'RE HERE TO HELP ADDRESS IN
THE NUTRITION CONTINUUM.
SO WHY A NEW FRAMEWORK FOR
NUTRITION SCIENCE?
I POSIT ONE IS NEEDED BECAUSE
ALL OF THE HARD AND EXCELLENT
WORK THAT HAS BEEN DONE IN THIS
FIELD IS NOT REALLY HAVING THAT
DESIRED OUT COME, AND MAYBE
BECAUSE OF SOME OF THE
LIMITATIONS DR. LANGEVIN
MENTIONED, ABOUT WORKING IN OUR
POCKETS.
THIS FIGURE WAS TAKEN FROM A CDC
REPORT LED BY AN ACTUAL ODS
SCIENTIST THAT SHOWS THE
PERCENTAGE OF ADULTS WHO HAVE
HEARD OF THE FEDERAL NUTRITION
RECOMMENDATIONS THAT ARE BEING
VISUALIZED IN THE CONTEXT OF
MYPLATE.
YOU CAN SEE HERE THAT 25% OF THE
ADULT POPULATION REPORT AT LEAST
SEEN WHAT MYPLATE IS BUT LESS
THAN 10% HAVE MADE ANY ATTEMPT
TO FOLLOW FEDERAL NUTRITION
GUIDELINES, AND THAT'S AN
ASTONISHING BUT NOT SURPRISING
NUMBER.
NOW, WE ALSO ARE WELL AWARE OF
THIS MAP.
I THINK EVERYONE HAS SEEN THE
OBESITY MAP FROM THE CDC AND
THIS IS THE MOST RECENT ONE.
NOW OBESITY IS NOT THE ONLY
REFLECTION OF NUTRITION.
I WANT TO MAKE SURE THAT'S CLEAR
AND I'M NOT SAYING THAT IT IS,
BUT IT IS A GOOD DEPICTION, AND
IT ALIGNS WITH HOW FEW AMERICANS
ACTUALLY FOLLOW DIETARY
GUIDELINES.
SO ALL OF THAT TO SAY IS THAT
WHY NOT TRY A NEW APPROACH THAT
BRINGS US TOGETHER?
THE TIME IS NOW TO EMPHASIZE
WHOLE PERSON HEALTH AND THE TIME
IS NOW TO NOT LOOK AT NUTRITION
IN SEGMENTED WAYS.
SO THE NUTRITION CONTINUUM IS
REALLY BREAKING DOWN SILO, AND
IT'S KEY TO ME, AT LEAST WHEN WE
WERE REPORTING TOGETHER THE
STRATEGIC PLAN IS THAT WITHIN
THE OFFICE ITSELF, AND AS WE
LOOK TO BUILD NEW STRATEGIC
PARTNERSHIPS, I WANT US TO BE
CONNECTED.
I WANT US TO BE MANEUVERABLE.
I DON'T WANT US TO BE LOCKED
INTO SILOS, SO IT WILL BE REALLY
HARD FOR US TO REILY M REALLY ME
NEEDLE FORWARD.
IF WE ALL WORKED IN OUR OWN
SILOS, AND LET'S JUST SAY NINR,
NIDDK, NIA, AND SO ON WORKED
ALONE AND DIDN'T COME TOGETHER
TO ADDRESS SHARED INTERESTS AND
SHARED NEEDS.
AND THIS SLIDE IS MY FINAL SLIDE
AND REALLY JUST MAKES THAT POINT
IN TEXT.
SO PEOPLE DON'T RESPOND TO
STIMULI, IN THIS CASE, NUTRITION
OR A VARIETY OF FACTORS IN THAT
MULTI-SCALE FRAMEWORK OF
NUTRITION CONTINUUM IN A VACUUM.
YET WE ARE STRUCTURED
ORGANIZATIONALLY, FINANCIALLY
AND ACADEMICALLY TO STUDY THESE
ASPECTS OF HEALTH IN ISOLATION.
FOR EXAMPLE, IF YOU WERE TO
STUDY DIETARY SUPPLEMENTS, YES,
OF COURSE WE NEED GOOD
ANALYTICAL PRE-CLINICAL WORK TO
UNDERSTAND MECHANISMS FROM
ACTION AND CHARACTERIZE THE
SUPPLEMENTS.
WE NEED GOOD EPIDEMIOLOGICAL
RESEARCH TO LOOK AT THOSE
RELATIONSHIPS THAT REALLY HELP
GENERATE HYPOTHESES FOR CLINICAL
RESEARCH.
BUT WHEN YOU GET INTO THAT
CLINICAL RESEARCH AREA, IF YOU
FAIL TO LOOK AT THE COLLECTIVE
AND ACCOUNT FOR EVERYTHING THAT
GOES ON WITHIN INDIVIDUALS'
LIVES SUCH AS ENVIRONMENTAL
FACTORS, THEIR DEMOGRAPHICS,
AGRICULTURE, FOOD SCIENCE,
UNDERLYING NUTRITION, I CAN'T
BELIEVE HOW MANY TIMES I'VE
HEARD PEOPLE SAY, IS IT REALLY
IMPORTANT TO CONTROL THE
UNDERLYING DIET OR KNOW WHAT
PEOPLE EAT IF YOU DO A DIETARY
SUPPLEMENT STUDY?
THAT BLOWS MY MIND.
YOU HAVE TO KNOW WHAT PEOPLE ARE
TAKING IN TO STUDY THE EFFECT OF
DIETARY SUPPLEMENT.
LIKEWISE, PHYSICAL ACTIVITY AND
A NUMBER OF OTHER FACTORS THAT
IF WE FAIL TO LOOK AT THINGS AS
A COLLECTIVE, AS A CONTINUUM, WE
REALLY LIMIT THE EXTENSION OF
THE SCIENCE THAT WE DO.
SO WE KNOW THAT THESE
LIMITATIONS ARE NOT JUST
SPECIFIC TO NUTRITION.
THEY CAN REALLY AFFECT AND APPLY
TO ALL BIOMEDICAL AND BEHAVIORAL
RESEARCH DOMAINS BUT THE
NUTRITION CONTINUUM IS OUR
OPPORTUNITY TO COME TOGETHER AND
I'M REALLY EXCITE TODAY DO THAT,
AND I KNOW DREW IS TOO, AND I
LOOK FORWARD TO SEEING WHERE
THIS GOES IN THE FUTURE.
SO WITH THAT, I JUST WANT TO
CLOSE AND THANK YOU ALL FOR YOUR
ATTENTION AND AGAIN,
DR. LANGEVIN, FOR THE
OPPORTUNITY TO SPEAK TO COUNCIL
TODAY AND COUNCILMEMBERS FOR
YOUR ATTENTION.
THANKS A LOT.
>> THANK YOU SO MUCH, AND I HOPE
EVERYBODY CAN SEE WHY I'M SO
EXCITED TO HAVE DR. PASIAKOS AS
DIRECTOR OF ODS.
SO WE'RE GOING TO SAVE QUESTIONS
FOR OUR PANEL, AND WE'RE GOING
TO NOW MOVE ON QUICKLY TO
DR. BREMER.
>> YOU SET ME UP BEAUTIFULLY!
I JUST WANT TO ECHO THE PROFOUND
THANKS FOR BEING HERE, HELENE,
STEFAN, AND STEPH GEORGE OVER
THERE.
NOW IS THE TIME, THIS IS A SUPER
EXCITING TIME.
I PROMISE I'LL KEEP THIS SHORT
BECAUSE I CAN TALK FOR DAYS
ABOUT NUTRITION AND I'M GOING TO
TAKE MY LEAD FROM STEFAN, I'M
GOING TO START BY HIGHLIGHTING
THE OFFICE AND REALLY WHERE I
THINK WE CAN -- WE AS AN OFFICE
CAN WORK WITH YOU, CAN WORK WITH
HELENE, AND THE NIH, AND REALLY
MAKE A DIFFERENCE.
BECAUSE THIS IS A SUPER EXCITING
TIME.
SO HERE WE ARE, AND I ALWAYS
LIKE STARTING WITH PROFOUND
GRATITUDE FOR THOSE I WORK WITH.
AND THAT'S -- AGAIN, I WANT TO
ECHO STEFAN'S REMARKS ABOUT JUST
HOW AMAZING IT IS TO HAVE HELENE
AT THE HEAD HERE.
I AM PRIVILEGED TO WORK WITH
A -- I CALL A SMALL BUT MIGHTY
OFFICE.
WE'RE AN OFFICE OF NINE.
BUT WHAT'S INCREDIBLE IS THAT
EVERYONE BRINGS THEIR OWN GIFTS
TO THIS OFFICE.
WE WAKE UP EVERY MORNING WITH
THE SAME CHARGE, HOW CAN WE
THINK ABOUT MOVING THE SCIENCE
FORWARD TO MAKE A DIFFERENCE.
NUTRITION, YOU'VE HEARD ABOUT,
WHOLE PERSON HEALTH, OF COURSE,
IT'S ONE OF THE CROSS-CUTTING
DISCIPLINES.
IT AFFECTS EVERYTHING.
SO WE TRY TO USE OUR COLLECTIVE
ENERGIES TO THINK ABOUT AGAIN
HOW CAN WE THINK ABOUT NUTRITION
IN A WAY THAT'S GOING TO IMPACT
PUBLIC HEALTH AND REALLY MAKE A
DIFFERENCE NOT JUST DOMESTICALLY
BUT INTERNATIONALLY AND AT A
GLOBAL SCALE.
SO AS STEFAN MENTIONED, KIND
ALLUDED TO, BOTH ODS AND OFFICE
OF NUTRITION RESEARCH DO SIT IN
THE OFFICE OF THE DIRECTOR, AND
THAT IS A WONDERFUL PLACE TO BE,
BECAUSE THAT GIVES US ACCESS TO
BREAK DOWN SILO, IF YOU WILL,
AND TO REALLY INTERACT WITH ALL
OF OUR SISTER INSTITUTES AND
CENTERS.
PARTICULARLY IN THIS AREA OF
NUTRITION, ON A SLIDE YOU'LL SEE
IN A SECOND, NUTRITION TOUCHES
EVERYTHING.
EVERY CELL, EVERY SYSTEM AT
EVERY AGE AND STAGE OF LIFE,
NUTRITION IS SOMETHING WE ALL
SHARE.
AND SO EVEN THOUGH AS STEFAN
MENTIONED THE NIH IS ORGANIZED
AROUND MAYBE DISEASES OR
DIFFERENT CATEGORIES OF
MEDICINE, NUTRITION IS SO
CROSS-CUTTING AND WE HAVE THE
OPPORTUNITY TO HOPEFULLY USE OUR
TEAM AND USE OUR OFFICE TO MAKE
THOSE CONNECTIONS, TO MAKE THOSE
SYNERGIES, TO REALLY THINK ABOUT
IN THE DOMAINS OF EACH OF THESE
INSTITUTES AND CENTER, HOW CAN
THEY THINK ABOUT NUTRITION TO
ACHIEVE THEIR MISSION AND
OUTCOMES.
AND WE ALSO WORK WITH OUR
FEDERAL PARTNERS.
AGAIN, THIS IS SUPER COOL!
YOU KNOW, WE HAVE THE
OPPORTUNITY TO WORK BEYOND NIH,
BECAUSE THE ENERGIES AND THE
SCIENCE THAT'S DONE HERE, YOU'LL
SEE THE MINUTES, I FIRMLY
BELIEVE ONE OF OUR ROLES IS TO
PROVIDE THE EVIDENCE BASE TO
INFORM PROGRAMS, PRACTICES AND
POLICIES THAT ARE GOING TO
IMPACT PUBLIC HEALTH.
SO WE ARE THE EVIDENCE
GENERATORS.
BUT AS MONICA WILL MENTION IN
HER TALKS, YOU KNOW, IT DOESN'T
END WITH DISCOVERY.
IT'S TAKING THAT DISCOVERY OUT
TO THE FIELD.
HOW CAN WE BRING THOSE
DISCOVERIES TO PATIENTS AND MAKE
AN IMPACT ON PUBLIC HEALTH, AND
THEN LEARN FROM OUR PATIENTS TO
MAKE MORE DISCOVERIES AND KEEP
THAT GOING.
WE HAVE THE PRIVILEGE OF WORKING
WITH A LOT OF OUR PARTNERS IN
THE FEDERAL SPACE WHO ARE ALL
REALLY INTERESTED IN DOING THE
RIGHT THING AND MAKING A PUBLIC
HEALTH IMPACT.
-- MORE SO THAN CIGARETTE
SMOKING, TOBACCO SMOKING, MORE
SO THAN AIR POLLUTION AND MORE
SO THAN HIGH BLOOD PRESSURE.
A -- DIET IS THE LEADING RISK
FACTOR FOR DEATH ACROSS THE
GLOBE.
SO WHAT IS OUR MISSION?
JUST LIKE STEFAN, WE ARE IN THE
PROCESS AS AN OFFICE OF GOING
THROUGH AND PUTTING TOGETHER AN
OFFICE-SPECIFIC STRATEGIC PLAN
TO THINK ABOUT HOW CAN WE MAKE
THE MOST IMPACT IN THE FIELD OF
NUTRITION ACROSS THE NIH.
AND THIS IS A VERY LONG SENTENCE
WITH A LOT OF ADJECTIVES.
I KNOW THAT.
BUT THINK ABOUT EACH ADJECTIVE
IS SUPER IMPORTANT.
TO ADVANCE NUTRITION SCIENCE TO
PROMOTE LI HEALTH ACROSS THE
LIFESPAN.
THIS GOES FROM PRECONCEPTION,
THE FIRST THOUSAND DAYS, THE
NEXT 7,000 DAYS UNTIL YOU'RE 21,
EARLY ADOLESCENCE, PRAGUE SEE,
LACTATION, OLDER ADULTHOOD
THROUGHOUT THE ENTIRE LIFESPAN.
TO SUPPORT THE DEVELOPMENT OF
EVIDENCE-BASED, EQUITABLE,
CONTEXT-SPECIFIC, CULTURALLY
APPROPRIATE.
HELENE MENTIONED FOOD AS
MEDICINE PROGRAMS.
RESILIENT AND SUSTAINABLE
SOLUTIONS.
JUST LIKE WITH STEFAN'S OFFICE,
WE'RE LOOKING FOR ACTIONABLE
RESEARCH THAT'S
SOLUTION-ORIENTED.
AND THAT CAN BE DISSEMINATED AND
IMPLEMENTED AT SCALE.
SO NOT JUST DISCOVERY FOR THE
SAKE OF DISCOVERY, BUT DISCOVERY
THAT'S GOING TO INFORM PROGRAMS,
PRACTICES AND POLICIES THAT ARE
GOING TO MITIGATE THE BURDENS.
I SAY BURDENS AS BOTH ECONOMIC
BURDENS AND HUMAN BURDENS,
DIET-RELATED DISEASES AND HEALTH
DISPARITIES.
SUPER LONG SENTENCE.
WHEN I TRIED A SMALLER, SHORTER
ONE, IT KIND OF GOT THERE, BUT
THIS LISTS ALL THE COMPLEXITIES
AND ALL THE DIFFERENT ASPECTS OF
WHAT OUR OFFICE IS REALLY TRYING
TO DO.
AND MUCH LIKE STEFAN MENTIONED,
HERE INTERNALLY, AND WITH OUR
FEDERAL PARTNERS, WE'RE REALLY
HERE TO PROVIDE SERVICE,
TECHNICAL ASSISTANCE, AND
COORDINATION.
AGAIN, WE HAVE THAT PRIVILEGE
AND I TAKE IT AS A PRIF LEM.
I GET UP EVERY MORNING, I'M
JAZZED TO GO TO WORK.
WHAT A GREAT OPPORTUNITY TO WORK
WITH PARTNERS AND INDIVIDUALS
WHO AT THE END OF THE DAY JUST
WANT TO DO THE RIGHT THING AND
HELP AND ADVANCE PUBLIC HEALTH.
ALL RIGHT.
SO WHAT ARE OUR GUIDING
PRINCIPLES?
WHEN I CAME TO THE OFFICE BACK
IN SEPTEMBER, AGAIN, IT WAS SUCH
AN HONOR TO JOIN THAT GROUP.
WE HUDDLED UP AND WE SAID GOSH,
WHAT'S OUR WHY?
I LOVE SIMON SINAK WILL HAVE A
WHY SLIDE IN A SECOND.
NUTRITION IS NOT FOOD, WE HEAR A
LOT ABOUT FOOD AND THERE'S A LOT
OF DISCUSSION ON THE SUPPLY SIDE
VERSUS WHAT THE BIOLOGY IS.
BUT NUTRITION -- WHEN I TALKED
TO MY DAUGHTER'S SCHOOL ABOUT
NUTRITION AND I SAY, I THINK OF
NUTRITION AS THE LINK BETWEEN
WHAT WE PUT IN OUR MOUTH AND OUR
HEALTH.
THAT'S THE BIOLOGY.
AFTER WE EAT, ALL THAT STUFF
THAT HAPPENS, AS FAR AS RIGOR
AND REPRODUCIBILITY IN THE
SCIENCE ARE THE COOL
OPPORTUNITIES.
BUT NUTRITION LINKS WHAT WE PUT
IN OUR MOUTHS TO OUR OVERALL
HEALTH.
IT TOUCHES EVERY CELL AND EVERY
SYSTEM.
IT'S INEXTRICABLY LINKED TO ALL
ASPECTS OF BIOLOGY.
AGAIN, THIS IS WHERE PEOPLE
THINK ABOUT NUTRITION, ABOUT
DIETARY PATTERNS AND THAT'S
IMPORTANT.
BUT WE THINK ABOUT ALL THE
BIOCHEMISTRY THAT NUTRIENTS
AFFECT.
HELENE'S SLIDE IS BEAUTIFUL.
NUTRIENTS WORK ACROSS AN ENTIRE
CONTINUUM, ENTIRE SPECTRUM.
STEFAN ALLUDED TO THIS IN
ANOTHER CORE PRINCIPLE,
NUTRITIONAL STATUS IS A
FUNDAMENTAL BIOLOGICAL VARIABLE.
LIKE AGE AND SEX.
HE MENTIONED IT IN THE COULD BE
TECONTEXTOF DIETARY SUPPLEMENT ,
BUT UNDERSTANDING AN
INDIVIDUAL'S NUTRITIONAL STATUS
IS PROFOUNDLY IMPORTANT FOR HOW
ONE INTERPRETS THE SCIENCE AND
WITHOUT DOING THAT, IT
DIMINISHES THE RIGOR AND
REPRODUCIBILITY OF DIETARY
STUDIES AND NUTRITION SCIENCE.
NUTRITIONAL STATUS IS REALLY
BOTH AN INPUT AND AN OUTCOME OF
HEALTH AND DISEASE.
IT CAN BE A DISEASE MODIFIER OR
AN OUTPUT OR OUT COME OF
PATHOLOGICAL PROCESS.
I LOVE THIS ONE, NUTRITION, IT'S
EVERYONE'S BUSINESS.
SO CROSS-CUTTING, WHY?
BECAUSE EVERYONE EATS.
AND WHAT WE EAT IMPACTS OUR
HEALTH.
FOOD -- I OFTEN USE THE
PHRASE -- IS A MAJOR THREAT OF
THE INTERLOW PEN TAPESTRY OF
CULTURE, TRADITION, HISTORY,
FAMILY AND MEMORY.
IT'S THERE.
MALNUTRITION IN ALL ITS FORMS IS
THE LEADING CAUSE OF MORBIDITY
AND MORTALITY ACROSS THE GLOBE,
HANDS DOWN.
SO IT'S EVERYONE'S BUSINESS.
IT'S ALSO DISEASE AGNOSTIC.
AGAIN, CROSS-CUTTING.
IT TOUCHES EVERY ASPECT OF THE
NIH, AND BEYOND.
AND AS HELENE AND STEIVE ALLUDED
TO, IT'S IMPORTANT FOR EVERY
PERSON, SOCIETY AND THE PLANET.
WHEN I TRIED TO PUT THE SIX
GUIDING PRINCIPLES INTO A
PICTURE FORM, THE BEST I COULD
DO IS THIS.
HELENE SET ME UP BEAUTIFULLY.
ALL THESE THINGS WORK IN
CONCERT, THEY'RE BIDIRECTIONAL
AND THEY IMPACT EACH OTHER.
SO WE THINK ABOUT FOOD SYSTEMS
WHICH CAN BE A TWO-HOUR LECTURE
IN AND OF ITSELF, HELENE
MENTIONED SO MANY ASPECTS OF THE
FOOD SYSTEMS, EVERY ASPECT HAS
AN IMPLICATION ON HUMAN HEALTH,
AND EVERY ASPECT ALSO HAS AN
IMPLICATION ON ENVIRONMENTAL
HEALTH AND PLAN TRI HEALTH.
AND WE HEARD ABOUT THE IMPACT OF
CLIMATE AND SOIL AND ABSOLUTELY,
THAT INFLUENCES THE NUTRITIONAL
QUALITY OF PLANTS AND PRODUCTS
AND THEN COULD IMPACT HEALTH BY
INDIVIDUAL PATIENTS.
SO ALL THESE THINGS ARE
INTERCOINTERCONNECTED.
SO AGAIN, STEFAN SET ME UP, WE
CAME TOGETHER AND SAID THIS
NUTRITION CONTINUUM, FROM SOIL
TO PERSON TO THE ENVIRONMENT TO
THE COMMUNITY TO THE SCHOOL TO
THE NURSING HOME, ALL THESE
THINGS ARE IMPORTANT, ALL THESE
THINGS COME TOGETHER.
AND WHY DO I CARE?
WHAT GETS ME UP IN THE MORNING?
THIS IS NOT NEW.
WE ARE IN THE MIDST OF AN URGENT
NUTRITION-RELATED HEALTH CRISIS.
I'VE ALREADY MENTIONED
MALNUTRITION IN ALL ITS FORMS,
THE LEADING CAUSE OF MORBIDITY
AND MORTALITY IN THE WORLD
TODAY.
1 IN 3 INDIVIDUALS ON THIS
PLANET SUFFERS FROM A FORM OF
MALNUTRITION.
MANY SUFFER FROM MULTIPLE FORMS
AT THE SAME TIME.
SOMETIMES IF THAT'S NOT ENOUGH,
NUTRITION IS IMPACTING NOT JUST
PUBLIC HEALTH BUT ALSO OUR
ECONOMY AND NATIONAL SECURITY.
NEARLY 8 IN 10 ADULTS IN THIS
COUNTRY CANNOT QUALIFY WITH
MILITARY SERVICE AND OVERWEIGHT
DISQUALIFIES 11% OF OUR YOUTH
RIGHT FROM THE GET-GO FROM
SERVING IN THE MILITARY AND
CONTRIBUTES TO 44% OF THOSE BHO
ARE DISQUALIFIED FOR MULTIPLE
REASONS.
IF IT'S NOT THE MONEY OR THE
PUBLIC HEALTH, THE NATIONAL
SECURITY ISSUE IS ALSO SOMETHING
THAT'S VERY PROFOUND.
AS FAR AS THE DOLLAR, MORE THAN
$1.1 TRILLION IN THIS SPACE IS
SPENT BECAUSE OF SUBOPTIMAL
DIETS.
I'VE ALREADY MENTIONED AS FAR AS
THE LEADING CAUSE OF DEATH, THE
HIGHEST RISK FACTOR, THEN THEY
CAN CONTEXTUALIZE THIS.
WHEN I MENTION THIS IN CERTAIN
AUDIENCES, THIS IS THE STAT THAT
SOMETIMES PEOPLE ARE LIKE, OH.
AS MANY AMERICANS DIE EACH YEAR
FROM DIET-RELATED ILLNESSES AS
DIED DURING THE AMERICAN CIVIL
WAR AND WORLD WAR II COMBINED.
THAT'S THE MAGNITUDE OF THE
ISSUE.
SO I TOLD YOU I LIKE SIMON
SINEK.
WHAT IS OUR WHY?
JUST LIKE WE HAVE GUIDING
PRINCIPLES AND THINGS THAT JAZZ
ME IN THE MORNING WHEN I GET UP,
I ALWAYS SAY, WHY AM I HERE?
I GET TO WORK WITH SUPER COOL
PEOPLE BUT WHY ARE WE HERE?
I'M NOT GOING TO READ THIS ALL
TO YOU BECAUSE IT REITERATES A
LOT OF OUR MISSION, WE WANT TO
BE THINKING ABOUT ACTIONABLE
RESEARCH THAT'S
SOLUTION-ORIENTED THAT CAN BE
IMPLEMENTED AND SCALED TO MAKE A
PUBLIC HEALTH DIFFERENCE.
WE WANT TO TAKE THOSE
DISCOVERIES AND BRING THEM OUT
TO THE COMMUNITY, AND AS
HELENE -- HER PARADIGM IS
BEAUTIFUL.
UTS AN ENTIRE CONTINUUM.
IT'S PRECONCEPTION.
IT'S PERI CONCEPTION, IT'S
CHILDHOOD, ADOLESCENCE,
ADULTHOOD IN THE CONTEXT OF
WHERE PEOPLE LIVE, IN THE
CONTEXT OF THEIR ENVIRONMENTS,
IN THE CONTEXT OF THE PLANET.
IT ALL WORKS TOGETHER.
SO THAT'S OUR WHY.
HOW ARE WE GOING TO DO IT?
STEFAN, AGAIN, SET ME UP
BEAUTIFULLY.
A PART OF THIS AND A LIMITATION
IN NUTRITION RESEARCH TO DATE
HAS REALLY BEEN PRECISION.
HOW DOES ONE DEFINE NUTRITIONAL
STATUS?
HOW DO WE KNOW WHAT IS OPTIMAL
NUTRITION FOR ME, FOR YOU, FOR
ANYONE?
WHAT IS OPTAL NUTRITION FOR THE
26 WEEKER IN THE NICU VERSUS THE
2-YEAR-OLD AT HOME VERSUS THE
5-YEAR-OLD AT DAYCARE?
THOSE ARE SUPER IMPORTANT
QUESTIONS AND WE DON'T HAVE THE
ANSWERS YET BUT WE'RE GOING TO
GET THERE.
SO OUR HOW IS TO REALLY THINK
HOLISTICALLY ABOUT ENHANCING
PRECISION IN NUTRITION SCIENCE
AND, AGAIN, HELENE SET ME UP,
HOW DO YOU DO THAT?
BY LOOKING AT IT HOLISTICALLY
AND DESILOING NUTRITION FROM A
RIGOROUS DISCIPLINE THAT'S BASED
ON BIOCHEMISTRY TO INCORPORATING
NUTRITION INTO THIS HOLISTIC
ECOLOGY THAT IS INFLUENCED
ABSOLUTELY BY SOMEONE'S
GENETICS, BY SOMEONE'S
MICROBIOME, BY THEIR
DEVELOPMENTAL STAGE, THEIR STATE
OF HEALTH, BUT WE LIVE IN A
WORLD AND WE CAN'T IGNORE THAT
AS STEFAN MENTIONED, AND SO
NUTRITIONAL STATUS IS ALSO --
IT'S IMPACTED, AND IT'S VERY
RELEVANT TO THE EXTERNAL
FACTORS, THE HOUSEHOLD, THE
SCHOOL, PHYSICAL ENVIRONMENT,
SOCIAL ENVIRONMENT, ALL THOSE
FACTORS THAT HELENE MENTIONED
PLAY INTO OUR ASSESSMENT AND
NUTRITIONAL STATUS, AND WE DON'T
EAT JUST NUTRIENTS.
IN MEDICAL SCHOOL, I WAS TAUGHT
THAT VITAMIN C EXISTS TO PREVENT
SCURVY.
THAT'S THE BOARD QUESTION BUT
I'M NOT QUITE SURE THAT'S WHY
VITAMIN C EXISTS.
SO HOW TO THINK ABOUT FOOD AND
DIETARY PATTERNS VERSUS ISOLATED
NUTRIENTS, WHETHER THEY BE MICRO
OR MACRO NUTRIENTS.
BECAUSE THE REALITY IS, AS
STEFAN MENTIONED, WE EAT FOOD
AND WE HAVE DIETARY PATTERNS,
AND WE'RE LEARNING MORE AND MORE
THAT IT'S THE PATTERN OF THE
FOODS, NOT NECESSARILY THE
INDIVIDUAL NUTRIENTS THAT MAY
HAVE BIOLOGICAL IMPACT, AND HOW
THEY'RE PACKAGED AND HOW THEY'RE
ORGANIZED IN FOOD MATRICES AND
SO ON AND SO FORTH.
THERE'S A LOT OF COOL SCIENCE
THERE.
BUT IT ALL WORKS TOGETHER.
FOR THOSE WHO HEAR ME TALK I
OFTEN USE THE WORD NUTRITIONAL
ECOLOGY, BUT AS HELENE MENTIONED
THIS, IS AN ECOLOGICAL APPROACH
TO NUTRITION AND ITS IMPACT ON
HEALTH AND DISEASE.
WE OFTEN USE -- I USE THE WORD A
FUNDAMENTAL BIOLOGICAL VARIABLE,
BECAUSE I THINK UNTIL WE START
DOING THAT AS STEFAN MENTIONED,
WE'RE MISSING OPPORTUNITIES TO
LEARN AND BE INFORMED BY OUR
SCIENCE.
WORST-CASE SCENARIO, WE'RE
MISINTERPRETING THAT AND MAYBE
PROVIDING RECOMMENDATIONS THAT
REALLY AREN'T BASED ON SCIENCE.
I USE ALSO THE TERM NUTRITIONAL
STATUS AS KIND OF THE
OPERATIONAL MEASURE OF THE
ADEQUACY OF THE DIET TO SUPPORT
HEALTH, AND AGAIN, THIS IS WHERE
THIS CONTINUUM APPROACH IS SO
SUPER IMPORTANT BECAUSE PEOPLE
CHANGE THROUGHOUT THE LIFESPAN.
THIS IS AGAIN THE 26 WEEKER IN
THE NICU IS DIFFERENT THAN THE
2-YEAR-OLD THAN THE 5-YEAR-OLD
THAN THE 34-YEAR-OLD THAN THE
85-YEAR-OLD.
SO AGAIN, WHAT IS OPTIMAL
NUTRITION FOR EACH INDIVIDUAL
DEPENDING ON WHICH STAGE OF LIFE
THEY'RE IN DEPENDING ON WHAT
ENVIRONMENT THEY'RE IN ARE ALL
IMPORTANT QUESTIONS.
SO WHAT ES 'S OSO WHAT'S OUR WH?
WE'RE A SMALL OFFICE.
JUST AS STEFAN'S OFFICE WENT
THROUGH THEIR PROCESS OF BEING
SUPER INTENTIONAL, WE'RE ALSO
BEING SUPER INTENTIONAL.
OUR GOAL IS NOT TO DUPLICATE
WORK THAT'S ALREADY BEING DONE
AND BEAUTIFULLY DONE BY OTHERS,
BUT TO THINK ABOUT HOW WE CAN
FILL GAPS, MOVE THE NEEDLE
FORWARD AND BE VERY INTENTIONAL,
AND AGAIN THAT INTENTION REALLY
HAS NOW FOCUSED ON BEING
ACTIONABLE RESEARCH AND
SOLUTION-ORIENTED IN A
TRANSLATIONAL WAY.
WE WANT TO INFORM SOLUTIONS, WE
WANT TO SUPPORT RESEARCH THAT'S
GOING TO INFORM SOLUTIONS DOWN
THE ROAD.
COMING DOWN THE PIPE, IT WASN'T
MENTIONED LAST YEAR BUT WE ARE
AT THE ONE-YEAR AB VERSE REOF
THE WHITE HOUSE CONFERENCE FOR
HUNGER, NUTRITION AND HEALTH.
CAN WE DEVELOP A NATIONAL
STRATEGY IN NUTRITION SCIENCE
THAT INCORPORATES ALL THESE
DIFFERENT ASPECTS OF MEDICINE
AND HEALTH AND ALL THESE
DIFFERENT TORES TO RE SECTORS TT
WHAT ARE THE KEY QUESTIONS TO
ASK AND HOW CAN WE ASK THEM.
WHAT MAY COME UP, WHERE WE'RE
LEVERAGE RG THE ALL-OF-US
RESEARCH PROGRAM TO KIND OF GET
IN THE WEEDS ABOUT WHAT ARE
CERTAIN ASPECTS OF SCIENCE THAT
WE NEED TO ADDRESS, TO HAVE A
NATIONAL NUTRITION SCIENCE
STRATEGY.
AND THEN THAT THIRD BULLET GOES
BACK TO PRECISION.
CAN WE DEVELOP THE METHODOLOGY,
THE TOOLS, THE CONSISTENCY AND
THE CONSENSUS FOR THOSE IN THE
FIELD ABOUT NUTRITIONAL
ASSESSMENTS, ATTRIBUTION, IF
SOMEONE IS IRON-DEFICIENT, WHAT
IS THE ETIOLOGY?
BECAUSE THAT MAY VERY WELL
INFORM AN INTERVENTION.
SO AGAIN, PRECISION AND
ASSESSMENT, ATTRIBUTION AND
INTERVENTIONS IS SOMETHING THAT
OUR OFFICE IS VERY MUCH ENGAGED
IN.
I AM WRAPPING UP SOON.
SO THE TAKE-HOME SLIDE FOR THE
OFFICE IS REALLY WHAT IS THE
BIOLOGY.
STEFAN'S POINT IS SUPER
IMPORTANT TO KNOW WHAT'S GOING
IN THE MOUTH.
WE HAVE LOTS OF INTERACTIONS AND
COLLABORATIONS WITH OUR FOOD
SCIENCE FRIENDS AND THE FOOD
TECHNOLOGISTS AND THE FOOD
SCIENTISTS BECAUSE THEY'RE IN
THE BUSINESS OF FEEDING THE
WORLD.
QUITE FRANKLY IN 2050, OUR
PLANET IS GOING TO BE HOME TO
10 BILLION PEOPLE, AND IT'S A
LAUDABLE AND IMPORTANT EFFORT TO
FEED EVERYONE, SO THE INPUT AND
THE IMPORT OF THE FOOD
TECHNOLOGISTS CANNOT BE
OVERLOOKED.
AND WE'RE INTERESTED IN WHAT'S
THE BIOLOGICAL IMPACT OF THE
FOOD THAT PEOPLE ARE EATING,
WHAT IS THE BIOLOGY THAT AFFECTS
WHOLE PERSON HEALTH.
AND SO YOU'VE SEEN THIS --
YOU -- WHYAM I EXCITED TO BE HE?
BECAUSE YOU'RE ALL SUPER COOL
PEOPLE.
WE SYNERGIZE WITH LOTS OF OTHER
INSTITUTES AND CENTERS, AND OUR
PRIVILEGE OF BEING WHERE WHERE
RE IN THE OFFICE OF THE DIRECTOR
IS TO HAVE THOSE OPPORTUNITIES
TO REALLY HAVE INTERACTIONS AND
MEANINGFUL CONVERSATIONS AND TO
QUOTE ARISTOTLE, THIS IS A FIELD
WHERE REALLY THE WHOLE IS MORE
THAN THE SUM OF ITS PARTS.
I CAN'T THINK OF ANOTHER
DISCIPLINE WHERE ALL THESE
DIFFERENT LENSES AND VISIONS
REALLY SYNERGIZE TO HAVE A
UNIFIED VISION OF HOW TO IMPROVE
NUTRITION.
AND SO HERE WE ARE, HERE YOU ARE
ALL.
THANK YOU AGAIN FOR THE
OPPORTUNITY TO BE HERE.
YOU HEARD FROM STEFAN.
AGAIN, LOTS OF SYNERGIES.
IT WAS GREAT TO HAVE STEFAN AND
STEPH IN THAT OFFICE TO WORK
WITH HELENE.
YOU'RE STUCK WITH ME TODAY,
THAT'S HOW DESPERATE THEY WERE,
BUT WE'RE A PART OF THIS EFFORT
TOO.
YOU'VE HEARD ABOUT SHANNON AND
NURSING.
AGAIN, HOW DO WE TAKE ALL THIS
GREAT SCIENCE, HOW DO WE GET IT
INTO THE FIELD, AND THE NURSING
INSTITUTE AND BEING A PHYSICIAN,
I LEARNED THE FIRST DAY OF
MEDICAL SCHOOL, YOU'RE THE LEAST
IMPORTANT PERSON ON YOUR TEAM.
IT'S YOUR NURSE AND YOUR
DIETITIAN.
AND THEY RUN THE SHOW, WE SIGN
THE ORDERS, BUT THEY RUN THE
SHOW.
AND I COULDN'T AGREE MORE.
THE IMPACT OF NURSES BOTH IN
SCHOOLS AND ON THE COMMUNITY AS
WE THINK ABOUT WHOLE PERSON
HEALTH IS EXTRAORDINARILY
IMPORTANT.
BUT IT'S NOT JUST THAT.
IT'S THE ENTIRE NIH AND BEYOND
AND OTHER FEDERAL AND
NON-FEDERAL PARTNERS, AND HELENE
HAS BEEN EXTRAORDINARILY
SUCCESSFUL IN MAKING THOSE
CONNECTIONS, INTERACTIONS,
SYNERGIES, AND WE'RE SUPER GLAD
TO BE A PART OF IT.
SO I HAVE FOUR MORE SLIDES, THIS
GOES BACK TO THE PICTURE I STOLE
FROM HELENE.
SHE DIDN'T EVEN NOTICE WHEN I
SAW THIS, I WAS LIKE, THAT'S
FANTASTIC!
I'M SO GOING TO BORROW THAT!
BECAUSE IT REALLY -- IN A
GRAPHICAL WAY DEMONSTRATES THIS
CONTINUITY, THIS CONTINUUM AND
THE IMPORTANCE ON HOW ALL THESE
THINGS ARE -- HOW THEY'RE ALL
INTERACTIVE, AND IT GOES, AGAIN,
FROM SOIL, BASIC MOLECULE, TO
THE PLANET.
I COULD NOT AGREE MORE.
SO WE KIND OF LANDED ON THAT
INDEPENDENTLY, BUT IT SYNERGIZES
SO WELL.
THEN WE THINK ABOUT FOOD.
NUTRITION IS EVERYONE'S
BUSINESS.
WE ALL EAT.
WHERE THAT FOOD COMES FROM, WHAT
ARE THE CONSTITUENTS, WHAT'S THE
FOOD MATRIX, THERE'S SO MUCH
RESEARCH JUST AROUND THAT LITTLE
BUBBLE UP THERE THAT I SHOWED
ABOUT FOOD, BUT AS HELENE
MENTIONED, AS WE'VE TRIED TO
PRESENT, THERE'S SO MANY OTHER
ASPECTS WHEN WE THINK ABOUT
NUTRITION ACROSS WHOLE PERSON
HEALTH.
AGAIN, THE FARMING ISSUE, THE
SUPPLY SIDE, ALL THE SCIENCE
THAT GOES INTO THAT.
HOW IT'S DISTRIBUTED, ACCESS,
THERE'S A WHOLE AREA OF SCIENCE
ABOUT ACCESSIBILITY.
PRODUCTION, KITCHEN, YOU KNOW, I
TRY TO COOK WITH MY DAUGHTER,
IT'S SUPER FUN, BUT THAT'S
ANOTHER ELEMENT IN SOCIETY, IS
FOOD PRODUCTION AT THE HOME.
WHO'S EATING AT HOME, WHO'S
PREPARING IT?
DO THEY HAVE LITERACY, COOKING
LITERACY AND NUTRITION LITERACY?
THERE'S SO MANY QUESTIONS TO
ASK.
BUT ASKING THEM IN ISOLATION
MISSES THE OPPORTUNITY TO PUT IT
ALL TOGETHER.
AND THIS IS WHERE, AGAIN, WHEN I
TRY TO CONDENSE THAT INTO
PICTURE FORM, I THINK THERE'S A
LOT OF SCIENCE ABOUT -- IN FOOD
SYSTEMS, SO MANY ELEMENTS THERE
BUT THESE ARE ALL INTEGRATED.
EVERY TIME THERE'S A
PERTURBATION OR MOVEMENT IN THE
FOOD SPACE, IT WILL AFFECT HUMAN
HEALTH AND IT WILL AFFECT
PLANETARY HEALTH.
THE THING THAT GETS ME JAZZED IS
I THINK WITH THE RIGHT PEOPLE AT
THE TABLE ASKING THE RIGHT
QUESTIONS, THIS DOESN'T HAVE TO
BE DOOM AND GLOOM.
IT CAN BE SUPER COOL AND IT CAN
MAKE A DIFFERENCE, AND IT CAN
SET OUT A TRAJECTORY WHERE
THERE'S EMPHASIS MORE ON HEALTH
THAN DISEASE.
SO WITH THAT, YOU'VE SEEN THIS
PICTURE BEFORE.
HELENE HELPED PUT THIS TOGETHER.
IT ENCOMPASSES THE WHOLE
CONTINUUM.
RIGHT NOW WE HAVE REPRESENTATION
OF FOUR ICs IN THIS SPACE.
THIS WILL ONLY GROW AS WE
CONTINUE TO TALK ABOUT IT, AND
IT'S EXCITING TO TALK ABOUT IT
WITH INDIVIDUALS BECAUSE PEOPLE
GET JAZZED AND THEY'RE LIKE,
YES, NOT JUST THIS MAKES SENSE
BUT WHERE CAN WE BRING OUR
SCIENCE INTO THIS PARADIGM.
AND WITH THAT, THIS IS MY LAST
SLIDE, I COULD TALK FOR DAYS
ABOUT THIS BUT I AM SUPER
EXCITED TO BE HERE, SUPER
EXCITED TO WORK WITH HELENE AND
ALL OF YOU.
BECAUSE AT THE END OF THE DAY,
WE WANT TO DO THE RIGHT THING,
AND BRINGING OUR LENSES
TOGETHER, BRINGING OUR VISIONS
TOGETHER, PARTICULARLY IN A
NUTRITION SPACE IS ONLY GOING TO
ENHANCE RIGOR AND
REPRODUCIBILITY IN THE SCIENCE
AND TO LEND ITSELF TO IMPROVING
PUBLIC HEALTH.
SO THANK YOU SO MUCH.
>> NOW YOU SEE HOW MUCH FUN
WE'VE BEEN HAVING TALKING ABOUT
ALL THIS.
THANK YOU SO MUCH, DREW.
YOU'RE SUCH A FANTASTIC
COLLEAGUE.
AND SO I NOW -- WE'RE GOING TO
BE OPENING THE CONVERSATION,
INCLUDING STEPHANIE GEORGE WHO'S
HERE, DEPUTY DIRECTOR OF ODS,
AND STEFAN IS ON ZOOM, AND THEN
OUR OTHER COUNCILMEMBERS ON
ZOOM, EVERYBODY IS THERE, SO THE
FLOOR IS OPEN.
>> I'LL GO FIRST IF THAT'S
OKAY.
YOU KNEW I'D GET IN THERE RIGHT
AWAY.
OKAY.
SO THIS WAS GREAT PRESENTATIONS.
I REALLY APPRECIATE THEM AND
VERY INSIGHTFUL AND EXCITING TO
THINK OF ALL OF THESE THINGS
COMING TOGETHER AND TO BE
STUDYING TOGETHER, AND AS ANDREW
KNOWS, I'VE BEEN A BIG ADVOCATE
OF MAKING SURE THAT WE'RE
LOOKING AT ALL KIND OF THINGS
THAT ARE AFFECTING US AND
AFFECTING THESE SMALL MOLECULES
IN OUR BODIES AND WHAT THEY'RE
DOING TO OUR NUTRIENTS.
SO WITH THAT IN MIND, I WANTED
TO SEE IF YOU HAD SOME THOUGHTS
ON HOW DO YOU THINK THIS
HOLISTIC INTEGRATED APPROACH TO
UNDERSTANDING HUMAN HEALTH AND
NUTRITIONAL NEEDS MAY END UP
IMPACTING HOW WE'RE CURRENTLY
SUPPLEMENTING OR FORTIFYING
FOODS.
JUST AS AN EXAMPLE, DO YOU THINK
THAT THIS MIGHT CHANGE HOW WE
LOCK AT WHAT WOULD BE THE
FORTIFICATION NEEDS IN CITIES
WHERE THERE'S LOTS OF POLLUTION
COMPARED WITH MORE RURAL
SETTING, WITH PESTICIDES OR, YOU
KNOW, MAYBE A VERY CLEAN URBAN
AREAS THAT WE HAVE, DO WE SEE
THAT THIS MIGHT CHANGE AND IT'S
NOT GOING TO BE ONE SIZE FITS
ALL FOOD FORTIFICATION SWITCH?
WE DO KNOW THAT THERE'S
CONTROVERSIES AROUND THOSE ALSO.
SO WOULD YOU LIKE TO --
>> YOU KNOW I CAN TALK.
SUSAN, THANK YOU FOR THE
QUESTION AND OTHERS, PLEASE,
PLEASE CHIME IN TOO.
TOO AS YOU WANT.
IT'S A BIG QUESTION AND I THINK
I'M GOING TO TAKE MAYBE A HALF
STEP BACK, YOU KNOW, ALL OF US,
ALL OF US, HELENE, STEFAN AND I
AND OTHERS HAVE REALLY HAD THE
CONVERSATION ABOUT, AGAIN,
ASSESSING GNAW TRITIONAL STATUSD
NEEDS.
TO YOUR POINT, THOSE CAN BE
VERY, VERY DIFFERENT DEPENDING
NOT JUST ON THE INDIVIDUAL AND
STAGE OF LIFE CO LIFECOURSE BUTO
LOCATION AND MYRIAD OTHER
EXTERNAL FACTORS.
SO I THINK SCIENTIFICALLY,
HAVING A BETTER UNDERSTANDING OF
NUTRITIONAL ASSESSMENT, ALSO A
BETTER UNDERSTANDING OF WHAT
FOODS ARE COMING IN MAYBE,
BECAUSE THAT WILL ALSO BE
AFFECTED BY GEOGRAPHY AND
LOCATION.
I THINK THOSE TWO PIECES OF THE
PUZZLE I THINK THEN CAN INFORM
IN HIGHER RISK OR MORE
VULNERABLE POPULATIONS THE ISSUE
OF INTENTIONAL FORTIFICATION.
TO YOUR POINT, I DON'T THINK --
IT WOULDN'T BE A ONE SIZE FITS
ALL, BUT LEARNING THAT, AND WE
USE PRECISION NUTRITION A LOT,
BUT THAT REALLY IS LOOKING AT
SUBPOPULATIONS, NOT NECESSARILY
DOWN TO THE PERSONAL LEVEL, BUT
USING THAT INFORMATION, CAN
IDENTIFY AT RISK SUBPOPULATIONS,
I THINK THAT COULD INFORM
FORTIFICATION PRACTICES.
I THINK IT ALSO -- GOING BACK TO
THE DISCUSSION ABOUT FOOD
SCIENTISTS, I ALSO THINK THAT
KIND OF INFORMATION CAN GO
BACK -- CAN BE BI DIRECTIONAL,
CAN GO BACK TO THE FOOD
SCIENTISTS AS THEY'RE
ENGINEERING TO DIFFERENT TYPES
OF FOOD PRODUCTS, WHAT ARE THOSE
NUTRIENTS, WHAT ARE THOSE
COMPONENTS, WHAT ARE THOSE
BIOACTIVE ELEMENTS IN THOSE FOOD
PRODUCTS THAT MAY BE BENEFICIAL
AS OPPOSED TO HA HARMFUL.
>> SO I WANT TO THANK ALL THE
SPEAKERS FOR REALLY EXCITING
PRESENTATIONS AND ALSO THIS
RECOGNITION OF HOW IMPORTANT
NUTRITION IS, NOT JUST FOR
HEALTH BUT ALSO ITS INFLUENCE ON
POTENTIAL HEALTH INTERVENTIONS.
BUT I HAVE TO SAY THAT AS A
RESEARCHER, IT'S ALSO MAKING ME
FEEL A BIT OVERWHELM AND ANXIOUS
ABOUT HOW THIS IS GOING TO BE
ACHIEVED.
EVEN TAKING -- I WORK WITH
DIETARY SUPPLEMENTS, AND JUST
THINKING ABOUT HOW ONE MIGHT
LOOK AT THE EFFECT OF NUTRITION
ON THE EFFICACY OF A BOTANICAL
DIETARY SUPPLEMENT, DO WE HAVE
THE TOOLS THAT WE NEED TO ASSESS
WHAT PEOPLE'S FOOD INTAKE IS, DO
WE HAVE THE TOOLS TO ASSESS WHAT
THEIR CURRENT NUTRITIONAL STATUS
IS, OR IS THE DEVELOPMENT OF
THESE TOOLS SEEN AS PART OF THIS
WHOLE STRATEGY?
AND THEN FINALLY, DOES THIS MEAN
THAT THE SCALE OF OUR CLINICAL
STUDIES WOULD HAVE TO BE
EXPANDED?
SO I GUESS I'M JUST LOOKING FOR
SOME GUIDANCE AND REASSURANCE AS
TO HOW YOU SEE THIS FIELD
CHANGING AS A RESULT OF THIS NEW
DIRECTION, WHICH I AGREE IS A
REALLY IMPORTANT AND HELPFUL
ONE?
>> YOU WANT TO ANSWER THAT,
STEFAN?
>> I WAS WONDERING, I SAW THE
CAMERA GO BACK TO DREW SO I
WASN'T SURE WHO WAS GOING TO
SPEAK UP.
LET ME TAKE THAT IN PIECES.
THAT WAS A VERY, VERY GOOD
QUESTION, AND IT KIND OF MAKES
SENSE IF YOU'RE LOOKING AT
BOTANICALS RIGHT NOW IN THE
CONTEXT THAT YOU MIGHT BE
RESEARCHING THAT.
YES, CONTINUOUS IMPROVEMENT IN
METHODOLOGIES IS A MUST IN THIS
AREA, BUT IT DOESN'T HAVE TO BE
THE END ALL BE ALL.
IT IS DEFINITELY A PIECE.
I WOULD SAY NUTRITION STATUS AND
BIOMARKERS CONTINUE -- NEED TO
CONTINUE TO EVOLVE AND BECOME
STRONGER.
I KNOW THERE ARE LARGE EFFORTS
HERE ACROSS NIH NOW THAT ARE
DOING JUST THAT, BUT WE HAVE TO
CONTINUE TO WORK TO MAKE SURE
THAT WE CAN ACTUALLY MEASURE THE
INTENDED OUT COME OF CONSUMING A
CERTAIN DIETARY SUPPLEMENT.
I WOULD SAY WE REALLY -- IT'S
VERY AMBITIOUS FOR US TO PUT
THIS FORWARD, AND I WOULD SAY I
REALLY DO THINK PIE IN THE SKY
IN NUTRITION CONTINUUM AND WHOLE
PERSON HEALTH IS JUST THAT, BUT
I THINK IF WE CAN TAKE A
PRAGMATIC APPROACH AND IDENTIFY
WHERE THOSE GAPS MIGHT BE AND WE
PRIORITIZE THEM, WE CAN DO SO IN
A WAY THAT NOT EVERY NUTRITION
STUDY BALLOONS TO BE, YOU KNOW,
LIKE A COMMON FUNDED PROJECT.
SO WE HAVE TO FIGURE OUT THE
RIGHT WAY TO KIND OF MARRY ALL
THIS UP TOGETHER SO IT CAN BE A
PRODUCTIVE RESEARCH FRAMEWORK
GOING FORWARD, BUT THIS IS JUST
THE BEGINNING.
EXPWR TH
>> THANK YOU, THAT'S GREAT, IT'S
REALLY EXCITING TO BE ABLE TO
START TO ADDRESS THIS AND I'M
SURE THE TOOLS WILL EVOLVE AS
THE CHALLENGE IS TAKEN UP.
>> HERE I AM AGAIN.
I SEE OTHER HANDS, I'LL BE
BRIEF.
YOUR QUESTION IS SPOT-ON, AND
STEFAN'S ANSWER IS SPECTACULAR.
THIS IS A PROCESS, BUT AS MANY
PEOPLE IN THIS ROOM ARE ENGAGED
WITH, RIGHT NOW ONE OF THE BIG
INVESTMENTS THAT THE NIH IS
DOING IS THE NUTRITION FOR
PRECISION HEALTH EMPOWERED BY
THE ALL-OF-US RESEARCH PROGRAM,
WHICH IS AN INVESTMENT, AGAIN,
ACROSS THE U.S. THAT'S GETTING
TO YOUR QUESTIONS.
IT'S AT SCALE, SO OVER 8,000
INDIVIDUALS IN THE PRIMARY
MODULE, BUT IT'S AT SCALE TO ASK
THE QUESTION HOW DO INDIVIDUALS
RESPOND TO VARIOUS DIETARY
CHALLENGES, IF YOU WILL, OR
DIETARY PATTERNS, AND THEN
AGAIN, PEOPLE IN THIS ROOM WHO
ARE MUCH SMARTER THAN I AM DOING
THE ANALYTICS, HOW TO THEN
DEVELOP PARTICULAR ALGORITHMS TO
HELP GUIDE INVESTIGATORS AND
GUIDE CLINICIANS ABOUT DIETARY
ASSESSMENTS AND POTENTIAL
DIETARY GAPS OR NUTRIENT GAPS
AND DIETARY NEEDS.
SO IT'S AN EXCITING TIME,
BECAUSE THESE TOOLS WILL BECOME
AVAILABLE, THEY WILL BE USED
PUBLICLY, AND THEY'LL BE USED TO
DEVELOP NEW QUESTIONS AND
VALIDATION MODELS TO THEN TAKE
THE RAW DISCOVERY INTO THE FIELD
TO WHERE WE CAN MAKE PUBLIC
HEALTH IMPACT.
>> FOR BOTH OF THOSE QUESTIONS,
THIS IS STEPHANIE GEORGE, OFFICE
OF DIETARY SUPPLEMENTS, FOR BOTH
OF THOSE QUESTIONS, BOTH THE
FORTIFICATION QUESTION AND THE
METHODS QUESTION, I THINK WE CAN
ALSO GO BACK TO SOMETHING THAT
WE HEARD STEFAN AND DREW BOTH
SAY, WHICH IS A GROUNDING IN THE
PUBLIC HEALTH CONCERNS.
SO TAKING WHAT IS THAT PRESSING
PUBLIC HEALTH ISSUE AND HOW CAN
WE LOOK ACROSS THE NUTRITION
CONTINUUM TO BE ABLE TO KIND OF
ADDRESS THAT SPECIFICALLY.
AND THAT WILL CERTAINLY HAVE
METHODS DEVELOPMENT PIECES THAT
ARE NECESSARY.
I KNOW A FEW YIERS BA YEARS BACH
DID AN EXCELLENT JOB AS YOU'RE
THINKING ABOUT WHOLE PERSON
HEALTH AND THEN THE METHODS WITH
WHICH WE'RE GOING TO BE ABLE TO
STUDY SO YOU'RE COLLECTING, LIKE
IN HELENE'S PRESENTATION, DATA
AT SO MANY DIFFERENT LEVELS, AND
THEN WHAT ARE THOSE ADVANCED
ANALYTIC METHODS WHERE WE CAN
TAKE IT -- BREAK IT DOWN AND
THEN PUT IT BACK TOGETHER LIKE
YOU SAID IN THAT SYNTHESIS
PIECE.
SO I THINK THERE WILL BE LOTS OF
MOVING PARTS, BUT THERE ARE WAYS
TO BREAK THAT DOWN.
AND THEN THE OTHER PIECE I'LL
COMMENT ON IS THAT THE POWER OF
ONR AND ODS AS COORDINATING
OFFICES, WE HAVE THE ABILITY TO
PULL IN ALL THE PARTNERS TO
THINK ABOUT WHOLE PERSON HEALTH
AND THINK ABOUT THE NUTRITION
CONTINUUM, AND WHERE ARE THOSE
PIECES OF SYNERGY WHERE WE CAN
ALL WORK TOGETHER TO TACKLE
PARTS OF THIS PROBLEM AND START
SOMEWHERE.
I ALWAYS TELL STEFAN, WHAT'S THE
NEXT FIRST STEP THAT WE'RE GOING
TO TAKE, RIGHT?
AND SO WHERE ARE THOSE FIRST,
YOU KNOW, CHUNKS THAT WE CAN
WORK TOGETHER ACROSS NIH TO
TACKLE, IMPROVING THIS, WITH THE
ULTIMATE GOAL OF IMPROVING
HEALTH FOR THE POPULATION.
>> I CAN ALSO -- OH, JEFF.
I JUST WANT TO JUST GIVE A
CONCRETE EXAMPLE OF ONE WAY, FOR
EXAMPLE, IMAGINE THAT YOU WANT
TO STUDY THE IMPACT OF A CERTAIN
SUPPLEMENT.
IT TAKES SOMETHING VERY, VERY
SIMPLE, LIKE, SAY, FISH OIL, AND
FINDING OUT IN ADDITION TO
LOOKING AT THE EFFECT OF THE
SUPPLEMENT, TO SEE HOW MUCH FISH
PEOPLE ARE EATING, RIGHT, I
MEAN, IT MAKES PERFECT SENSE
THAT YOU WOULD WANT TO DO THAT.
THIS IS JUST THE SIMPLEST
EXAMPLE YOU COULD THINK OF, BUT
THERE ARE OTHER MORE COMPLEX,
FOR EXAMPLE -- THE COMPONENT
OF -- IN A BOTANICAL, HOW MUCH
OF THAT COMPOUND IS ALREADY
PRESENT IN WHAT PEOPLE HAVE ON
THEIR PLATE.
SO IT'S JUST A START.
AND SO WE HAVE TO GO IN STAGES
LIKE STEPHANIE WAS JUST SAYING.
WE CAN'T JUST ANSWER EVERYTHING
ALL AT ONCE.
IT'S REALLY MOVING IN THE
INTEGRATIVE DIRECTION.
THAT'S REALLY -- AND THIS IS A
QUESTION WE GET ALL THE TIME.
HOW DO WE GET FROM ZERO TO A
THOUSAND?
WELL FIRST YOU GO FROM ZERO TO ,
SO THAT'S THE IDEA.
>> I THINK THAT'S A VERY CLEAR
ANSWER, AND SO IT'S JUST OBVIOUS
THAT WE SHOULD ALSO BE PAYING
ATTENTION TO PEOPLE'S
NUTRITIONAL STATUS --
>> YES, AND MEASURING IT.
>> FOR CLINICAL RESEARCHERS,
WHAT'S A BRIEF, USEFUL WAY TO
MEASURE NUTRITIONAL STATUS?
I COULD BE REALLY KNEE EVE BUT
THEY ALL SEEM REALLY LONG, VERY
ONEROUS AND NOT
PATIENT-FRIENDLY.
>> I'LL HOP IN HERE.
>> NO PRESSURE.
>> NO, IT'S A SPECTACULAR
QUESTION.
HOW DOES ONE DEFINE
MALNUTRITION?
THERE IS NO GENERALIZED CON
CONSENSUS STATEMENT.
THERE ARE LOTS OF MODELS AND
PARADIGMS THAT ARE USED.
SOME VERY CUMBERSOME AND SOME
NOT VERY PRACTICAL, NONE OF
WHICH HAVE CONSISTENT
ENDORSEMENT FROM THE VARIOUS
AGENCIES.
THAT IS A -- I'M GLAD YOU CALLED
OUT THE ELEPHANT IN THE ROOM.
HOW DO WE DO IT?
WE DON'T KNOW.
I HAVE SOME IDEAS.
SO ONE OF OUR GOALS FOR THE
OFFICE VERY, VERY SOON IS TO
DIVE FOO THAT QUESTION.
AND THAT'S IMPORTANT ON SO MANY
LEVELS.
IT'S IMPORTANT FOR THE
SCIENTIFIC COMMUNITY TO HAVE
CONSENSUS AND SOME GUARDRAILS,
IF YOU WILL.
BUT BY GOLLY, IT'S ALSO SUPER
IMPORTANT FOR CLINICAL CARE.
BECAUSE RIGHT NOW, AND I ALWAYS
TRY TO GIVE A SHOUT OUT TO THE
RDs AND THE RDNs, EITHER IN
THE ROOM OR IN THE WORLD,
BECAUSE THEY'RE THE ONES WHO ARE
ON THE -- THEY'RE ON THE FRONT
LINES WHO ARE INTERACTING WITH
PEOPLE.
AND YOU KNOW, THEY'RE ALSO
STRUGGLING WITH HOW DO WE
IMPLEMENT ALL THESE THINGS WE'RE
TALKING ABOUT TO ACTUALLY GET TO
THE PERSON AND HOW DO WE MAKE
ASSESSMENTS AND HOW DO WE MAKE
MEASUREMENTS THAT THEN WE CAN
TRACK OVER TIME TO ACTUALLY
ASSESS WHETHER INTERVENTIONS ARE
EFFECTIVE OR NOT.
>> EXACTLY, BECAUSE CURRENTLY
WE'RE IGNORING IT, AND THAT'S
WRONG.
>> CORRECT.
>> SO HOW DO WE GET THERE TO AT
LEAST ACKNOWLEDGE IT BUT NOT
MAKE IT SO PATIENT ONEROUS.
>> THAT IS THE GOAL OF OUR
OFFICE, TO HAVE BUY-IN FROM ALL
THE PARTNERS.
>> JUST AS A RESPONSE, EVERY
TIME YOU TALK, DREW, YOU BRING
EXCITEMENT TO EVERYTHING, SO
ALWAYS APPRECIATE THAT.
THIS IS AN EXAMPLE OF WHERE
NEWER METHODS, A.I. AND MODELING
METHODS CAN HELP, BECAUSE WHEN
YOU'RE TALKING ABOUT NUTRITION
STATUS, YOU'RE NOT REALLY
TALKING ABOUT A SLICE IN TIME.
YOU'RE REALLY TALKING ABOUT HOW
IT'S ACTUALLY GOING TO IMPACT
SOMEONE'S HEALTH TRAJECTORY OVER
TIME, AND THAT'S GOING TO BE
DIFFERENT FOR DIFFERENT PEOPLE.
SO IF YOU CAN FIND WAYS OF KIND
OF PROJECTING AND FORECASTING,
OKAY, YOU'RE AT THIS CURRENT
STATUS, BUT FIVE, 10, 15 YEARS,
YOU'LL BE SUCH AND SUCH, OH,
THAT'S NOT A GREAT TRAJECTORY
AND THAT JUST -- WHERE IT SHOULD
BE VERSUS WHERE IT IS.
SO I THINK THIS IS REALLY
EXCITING, AND AGAIN IT'S HARD TO
ADD MORE EXCITEMENT TO WHAT DREW
SAID, BUT I THINK THIS HAS EVEN
A LARGER POTENTIAL EFFECT,
BECAUSE A LOT OF THIS INVOLVES
CHANGING THE PARADIGM IN HOW
SCIENCE IS ACTUALLY DONE.
FOR MANY YEARS, BECAUSE OF
HISTORICAL REASONS, THERE'S THE
CLINICAL TRIAL METHOD, THE
OBSERVATIONAL STUDY METHOD, ET
CETERA, BUT YOU REACH THE
LIMITATIONS, I THINK, WHEN YOU
HAVE TO INTEGRATE ALL THESE
DIFFERENT THINGS, ESPECIALLY
OVER TIME, SO THERE'S A REAL
OPPORTUNITY TO ACTUALLY
CHANGE -- INTEGRATE ALL THESE
DIFFERENT TYPES OF NEW STUDY
METHODOLOGIES AND APPROACHES IN
DIFFERENT WAYS, TOO, FOR
INSTANCE, I'LL JUST SPEAK FOR
A.I., YOU CAN HAVE A.I.
APPROACHES HELP GUIDE STUDY
DESIGN, RIGHT, FOR EXAMPLE, IT'S
NOT NECESSARY, THE REVERSE,
WHERE YOU DO THE STUDY AND YOU
USE A.I. TO EVALUATE THOSE
THINGS.
SO I GUESS THE EXCITEMENT BUT
ALSO THE CHALLENGES THEN YOU'RE
GOING AGAINST THE EXISTING
PARADIGMS THAT EVERYONE HAS BEEN
KIND OF SCHOOLED IN FOR YEARS.
SO I GUESS I WANTED TO TOSS OUT
THE QUESTION LIKE HOW DO YOU
ACHIEVE THIS KIND OF LARGER
BIGGER PARADIGM SHIFTING
SITUATION THAT WILL ACTUALLY
PROBABLY EXTEND BEYOND
NUTRITION, EXTEND BEYOND
EVERYTHING, AT THE SAME TIME,
WITH AN UNDERSTANDING THAT YOU
ARE MOVING AGAINST MOUNTAINS IN
SOME CASES AND HOW DOES ONE LAY
THE GROUNDWORK TO TRY TO MAKE
THOSE CHANGES.
>> CAN I JUMP IN FIRST?
I KNOW YOU PROBABLY HAVE SOME
STUFF TO SAY TO THIS.
IS THAT OKAY?
I WANT TO GIVE AN EXAMPLE.
WHAT WEAR PROPOSING IS VERY,
VERY AMBITIOUS, IT IS BIG, AND
IT'S NOT GOING TO BE EASY TO
ACHIEVE AND AS HELENE SAID, YOU
HAVE TO GO STEP BY STEP BY STEP.
WHEN I WAS WITH THE ARMY, AND I
WAS AT AN ARMY RESEARCH
INSTITUTE THAT WAS BROKEN INTO
FOUR RESEARCH DIVISIONS BASED ON
DISCIPLINES AND ENVIRONMENTAL
FACTORS THAT A SOLDIER WOULD BE
EXPOSED TO, OUR FUNDING LINES
WERE BROKEN INTO THOSE FOUR
DIVISIONS.
THERE WAS VERY LITTLE, IF ANY,
CONSIDERATION OF THE OTHER
DIVISIONS WHEN YOU RAN YOUR OWN
RESEARCH PROGRAM.
SO NUTRITION IS A LARGE
COMPONENT OF MUSCULOSKELETAL
INJURY, ESPECIALLY NUTRITION
STATUS IF THE CONTEXT OF VITAMIN
D AND CALCIUM, FRESH FRACTURE
INCIDENTS IN FEMALES AND YOUNG
TRAINEES.
THE NUTRITION DIVISION RARELY
WAS ENGAGED IN THAT WORK.
THAT'S JUST SHOWING THAT WE HAVE
TO CHANGE THIS FRAMEWORK, AND IT
WAS VERY HARD TO DO THERE
ORGANIZATIONALLY TO CREATE A
MORE CROSS FUNCTIONAL EFFORT,
BUT IT CAN BE DONE AND WE JUST
HAVE TO START HAVING THESE HARD
CONVERSATIONS OF HOW DO WE
CREATE SOMETHING THAT WE CAN
ACTUALLY BITE OFF, WE CAN'T BITE
OFF MORE THAN WE CAN CHEW RIGHT
AWAY, AND START BUILDING TOWARDS
THIS I WOULD SAY MORE ACCEPTED
FRAMEWORK OF RUNNING SCIENCE,
ESPECIALLY IN THIS SPACE.
SO THAT'S WHY I WANT TO SHARE
GOING THROUGH THIS ALREADY,
THERE'S GOING TO BE SOME BUMPS
AND IT'S GOING TO BE HARD BUT WE
HAVE TO START SOMEWHERE.
>> THANK YOU.
HELEN.
>> I HAVE SEVERAL PROBLEMS WITH
THE WHOLE THING.
I'M A CLINICIAN, WORK WITH
PATIENTS WHO TAKE 10 TO 15
SUPPLEMENTS FROM DIFFERENT
QUARTERS, ORDERING ONLINE, BU
BUYING AT THE PHARMACY AND THEN
TRYING TO EXPLAIN TO THEM WHAT
IS THE VALUE OF THIS VERSUS
THAT, BY ADJUSTING NIH
LITERATURE AND NIH FUNDED TRIALS
THAT REPORT VERY MISLEADING
INFORMATION WITHOUT ANY BASELINE
ASSESSMENT OF NUTRITION AND
LEVELS, AND THEN I'M RUNNING A
RISK AND RESILIENCE STUDY
ASSESSING THE ROLE OF NUTRITION
AND RISK AND RESILIENCE FOR THE
NIA FUNDED MULTISITE STUDY.
AND I RUN INTO A PROBLEM OF
PEOPLE FILLING OUT DIETARY
QUESTIONNAIRES, AND THEN TRYING
TO CORRELATE THEM WITH LEVELS IN
THE BLOOD AND THERE'S LIKE ZERO
CORRELATION.
SO I THINK THE STARTING POINT
WOULD BE TO ESTABLISH SOME KIND
OF STANDARD FOR RESEARCH METHODS
AND REPORTING SO THAT IT
WOULDN'T BE SUCH A CONFUSING
MATTER FOR RESEARCHES, FOR
CONSUMERS, AND EVERYBODY IN
BETWEEN.
>> THIS HAS BEEN GREAT.
I GUESS THE COMMON THEME IS THE
FRAMEWORK THAT YOU'RE ALL
ADOPTING AND THE WHOLE PERSON
FRAMEWORK IS A BEAUTIFUL ONE,
BUT I'M WONDERING IS THERE ANY
UTILITY IN THINKING ABOUT THE
PREVENTION FRAMEWORK OF PRIMARY,
SECONDARY AND TERTIARY AS WAYS
TO THINKING ABOUT HOW TO
INTERVENE AND TO WHAT POPULATION
OR WHAT GROUP OR WHAT
INDIVIDUALS.
FLUORIDE IN THE WATER, OF COURSE
THAT'S A PRIMARY INTERVENTION,
SECONDARY, YOU'RE TRYING TO
DETECT A PROBLEM AND TARGET A
GROUP THAT MAY BE VULNERABLE AND
THEN OF COURSE TERTIARY IS
DEALING WITH INDIVIDUALS WHO
ALREADY MAY HAVE SYMPTOMS OF THE
PROBLEM.
DOES THAT AT ALL RESONATE WITH
THIS NUTRITION SPACE?
>> I'LL JUMP IN.
BUT IT DOES, I THINK -- NOT
THINK, I'LL USE FOOD AS MEDICINE
AS AN EXAMPLE TO YOUR QUESTION,
BUT I WANT TO IF I COPY VOT BACK
A LITTLE BIT TO WHAT BRUCE WAS
SAYING.
HE'S WAY TOO MODEST.
WHEN WE THINK ABOUT PARADIGM
SHIFTS AND THE USE OF NOVEL
METHODOLOGY, YOU KNOW, WE PING
BRUCE ALL THE TIME FOR HIS BRAIN
POWER.
I THINK IT THE INTEGRATION OF
RECOGNIZING THESE NEW AREAS OF
SCIENCE AND HOW THEY CAN BE
BIDIRECTIONAL, AS WE'RE FORWARD
THINKING ABOUT THE DESIGN AND
METHODOLOGY.
SO I THINK THOSE SYNERGIES EXIST
AND BRUCE YOU'VE BEEN SUPER
HELPFUL EVERY STEP OF THE WAY,
SO THANK YOU.
AND TO THE POINT ABOUT CONSENSUS
ABOUT BASELINE, YES, TO THE
QUESTION THAT CAME UP BEFORE, I
THINK PART OF OUR CHARGE IS CAN
WE DEVELOP AS A COMMUNITY BOTH
FOR RESEARCH PURPOSES AND
CLINICAL CARE, BASELINE ELEMENTS
THAT CAN BE TRACKABLE AND
MEASURABLE THAT ARE AGAIN THE --
IRRESPECTIVE OF WHAT QUESTION IS
BEING ASKED, SO THAT IS A CHARGE
AND THAT IS SOMETHING THAT WE'RE
CONSIDERING.
IN THIS PARADIGM OF PREVENTION,
I THINK FOOD AS MEDICINE IS A
GREAT EXAMPLE, AND FOOD AS
MEDICINE IS A CONCEPT I THINK TK
WILL ONLY ACHIEVE ITS MAXIMAL
EFFICACY IF THE METHODOLOGY, IF
THE METHODS ARE APPROPRIATE.
BECAUSE ONE HAS TO HAVE A
DIAGNOSIS AND UNDERSTANDING OF
THE ETIOLOGY BEFORE INTERVENTION
CAN BE MADE SO I THINK THOSE GO
HAND IN HAND.
BUT I THINK ON THE FOOD AS
MEDICINE SCALE GOING FROM PUBLIC
TO FORTIFICATION OR TARGETING
POPULATIONS TO THAT PRESCRIPTION
WHICH MAY BE A LITTLE HIGHER UP
THE SCALE TO A MEDICALLY
TAILORED MEAL, THAT'S WHERE THAT
TRIANGLE, IF YOU WILL, OF FOOD
AS MEDICINE REALLY DOES, I
THINK -- I THINK IT INTEGRATES
BEAUTIFULLY WITH THE CONTINUE C,
BECAUSE EVERY LEVEL OF THAT FOOD
AS MEDICINE SCALE IS GOING TO BE
IMPACTED BY THE ENVIRONMENT AND
THE CONTINUUM.
SO I THINK THOSE TWO GO TOGETHER
BEAUTIFULLY.
IT'S A GREAT PARADIGM.
>> YOU NEED MORE THAN NINE
PEOPLE, I THINK, IN YOUR
DEPARTMENT.
>> I'LL PIGGY BACK ON THAT.
I THINK ALSO THERE'S OF PIECE OF
GROUNDING THE RELATIONSHIP
BETWEEN PUBLIC HEALTH AND
PREVENTION IN ALL THAT WE'RE
DOING AT ODS.
I THINK ESPECIALLY AS YOU
APPROACH THOSE TOPICS, THERE'S
ALSO THE OVERLAY OF PREVENTION
THROUGHOUT THE LIFECOURSE, AND
SO WE HAVE THAT HEALTHY LIFESPAN
PIECE THAT STEFAN MENTIONED IN
OUR STRATEGIC PLAN.
AND WE ALSO HAVE TO THINK ABOUT
THE HEALTH DISPARITIES THAT
EXIST IN PREVENTION IN BOTH
PRIMARY, SECONDARY AND TERTIARY
PREVENTION.
WE MIGHT HAVE VERY EFFICACIOUS
NUTRITION INTERVENTIONS THAT
COULD WORK TO PREVENT A CERTAIN
CONDITION OR DELAY THE ONSET OF
A CERTAIN CONDITION, BUT IT
MIGHT NOT BE ACCESSIBLE,
EQUITABLE, CULTURALLY COMPETENT,
AND SO WE'RE THINKING ABOUT ALL
THOSE QUESTIONS TOO.
>> SO I HAVE TO SAY I'M
ALWAYS -- OH, SORRY, GO AHEAD.
>> I JUST WANT TO TAKE ONE QUICK
SECOND AND RESPOND TO COMMENT
ABOUT STANDARDIZATION AND SOME
OF THE NOISINESS IN DIETARY
SUPPLEMENT SCIENCE.
WE FULLY RECOGNIZE THAT AT ODS,
IT'S ONE OF THE FIRST QUESTIONS
I ASK MY STAFF, HAVE WE DONE
ANYTHING TO ADDRESS, I WOULD
SAY, THE COMPLICATIONS AND
HETEROGENEITY IN DIETARY
SUPPLEMENT SCIENCE, AND THE
ANSWER IS WE HAVE ADDRESSED A
PART OF IT WITH THE ANALYTICAL
PIECE.
THERE'S SO MUCH MORE WE CAN DO,
AND WE KNOW THAT WE HAVE TO
IMPROVE OUR TOOLS AND
METHODOLOGIES FOR UNDERSTANDING
DIETARY INTACT, NUTRITIONAL
STATUS, UNDERSTANDING WHAT'S IN
DIETARY SUPPLEMENTS, HOW TO
MEASURE THEM BIOLOGICALLY, BUT
MORE IMPORTANT HOW TO GET
TRIALS.
SO IT'S A NEW LIFT, CONCEPT
WE'RE STARTING TO DEVELOP NOW
AND IT'S MORE COMPLEMENTARY TO
THE NUTRITION CONTINUUM BUT AN
IMPORTANT FOUNDATIONAL PIECE AS
WE MOVE THIS FORWARD.
SO FULLY RECOGNIZE THE COMMENTS
YOU MADE.
>> THANKS.
IF WAS JUST GOING TO SAY, IT'S
ALWAYS WONDERFUL WHEN THERE'S SO
MUCH ENTHUSIASM IN THIS AREA
BECAUSE IT'S ALSO PARTIALLY MY
AREA, BUT I WANTED TO PIGGY BACK
ON THE PUBLIC HEALTH PIECE, AND
EVEN ASK, I IS THE FRAMEWORK
INDEED BIGGER IN THAT IT'S
PLANETARY AND ECOLOGICAL,
BECAUSE RIGHT NOW WE HAVE A FOOD
SYSTEM, I BELIEVE THAT THEY SAID
IF YOU MET THE USDA FOR
EVERYBODY EATING GREENS AND
BEANS, SOME RIDICULOUS AMOUNT --
LIKE 15% OF PEOPLE WOULD WIPE
OUT ALL OF OUR GREENS AND BEANS
THAT WE CURRENTLY GROW.
AND WE HAVE AN AGRICULTURAL
SYSTEM THAT CAUSE PROBABLY
SENTIENT ANIMALS TO SUFFER
HORRIBLY THROUGH THEIR ENTIRE
LIFE IN OUR SERVICE FOR THINGS
THAT SEEM NUTRITIONALLY SOUND.
WHETHER IT BE A CHICKEN OR FISH
FARMING.
SO I MEAN, WHERE'S THE LINE OF
WHERE YOU GUYS WANT TO PUSH
THAT?
BECAUSE I KNOW IT'S BIG.
>> I CAN'T HOLD MYSELF -- I'M
DIVING IN.
I'LL BE FAST.
YOU'RE SPOT-ON, BECAUSE THE
CURRENT STATS, RIGHT NOW OUR
AGRICULTURAL PRACTICES USE 40%
OF OUR LAND MASS, 70% OF OUR
FRESHWATER WITHDRAWAL, 25% OF
OUR GREENHOUSE CARBONS EMISSIONS
ARE FROM AGRICULTURE, AS WELL AS
AIR AND WATER POLLUTION.
THAT'S WHERE WE ARE.
SO WHERE DOES THIS FIT IN TO THE
PICTURE?
THERE'S RECOGNITION THAT OUR
CURRENT PRACTICES HAVE TO
CHANGE.
CAN WE USE SCIENCE TO INFORM THE
SOLUTIONS, THOUGH, AND THIS IS
WHERE I SHOWED THE SLIDE WORKING
WITH THE USDA, I HAVE LOTS OF --
HOW TO USE A.I. AND OTHER TYPES
OF METHODS TO IMPROVE FARMING.
THERE'S MOTION IN ALL THESE
SPACES, BUT THEY'RE ALL PART OF
THIS CONTINUUM TOO.
AND SO I APPRECIATE YOUR COMMENT
BECAUSE MY LITTLE -- I DREW THAT
TRIANGLE IN MY HEAD DURING A RUN
ONE NIGHT, IT'S VERY -- TO ME,
THEY'RE ALL INTERCONNECTED.
AND I THINK, AGAIN, THIS IS
BIGGER THAN JUST THE POPULATION,
IT IS THE PLANET, BUT HELENE'S
POINT IS BEAUTIFUL, THAT SOIL
THAT WE GO OUTSIDE AND PLAY
SOCCER LATER WITH MY DAUGHTER,
WE KICK THE SOIL, THAT'S
IMPACTING WHAT'S BEING GROWN AND
THAT'S BEING IMPACTED BY THE
ENVIRONMENT AND THAT COULD BE
DIFFERENT TOMORROW AND NEXT WEEK
AND WE NEED TO BE NIMBLE AND
ADAPT WITH IT.
>> WE'RE PRETTY MUCH AT TIME,
RIGHT?
IS THERE ONE MORE QUESTION?
YEAH, BOB.
NADIA, HAVE YOU BEEN LEFT
BEHIND?
>> I HAD A QUESTION BUT THE
DISCUSSION ACTUALLY ADDRESSED
IT, SO THIS HAS BEEN REALLY
INTERESTING TO LISTEN TO.
THANK YOU ALL.
>> I DO HAVE A QUICK QUESTION,
IT COMES FROM A TRIP TO THE
GROCERY STORE TO BUY A WHOLE RAW
CHICKEN.
THE INGREDIENT SHOULD BE NOTHING
BUT CHICKEN, OKAY?
UNCOOKED RAW CHICKEN.
I LOOK AT THE LABEL, BECAUSE I
WANT A RAW CHICKEN, AND WHAT'S
IN THERE, IT'S LIKE UP TO 15%
WEIGHT OF CHICKEN BROTH, SALT,
AND CARE GEENEN, ONE OF THE VERY
COMMON FOOD ADDITIVES, AND I'M A
BASIC SCIENTIST OR SOMEWHAT
BASIC TRANSLATIONAL SCIENTIST
AND BACK IN THE DAY, PEOPLE
WOULD INJECT CARAGEENAN INTO THE
RAT MEAT TO CAUSE A MODEL OF
INFLAMMATION, AND I'M WONDERING,
IS THERE A MECHANISM, AND WHOSE
PURVIEW WOULD A CURRENTLY
INVOLAPPROVED DIETARY SUPPLEMENT
MIGHT BE CAUSING SOME MAYBE
SUBTLE, LONG TERM NEGATIVE
HEALTH CONSEQUENCES, NOT
OUTRIGHT TOXICITY, WHOSE EJUS
WOULD THAT FALL UNDER?
>>
>> THIS WHOLE RECOGNIZED
GENERALLY RECOGNIZED AS SAFE
DESIGNATION IS THE ISSUE, RIGHT?
THIS IS NOT JUST IN FOOD, IN
COST MEDICS.
WE HAD A BIG DISCUSSION OF THAT
AT THE ENDOCRINE DISRUPTOR
CONFERENCE WE ARE RECENTLY, ALL
THESE THINGS THAT WE CONSUME,
THAT WE PUT ON OUR SKIN, THAT --
SO YES, BIG TOPIC.
AND I THINK THAT THERE'S A FEW
THINGS THAT ARE BUBBLING UP TO
THE SURFACE SUCH AS, FOR
EXAMPLE, THE PFAS SUBSTANCES
THAT PEOPLE ARE STARTING TO
BECOME MORE AWARE.
CAR GEENEN, I TOTALLY AGREE WITH
YOU, IT'S A SCARY THING.
I NEVER BUY ICE CREAM THAT HAS
CARRAGEENAN BUT IT'S HARD TO
FIND.
SO YEAH, I MEAN, I DON'T KNOW IF
YOU HAVE ANY --
>> I VOLUNTEERED STEFAN FOR
THAT.
KIDDING.
YOUR POINT IS SPOT ON BUT I WANT
TO REASSURE YOU THAT THIS IS
SOMETHING THAT WE HAVE ALMOST
DAILY DISCUSSIONS WITH OUR FDA
COLLEAGUES, AND IN THE NEW
ENGLAND JOURNAL JUST YESTERDAY,
THERE WAS A NICE PIECE BY EMILY
LEIB AND HER COLLEAGUES AT
HARVARD THAT TOUCHED ON THESE
PRODUCTS IN FOOD.
AND ROCK CALIFF IS CERTAINLY
VERY INVESTED IN THIS SPACE, AND
ONE OF THE CHALLENGES, WHAT IS
THE EVIDENCE, WHAT IS THE DATA
AND WHAT IS THE EVIDENTIARY BAR
FOR REGULATING FOOD.
NOT TO BE SELF PROMOTING, IN
DEAS OF DECEMBER OF THIS YEAR, E
HAVING A JOINT NIH FDA WORKSHOP,
IT IS FOCUSED ON NUTRITION
REGULATORY SCIENCE.
WHAT ARE THE BARS, WHAT IS THE
EVOLUTIONARY STANDARD AND WHAT
ARE THE SPECIFIC BIOMARKERS AND
QUESTIONS THAT FDA CAN THEN
UTILIZE TO INFORM THESE TYPES OF
REGULATORY DECISIONS.
SO HE'LL PROMOT I'LL PROMOTE THT
THEY RECOGNIZE THE GRASS IS AN
IMPERFECT SYSTEM AND THEY'RE
LOOKING FOR SCIENTIFIC GUIDANCE,
WHAT ARE THE BARS, HOW CAN
SCIENCE BE DONE TO INFORM
BIOLOGY BUT ALSO TO INFORM
REGULATORS.
SO WE'RE HAVING THOSE
DISCUSSIONS.
>> GREAT.
THANKS VERY MUCH.
>> WE'RE DEFINITELY -- WE'RE
JUST A FEW MINUTES PAST TIME.
I REALLY WANT TO THANK OUR
DISCUSSANT AND OUR SPEAKERS.
THIS WAS A REALLY, REALLY
FASCINATING SESSION.
SO THANK YOU.
>> LET'S QUICKLY CHECK IN WITH
EVERYBODY.
HOW ARE WE DOING?
DO WE NEED A BREAK FOR A FEW
MINUTES?
DURING THIS, OR DO WE WANT TO
PUSH THROUGH -- FIVE MINUTES?
FIVE MINUTES BREAK, OKAY.
IT IS DECIDED, FIVE-MINUTE
BREAK.
WELCOME BACK, EVERYONE.
WE ARE GETTING STARTED IN THE
LAST HOUR OF OUR MEETING WITH
THE PRESENTATION ON THE NIH CARE
OF HEALTH INITIATIVE.
I'M TURNING THE MEETING BACK
OVER TO DR. LANGEVIN TO
INTRODUCE OUR SPEAKER.
>> OKAY.
SO IT MY GREAT PLEASURE NOW TO
INTRODUCE OUR NEXT SPEAKER, WHO
IS GOING TO GIVE US A
PRESENTATION ON THE NIH CARE FOR
HEALTH INITIATIVE.
THIS IS AN INITIATIVE I TALKED
ABOUT A LITTLE EARLIER TODAY IN
MY DIRECTOR'S REPORT.
AND WE ARE SO LUCKY TO HAVE WITH
US TODAY DR. AMY PATTERSON,
WHO'S THE INTERIM SCIENTIFIC AND
MEDICAL DIRECTOR FOR THE -- NO,
SHE'S NOT INTERIM ANYMORE,
SCIENTIFIC PED MEDALLION CAL
DIRECTOR FOR THE NIH COMMUNITIES
ADVANCING HEALTH RESEARCH EQUITY
OR CARE FOR HEALTH INITIATIVE,
WHICH IS A PILOT PROGRAM FOCUSED
ON INTEGRATING CLINICAL RESEARCH
IN PRIMARY CARE SETTINGS.
SHE PREVIOUSLY SERVED FOR
SEVERAL YEARS AS THE DEPUTY
DIRECTOR FOR CLINICAL RESEARCH
AS THE DIRECTOR OF SCIENTIFIC
RESEARCH PROGRAMS, POLICY AND
STRATEGIC INITIATIVES AT THE
NATIONAL HEART, LUNG AND BLOOD
INSTITUTE.
DR. PATTERSON ALSO SERVED FOR
MANY YEARS AS THE NIH ASSOCIATE
DIRECTOR FOR SCIENCE POLICY.
SHE HAS A LONG TRACK RECORD OF
ACCOMPLISHMENT IN SUCH AREAS AS
THE DEVELOPMENT OF OVERSIGHT TO
CLINICAL TRIALS, CLINICAL
RESEARCH POLICY, DEVELOPMENT,
AND SCIENCE POLICY IMPLICATIONS
FOR EMERGING NEW TECHNOLOGIES.
I'M SO EXCITED TO HAVE AMY HERE
TO PRESENT ABOUT THE IMPORTANT
WORK OF THE CARE FOR HEALTH
INITIATIVE.
AS ONE OF THE THREE CO-CHAIRS OF
THIS INITIATIVE, I HAVE ENJOYED
VERY MUCH WORKING WITH AMY AND
THE TEAM AND THEY'VE GOTTEN
RIGHT TO WORK IN LAUNCHING THIS
CARE FOR HEALTH INITIATIVE IN
ABSOLUTELY RECORD SPEED, AND
THIS TEAM IS WITHIN THE NIH
DIVISION OF PROGRAM
COORDINATION, PLANNING AND
STRATEGIC INITIATIVES HERE AT
NIH.
SO AMY, TAKE IT AWAY.
>> THANK YOU SO MUCH,
DR. LANGEVIN, AND GOOD
AFTERNOON, EVERYONE.
ON BEHALF OF THE NIH CARE FOR
HEALTH TEAM, I'M REALLY PLIED TO
PLEASETODAY HAVE THIS OPPORTUNIO
INTRODUCE THIS NEW PROGRAM TO
YOU AND LOOK FORWARD TO HEARING
YOUR COMMENTS AND QUESTIONS
BECAUSE WE'RE REALLY AT THE
BEGINNING STAGES OF DEVELOPING
THE PROGRAM.
WE'LL TAKE THE FIRST FEW MINUTES
TO GO OVER THE OVERARCHING AIMS
OF THE PROGRAM AND THEN WE'LL
DRILL DOWN ON THE PROPOSE AID
PPROPOSEDAPPROACH AND TIMELINE.
BUT FIRST LET'S START WITH THE
WHY, WHY THIS PROGRAM AND WHY
NOW.
I THINK THIS GROUP IS QUITE WELL
AWARE THAT THE HEALTH OF THE
U.S. POPULATION FOR A VARIETY OF
REASONS IS DECLINING, WITH
SIGNIFICANT DECLINES IN THE PAST
SEVERAL YEARS.
IN FACT, AS ILLUSTRATED IN THIS
SLIDE, U.S. LIFE EXPECTANCY
RANKS LOW AMONG OUR OEDC PIERCE.
THIS IS DESPITE THE FACT THAT WE
HAVE AMONG THE HIGHEST HEALTH
EXPENDITURES IN THE WORLD.
THIS DECLINE IS MOST PRONOUNCED
IN THE MEDICALLY UNDER KS
SERVED, AS U.S. HEALTH
DISPARITIES PERSIST AND GAPS
WIDEN.
POPULATIONS THAT ARE MEDICALLY
UNDERSERVED AND
DISPROPORTIONATELY IMPACTED BY
DISEASE AND ILLNESS ARE OFTEN
THOSE ALSO HISTORICALLY
UNDERREPRESENTED IN RESEARCH.
THIS LACK OF REPRESENTATION
COMPROMISES THE GENERALIZABILITY
OF OUR RESEARCH FINDINGS, IT
CREATES EVIDENCE GAPS, AND IT
FURTHER COMPOUNDS HEALTH
DISPARITIES.
SO AS THIS GROUP ALSO PREESHTSZ,
APPRECIATES, WE HAVE A CRITICAL
NEED TO EXTEND THE OPPORTUNITIES
FOR PARTICIPATING IN RESEARCH TO
UNDERSERVED AND UNDERREPRESENTED
POPULATIONS AND TO OFFER THOSE
OPPORTUNITIES FOR INCREASED
ACCESS TO RESEARCH WHERE PEOPLE
LIVE, WORK, AND SEEK CLINICAL
CARE.
AND TOWARD THIS END, NIH
RECENTLY ANNOUNCED THE LAUNCH OF
A PRIMARY CARE-BASED CLINICAL
RESEARCH NETWORK, OR COMMUNITIES
ADVANCING RESEARCH EQUITY FOR
HEALTH.
OR CARE FOR HEALTH.
THIS WILL BE A NETWORK OF
NETWORKS.
IT'S INTENDED TO BE
DISEASE-AGNOSTIC FACILITATING
AND ADVANCING THE MISSION AREAS
OF ALL OF OUR 27 INSTITUTES AND
CENTERS AND IT WILL FACILITATE
RESEARCH ACROSS HEALTH
CONDITIONS AND ACROSS THE
LIFESPAN, ADULT AND PEDIATRIC.
THE OVERARCHING GOAL OF CARE FOR
HEALTH IS TO WORK TOWARD A
FUTURE STATE, ONE IN WHICH WE
HAVE CLINICAL RESEARCH ROUTINELY
EMBEDDED ALONGSIDE WITH AND FOR
PRIMARY CARE.
SUCH THAT THE FRUITS OF THE
RESEARCH CAN ADVANCE CLINICAL
CARE AND ITS DELIVERY, AND ARE
APPLICABLE ACROSS OUR POPULA
POPULATION.
THE CARE FOR HEALTH PROGRAM WILL
SUPPORT PRIMARY CARE-BASED
CLINICAL RESEARCH IN MISSION
AREAS SPANNING PREVENTION TO
TREATMENT, DISSEMINATION AND
IMPLEMENTATION, AND IT WILL HAVE
A FOCUS ON HEALTH EQUITY AND AN
EMPHASIS ON WHOLE PERSON HEALTH,
AND BASED ON THE INPUT WE'VE
RECEIVED SO FAR, WE KNOW THAT TO
BE SUCCESSFUL, THIS PROGRAM IS
GOING TO HAVE TO HAVE A NUMBER
OF KEY CHARACTERISTICS.
NUMBER ONE, IT'S GOT TO BE
PRACTICE-BASED AND
PATIENT-CENTERED, MEANING THAT
PRACTITIONERS AND PATIENTS ARE
OUR PARTNERS IN PLANNING THE
RESEARCH.
THE PROGRAM WILL ALSO NEED TO
CREATE A FOUNDATION FOR
SUSTAINED ENGAGEMENT AND
INFRASTRUCTURE.
IT WILL NEED TO FA WI FACILITATE
INNOVATIVE RESEARCH THAT
ADDRESSES THE QUESTIONS OF
IMPORTANCE TO FRONT LINE
PRACTITIONERS AND THEIR PATIENT
COMMUNITIES, AND IT WILL NEED TO
ENHANCE DISSEMINATION AND
IMPLEMENTATION OF EFFECTIVE CARE
STRATEGIES.
AS DR. LANGEVIN ALLUDED TO, SHE
IS A MEMBER OF A SENIOR NIH
LEADERSHIP TEAM THAT IS
PROVIDING OVERSIGHT FOR THE
PROGRAM.
SHE'S JOINED BY DR. JONI RUTTER
OF NCATS AND DR. DEBARA TUCCI
FROM NIDCD, ALONGSIDE DR. TARA
SCHWETZ, NIH DEPUTY DIRECTOR FOR
PROGRAM COORDINATION, PLANNING
AND STRATEGIC INITIATIVES AT
NIH.
THIS REALLY IS A TRANS-NIH
INITIATIVE.
AGAIN, THESE EFFORTS WILL TOUCH
THE MISSION AREAS OF ALL OF OUR
DIFFERENT INSTITUTES AND CENTERS
AND WE'RE GRATEFUL FOR MANY OF
THE STAFF ACROSS THE AGENCY
BEGINNING TO LEAN IN AND HELP US
SHAPE THIS EFFORT.
FORTUNATELY, WE DON'T HAVE TO
START FROM SCRATCH AT BUILDING
THE PROGRAM.
WE RECOGNIZE THERE'S A
TREMENDOUS AMOUNT OF EXPERTISE
IN A SUBSTANTIAL BODY OF WORK
ALREADY SHOWN ON THIS SLIDE, SO
WE LOOK FORWARD TO LEARNING FROM
AND WORKING WITH THEM AND OTHER
PARTNERS AS WE DEVELOP THIS
PROGRAM.
NOW PLANNING FOR THE CARE FOR
HEALTH INITIATIVE BEGAN EARLIER
THIS YEAR.
IT BEGAN WITH LISTENING,
LISTENING TO THOSE ENGAGED IN
AND WITH PRIMARY CARE CLINICAL
PRACTICE.
SO FOR THE FIRST HALF OF THIS
YEAR, WE HOSTED A SERIES OF
LISTENING SESSIONS AND A PUBLIC
WORKSHOP TO HEAR DIRECTLY FROM
PRIMARY CARE PROVIDERS, PATIENTS
AND PATIENT COMMUNITIES,
COMMUNITY HEALTH CENTERS,
RESEARCH NETWORKS, FEDERAL
AGENCIES, AND I WANTED TO SHARE
WITH YOU TODAY SOME OF THE MAJOR
THEMES THAT EMERGED DURING THESE
SESSIONS.
I'LL JUST TOUCH ON A FEW OF
THEM, BUT THEY'RE SERVING AS
FOUNDATIONAL CONCEPT TO US AS WE
DESIGN THIS PROGRAM.
PARTICIPANTS IN THE LISTENING
SESSIONS HIGHLIGHT THE
IMPORTANCE OF BUILDING
SUSTAINABLE AND EFFECTIVE
PARTNERSHIPS, TRANSITIONING FROM
EPISODIC ENGAGEMENT WHERE
RESEARCH IS PRESENT IN A RURAL
COMMUNITY FOR MAYBE A SINGLE
GRANT.
AND THERE'S A RESEARCH DESERT
FOR MANY YEARS TO COME.
SO TRANSITIONING FROM THIS KIND
OF E EPISODIC MODEL OF ENGAGEMET
TO MORE CONTINUOUS, WHERE WE
BUILD AND MAINTAIN CAPACITY
THROUGH MENTORSHIP,
ADMINISTRATIVE SUPPORT,
SUSTAINED STAFFING, AND MAINTAIN
ONGOING RELATIONSHIPS WITH LOCAL
COMMUNITY PARTNERS.
THEY POINTED TO -- WE OFTEN USE
THE WORD ABOUT BUILDING TRUST.
THEY POINTED OUT WE REALLY
SHOULD BE TALKING ABOUT
DEMONSTRATING TRUSTWORTHINESS,
TALKING ABOUT CODEVELOPING AND
CO-CREATING A RESEARCH AGENDA SO
THAT IT'S REALLY A BALANCED AND
BIDIRECTIONAL PARTNERSHIP.
THEY ALSO POINTED OUT THAT WE
NEEDED TO UNDERSTAND THE NEEDS
OF DIVERSE COMMUNITIES.
THAT THERE WOULD BE NO ONE SIZE
FITS ALL APPROACH THAT WOULD
WORK ACROSS THE BOARD THAT WE'D
NEED TO ADAPT THE ENGAGEMENT
STRATEGY, WE'D NEED TO ADAPT THE
RESEARCH APPROACHES, THAT WE'D
NEED TO RAISE PROVIDER AND
RESEARCHER CULTURAL COMPETENCIES
IN CERTAIN CONTEXTS, AND WE MAY
NEED TO ENHANCE COMMUNITY HEALTH
LITERACY.
THEY ALSO UNDERSCORED THE
IMPORTANCE OF ADDRESSING
PROVIDER NEEDS, AS PRACTICES ARE
ALREADY STRETCHED TO THE LIMIT
WITH VERY PRECIOUS MINUTES,
SCARCE MINUTES SPENT WITH EACH
PATIENT DURING THE DAY, AND THEN
TO TRY TO STRETCH THE TIME AND
HOURS AND EFFORT TO ALSO
UNDERTAKE RESEARCH IS A MAJOR
UNDERTAKING.
AND IN THIS REGARD, THEY ASKED
US TO CONSIDER THE WORKLOAD OF
HEALTHCARE PROVIDERS TO CONSIDER
WHAT THE ROUTINE WORK DAY
OPERATIONS LOOK LIKE, AND TO
PROVIDE ADEQUATE SUPPORT FOR
IMPLEMENTING RESEARCH.
THEY ALSO ASKED US TO LOOK AT
STUDIES THAT REDUCE BURDEN TO
PATIENTS AND PRACTITIONERS, AND
IN PARTICULAR, THINK ABOUT
INNOVATIVE STUDY DESIGNS THAT
LEVERAGE THE POWER OF
TECHNOLOGY.
I WAS LISTENING TO THE PREVIOUS
DISCUSSION THAT MENTIONED
UTILIZATION OF A.I., NOT ONLY IN
THE ANALYSIS OF DATA, BUT ALSO
IN THE DESIGN OF RESEARCH
STUDIES, AND THAT WAS ONE
EXAMPLE THAT WAS BROUGHT TO OUR
ATTENTION.
OTHER THEMES INCLUDED
RECOGNIZING THE FINANCIAL
IMPLICATIONINGS OF A PRACTICE
PARTICIPATING IN RESEARCH, AND
TO RECOGNIZE THE CONTRIBUTIONS
OF PATIENTS IN COMMUNITIES.
SO THE APPROACH WE'RE TAKING TO
LAUNCH THIS EFFORT AS
DR. LANGEVIN SAID, WE'RE VERY
EAGER TO GET STARTED THIS FISCAL
YEAR, MOVE FROM IDEA TO
IMPLEMENTATION IN FY 24, SO
WE'RE JUMPSTARTING THE EFFORT BY
PARTNERING WITH EXISTING
CLINICAL RESEARCH NETWORKS AND
PROVIDING RESOURCES TO EXPAND
ENROLLMENT INTO EXISTING NIH
STUDIES, STUDIES THAT ARE BEING
SELECTED BECAUSE THEY ALIGN WITH
THE HEALTH CONDITIONS OF
IMPORTANCE TO AND WERE
PRIORITIZED BY PRIMARY CARE
PRACTICES IN LOCAL COMMUNITIES.
FOR THE NEXT YEAR OR TWO AS WE
ESTABLISH THE SUPPORTIVE
INFRASTRUCTURE, WE'LL ALSO BE
PILOTING NEW STUDIES AND, AGAIN,
TO BE TRUE TO OUR WORD ABOUT
BEING PRACTICE-BASED AND
PATIENT-CENTERED, THOSE NEW
STUDIES WILL BE DESIGNED IN
PARTNERSHIP WITH THE NETWORK
RESEARCH HUBS, THEIR
PRACTITIONERS AND PATIENT
COMMUNITIES.
SO IN TERMS OF TIMELINE AND
BUDGET AGAIN, WE GOT A LOT OF
INPUT THE FIRST HALF OF THIS
YEAR, MULTI-SECTOR PERSPECTIVES,
AND THESE REALLY HELPED INFORM
THE DEVELOPMENT OF A RESEARCH
OPPORTUNITY ANNOUNCEMENT THAT
WAS ISSUED IN EARLY MAY.
IT WAS ON THE STREETS, THROUGH
MID JUNE.
AND IT WAS IN SUPPORT OF THE
EARLY DEVELOPMENT OR PILOT PHASE
OF THIS PROGRAM, WHICH THE EARLY
PART OF THE PROGRAM IS A
TWO-YEAR PILOT.
THE ANNOUNCEMENT INVITED
APPLICATIONS FOR ORGANIZATIONS
TO SERVE AS NETWORK RESEARCH
HUBS, AND PROVIDE THE CRITICAL
INFRASTRUCTURE FOR RURAL PRIMARY
CARE SETTINGS.
SO THE INITIAL PILOT PHASES
FOCUSED ON RURAL SETTINGS.
WE ANTICIPATE MAKING THE INITIAL
NETWORK RESEARCH HUB AWARDS FOR
THE FIRST YEAR OF ACTIVITY BY
THE END OF THIS MONTH.
AND IT WILL TOTAL APPROXIMATELY
$5.6 MILLION, AND WE'RE LOOKING
FORWARD TO MAKING ADDITIONAL
AWARDS IN EARLY 2025, AND
LOOKING AHEAD TO 2025 AND
BEYOND, WE'LL BE LAUNCHING
ADDITIONAL STUDIES THROUGHOUT
THE NETWORK.
WE'LL BE DESIGNING NEW STUDIES,
AND WE'LL BE FURTHER
ESTABLISHING THE NETWORK
INFRASTRUCTURE.
AND THIS SLIDE GIVES YOU AN IDEA
OF WHAT THOSE INFRASTRUCTURE
COMPONENTS ARE IN ADDITION TO
THE NETWORK RESEARCH HUBS.
SO THIS WILL BE NIH-BASED
INFRASTRUCTURE THAT'S INTENDED
TO REALLY FOSTER, SUPPORT AND
FACILITATE RESEARCH IN THE
PRIMARY CARE SETTING,
UNDERSTANDING HOW CHALLENGING
THAT CAN BE.
IT WILL PROVIDE RESOURCES TO
FACILITATE AND SUPPORT PATIENT
PRACTICE AND COMMUNITY
ENGAGEMENT.
THIS WILL BE DONE IN PART WITH
SOME PROGRAMS THAT ARE ALREADY
UNDERWAY WITH SOME ROBUST
EFFORTS IN THIS SPACE SUCH AS
THE NIH COMMUNITY ENGAGEMENT
ALLIANCE AND OTHERS.
IT WILL ALSO INCLUDE A CLINICAL
SCIENCE CENTER, WHERE WE WILL BE
SUPPORTING AND ENABLING THE
DEVELOPMENT OF INNOVATIVE
CLINICAL STUDY DESIGNS AND
IMPLEMENTATION STRATEGIES, AND
THIS WILL BE DONE IN PART
THROUGH TAPPING INTO THE
EXPERTISE OF THE NIH
COLLABORATORY THAT'S DONE A
TREMENDOUS AMOUNT OF GREAT WORK
IN THIS SPACE.
THE CLINICAL SCIENCE CENTER WILL
ALSO PROVIDE STATISTICAL AND
DATA MANAGEMENT SUPPORT.
INFRASTRUCTURE WILL ALSO INCLUDE
AN OPERATIONS CENTER TO PROVIDE
THAT FULL SUITE OF STUDY
OPERATIONS ACTIVITIES, FROM
HELPING WITH PROTOCOL REFINEMENT
TO COMPLIANCE WITH REGULATORY
REQUIREMENTS, FDA IF APPLICABLE,
TRAINING, AND DATA MONITORING.
THE PROGRAM WILL ALSO PROVIDE
INDEPENDENT REVIEW AND
MONITORING, SO WILL PROVIDE THE
CENTRAL IRB, DSM B AND OSMB AS
NEEDED, AND AS THE PROGRAM
MATURE, WE'LL ALSO BE PROVIDING
OPPORTUNITIES TO EXPLORE AND
THEN AS APPROPRIATE FACILITATE
PARTNERSHIPS WITH THE PRIVATE
SECTOR.
NOW NOTICE WE MENTIONED EARLIER
THE INITIAL PHASE OF THIS PILOT
IS FOCUSED ON RURAL COMMUNITIES
FOR THIS FIRST SOLICITATION.
BUT WE DO EXPECT THE SCOPE OF
THE PROGRAM TO EXPAND AS THE
INFRASTRUCTURE IS DEVELOPED AND
THE ATTENTION HERE IS TO
ENCOMPASS THE FULL RANGE OF
POPULATIONS REGARDLESS OF
LOCATION, AGAIN WITH A FOCUS ON
THOSE UNDERREPRESENTED IN
RESEARCH.
SO TO WRAP UP DURING THE
TWO-YEAR PILOT PHASE OF THIS
PROGRAM, WE HAVE A CRITICAL
MISSION AND A FAIRLY AMBITIOUS
TIMELINE DURING THIS FIRST YEAR,
WE'LL BE FUNDING NETWORK
RESEARCH HUBS THAT WILL
PARTICIPATE IN EXISTING STUDIES.
THEY MAY BE INTERVENTIONAL OR
OBSERVATIONAL, THEY WILL BE
SUITABLE FOR RURAL PRIMARY CARE
SETTINGS.
AND ALSO OVER THE COURSE OF THIS
COMING YEAR, WE WILL BE
DEVELOPING NEW CLINICAL STUDIES,
LEVERAGING INNOVATIVE DESIGNS
AND TECHNOLOGIES TO MINIMIZE
BURDEN TO PATIENTS AND
PRACTITIONERS IN IMPLEMENTING
THE STUDIES.
AND BEFORE THE SECOND YEAR OF
THE PILOT COMES TO AN END, WE'LL
BE UNDERTAKING AN EVALUATION OF
WHICH APPROACHES HAVE WORKED AND
WOULD BE SUITABLE FOR BROADER
IMPLEMENTATION.
SO I'LL WRAP UP HERE AND FOR
THOSE OF WHO YOU ARE INTERESTED
IN MORE INFORMATION ON THE
PROGRAM, I'LL POINT YOU TO OUR
WEBSITE, BUT I'D BE DELIGHTED TO
HEAR YOUR COMMENTS AND TRY TO
ANSWER ANY QUESTIONS YOU MIGHT
HAVE.
THANK YOU, BACK OVER TO YOU, DR.
>> THANK YOU SO MUCH.
THIS WAS OBVIOUSLY -- REPRESENTS
JUST THIS ENORMOUS AMOUNT OF
WORK TO STAND THIS UP.
I REALLY WANT TO COMMEND YOU,
AMY, WITH HOW YOU'VE BEEN SUCH A
FEARLESS LEADER IN THIS PROGRAM.
IT'S BEEN AMAZING TO WATCH THIS
ALL HAPPEN.
IN FRONT OF OUR EYES.
>> IT'S BEEN A TEAM.
>> YEAH, FOR SURE.
SO YES, DAN.
>> I'D LIKE TO ECHO THOSE
COMMENTS BECAUSE I'M A
CLINICIAN, A PSYCHIATRIST AS
WELL, ADDICTION PSYCHIATRIST,
AND I THINK THIS ALSO WOULD ALL
APPLY TO THE BEHAVIORAL HEALTH
SETTING, THE HUGE BEHAVIORAL
HEALTH WORLD.
>> I COULDN'T AGREE MORE, AND
BEHAVIORAL HEALTH IS A HUGE
COMPONENT OF WHAT WE'RE -- YOU
KNOW, WHAT DOESN'T IT TOUCH.
AND WE VERY MUCH ANTICIPATE
BEHAVIORAL INTERVENTIONS BEING
PARD3 OF THIS PROGRAM, SO STAY
TUNED.
>> YES, AND JUST AN ADDITIONAL
QUICK COMMENT.
IT ALSO REALLY HEROIC WORK
BECAUSE I THINK WITHIN THE
CLINICAL SETTING, RESEARCH, YOU
REALLY SEE THE DIVIDE, HOW
RESEARCH I AND THE CLINICAL WORS
ARE JUST NOT MERGING, AND A LOT
OF THE INTERVENTIONS BEING
PROVIDED, I'LL JUST SPEAK FOR
MYSELF IN THE BEHAVIORAL HEALTH
SETTING, JUST AREN'T -- IT'S THE
SAME BASIC, YOU KNOW, GOOD
TREATMENTS BUT KIND OF THE SAME
STUFF AND VERY FEW NEW
INNOVATIVE STRATEGIES.
SO THERE'S A HUGE NEED FOR A
WHOLE -- A BIG, BIG -- WE NEED
SOME BIG STRIDES TO TRY TO
INTEGRATE SOME STRUCTURE,
RESEARCH, KNOWLEDGE AND
INFRASTRUCTURE RESEARCH WITHIN
THE CLINICAL SETTING.
SO THAT'S REALLY COMMENDABLE
WORK BECAUSE THAT'S A HUGE
UNDERTAKING.
>> THANK YOU.
AND ANY ADVICE YOU HAVE, WE'RE
VERY WELCOMING OF IT.
I SHOULD ALSO EMPHASIZE, ONE OF
THE GOALS OF THE PROGRAM IS TO
PROVIDE THE INFRASTRUCTURE THAT
I DESCRIBED, AGAIN TO BE A
RESOURCE FOR ALL OF THE
INSTITUTES, AND TO HELP
FACILITATE TYPES OF RESEARCH
THAT YOU'VE JUST DESCRIBED
INCLUDING FOR SOME OF THE
SMALLER MID SIZED INSTITUTES
THAT MAY NOT TYPICALLY HAVE
LARGE NETWORKS AT THEIR
DISPOSAL.
IN THIS REGARD.
>> SO BEING HERE AT NCCIH, WHAT
RELATIONSHIP DO YOU SEE --
INTERVNGINTERVENTIONS IN PRIMAR?
THEY'RE NOT THAT COMMON.
JUST UNDERSTANDING HOW YOU'RE
SEEING THAT.
I HAVE A SECOND QUESTION AS
WELL, BUT JUST WHAT'S THE VISION
OF HOW THAT IS -- WHAT'S THE
CURRENT STATE?
>> MEANING COMPLEMENTARY AND
ENGINEERING --
>> YEAH.
>> THIS PROGRAM, I DON'T THINK
THAT WE SEE ANY DIVIDE BETWEEN
COMPLEMENTARY AND INTEGRATIVE
AND OTHER INTERVENTIONS, ALL ARE
WELCOME AND WE'RE WORKING VERY
CLOSELY WITH ALL OF THE
INSTITUTES INCLUDING
DR. LANGEVIN AND OTHERS IN THIS
ROOM TO IDENTIFY STUDIES THAT
WOULD BE FIT-FOR-PURPOSE IN A
PRIMARY CARE SETTING AND MAYBE
LOW TOUCH MORE PRAGMATIC, AND I
THINK THAT SOME OF THE
COMPLEMENTARY AND INTEGRATIVE
MEDICINE INTERVENTIONS LEND
THEMSELVES VERY NICELY, AND
THEY'RE VERY APPEALING TO
PARTICIPANTS AS WELL, SO --
>> BUT THEY'RE NOT AVAILABLE IN
PRIMARY CARE THAT OFTEN, SO DO
YOU SEE THAT RELATIONSHIP
HAPPENING OR --
>> YES, VERY MUCH SO.
I THINK WHAT YOU'LL SEE IN THIS
INITIAL PORTFOLIO OF STUDIES
WHEN WE CAN ANNOUNCE IT LATER
THIS MONTH, YOU'LL SEE SOME OF
THAT PRESENT EVEN IN THE
BEGINNING PORTFOLIO FOR THIS
PROGRAM.
>> SECOND QUESTION IS, HOW -- IF
THERE WERE OTHER EXISTING
NETWORKS, I LEAD A PRACTICE
BASED RESEARCH NETWORK OF
INTEGRATIVE THERAPIES BUT IT'S
ALL -- PRACTICE OR MOSTLY.
RIGHT NOW WE HAVE 30 MEMBERS AND
ABOUT -- WE'VE GOT DATA ON LIKE
15 OF THEM, I JUST ACTUALLY
COLLECTED IT FOR TODAY, WE SEE
ON AVERAGE LIKE 327,000 SESSIONS
PER YEAR ACROSS CHIROPRACTIC,
ACUPUNCTURE, SO THAT'S ADJACENT
TO PRIMARY CARE BUT DO YOU SEE
THAT BEING A PARTNERSHIP, HOW DO
YOU SEE THAT TOGETHER?
>> THAT'S A REALLY GREAT
QUESTION.
THE NUMBER OF STUDIES, THE
STRATEGYS THAT WE'VE HEARD FROM
THE FIELD ARE MORE OF A
COLLABORATIVE CARE-TYPE MODEL,
CONSULTATIVE CARE, SO THAT THE
STUDIES THAT WE UNDERTAKE
INVOLVE A TEAM THAT IS ACCESSED
VIRTUALLY, AND CAN COMPLEMENT
THE CARE ON THE GROUND IN THE
CLINIC, IN A COST-EFFECTIVE WAY.
SO I THINK THAT THOSE TYPES OF
MODELS THAT CAN BRING 360 CARE
FOR PATIENTS ARE VERY IMPORTANT
TO THIS INITIATIVE.
ESPECIALLY IN ROW RURAL SETTINGS
WHERE WEAR NOT GOING TO BE ABLE
TO FIND WITHIN A REASONABLE
GEOGRAPHIC RADIUS THE TYPES OF
SPECIALTY SERVICES OR EXPERTISE
TO DELIVER THOSE TYPES
MODALITIES.
>> THANK YOU.
>> WELL, THANK YOU SO MUCH FOR
THIS.
I'LL SELF-REVEAL THAT I'M THE
ASSOCIATE CHAIR FOR RESEARCH AND
FAMILY MEDICINE, AT THE
UNIVERSITY OF MICHIGAN, AND SO
WHEN THIS CAME OUT, THERE WAS A
LOT OF EXCITEMENT.
SO I WANT TO SAY THAT.
THEN I SAW THE WORD JUST RULE
AND THE EXCITEMENT DIED.
I HAVE THREE KIND OF QUESTION
COMMENTS.
I'LL TRY TO DO IT REALLY QUICK
AND IN ORDER TO COMPLEXITY AND
YOU CAN TELL ME TO STOP, BUT ONE
OF THEM IS, HAVE YOU
CONSIDERED -- I DIDN'T SEE LIKE
THE SWOG MODEL, THE SOUTHWEST
ONCOLOGY GROUP MODEL, THINKING
ABOUT THAT IT BRINGS COMMUNITY
GROUPS, ACADEMIC GROUPS, ET
CETERA, AND HAS A LOT OF THESE
OTHER THINGS AS A MODEL.
SO I WAS CURIOUS AS TO WHY THAT
WOULD BE CONSIDERED -- I MEAN,
IT'S NOT ONE TO ONE, BUT IT
CERTAINLY WOULD BE SOMETHING
THAT'S BUILT THIS OUT FOR A LONG
TIME.
>> ARE YOU ASKING -- I WANT TO
MAKE SURE I UNDERSTAND THE
QUESTION, AND IS THIS THE EASY
QUESTION?
>> YEAH.
>> OKAY.
>> WELL, MAYBE IT ISN'T.
>>.I PERCEIVED IT AS WE HAD OR E
HADN'T OR IT'S NOT A GOOD MODEL.
>> RATE.
I THINK THAT WE DIDN'T
NECESSARILY PICK THE SPECIFIC
MODELS.
WITH OPENED THE PWE OPENED PLATE
WHO WOULD COME FORWARD HOPING
FOR BOTH SORT OF TRADITIONAL
PLAYERS IN THIS AREA AS WELL AS
WE'RE OPEN TO NEW PLAYERS IN THE
AREA, AND I'LL ALSO SAY THAT AS
THE PROGRAM DEVELOP, WE FULLY
ANTICIPATE BEING A VERY, VERY
LARGE TENT.
WE DO IN TERMS OF THE MODEL
ITSELF ENVISION A VERY
CONSULTATIVE MODEL, BOTH IN
TERMS OF JUST AS I TRIED TO
DESCRIBE THE DESIGN OF THIS
EARLY CONCEPTUALIZATION, BUT
THIS WILL BE A WORK IN PROGRESS,
AND WE WILL BE WORKING, THE
INFRASTRUCTURE I DESCRIBED IS
NOT TOP-DOWN OR NOT DEVELOPING
STUDIES AND THEN SAYING, YOU
KNOW, WHO'S INTERESTED, WHO
WANTS TO DO IT.
THE STUDIES THEMSELVES WILL BE
DEVELOPED ORGANICALLY IN
PARTNERSHIP WITH THE NETWORK
RESEARCH HUBS, THEIR
PRACTITIONERS AND THEIR
COMMUNITIES.
SO I HOPE THAT AT THE END OF THE
DAY, WE'LL CAPTURE SOME OF THE
FEATURES OF THE MODEL YOU JUST
DESCRIBED AND MAYBE WE WILL
ULTIMATELY INCLUDE THEM.
DOES THAT HELP?
>> YES.
I'M GOING TO SAY GOOD LUCK,
HAVEN'T SEEN A LOT OF
PRACTICE-BASED RESEARCH NETWORK
THAT HAS THAT SORT OF FI PHILOSY
AND I LOVE IT.
MY SECOND QUESTION IS, A LOT OF
NETWORKS, ESPECIALLY WITH
CONSOLIDATION, HAVE RURAL AND
NOT RURAL, THEY HAVE PEDIATRICS
AND NOT -- YOU KNOW, NOT
PEDIATRICS, ET CETERA, SO HOW
ARE WE REALLY DEFINING RURAL AND
HOW IS THAT NOT JUST GETTING RID
OF THE MORE HETEROJEAN JUST
GROUPS OF PRIMARY CARE THAT ARE
OUT THERE?
>> WELL, AGAIN, THE INTENTION
HERE, WE SORT OF HAD TO START
SOMEWHERE.
AND WE HAD AN INITIAL BUDGET OF
5 MILLION FOR FY 24.
SO AGAIN, THE INTENTION HERE IS
TO GO MORE BROADLY.
WHEN WE LOOK AT THE DEMOGRAPHICS
AND GEE GRAPHICS OF PARTICIPANTS
IN NIH-FUNDED RESEARCH, I THINK
AS ALL OF YOU APPRECIATE, THERE
ARE SEVERAL GROUPS THAT ARE MORE
CHALLENGING FOR US TO REACH AND
THE RURAL IS ONE OF THEM.
WE TYPICALLY DON'T DO VERY WELL
WITH RURAL POPULATIONS, BUT
AGAIN I WANT TO EMPHASIZE THAT
THIS IS JUST FOR THIS EARLY
PHASE, THIS FIRST YEAR OR SO,
AND THEN WE WILL BE BROADENING
OUT.
SPECIFICALLY AS TO YOUR
QUESTION, RURAL WAS DEFINED AS
THE FUNDED ORGANIZATION AND ITS
CATCHMENT HAVING AT LEAST 25% OF
ITS CENSUS, THE STATE IT'S IN,
THE CENSUS TRACTS TO BE THE
UPDATED RAQQA CODES 4 THROUGH
10.
>> I REMEMBER US TALKING ABOUT
THAT ACTUALLY, SO THANKS.
AND MY LAST QUESTION IS ABOUT
COORDINATING WITH NON-PROFITS,
IF THERE'S ANY IDEA ABOUT THAT,
BECAUSE OF COURSE THERE'S A LOT
OF REPLICATION ACROSS
NON-PROFITS, ESPECIALLY WITH A
LOT OF THINGS THAT PRIMARY CARE
TRIES TO DO.
ANY THOUGHT ABOUT THAT?
>> AGAIN, WE ARE OPEN.
WE KNOW WE NEED TO PARTNER WITH
A LOT OF DIFFERENT GROUPS, AND I
THINK WE WOULD VERY MUCH WELCOME
AND IF YOU HAVE IDEAS ALONG
THOSE LINES, WE'D CERTAINLY LIKE
TO TALK TO PEOPLE.
>> GREAT.
THANK YOU SO MUCH.
>> SURE.
>> ANY OTHER QUESTIONS?
OKAY.
WELL, I REALLY WANT TO THANK
YOU.
AMY, THIS IS REALLY GREAT AND,
YOU KNOW, W I HAVE TO SAY WHEN E
INVITED AMY TO PRESENT TODAY, WE
WERE HOPING WE WOULD BE ABLE TO
TALK ABOUT THE AWARDS
THEMSELVES.
WE MISSED BY, I DON'T KNOW, NOT
LONG, NOT MUCH -- PERHAPS IN A
COUPLE WEEKS, BUT YOU'LL BE
HEARING ABOUT THAT VERY SOON.
AND AGAIN, I HAVE TO EMPHASIZE
THE FACT THAT THIS IS A PILOT,
AS AMY DESCRIBED, THIS IS REALLY
THE FIRST STEP, BUT THERE'S SO
MUCH POTENTIAL FOR THIS PROGRAM
AND SO WE'RE SO VERY EXCITED TO
HEAR ABOUT THIS, TO HAVE THE
OPPORTUNITY TO PRESENT TO ALL,
AND THANK YOU VERY MUCH FOR THE
DISCUSSION, THANK YOU FOR COMING
OVER AND PRESENTING TO US AND WE
LOOK FORWARD TO HEARING WHAT
HAPPENS IN THE FUTURE.
>> THANK YOU ALL SO MUCH, AND I
HOPE YOU STAY IN TOUCH BECAUSE
WE'LL NEED ALL THE HELP WE CAN
GET.
>> FOR SURE.
THANK YOU.
>> SO THANK YOU, HELENE, AND
THANK YOU, DR. PATTERSON.
WE ARE NOW MOVING ON TO CONCEPT
CLEARANCE.
AND WE HAVE TWO CONCEPTS TODAY.
THE FIRST ONE WILL BE PRESENTED
BY DR. BEDA JEAN-FRANCOIS, A
PROGRAM DIRECTOR IN OUR CLINICAL
RESEARCH -- A BRANCH AND SHE WIL
PRESENT THE CONCEPT, ADVANCING
THE SCIENCE OF COMPLEMENTARY AND
INTEGRATIVE HEALTH APPROACHES TO
IMPROVE MATERNAL HEALTH
OUTCOMES.
THEN WE WILL MOVE ON TO DR. WEN
CHEN, AND SHE WILL PRESENT THE
CONCEPT ON ADVANCING AND
COORDINATING INTEROCEPTION
RESEARCH ACROSS THE NATIONAL
INSTITUTES OF HEALTH.
SO BEDA, I'M HANDING IT OVER TO
YOU.
PLEASE GO AHEAD.
>> THANKS, EVERYBODY.
GOOD AFTERNOON TO YOU ALL.
WE'RE HAPPY TO PROVIDE AN
OVERVIEW OF THE MATERNAL HEALTH
CONCEPT.
BEFORE I BEGIN, I JUST WANT TO
SAY A BIG THANK YOU TO MY TWO
WONDERFUL COLLABORATORS, DRS.
LANAY MUDLANAY MUDD AND WHITNEY.
THE UNITED STATES HAS THE
HIGHEST MATERNAL MORTALITY RATE
AMONG HIGH-INCOME COUNTRIES.
RESPONDING TO THE MATERNAL
HEALTH CRISIS IN THE UNITED
STATES IS A NATIONAL PRIORITY
FOR THE BIDEN HARRIS
ADMINISTRATION, AS WELL AS
ENSURING THAT HEALTH ISSUES OF
WOMEN ACROSS THE LIFESPAN ARE
INTEGRATED ACROSS THE FEDERAL
RESEARCH PORTFOLIO IN BUDGET.
AS A RESULT OF THIS NATIONAL
FOCUS, NIH IS INVESTING IN
SEVERAL INITIATIVES TO SUPPORT
RESEARCH PRIORITIES ON WOMEN'S
HEALTH.
ONE NIH RESEARCH EFFORT IS THE
IMPROVE MULTIPRONG INITIATIVE
THAT WAS LAUNCHED IN 2019, AND
RESPONINRESPONSE TO THE MATERNAH
CRISIS IN THE UNITED STATES.
IT WAS CREATED TO BUILD THE
EVIDENCE BASE OF MATERNAL HEALTH
RELATED SOLUTIONS FOR ALL WOMEN
TO PROMOTE MATERNAL HEALTH
EQUITY.
THE SIX GOALS OF THE IMPROVE
INITIATIVE ARE LISTED ON THAT
SLIDE FOR YOU AND YOU CAN SEE
THERE'S SPECIAL FA CYST ON
HEALTH DISPARITY POPULATIONS AS
WELL AS THE USE OF INNOVATIVE
TECHNOLOGY TO PROMOTE ACCESS TO
MATERNAL HEALTHCARE.
AS CAN BE SEEN ON THAT SLIDE,
THE IMPROVE INITIATIVE
ENCOMPASSES SEVERAL INTEGRATED
PROGRAMS WHICH ARE
GEOGRAPHICALLY DISTRIBUTED
THROUGHOUT THE COUNTRY.
ONE PROGRAM THAT I WANT TO FOCUS
YOUR ATTENTION ON THAT'S
RELEVANT FOR THE PROPOSED
CONCEPT IS THE MATERNAL HEALTH
RESEARCH CENTERS OF EXCELLENCE.
THE GOAL OF THESE CENTERS IS TO
REDUCE PREVENTABLE CAUSES OF
MATERNAL DEATHS AND IMPROVE
HEALTH FOR WOMEN BEFORE, DURING
AND AFTER PREGNANCY BY
PARTNERING WITH COMMUNITIES MOST
AFFECTED.
WITH SUPPORT FROM A DATA
INNOVATION AND COORDINATION HUB
AND AN IMPLEMENTATION SCIENCE
HUB, THE CENTERS WILL SHARE
LESSONS LEARNED, PARTICIPATE IN
TRAININGS AND RESEARCH, AND
DISSEMINATE THEIR RESULTS.
ADDITIONALLY, THE CENTERS HAVE A
ROBUST TRAINING AND PROFESSIONAL
DEVELOPMENT TO GROW THE MATERNAL
HEALTH WORKFORCE.
THE CENTERS ARE FUNDED FOR SEVEN
YEARS.
THEY HAVE RECENTLY COMPLETED
THEIR PLANNING YEAR AND THEY
WILL BEGIN IMPLEMENTING THEIR
RESEARCH PROJECTS FOR THE NEXT
FOUR YEARS.
WITH THE REMAINING YEARS' FOCUS
ON TRANSLATING THEIR RESULTS AND
SUSTAINING THEIR FINDINGS.
CURRENTLY THERE'S 12 CENTERS,
INCLUDING TWO THAT WERE RECENTLY
ADDED THIS JUNE AND THERE'S OVER
20 RESEARCH PROJECTS.
AS YOU CAN TELL ON THIS SLIDE,
ALTHOUGH THE CENTERS ARE
EXPLORING A WIDE DIVERSITY OF
TOPICS AND CONDITIONS THAT
IMPACT MATERNAL HEALTH,
COMPLEMENTARY INTEGRATIVE HEALTH
APPROACHES ARE NOT INCLUDED IN
THE INTERVENTIONS PROPOSED BY
THE CENTERS.
SO THUS THIS PROVIDES AN
OPPORTUNITY TO EXPAND THE
SCIENCE OF THE CENTERS TO
INCLUDE THESE APPROACHES AND
BUILD THE EVIDENCE BASE OF
COMPLEMENTARY INTEGRATIVE
APPROACHES TO PROMOTE A HEALTHY
PREGNANCY AND ENHANCE MATERNAL
HEALTH OUTCOMES.
AND IN FACT, COMPLEMENTARY
INTEGRATIVE HEALTH APPROACHES
FOR MATERNAL HEALTH IS
UNDERSTUDIED AT NIH.
FROM FISCAL YEAR 2010 TO 2023,
NIH HAS FUNDED 62 AWARDS ON THIS
TOPIC.
THE TOP 3ICs WHO ARE FUNDING
GRANTS FOCUSED ON THIS CONTENT
ARE NIMH, FOLLOWED BY NICHD AND
NCCIH.
ADDITIONALLY, SYSTEMATIC REVIEWS
AND META-ANALYSIS ALSO SUPPORT
THE NEED FOR MORE RIGOROUS
STUDIES TO STRENGTHEN THE
EVIDENCE BASE OF THESE
NON-PHARMACOLOGICAL
INTERVENTIONS TO ENHANCE
MATERNAL HEALTH OUTCOMES.
AND THAT REALLY IS THE PURPOSE
OF OUR INITIATIVE.
WE WANT TO DEVELOP A FUNDING
OPPORTUNITY TO IMPROVE THE
EVIDENCE BASE OF COMPLEMENTARY
INTEGRATIVE HEALTH APPROACHES TO
PROMOTE A HEALTHY PREGNANCY AND
OPTIMIZE IMPLEMENTATION OF
PSYCHOLOGICAL PHYSICAL AND
NUTRITIONAL INTERVENTIONS TO
ENHANCE MATERNAL HEALTH OUTCOMES
IN AREAS, FOR EXAMPLE, AS
STRESS, SLEEP, DEPRESSION, PAIN,
OBESITY, THE INITIATIVE ALIGNS
WELL WITH NCCIH'S STRATEGIC
PRIORITY ON WHOLE PERSON HEALTH,
AND HEALTH DISPARITIES.
SO SPECIFICALLY WHAT WE'RE
PROPOSING TO DO IS LEVERAGE THE
RICH INFRASTRUCTURE OF THE
IMPROVE CENTERS OF EXCELLENCE TO
TEST THE FEASIBILITY OF
EMBEDDING AND EVALUATING
COMPLEMENTARY INTEGRATIVE HEALTH
APPROACHES TO PROMOTE A HEALTHY
PREGNANCY AND ENHANCE MATERNAL
HEALTH OUTCOMES.
WE ALSO WOULD LIKE TO STIMULATE
THE NCCIH MATERNAL HEALTH
PORTFOLIO BY DEVELOPING A CADRE
OF INVESTIGATORS TO CONDUCT
RESEARCH ON MATERNAL HEALTH
OUTCOMES IN THE PREPREGNANCY,
PREGNANCY OR POSTPARTUM PERIOD.
OUR POTENTIAL PARTNERS ARE
LISTED HERE.
WE CONTINUE OUR CONVERSATIONS
WITH THEM.
THE LEADS OF IMPROVE, FOR
EXAMPLE, THEY'RE VERY EXCITED
ABOUT OUR EFFORT, AND THEY SEE
THE VALUE ADDED OF THESE
NON-PHARMACOLOGICAL APPROACHES
WITHIN THE CENTERS TO ADDRESS
THIS MULTIFACETED PROBLEM OF
MATERNAL HEALTH CRISIS.
THANK YOU SO MUCH.
I'M HAPPY TO TAKE YOUR QUESTIONS
NOW.
>> A REALLY IMPORTANT RESEARCH
DIRECTION.
AND I'M WONDERING, GIVEN SOME OF
THE HEAL WORK THAT'S GOING ON
WITH SUBSTANCE-EXPOSED FEE OWE
NATES, IS THERE ANY WAY THAT
PART OF THIS COULD BE TIED INTO
THAT BY LOOKING AT THE
MOTHERS -- THE SUBSTANCE USING
MOTHERS AND FANNI FACTORS THAT D
MINIMIZE THEIR SUBSTANCE USE,
DEPRESSION OR ANYTHING LIKE
THAT?
>> THANK YOU SO MUCH FOR THAT
QUESTION.
IN FACT, YES, THE IMPROVE EFFORT
CONNECTS WITH OTHER EXISTING
NETWORKS, AND HEAL IS ONE OF THE
INITIATIVES THAT THEY ARE
CONNECTED WITH.
SO INVESTIGATORS THERE AS WELL
CAN APPLY AND BE PART OF THE
IMPROVE NETWORK, YES.
SO WE GET TO CAPITALIZE ON THAT
AS WELL.
>> THERE ARE NO MORE QUESTIONS.
THEN I WOULD LIKE TO -- DO WE
HAVE A MOTION TO APPROVE THE
CONCEPT?
OKAY.
WE HAVE A SECOND?
ALL IN FAVOR, RAISE YOUR HAND.
IN THE ROOM AS WELL AS ON ZOOM.
SO DO WE HAVE EVERYBODY?
DR. CECH, DID WE GET YOUR HAND?
YOU KNOW BY NOW -- OKAY, SO WE
HAVE EVERYBODY?
OKAY, GOOD.
SO THE CONCEPT HAS BEEN
APPROVED.
THANK YOU SO MUCH, BEDA.
>> THANK YOU, EVERYONE!
>> HI, GOOD AFTERNOON.
I'M WEN CHEN FROM NCCIH.
TODAY I AM PRESENTING THE
CONCEPT ADVANCING AND
COORDINATING INTEROCEPTION
RESEARCH ACROSS THE NIH.
THIS CONCEPT IS A TIMELY AND
NECESSARY EXPANSION OF THE NIH
BLUEPRINT FOR NEUROSCIENCE
INITIATIVE ON INTEROCEPTION, AND
AIMING TO TRANSFORM BOTH OUR
SCIENTIFIC UNDERSTANDING AND THE
FUTURE OF PATIENT CARE.
IMAGINE THE PATIENT WITH CHRONIC
PAIN OR SUBSTANCE USE ABUSE
DISORDER OR ANXIETY, DISORDERS
IMPACT MILLIONS OF AMERICANS AND
PEOPLE AROUND THE WORLD TODAY.
DESPITE COUNTLESS TREATMENTS,
COUNTLESS INTERVENTIONS,
TREATMENT OFTEN FELL SHORT FOR
THESE PATIENTS BECAUSE WE DO NOT
UNDERSTAND, AND THESE
INTERVENTIONS DO NOT ADDRESS THE
FUNDAMENTAL QUESTIONS OF HOW THE
BRAIN INTERPRETERS AND REGULATES
THE SIGNALS FROM THE BODY
ITSELF.
INTEROCEPTION, WHICH IS DEFINED
AS THE BRAIN'S ABILITY TO SENSE,
INTEGRATE, INTERPRE INTERPRET AD
REGULATE THESE INTERNAL SIGNALS
HOLDS THE KEY TO ANSWER THIS
QUESTION.
INTEROCEPTION INFLUENCES OUR
EMOTIONS, DECISION-MAKING AND
PHYSICAL WELL-BEING.
DYSFUNCTION IN THIS SYSTEM ARE
OFTEN LINKED TO DISEASES FROM
DEPRESSION AND PAIN TO SYSTEMIC
DISEASE SUCH AS HYPERTENSION AND
DIABETES.
SO THIS CONCEPT AIMS TO FOSTER A
STRONGER AND MORE COORDINATED
RESEARCH COMMUNITY, EXPAND NIH'S
INTEROCEPTION RESEARCH PORTFOLIO
AND ULTIMATELY PAVE THE WAY FOR
MORE EFFECTIVE INTERVENTIONS
THAT CAN SAVE LIVES AND PROMOTE
HEALTH.
SO OUR CONCERTED EFFORT TO
ADVANCE INTEROCEPTION RESEARCH
BEGAN WITH THE FIRST EVER NIH
WORKSHOP ON THIS TOPIC HELD IN
2019.
IT FEATURES KEYNOTE SPEAKER WHO
WENT ON TO WIN THE NOBEL PRIZE
IN PHYSIOLOGY AND MEDICINE TWO
YEARS LATER.
THE LANDMARK EVENT BROUGHT
TOGETHER LEADING EXPERTS TO
DISCUSS KEY ISSUES, INCLUDING
BRAIN-BODY CONNECTIONS,
INTEROCEPTIVE NEUROCIRCUITRY,
DISEASE MECHANISMS, POTENTIAL --
AND COMPUTATIONAL MODELS.
THE WORKSHOP ALSO IDENTIFIED ONE
CLEAR MESSAGE, UNDERSTANDING
INTEROCEPTION IS ESSENTIAL FOR
ADDRESSING SOME OF THE MOST
PRESSING MEDICAL CHALLENGES OF
OUR TIME FROM BRAIN HEALTH TO
CHRONIC ILLNESS.
THE MOMENTUM FROM THIS WORKSHOP
LAID THE GROUNDWORK FOR BROADER
EFFORT WE SEE TODAY.
ONE OF THE KEY PRODUCTS FROM THE
2019 WORKSHOP WAS THE SPECIAL
ISSUE PUBLISHED IN TRENDS IN
NEUROSCIENCE IN 2020 WHICH
FEATURED SIX ARTICLES REFLECTING
THE MAJOR THEMES OF THE
WORKSHOP.
ONE OF THE MOST SIGNIFICANT GAPS
IDENTIFIED WAS OUR LIMITED
UNDERSTANDING OF THE NEURAL
CIRCUITS CONNECTING THE BRAIN TO
THE BODY AT A FUNDAMENTAL LEVEL.
SO THE LACK OF -- AND
UNDERSTANDING OF -- HAVE
HINDERED OUR PROGRESS,
UNDERSTANDING HOW IT INNUNESES
DIIN -- LEDBY NCCIH LAUNCHED A L
FUNDING OPPORTUNITY.
FOCUSING ON THE FUNCTIONAL
NEURAL CIRCUITS OF INTEROCEPTION
IN MAMMALIAN MODELS.
THIS INITIATIVE LED TO SEVEN R0G
OVER $18 MILLION FOR FIVE YEARS.
THE PROJECTS ARE BEGINNING TO
UNCOVER SOME VERY UNEXPECTED
CONNECTIONS THROUGH VAGAL AND
SPINAL PATHWAYS BETWEEN INTERNAL
ORGANS, INCLUDING THE STOMACH,
LUNG, ADIPOSE TISSUE, TRACHEA,
LIVER, AND SPECIFIC BRAIN AREAS
INCLUDING MOTOR CORTEX AND
ORBITOFRONTAL CORTEX.
THESE DISCOVERIES ARE REDEFINING
OUR UNDERSTANDING OF HOW
INTEROCEPTION SIGNALS REGULATE
BOTH THE PHYSICAL AND EMOTIONAL
HEALTH.
THE GROWING BODY OF RESEARCH
ALSO GATHERED INTEREST FROM
OTHER NIH INSTITUTES, BROADENING
THE SCOPE OF THE RESEARCH WITHIN
NIH.
FOR INSTANCE, THE NATIONAL
CANCER INSTITUTE ARE EXPLORING
HOW INTEROCEPTION MAY REGULATE
CANCER CONTROL, AND OTHER NIH
INSTITUTES ARE BEGINNING TO LOOK
AT INTEROCEPTION'S ROLE IN
SUBSTANCE USE DISORDERS AND
CHRONIC PAIN MANAGEMENT.
THIS INTERDISCIPLINARY INTEREST
POINTS TO THE WIDE REACHING
IMPLICATION OF INTEROCEPTION NOT
ONLY FOR NEUROSCIENCE BUT ALSO
FOR UNDERSTANDING AND TREATING A
VARIETY OF SYSTEMIC DISEASES.
OVER THE LAST DECADE, THE NUMBER
OF NIH-FUNDED GRANTS ON
INTEROCEPTION HAS NEARLY
TRIPLED.
THE GROWTH REFLECTS AN
INCREASING RECOGNITION OF HOW
INTEROCEPTION MAY SHAPE HEALTH
AND DISEASE, HOWEVER, THE
TRIPLING LIKELY UNDERESTIMATE
THE ACTUAL GROWTH BECAUSE
INTEROCEPTION RELATED RESEARCH
IS OFTEN EMBEDDED IN BROADER
RESEARCH FIELDS.
AS INTEROCEPTION RESEARCH GAINS
MOMENTUM, WE EXPECT EVEN MORE
RAPID EXPANSION UNDERSCORING THE
NEED FOR COORDINATION AND
FOCUSED SUPPORT.
SO THIS INCREASE FUNDING IS ALSO
DISTRIBUTED ACROSS DIVERSE NIH
INSTITUTES AND CENTERS.
SECONDLY, A SIGNIFICANT SHIFT IN
THINKING, FOR EXAMPLE, SOME OF
THE BODY CENTRIC SUCH AS THE
NIDDK AND NHLBI RL NOW EXPLORING
THE BRAIN SWELL IN REGULATING
ORGAN FUNCTIONS WHILE THE MORE
TRADITIONAL BRAIN CENTRIC
INSTITUTES SUCH AS NINDS AND
NIMH ARE INVESTIGATING HOW
ORGANS LIKE THE HEART, GUT, AND
LUNGS ARE INFLUENCING BRAIN
HEALTH.
EVEN ALZHEIMER'S DISEASE
RESEARCH IS BEGINNING TO EXAMINE
THE ROLE OF INTERNAL ORGANS IN
THE DISEASE PROGRESSION,
HIGHLIGHTING THE IP
INTERCONNECTEDNESS BETWEEN BRAIN
AND BODY.
THE IMPORTANCE OF INTEROCEPTION
RESEARCH IS ALSO REFLECTED IN
THE GROWING NUMBER OF
PUBLICATIONS IN THE LITERATURE,
ESPECIALLY IN HIGH IMPACT
JOURNALS SUCH AS NATURE, SCIENCE
AND CELL.
THOSE PAPERS REPORT
GROUNDBREAKING DISCOVERIES,
INCLUDING NOVEL CONNECTIONS
BETWEEN THE HEART AND BRAIN, THE
GUT AND BRAIN, AND THE ROLE OF
BREATHING AND EMOTIONAL
REGULATION.
THESE STUDIES ARE CHANGING HOW
WE UNDERSTAND BRAIN REGULATION
OF PHYSICAL AND EMOTIONAL HEALTH
AND CREATING NEW OPPORTUNITIES
FOR THERAPEUTIC DEVELOPMENT.
ALONGSIDE THOSE ACHIEVEMENTS,
TWO HIGHLY SUCCESSFUL
INVESTIGATOR MEETINGS WERE HELD
IN THE LAST TWO YEARS.
BOTH WELL ATTENDED BY THE
RESEARCH COMMUNITY.
THE FIRST MEETING FOCUSED ON THE
BASIC SCIENCE OF CIRCUITS, WHILE
THE SECOND ONE WAS EXPANDED INTO
CLINICAL RESEARCH.
THOSE MEETINGS FEATURE CLOSE TO
30 -- TALKS AND OVER 80 POSTER
PRESENTATIONS, AND REPRESENT A
MAJOR PLATFORM FOR -- INTO
DISCIPLINARY COLLABORATION.
PARTICIPANTS INCLUDE NARROW
SCIENTISTS, THE MEETING ALSO
PROVIDED CRITICAL SUPPORT FOR
JUNIOR INVESTIGATORS, INCLUDING
STUDENTS, POSTDOCS AND EARLY
STAGE INVESTIGATORS HELPING TO
CULTIVATE THE NEXT GENERATION OF
RESEARCHERS.
IT HIGHLIGHTED NEED FOR A
SIMILAR SCALED COMMUNITY EVENT
THAT CAN CONTINUE IN THE LONG
TERM.
DESPITE MOMENTUM, SIGNIFICANT
CHALLENGES REMAIN.
THE COMMUNITY HAS VOICED CONCERN
ABOUT THE LACK OF A PROFESSIONAL
SOCIETY OR ESTABLISHED NETWORK,
TO BRING TOGETHER THE DIVERSE
GROUPS INTERESTED IN
INTEROCEPTION RESEARCH.
WHILE INVESTIGATOR MEETINGS
WHICH ARE ORGANIZED BY NIH HAVE
GROWN WELL BEYOND OUR
EXPECTATIONS, THERE'S NO FORMAL
STRUCTURE TO SUPPORT REGULAR
LARGE SCALE INTERACTIONS.
IN ADDITION, NIH INSTITUTES AND
CENTERS ORGANIZATIONAL
STRUCTURE, WHICH IS LARGELY --
IT NOT VERY CONDUCIVE FOR
COORDINATED RESEARCH, ACROSS
BRAIN AND BODY.
ON A SCIENTIFIC FRONT, STUDYING
BRAIN-BODY CONNECTION IN HUMANS
REMAINS A CHALLENGE, ESPECIALLY
TRYING TO TRANSLATING THOSE
EXCITING BASIC FINDINGS INTO
EXCITING CLINICAL SCIENCE.
THE COMPLEXITY OF THOSE
CONNECTIONS OFTEN REQUIRE NOVEL
TECHNOLOGICAL INNOVATIONS AND
COMPUTATIONAL MODELS.
SO TO ADDRESS THOSE CHALLENGES,
WE PROPOSE TWO KEY INITIATIVES
HERE.
THE FIRST ONE IS TO ESTABLISH AN
NIH BLUEPRINT COORDINATION
CENTER FOR INTEROCEPTION
RESEARCH.
THIS CENTER WILL SERVE AS A
GOVERNING BODY TO BRING TOGETHER
EXPERTS TO LEAD THE FIELD AS FAR
AS COMMUNITY BUILDING AND
SUPPORT, LONG TERM
COLLABORATIONS AND INTERACTIONS,
AND WILL FACILITATE ANY
INVESTIGATOR MEETINGS, CROW ATE
A DIGITAL PLATFORM TO ENHANCE
COMMUNICATION AND COLLABORATION
AND PUBLISH WHITE PAPERS ON
TAXONOMY, RESEARCH STANDARDS AND
TECHNOLOGICAL OPPORTUNITIES.
THE ULTIMATE GOAL OF THIS CENTER
IS TO BUILD A SUSTAINABLE
RESEARCH ECOSYSTEM THAT WILL
ACCELERATE PROGRESS IN THE
FIELD.
THE SECOND INITIATIVE IS TO --
THE SECOND TYPE OF INITIATIVE IS
TO DEVELOP AS SUITE OF
MULTIDISCIPLINARY RESEARCH
FUNDING OPPORTUNITIES TA WILL
SUPPORT THE MULTIDISCIPLINARY
RESEARCH WITH AN EMPHASIS ON
TECHNOLOGICAL INNOVATION BY
DIRECTIONAL TRANSLATIONAL
RESEARCH AND THEORETICAL AND
COMPUTATIONAL MODEL DEVELOP M.
WE HOPE THIS INITIATIVE WILL
ENABLE STUDY OF THE COMPLEXITY
OF THE BRAIN-BODY CONNECTION AND
ENSURE THAT BASIC SCIENCE, BASIC
SCIENTIFIC DISCOVERIES CAN BE
EFFECTIVELY TRANSLATED INTO
CLINICAL PRACTICE.
SO IN CONCLUSION, BY ADDRESSING
THESE CHALLENGES AND BUILDING
STRONGER, MORE COORDINATED
RESEARCH COMMUNITY, WE'RE HOPING
TO UNLOCK MORE DISCOVERIES THAT
WILL TRANSFORM OUR UNDERSTANDING
OF HOW BRAIN BODY COMMUNICATE,
AND ALSO I BELIEVE THAT THIS HAS
FAR REACHING IMPLICATIONS TO
IMPROVE HEALTH IN GENERAL, AND
IN PARTICULAR, FITTING INTO
NCCIH'S VISION OF WHOLE PERSON
HEALTH.
SO WITH THAT, I THANK YOU FOR
YOUR ATTENTION, AND WELCOME YOUR
FEEDBACK AND QUESTIONS.
ON THIS
CONCEPT.
>> ANY COMMENTS, QUESTIONS ON
IT?
>> WELL DONE.
>> THAT'S WHAT I WAS GOING TO
SAY, AND I'M ALWAYS JUST BLOWN
AWAY THAT PEOPLE THINK, LIKE,
THE BRAIN ISN'T THE BODY AND
THAT IT ISN'T AN ORGAN THAT
WOULD COMMUNICATE WITH OTHERS,
AND IT TOOK US THIS LONG.
SO THANK YOU.
>> I WANT TO JUST UNDERSCORE HOW
DR. CHEN'S WORK WITH THE
BLUEPRINT, THE NEUROSCIENCE
BLUEPRINT THAT SHE SHOWED ON ONE
OF THE SLIDES, IT'S A COLLECTION
OF MANY, MANY DIFFERENT
INSTITUTES AT NIH, INSTITUTES
AND CENTERS, AND SHE'S BEEN
RELENTLESS AT INSPIRING THIS
ENTIRE GROUP OF COMMUNITY AS TO
THE IMPORTANCE OF INTEROCEPTION,
AND IT PAID OFF, BECAUSE -- BUT
REALLY, YOUR WORK HAS BEEN
SUPERB.
SO REALLY WANT TO THANK YOU.
OKAY.
THANK YOU.
>> WITH THIS, MAY I HAVE A
MOTION TO APPROVE THE CONCEPT?
I'M PAYING ATTENTION THIS TIME
NOT TO THE SCREEN, SO WHOEVER IS
RAISING THEIR HANDS THERE --
OKAY.
YOU'RE GOOD?
OKAY.
YOU'RE GOOD?
OKAY.
PERFECT.
THANK YOU.
GOOD.
AND THEN WITH THIS, I WOULD NOW
LIKE TO THANK YOU SO MUCH, WEN
AND ALSO BEDA.
FOR THIS, I WOULD LIKE TO MOVE
ON NOW AND WELCOME TO DR. WENDY
WEBER, CHIEF OF OUR CLINICAL
RESEARCH IN COMPLEMENTARY AND
INTEGRATIVE HEALTH BRANCH TO THE
PODIUM HERE.
WENDY IS GOING TO BRIEFLY
PRESENT ON THE REISSUE OF
NCCIH'S U24 FUNDING
OPPORTUNITIES.
WENDY, GO AHEAD.
>> GREAT.
WELL, THANK YOU.
AND I RECOGNIZE I'M OUR LAST
TALK BEFORE WE GO, SO THIS
REALLY IS JUST A BRIEF UPDATE,
REALLY A TECHNICAL ISSUE THAT WE
NEED TO ALERT YOU TO IN TERMS OF
REISSUING.
SO WE ARE IN THE PROCESS, AS YOU
HEARD EARLIER IN DR. LANGEVIN'S
TALK,' KROTION, ACROSS ALL OF NE
GOING TO SEE EVERY SINGLE
FUNDING OPPORTUNITY GET REISSUED
FOR THE MOST PART, AND THIS IS
TRUE FOR ALL -- LIKE EVERY R01,
EVERY R21, EVERY SINGLE ONE OF
THEM HAS TO BE REISSUED BECAUSE
WE'RE USING NEW RA REVIEW CRITE.
AND IT'S NO LONGER CRITERIA,
THEY'RE FACTORS, AND SO THAT'S
ONE OF THE THINGS THAT'S
CHANGING GOING FORWARD.
SO WE'RE GOING THROUGH THAT
PROCESS FOR ALL OF OUR CLINICAL
TRIAL NOTICE OF FUNDING
OPPORTUNITIES.
THE TECHNICALITY IS, THIS IS
TRUE FOR EVERYTHING WE HAVE ON
OUR -- IN OUR PORTFOLIO OF
FUNDING OPPORTUNITIES.
EXCEPT FOR THESE U24s THAT WE
HAVE, WHICH DON'T GET THE NEW
REVIEW FRAMEWORK AS PART OF
THEM.
AND SO WE HAVE TO STILL REESHOO
THEM, AND I WILL TELL YOU THE
LITTLE NUANCE THAT'S HERE.
SO THIS IS HAPPENING FOR JANUARY
AN WE JUST NEED TO GIVE YOU AN
UPDATE THAT WE'RE PLANNING TO
ALSO REISSUE OUR U24s AT THE
SAME TIME SO THAT THEY GO
TOGETHER.
SO AS YOU KNOW, I'VE PRESENTED
TO THIS GROUP BEFORE, WE HAVE A
WHOLE SUITE OF FUNDING
OPPORTUNITIES FOR CLINICAL
TRIALS.
EVERYTHING FROM VERY EARLY
FEASIBILITY STUDIES IN SINGLE
SITES TO MULTISITE FEASIBILITY
TO FULL SCALE EFFICACY
EFFECTIVENESS IN PRAGMATIC
TRIALS.
WE HAVE A SET OF COMPANION
FUNDING OPPORTUNITIES FOR THOSE
LARGER SCALE STUDIES THAT
REQUIRE AN INDEPENDENT CLINICAL
COORDINATING CENTER AND AN
INDEPENDENT DATA COORDINATING
CENTER.
THOSE TWO APPLICATIONS MUST COME
IN TOGETHER.
SO FOR THE FIRST,
THEY'RE ALL UNDER THE SIMPLIFIED
REVIEW FRAMEWORK AND SO ALL OF
THOSE ARE BEING UPDATED IN THIS
EXPEDITED PROCESS THAT WE HAVE
HERE AT NIH TO DO THAT.
THE U24 IS GIVING THE UPDATED
PEDP, PLAN FOR ENHANCING DIVERSE
PERSPECTIVES THAT I TALKED
ABOUT.
AND IF WE DIDN'T REISSUE WITH
THE U24 ALONG WITH THE UG33 --
WE'VE GOT TO REISSUE EVERYTHING
ALL AT THE SAME TIME.
SO I'M JUST HERE TO ALERT EACH
OF THE TO THE FACT THAT WE ARE
REISSUING THIS AND SIMILARLY FOR
OUR NATURAL PRODUCT SUITE OF
FUNDING OPPORTUNITIES, WE HAVE
EARLY STAGE STUDIES, SORT OF
LIKE PHASE 1, PHASE 2 TRIALS,
AND WE HAVE THINGS TO LOOK AT
DOSING AND THEN WE HAVE OUR
LARGER SCALE STUDIES, AND THEY
WILL ALSO BE UPDATING BOTH OUR
UG3, UH3 AND OUR U24.
SO THAT IS THE UPDATE.
WE WANTED TO MAKE SURE YOU WERE
AWARE OF THIS, AND I'M SURE IN
THE NOT TOO DISTANT FUTURE,
PROBABLY UPCOMING WE'LL GIVE YOU
AN UPDATE ON HOW THIS WHOLE
SUITE OF FUNDING OPPORTUNITIES
IS WORKING FOR US.
WE REALLY LIKE THEM, AND THEY'RE
WORKING WELL, BUT WE NEEDED TO
ALERT TO YOU THE FACT THAT WE
WERE GOING TO DO THIS UPDATED
VERSION OF THE PROGRAM.
I'M HAPPY TO TAKE ANY QUESTIONS
AND APOLOGIZE THAT WE HAVE TO GO
INTO THE DETAILS OF THE
TECHNICALITIES ON ALL OF THESE
THINGS.
HAPPY TO TAKE QUESTIONS.
>> THERE R WILL THERE BE A LOT
OF TRAINING, BECAUSE I DO A LOT
OF REVIEW PANEL WORK, I'M AN
INVESTIGATOR, I MEAN, THAT'S A
LOT OF MOVING PARTS AND IT'S
GOING TO BE MATCHING THE RUBRIC
CRITERIA TO REVIEWERS KNOWING
THAT THEY'VE CHANGED.
I KNOW JESSICA IS PROBABLY ON IT
ALREADY, BUT KIND OF A BIG ASK,
RIGHT, IF THEY CHANGE THEIR
MINDS?
>> MARTINA, DO YOU WANT TO TAKE
THE QUESTION ABOUT HOW WE'RE
RE-EDUCATING REVIEWERS ABOUT THE
UPDATED REVIEW FRAMEWORK?
THERE'S LOTS OF INFORMATION
ALREADY ONLINE, AND ALL OF THE
NEW APPLICATIONS COMING IN IN
JANUARY WILL HAVE THIS.
SO IT'S NOT GOING TO HIT PEER
REVIEW FOR A LITTLE BIT, BUT
JESSICA, I KNOW YOU GUYS ALREADY
HAVE A PLAN.
>> JESSICA IS OUR CHIEF IN THE
OFFICE OF SCIENTIFIC REVIEW, SO
SHE'S THE EXPERT.
>> THAT WILL BE HAPPENING AND
TAKING EFFECT IN SUMMER MEETINGS
FOR NEXT YEAR, AND SO WE ARE
WORKING HARD ON DEVELOPING
MATERIAL AND GUIDANCE FOR
REVIEWERS.
THERE ARE A NUMBER OF PUBLIC
WEBINARS AVAILABLE THAT EXPLAIN
THE CHANGES THAT ARE COMING, SO
MUCH MORE TO COME.
WE'LL MAKE SURE EVERYONE IS WELL
PREPARED.
>> OKAY.
IF THERE ARE NO MORE QUESTIONS,
THEN THANK YOU SO MUCH, WENDY,
AND AS THIS WAS MORE A FYI KIND
OF ACTION, SO WE DON'T HAVE TO
VOTE ON THAT ONE.
SO THAT'S GOOD.
OKAY.
WITH THIS, WE ARE NOW COMING TO
THE LAST AGENDA ITEM FOR OUR
OPEN SESSION, AND THIS IS THE
PUBLIC COMMENT SESSION.
A REMINDER THAT ANY MEMBER OF
THE PUBLIC WHO WISHES TO MAKE A
COMMENT MAY DO SO BY SENDING ME
YOUR WRITTEN COMMENTS NO LATER
THAN 15 DAYS BEFORE THE COUNCIL
MEETING IS HELD.
THESE COMMENTS SHOULD BE SENT
EITHER BY EMAIL OR THROUGH A
HARD COPY LETTER.
YOUR WRITTEN COMMENTS SHOULD BE
LESS THAN 700 WORDS IN LENGTH,
WHICH IS APPROXIMATELY
CONSISTENT WITH A FIVE-MINUTE
ORAL PRESENTATION.
YOUR WRITTEN COMMENTS WILL BE
PROVIDED TO THE MEMBERS OF THE
COUNCIL.
VIA OUR ELECTRONIC COUNCIL BOOK,
IN ADVANCE OF THE LAST MEETING.
I WILL ACKNOWLEDGE THE RECEIPT
OF THESE COMMENTS DURING THE
OPEN SESSION.
NOW, FOR THIS MEETING, WE DID
NOT RECEIVE ANY PUBLIC COMMENTS
FOR THE MEETING TODAY.
OKAY.
WITH THIS, WE ARE GETTING CLOSE
TO THE END NOW, SO WITH THIS,
THE MEETING IS CLOSED, I WOULD
OFFER MY SINCERE THANKS TO NCCIH
STAFF, WHOSE HELP AND WORK MADE
THIS MEETING POSSIBLE.
IT REALLY TRULY TAKES A VILLAGE
TO MAKE ALL OF THIS WORK.
I WOULD ALSO LIKE TO THANK OUR
COUNCILMEMBERS FOR THEIR HARD
WORK AND PARTICIPATION IN
TODAY'S MEETING, AND A SPECIAL
THANK YOU GOES TO OUR AD HOC
COUNCILMEMBERS WHO WERE WILLING
TO COME TO THIS MEETING, LEARN
MORE ABOUT COUNCIL 40 SES AND
HEPROCESS ANDEXPERTISE.
WITH THIS, I WOULD LIKE TO
INVITE DR. LAN LANGEVIN TO PROVE
ANY CONCLUDING REMARKS.
>> WELL, THANK YOU, ERCH, FOR
STAYING UNTIL THE END.
WE'RE SO HAPPY THAT SO MANY OF
YOU WERE ABLE TO COME IN PERSON
TODAY.
WE REALLY WANT TO CONTINUE THIS,
WE THINK THAT IT'S GREAT, AND
IT'S ALSO NICE TO HAVE THE
OPTION OF BEING ON ZOOM BECAUSE
WE UNDERSTAND THAT NOT --
SOMETIMES THERE ARE
CIRCUMSTANCES THAT DON'T ALLOW
US TO TRAVEL.
SO I THINK WE HAVE THE BEST OF
BOTH WORLDS HERE, AND I THINK
WE'RE LEARNING HOW TO PERFORM
THESE HYBRID MEETINGS IN WAYS
THAT ARE PRETTY, YOU KNOW,
SMOOTH, CONSIDERING, YOU KNOW,
FIRST COUPLE OF TIMES WE DID
THIS, WE WERE ALL KIND OF
NERVOUS, BUT I THINK TODAY I
DIDN'T FEEL NERVOUS.
I THINK WE DID PRETTY WELL.
SO I WANT TO REALLY THANK
MARTINA FOR LEADING MEETING SO
ABLY, AND ALL THAT HAVE
CONTRIBUTED TO MAKING THIS
MEETING A SUCCESS, ESPECIALLY
THE TEAM THAT TAKE CARE OF ALL
OF THE DETAILS, MAKE SURE THAT
WE DON'T RUN AFOUL OF OURSELVES.
SO YOU KNOW, THANK YOU, THANK
YOU, EVERYONE, AND WE WILL SEE
YOU NEXT TIME IN JANUARY, ALL
VIRTUAL BECAUSE OUR NEXT MEETING
IN WINTERTIME, WE DECIDED WE'RE
NOT TRYING TO DO THIS IN PERSON.
AND THEN BACK IN PERSON IN MAY.
SO THANK YOU AGAIN, AND HAVE A
GOOD SAFE TRIP HOME, THOSE OF
YOU GOING BACK HOME, AND WE'LL
SEE YOU NEXT TIME.
>> IF THERE ARE NO FURTHER
COMMENTS, THE 88TH MEETING OF
THE NCCIH ADVISORY COUNCIL IS
NOW ADJOURNED AND I'M GETTING TO
DO THIS.
THANK YOU.