Federal Support For Research Research Articles

Diabetes Research and the Public Good: Federal Support for Research on Type 1 Diabetes

Diabetes is one of the most common, rapidly-growing life-threatening medical conditions in the United States today: Nearly 26 million Americans had diabetes in 2011, up from 24 million in 2007; and epidemiologists estimate that by 2020, nearly 12 percent of Americans or 39.2 million people will have diabetes. Diabetes is the underlying cause of death of over 70,000 Americans a year and a contributor to an additional 160,000 deaths. Diabetes also exacts a large toll on the U.S. economy. This study analyzes these economic effects and assesses whether continuing the Special Diabetes Program, which funds research into treating and curing Type 1 Diabetes (T1D) through the National Institutes of Health, could contribute to meaningfully ameliorating the adverse economic effects associated with diabetes. We found that treating people with diabetes cost Americans $128 billion in 2007 or about 0.9 percent of GDP; and we estimate that by 2020, these medical costs will reach $410 billion or an estimated 1.8 percent of a projected GDP of $23.4 trillion in 2020. We further estimate that the productivity losses associated with missed work, permanent disabilities and premature deaths from diabetes and its complications totaled $65 billion in 2007 or 0.5 percent of U.S. GDP in that year. We further estimate that by 2020, these non-medical, economic costs will reach $196 billion or more than 0.8 percent of projected GDP in that year. The NIH currently provides $150 million per-year to support research into T1D, as well as additional funds through other grant programs, and we cannot know if this research will ultimately produce better treatments for the disease. However, after 15 years of NIH support for T1D research, the likelihood of additional breakthroughs should increase if the program is maintained. We further project that if such those advances reduce the incidence and severity of T1D by 10 percent by 2020, the savings in medical costs would exceed $2.6 billion per-year, including $1.9 billion in savings for Medicare and Medicaid, plus another $2.2 billion in annual non-medical economic savings, for a total savings of $4.8 billion a year. In this scenario, the advances would produce an annual rate of return of 163 percent year after year. We also estimate that if spillovers from these advances reduce the incidence and severity of Type 2 Diabetes (T2D) by 5 percent in 2020, that would save nearly $17.4 billion per-year in medical costs, including more than $12.3 billion per-year in Medicare and Medicaid costs, plus nearly $7.5 billion per-year in non-medical economic costs. Based on this analysis, we conclude that federal support for research in T1D should continue.

Landmark legislation, 1774-2012: major U.S. acts and treaties

The Second Edition of this renowned treasure trove of information about the most important laws and treaties enacted by the U.S. Congress now deepens its historical coverage and examines an entire decade of new legislation. Landmark Legislation 1774-2012 includes additional acts and treaties chosen for their historical significance or their precedential importance for later areas of major federal legislative activity in the over 200 years since the convocation of the Continental Congress. Brand new chapters expand coverage to include the last five numbered Congresses (10 years of activity from 2003-2012), which has seen landmark legislation in the areas of health insurance and health care reform; financial regulatory reform; fiscal stimulus and the Temporary Asset Relief Program; federal support for stem cell research; reform of federal financial support for public schools and higher education; and much more.

Destination First Grant

Destination First Grant

R&D ekes out an increase in FY 2015 budget request

With spending caps in place, President Obama proposes an off-budget fund to support additional R&D. NASA would ground a flying observatory, and DOE would sharply curtail its nonproliferation programs.

Opportunities and Challenges in Horticultural Science and Their Impact on the American Society for Horticultural Science

Opportunities and Challenges in Horticultural Science and Their Impact on the American Society for Horticultural Science

Firearm Injuries as a Public Health Issue

The full article is available online (Open Access). In 2011, firearm injuries accounted for 32 163 deaths in the United States, nearly as many as the 34 677 fatalities from motor vehicle traffic accidents. The total includes 19 766 suicides, 11 101 homicides, and 851 deaths from the accidental discharge of firearms... Yet federal law prohibits all Department of Health and Human Services (DHHS) agencies, including the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health, from using funds, “in whole or in part, to advocate or promote gun control.” The ban has applied to the CDC since 1996, and, more recently, to the entire DHHS. The meaning of the clause is not clear—preventing firearm injuries and gun control are related but are not synonymous—but it has effectively ended federal support of gun research. Kellerman and Rivara note that at the CDC, “no federal employee was willing to risk his or her career or the agency's funding to find out [what the clause meant]. Extramural support for firearm injury prevention research quickly dried up.” The federal government's neglect of firearm injuries as a public health issue is a national shame that should be urgently corrected. Reducing lives lost to gun violence is a public health issue about a major mechanism of fatal injury, not a Second Amendment to the US Constitution issue about “the right of the people to keep and bear arms.” Following the mass shooting of school children and educators at Sandy Hook Elementary School in Newtown, Connecticut, in December 2012, the CDC's website offered little information to people trying to understand and prevent such violent events. The CDC's “A-Z Index” has no listing for either “guns” or “firearms,” and the 24 topics on the “Injury, Violence & Safety” web page include explosion and blast injuries and fireworks, but not firearms. Indeed, federal health officials rarely speak about any aspect of firearms injury, violence, and safety. The mass killing in Connecticut shows once again the high price our society pays for ignoring legal reforms and other measures, including improvements in the mental health system, which would help to reduce gun violence and save lives.... These and many other long-overdue reforms do not require further study, only the political will to implement them. In 2011, Florida enacted a law that impeded physicians' ability to talk to their patients about the risks of guns, whether they own guns, and if so, how the guns are stored at home. Unfortunately, after a federal district court judge blocked enforcement, the state appealed, and the case is still pending. Physicians routinely ask patients potentially sensitive questions so they can help them to protect their health, and legislation should not inappropriately interfere with the physician-patient relationship. In the aftermath of the carnage at Sandy Hook, the Obama administration and Congress should act quickly to make the prevention of firearm injuries a pubic health priority....All federal health agencies, including the National Center for Injury Prevention and Control at the CDC, should regain the ability to fund research aimed at reducing injuries and deaths from firearms, regardless of whether some might label such research as “gun control.” Funding should be substantial for specific projects, as well as for research infrastructure and the training of investigators. President Obama should make a concerted effort to get the restrictive language about using federal funds “in whole or in part, to advocate or promote gun control” out of future appropriations bills.... President Obama should empower federal health officials to speak and provide leadership about firearm injuries and violence, the potentially intimidating legislative language in current law notwithstanding. The secretary of Health and Human Services, the Surgeon General, the director of the CDC, and the director of the CDC's National Center for Injury Prevention and Control should be allowed to protect the public health by working to reduce injuries and deaths from firearms, in the same way that they work to reduce injuries and deaths from poisonings, motor vehicle traffic accidents, and falls.... Research and policy efforts to prevent injuries can make a big difference. The federal government has invested billions of dollars to better understand motor vehicle fatalities, and hundreds of thousands of lives have been saved. However, as traffic fatalities have steadily declined, gun-related deaths are trending upward, from a recent low point in 2000. If the United States were to get serious about preventing firearms-related injuries and deaths, thousands of lives could be saved each year. We can wait no longer to protect the public health. This article is open access. Language: en

Between prevention and therapy: Gio Batta Gori and the National Cancer Institute's Diet, Nutrition and Cancer Programme, 1974-1978.

This paper explores the origins of the Diet, Nutrition and Cancer Programme (DNCP) of the National Cancer Institute (NCI) and its fate under its first director, Gio Batta Gori. The DNCP is used to explore the emergence of federal support for research on diet, nutrition and cancer following the 1971 Cancer Act, the complex relations between cancer prevention and therapeutics in the NCI during the 1970s, the broader politics around diet, nutrition and cancer during that decade, and their relations to Senator George McGovern’s select committee on Nutrition and Human Needs. It also provides a window onto the debates and struggles over whether NCI research should be funded by contracts or grants, the nature of the patronage system within the federal cancer research agency, how a director, Gio Gori, lost patronage within that system and how a tightening of the budget for cancer research in the mid-to-late 1970s affected the DNCP.

How Economics Shapes Science

How Economics Shapes Science

Modest but uneven R&D increases proposed for FY 2013

Uncertainty created by the Budget Control Act of 2011 clouds the outlook for federal science and technologyfunding. Some Department of Energyphysics programs face significant cuts.

Deliberations and recommendations of the Pediatric Emergency Mass Critical Care Task Force: Executive summary

Despite difficult challenges during responses to the terrorist attacks of September 11, 2001, Hurricane Katrina, and the 2009 Pandemic Influenza A/H1N1 and severe acute respiratory syndrome outbreaks, no North American emergency to date has overwhelmed intensive care unit (ICU) services on a widespread basis since the modern development of the field of critical care. However, planners have recognized that in a future public health emergency we may not be so fortunate. To deal with very large emergencies involving many patients whose survival depends on immediate access to intensive care, an international Task Force for Mass Critical Care proposed recommendations in January 2007 to extend critical care resources for the adult population, referred to as the Emergency Mass Critical Care (EMCC) approach (1–5). The EMCC approach triples critical care capabilities for a period of up to 10 days in a very large public health emergency by focusing on immediately lifesaving interventions, while delaying or forgoing less urgent care. Crisis standards of care in a large public health emergency would attempt to optimize population outcomes, rather than use unlimited efforts to maximize survival of each individual. Available resources would be substituted or adapted for equivalent or nearly equivalent unavailable resources. Resources would be conserved, reused, and reallocated to those patients most likely to benefit from them. Modest increases in stockpiles and major changes in the organization of care would be essential. While planners in the field acknowledge that mass critical care is a reasonable concept, we lack evidence that such an approach is feasible. However, failure to begin operational planning for mass critical care guarantees a failed response. As public health emergency planners begin to consider the EMCC framework, it is urgent that pediatric implications be detailed for integration into these developing plans. This supplement represents the discussions of a multidisciplinary panel convened by the Oak Ridge Institute for Science and Education (supported financially by the Centers for Disease Control and Prevention), and provides guidance for pediatric EMCC (PEMCC). Work of the PEMCC Task Force was directed by a 17-member Steering Committee selected on the basis of their expertise and experience, and included representatives from the Task Force for Mass Critical Care, World Federation of Pediatric Intensive and Critical Care Societies, American Academy of Pediatrics, American College of Critical Care Medicine, American College of Emergency Medicine, Royal College of Physicians (Canada), and National Commission on Children and Disasters, as well as several unaffiliated disaster preparedness experts. This Steering Committee led development of all manuscripts and selected individuals for the PEMCC Task Force. The full PEMCC Task Force comprised 44 experts from fields including bioethics, pediatric critical care, pediatric trauma and surgery, neonatology, obstetrics, general pediatrics, emergency medicine, pediatric emergency medicine, disaster preparedness and response, emergency medical services (EMS), infectious diseases, toxicology, military medicine, nursing (including critical care nursing), pharmacy, veterinary medicine, information sciences, public health law, maternal and child public health, and local, state, and federal government emergency planning and response agencies. Priority topics were organized on the basis of MEDLINE and Ovid database literature searches, bibliographies, state and federal government planning documents, after-action reports of recent medical responses to catastrophes, and through participation in local, state, and federal government working groups on hospital and disaster preparedness. Where evidence was available, it was utilized in formulating recommendations. Where evidence was lacking, recommendations represent expert opinion. Wherever possible, recommendations are consistent with and easily integrated into prior recommendations of the adult Task Force for Mass Critical Care. The Steering Committee produced draft outlines by synthesizing information obtained in the evidence-gathering process and convened October 6–7, 2009, to review and Vice President, Medical Affairs, British Columbia Children’s Hospital and Sunny Hill Health Centre; BCCH and UBC Global Child Health, Department of Paediatrics and Emergency Medicine, University of British Columbia, Child and Family Research Institute, Vancouver, British Columbia, Canada. The Pediatric Emergency Mass Critical Care Task Force meeting was supported, in part, by the Centers for Disease Control and Prevention. Disclaimer: The views expressed in this article are those of the authors and do not represent the official position of the Centers for Disease Control and Prevention. The author has not disclosed any potential conflicts of interest. For information regarding this article, E-mail: nkissoon@cw.bc.ca Copyright © 2011 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies

Share your expertise with Congress: Apply for an AGU Congressional Science Fellowship

Scientists interested in using their skills to work on problems of public importance should consider applying for an AGU Congressional Science Fellowship. The fellowship is an opportunity to directly influence high‐priority public policy issues such as natural hazards mitigation, mineral and energy resources, air and water quality, and federal support for basic research. Following an intensive 2‐week course on politics and the legislative process run by the American Association for the Advancement of Science, congressional fellows work for a year as staff members in the offices of a senator, representative, or congressional committee. Their duties as staff members may include writing legislation, advising on votes, organizing congressional hearings, meeting with lobbyists and constituents, and conducting legislative research, among other tasks.

Barriers to conducting clinical research in reproductive medicine: Australia and the United Kingdom

There are several major barriers to research in reproductive medicine in the United Kingdom and Australia. In Australia these mainly reflect income disparity between research and private practice whereas in United Kingdom they reflect the consequences of the economic downturn.

Canadian federal support for climate change and health research compared with the risks posed.

For emerging public health risks such as climate change, the Canadian federal government has a mandate to provide information and resources to protect citizens' health. Research is a key component of this mandate and is essential if Canada is to moderate the health effects of a changing climate. We assessed whether federal support for climate change and health research is consistent with the risks posed. We audited projects receiving federal support between 1999 and 2009, representing an investment of Can$16 million in 105 projects. Although funding has increased in recent years, it remains inadequate, with negligible focus on vulnerable populations, limited research on adaptation, and volatility in funding allocations. A federal strategy to guide research support is overdue.

True translational research: bridging the three phases of translation through data and behavior

Translational medicine has yet to deliver on its vast potential. Obstacles, or "blocks," to translation at three phases of research have impeded the application of research findings to clinical needs and, subsequently, the implementation of newly developed interventions in patient care. Recent federal support for comparative effectiveness research focuses attention on the clinical relevance of already-developed diagnostic and therapeutic interventions and on translating interventions found to be effective into new population-level strategies for improving health-thereby overcoming blocks at one end of the translational continuum. At the other end, while there is a preponderance of federal funding underwriting basic science research, further improvement is warranted in translating results of basic research into clinical applications and in integrating the basic sciences into the translational continuum. With its focus on the human and interactional aspects of health, medical practice, and healthcare delivery systems, behavioral medicine, itself a component of translational medicine, can inform this process.

Eyes on a Climate Prize: Rewarding Energy Innovation to Achieve Climate Stabilization

Stabilizing atmospheric concentrations of greenhouse gases at double their pre-industrial levels (or lower) will require emission reductions far in excess of what can be achieved with current or projected levels of technology at a politically acceptable cost. Substantial technological innovation is required if the nations of the world are to come anywhere close to proposed emission reduction targets. Neither traditional federal support for research and development of new technologies nor traditional command-and-control regulations are likely to spur sufficient innovation. Technology inducement prizes, on the other hand, have the potential to incentivize and accelerate the rate of technological innovation in the energy sector. This paper outlines the theory behind the use of inducement prizes to encourage and direct inventive efforts and technological innovation and identifies several comparative advantages inducement prizes have over traditional grants and subsidies for encouraging the invention and development of climate-friendly technologies. While no policy measure guarantees technological innovation, greater reliance on inducement prizes would increase the likelihood of developing and deploying needed technologies in time to alter the world’s climate future. Whatever their faults in other contexts, prizes are particularly well suited to the climate policy challenge.

Des enfants de la guerre : les centres de recherche universitaires canadiens, 1945–1960

This paper on Canadian university-based research centres and institutes in the immediate post-war period shows that the traditional view of federal government support for university research must be revised. We have found that centres financed by the Defence Research Board of Canada did not only perform fundamental research and that the federal agency relied on extra-scientific criteria in the distribution of its research funds. Beside enhancing recent work that show that universities have never been “ivory towers”, our study sheds knew light on the role and place of research centres in Canadian institutions of higher education. By responding to the knowledge needs of external constituencies, centres enable universities to access a broader range of research support. They also serve to buffer the academic core of the university from the distortions that those demands would undoubtedly cause if they had to be met within a departmental context.

Stem Cells: Growth and Development…in Policy

any scientists and patient advocates cheered earlier this summer when the National Institutes of Health (NIH) released new guidelines for human embryonic stem cell (hESC) research. The guidelines came after President Obama’s March 2009 executive order lifting the restrictions on federal support for research using embryonic stem cells. Obama’s directive revoked the Bush administration’s restrictions and funding ban on hESC research, which had limited scientists to using only 21 approved cell lines out of about 700 in existence. The directive also ordered the NIH to issue new guidelines for hESC research, which were released in July 2009. These new guidelines specify that NIH funding can be provided for research on hESCs derived from human embryos “that were created using in vitro fertilization for reproductive purposes [but] were no longer needed for this purpose,” and were donated by individuals who were fully informed about embryo treatment and gave their voluntary, written consent to use the embryos for research. The guidelines also stipulate that there can be no financial inducements for embryo donations, and that NIH-funded research must remain separate from privately funded research. Additionally, the NIH will establish a working group of scientists and ethicists to review existing cell lines, determine their eligibility for federal funding, and post those hESCs eligible for federal funds in an online registry. The presidential directive greatly expands the research potential in this field, but Obama noted in his remarks about the order that the “full promise of stem cell research remains unknown, and it should not be overstated.” Many advocates of stem cell research agree: Much more stem cell research will take place, yet much more policy work still awaits action. The spotlight is currently on the NIH working group. This is because until the NIH determines which cell lines are eligible for federal funding, hESC research remains on hold and, as of early September 2009, the NIH registry was still empty. Alan Smith, senior research scientist at Stemina Biomarker Discovery (a metabolomics company in Madison, Wisconsin), says that this void in the registry is a major concern for industry because it is slowing efforts to build new collaborations with other companies that are using yet-to-beapproved cell lines and to spur innovations in stem cell research. It is unclear when new stem cell lines will be entered into the registry—no timeline has been announced—but some researchers are concerned that the addition of the new lines may take years. Other pressing policy issues remain. Some analysts have suggested that the government focus on developing a coalition among all the entities that work on stem cells, perhaps by supporting the formation of geographic innovation hubs. Such a large-scale collaboration between universities and industries could be transformative for the field of regenerative medicine. Other experts, such as Jonathan Moreno, a senior fellow at the Center for American Progress, believe that the next grand policy challenge will be to develop guidelines for

Professor Michael J. Pikal: Scientist, family man, educator, colleague and friend

Professor Michael J. Pikal: Scientist, family man, educator, colleague and friend

The Alzheimer’s project

The Alzheimer’s project

Comparative International Water Research

The early decades of the 21st century will witness increased efforts to learn from water experiences and experiments in distant places and times. Water problems in different regions are increasingly linked through processes of globalization that drive the international diffusion of water technologies, policies, and water use patterns, as well as global climate change that has regional manifestations and teleconnections that cascade through regional hydrologic systems. Information technologies and international organizations will also facilitate comparative international water inquiry. But many areas, including wealthy countries such as the U.S., have been slow to draw upon international experience (Wescoat, Theobald, and Headington 2008). The U.S. National Research Council’s (2004) report on Confronting the Nation’s Water Problems: The Role of Research did not document significant federal support of international water research over the past 25 years, although there have been a variety of U.S. Aid for International Development, U.S. Environmental Protection Agency, and U.S. Army Corps of Engineers international research programs. A century earlier, U.S. water scientists traveled around the world searching for ways to address issues such as development of the Central Valley of California (Wescoat 2000). The problem is extensive – there are few comparisons of major flood hazards problems and programs underway on mainland rivers such as the Ganges-Brahmaputra, Indus, Mekong, Huang Ho, and Yangtze, not to mention the unprecedented Bangladesh Flood Action Plan. Yet there is growing evidence of informal, non-governmental, and historical lines of comparative research that offer promising directions (e.g., Duryog Nivaram on hazards, the Centre for Science and Environment on rainwater harvesting; and the International Rivers Network on basin development). Other sections of this journal issue include many examples of international research, so this section focuses on theoretical, methodological, and organizational trends – and vibrant research opportunities – for comparative research. The first section documents the implicit use of comparison in contemporary water research. The second section argues for a shift to explicit comparative research on critical water problems. The third and fourth sections show how longterm historical research and analogical methods contribute to that goal. The final section outlines how future research along these lines can inform water resource management adjustment, planning, and design.