NATIONAL INSTITUTES OF HEALTH
DEPARTMENT OF HEALTH AND HUMAN SERVICES
National Institute of Nursing Research (NINR)


FY 2011 Budget Table of Contents

FY 2011 Budget
Organization chart
Appropriation language
Amounts available for obligation
Budget mechanism table
Budget authority by program
Major changes in budget request
Summary of changes
Budget graphs
Justification narrative
Budget authority by object
Salaries and expenses
Authorizing legislation
Appropriations history
Detail of full-time equivalent employment (FTE)
Detail of positions
New positions requested

Organization chart for NINR. The chart shows 6 boxes, the Director box at the top with 4 beneath, one to the left. The box parrallel, and to the left is the National Advisory Council for Nursing Research. The Director of NINR is Dr. Patricia A. Grady, the Deputy Director is Dr. Mary E. Kerr. The Office of the Director has four reporting groups: Office of Administrative Management, the Division of Intramural Research, the Division of Extramural Affairs, and the Office of the Associate Director for Scientific Programs. Cheryl Stevens is the Executive Officer for Office of Administrative Management, Dr. Raymond Dionne is the Scientific Director for Division of Intramural Research, Dr. Denise Russo is the Extramural Director, and Dr. Mary E. Kerr is the Associate Director for Office of the Associate Director for Scientific Programs.

Top


NATIONAL  INSTITUTES OF HEALTH
National Institute of Nursing Research

For carrying out section 301 and title IV of the Public Health Services Act with respect to nursing research, [$145,600,000], $150,198,000 (Public Law 111-117, Consolidated Appropriation Act, 2010)

Top

National Institutes of Health
National Institute of Nursing Research

Amounts Available for Obligation 1/

Source of FundingFY 2009 ActualFY 2010 EnactedFY 2011 PB
Appropriation$141,879,000$145,660,000$150,198,000

Type 1 Diabetes    

0   00
Rescission000
Supplemental000
Subtotal, adjusted appropriation141,879,000 145,660,000 150,198,000
Real transfer under Director's one-percent transfer authority (GEI)-216,00000
Real transfer to the Global Fund to fight HIV/AIDS, Malaria and Tuberculosis    000
Comparative transfer to/from (specify)-45,000-60,0000
Comparative transfer under Director's one-percent transfer authority (GEI)216,00000
Comparative transfer to the Global Fund to fight HIV/AIDS, Malaria and Tuberculosis 000
Comparative transfer from DHHS for Autism   000
Subtotal, adjusted budget authority141,834,000 145,600,000 150,198,000
Unobligated balance, start of year000
Unobligated balance, end of year00 0
Subtotal, adjusted budget authority141,834,000 145,600,000 150,198,000
Unobligated balance lapsing-3,00000




Total obligations141,831,000 145,600,000 150,198,000
1/ Excludes the following amounts for reimbursable activities carried out by this account:
FY 2009 -$0 FY 2010 -$0 FY 2011 -$0

Top


NATIONAL INSTITUTES OF HEALTH
National Institute of Nursing Research
(Dollars in Thousands) Budget Mechanism -Total

MECHANISMFY 2009 Actual

FY 2009 Recovery Act Actual

FY 2010 Recovery Act Estimated

FY 2010 EnactedFY 2011 PBChange
Research Grants:No. Amount No.AmountNo.  Amount No.Amount No. AmountNo. Amount 
Research Projects:              
Noncompeting179$69,7830$031$11,059180$77,475180$79,8370$2,362
Administrative supplements(8)492(17)934(21)1,960(8)492(8)49200
Competing:           
    Renewal104,162000083,11283,154042
    New7026,1693713,23993,6975922,9515923,2630312
    Supplements000000000000
        Subtotal, competing8030,3313713,2394014,7566726,0636726,4170354
        Subtotal, RPGs259100,6063714,1734016,716247104,030247106,74602,716
SBIR/STTR93,394000093,49493,6060112
    Subtotal, RPGs268104,0003714,1734016,716256107,524256110,35202,828
Research Centers:            
    Specialized/comprehensive155,32843,14321,315165,317165,4190102
    Clinical research000000000000
    Biotechnology000000000000
    Comparative medicine000000000000
    Research Centers in Minority Institutions000000000000
        Subtotal, Centers155,32843,14321,315165,317165,4190102
Other Research:            
    Research careers323,2810000333,331343,4311100
    Cancer education000000000000
    Cooperative clinical research000000000000
    Biomedical research support000000000000
    Minority biomedical research support000000000000
    Other030000000200000-200
        Subtotal, Other Research323,5810000333,531343,4311-100
Total Research Grants315112,8194117,3166318,031305116,372306119,20212,830
             
Research Training:FTTPs FTTPs FTTPs FTTPs FTTPs    
    Individual awards782,5300000782,530782,6820152
    Institutional awards1486,46600001486,4661486,8540388
    Total, Training2268,99600002268,9962269,5360540
             
Research & development contracts0 3,999000003,96004,4620502
(SBIR/STTR)(0)(6)(0)(0)(0)(0)(0)(6)(0)(6)(0)(0)
 FTEs FTEs   FTEs   FTEs  FTEs  
Intramural research124,827017900124,899145,0562157
Research management and support4511,193015002013911,3733911,9420569
Construction 0 0     0 0 0 0
Buildings and Facilities 0 0     0 0 0 0
Total, NINR57141,834017,645018,23251145,60053150,19824,598

Top

National Institutes of Health
National Institute of Nursing Research
BA by Program
(Dollars in thousands)

 
FY 2007 Actual
FY 2008 Actual
FY 2009 Actual
FY 2009 Comparable
FY 2010 Enacted
FY 2011 PB
Change
Extramural Research DetailFTEs
Amount
FTEs 
Amount
FTEs 
Amount
FTEs 
Amount
FTEs 
Amount
FTEs 
Amount
FTEs 
 Amount
Self-Management, Symptom Management, and Caregiving 
 43,548
 
42,847
 
42,130
 
42,201
 
43,380
 
44,678
 
1,298 
Health Promotion and Disease Prevention 
 38,155 
 
40,073 
 
41,064 
 
41,134
 
42,283
 
43,549
 
 1,266 
Research Capacity Development 
 20,348
 
19,432
 
19,137
 
19,169
 
19,704
 
20,294
 
   590 
Technology Integration 
 10,939
 
10,368
 
11,638
 
11,658
 
11,984
 
12,343
 
   359
End-of-Life 
 11,490
 
11,502
 
11,632
 
11,652
 
11,977
 
12,336
 
   359
  
 
 
 
 
 
 
 
 
 
 
 
 
 
Subtotal, Extramural 
124,480 
 
 124,222
 
 125,601
 
125,814
 
 129,328
 
 133,200
 
3,872 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
Intramural research
10
3,348
9
3,854
12 
4,827 
12
4,827 
12
4,899 
14
5,056 
157 
Res. management & support
30
9,360
34
9,914
45 
11,235
45 
11,193 
39 
11,373
39 
11,942
569 
TOTAL
40
137,188
43
137,990
57
141,663
57
 141,834
51
145,600
53
150,198
2
4,598 
Includes FTEs which are reimbursed from the NIH Roadmap for Medical Research

Top


Major Changes in the Fiscal Year 2011 Budget Request

Major changes by budget mechanism and/or budget activity are briefly described below.  Note that there may be overlap between budget mechanism and activity and these highlights will not sum to the total change for the FY 2011 budget request for NINR, which is $4.598 million more than the FY 2010 enacted level, for a total of $150.198 million.

Research Project Grants (RPGs; +$2.716 million; total $106.746 million) :  NINR will continue to maintain the number of competing RPGs—67 awards in FY 2011, approximately the same number as in FY 2010.  About 180 noncompeting RPG awards, totaling $79.837 million will be made in FY 2011.   

Top


NATIONAL INSTITUTES OF HEALTH
National Institute of Nursing Research

Summary of Changes

FY 2010 estimate145,600,000
FY 2011 estimated budget authority150,198,000
Net change4,598,000
 2010 Current
Estimate Base
Change from Base
CHANGESFTEsBudget AuthorityFTEsBudget Authority

A. Built-in:

  1. Intramural research:

    
 a. Annualization of January 2010 pay increase $1,919,000 $12,000
 b. January FY 2011 pay increase   1,919,000  20,000
 c. Zero less days of pay (n/a for 2011)   1,919,000           0
 d. Payment for centrally furnished services     682,000 14,000
 e. Increased cost of laboratory supplies, materials, and other expenses  2,298,000 38,000
 Subtotal   84,000

 2. Research management and support:

    
 a. Annualization of January 2010 pay increase  $6,360,000  $38,000
 b. January FY 2011 pay increase  6,360,000   67,000
 c. Zero less days of pay (n/a for 2011)  6,360,000            0
 d. Payment for centrally furnished services   1,276,000    26,000
 e. Increased cost of laboratory supplies, materials, and other expenses   3,737,000    63,000
 Subtotal     194,000
      
 Subtotal, Built-in     278,000
CHANGESNo.AmountNo.Amount

B. Program:

  1. Research project grants:

    
 a. Noncompeting180 $77,967,000 $2,362,000
 b. Competing  67    26,063,000     354,000
 c. SBIR/STTR    9   3,494,0000     112,000
 Total256107,524,000  2,828,000

 2. Research centers

  16    5,317,0000     102,000

 3. Other research

  33    3,531,000   (100,000)

 4. Research training

226    8,996,000   540,000

 5. Research and development contracts

0    3,960,0000   502,000
 Subtotal, extramural   3,872,000
  FTEs FTEs 
6. Intramural research12  4,899,000     73,000 
7. Research management and support39  11,373,000   375,000
8. Construction                  0              0
9. Buildings and Facilities                   0              0
 Subtotal, program 145,600,000 4,320,000
Total changes51 24,598,000

Top


Fiscal  Year 2010 Budget Graphs

History of Budget Authority and FTEs:

Chart: Funding Levels by Fiscal Year. (Dollars in Millions). 2007: $137.3; 2008: $137.5; 2009: 141.8; 2010: $145.6; 2011: $150.2

Chart: FTEs by Fiscal Year. 2007: 40; 2008: 40; 2009: 57; 2010: 51; 2011: 53

Distribution by Mechanism:

Pie Chart: FY 2011 Budget Mechanism (Dollars in Thousands). Research Project Grants: 74%; Research Centers: 3%; Other Research 2%; Research Training: 7%; R&D Contracts: 3%; Intramural Research, 3%; RM&S: 8%;

Change by Selected Mechanism:

FY 2011 Estimate Percent Change FY 2010 Mechanism. Research Project Grants: 2.6%; Research Centers: 1.9%; Other Research: -2.8%; Research Training: -6.0%; R&D Contracts: 12.7%; Intramural Research: 3.7%; Res. Mgmt. & Support: 5.0%; B & F: 0.0%;

Top


Justification
National Institute of Nursing Research

Authorizing Legislation:Section 301 and title IV of the Public Health Service Act, as amended.
Budget Authority:

 

FY 2009
Actual

FY 2010 
Estimate

FY 2011 Estimate

Increase or Decrease

BA

$141,854,000

$145,600,000

$150,198,000

+$4,598,000

FTE

57 

51

53

+2

This document provides justification for the Fiscal Year (FY) 2011 activities of the National Institute of Nursing Research (NINR), including HIV/AIDS activities.  Details of the FY 2011 HIV/AIDS activities are in the "Office of AIDS Research (OAR)" Section of the Overview.  Details on the Common Fund are located in the Overview, Volume One.  Program funds are allocated as follows: Competitive Grants/Cooperative Agreements; Contracts; Direct Federal/Intramural and Other. 

Top

DIRECTOR'S OVERVIEW

The National Institute of Nursing Research (NINR) supports clinical and basic research to build the scientific foundation for clinical practice, prevent disease and disability, manage and eliminate symptoms caused by illness, and enhance end-of-life and palliative care.  The Institute’s scientific focus spans multiple disciplines and unites the biological and behavioral sciences to better understand the complex interactions between the physiological factors of health and disease and an individual’s knowledge, beliefs, and behavior.  NINR’s focus on science that spans the full disease spectrum and all stages of life enables the Institute to explore and address some of the most important challenges affecting the health of the American people.  These issues include:

  • Improving management of chronic illness, including in persons with co-morbid conditions;
  • Developing new strategies for preventive health that are culturally relevant at a time of increasing ethnic, racial, and cultural diversity, and in the face of persistent health disparities;
  • Enhancing our ability to translate emerging patient management technologies into clinical practice and home- and community-based use, and;
  • Developing the future research and clinical workforce at a time of increased demand across numerous sectors of the health care system. 

Confronting these challenges requires shifting to a patient management paradigm that is increasingly person-centered rather than disease-oriented, focuses on preventing the development of chronic illness rather than treating it, and supports the person as an active participant in his or her own health. The science supported by NINR advances this emerging model of health care.

Advancing the Goals of the NIH

Given the patient-centered focus of its science, as well as its strategic emphasis on improving clinical practice, NINR research has long sought to translate studies on new interventions into standard practice.  Among the strategies employed by NINR investigators to bridge the research-to-practice gap is the involvement of the community in the design and implementation of studies, known as community-based participatory research, or CBPR.  Recently, CBPR has been used by NINR investigators in developing and testing new programs to: improve asthma management in low-income communities; reduce HIV-risk behaviors in vulnerable populations; and, promote weight management for children in primary school settings.

NINR’s support of research empowers patients to manage their own care, prevents the development of long-term chronic illness, and establishes the evidence-base for more effective clinical practice positions NINR investigators to make significant contributions to many of the changes that will occur in the health care system in the coming years. In 2004, an NINR-supported researcher reported on a new program that partnered an interdisciplinary group of caregivers with older heart failure patients to ease their transition from clinical to home care.  In a randomized clinical trial, the program was successful in reducing re-hospitalization rates for this high-risk group of patients; in addition, it reduced total costs by about 38 percent or $3,500 per patient.

A fundamental part of NINR’s mission is developing the next generation of scientists. To support continued advancements in science and improvements in health, it is essential that the scientific workforce of the future be innovative, multidisciplinary, and diverse. NINR training programs are designed to achieve this vision. For example, the NINR Summer Genetics Institute (SGI) is an intensive summer training program that provides graduate students and faculty with a foundation in molecular genetics to enhance their research and clinical practice. Along with supporting numerous other pre- and post-doctoral research opportunities, NINR also participates in the NIH Graduate Partnerships Program (GPP), a doctoral fellowship training program that coordinates training and funding for doctoral students attending schools of nursing with established NINR-supported training programs.  Another program, the K22 Career Transition Award, funds postdoctoral research in two phases: an intramural phase at NIH, and an extramural phase to aid the transition to tenure-track research and faculty positions.  In addition, the BNC Fellowship, supported by the Bravewell Collaborative, NINR, and the NIH Clinical Center, trains individuals on how to address key issues in integrative health research.  Finally, many NINR-trained scientists will also serve as faculty in schools of nursing, responsible for educating future nurses that are vital to improving patient health and the effectiveness of the Nation’s health care. 

Broadly, NINR will continue to support innovative studies in research areas highlighted in its strategic plan, including: self-management, symptom management, and caregiving; health promotion and disease prevention; research capacity development; and, technology integration.  In addition, NINR will advance its leadership in end-of-life research efforts at NIH through its newly-established Office of Research on End-of-Life Science and Palliative Care, Investigator Training, and Education.  NINR also has begun the process of formulating its next strategic plan, scheduled for release in early FY 2012.  Input from stakeholders from across the research, academic, and health care communities, trans-NIH planning and priority setting processes such as the NIH Roadmap, Neuroscience Blueprint, and Pain Consortium, and public health concerns will continue to shape the future directions of NINR research. In FY 2011, NINR will continue to improve the health of the American people by supporting scientific discovery and fostering the development of the next generation of scientists.

Overall Budget Policy:  Investigator-initiated research projects, supporting new investigators, research training, and career development continue to be the Institute’s highest priorities.  The NINR will follow the NIH Budget policy for RPGs in FY 2010, which is to provide a 2 percent inflationary increase in noncompeting awards and a 2 percent inflationary increase in the average cost for competing RPGs.  NINR evaluates investigator-initiated grant applications for all research programs.  Scientific reviews are conducted, and the results are presented to the National Advisory Council for Nursing Research to determine the level of recommended support for the application, if any.  The level of support provided for Institute-initiated projects is also evaluated.  The Institute maintains a balance between solicitations issued to the extramural community and funding made available to support investigator-initiated projects.  Intramural Research and an increase of 3.2 percent and Research Management and Support received a 5 percent increase to help offset the cost of pay and other associated costs.  NINR will continue to support new investigators and to maintain the number of competing RPGs.

Funds are included in R&D contracts to support several trans-NIH initiatives, such as the Therapies for Rare and Neglected Diseases program (TRND), the Basic Behavioral and Social Sciences Opportunity Network (OppNet), and support for a new synchrotron at the Brookhaven National Laboratory, as well as increased support for other HHS agencies through the program evaluation set-aside.  

FY 2010 JUSTIFICATION BY ACTIVITY DETAIL

Program Descriptions and Accomplishments

Self-Management, Symptom Management, and Caregiving

Improving the quality of life of individuals in clinical, home, and community settings is a fundamental part of NINR’s mission.  NINR studies quality of life as a continuum composed of three key elements: self-management, symptom management, and caregiving.  The Self-Management, Symptom Management, and Caregiving program addresses the challenges of short- and long-term management of symptoms resulting from disease and disability by supporting research to: enhance the individual's role in managing disease; manage debilitating symptoms; and improve health outcomes for individuals and caregivers.  For example, given the millions of Americans who suffer from pain, there is need for research to explore the biological, genetic, and behavioral mechanisms that underlie acute and chronic pain.  To build on past advances in this area, NINR recently renewed, under the auspices of the NIH Pain Consortium, a promising initiative to explore the mechanisms and management of acute and chronic pain.  Other recent efforts in this program include studies to explore: novel approaches to improving self-management of diabetes in minority and underserved populations; interventions to reduce fatigue in cancer patients; and, the biological mechanisms of pain in premature infants. In addition, NINR currently sponsors an initiative to explore the biobehavioral interactions between co-occuring symptoms in patients with cancer or immune disorders. 

Budget Policy : The FY 2011 budget estimate for this program is $44.678 million, an increase of $1.298 million or 3 percent above the FY 2010 estimate.  NINR plans in FY 2011 to continue to address the many challenges and opportunities that exist in the areas of self-management, symptom management, and caregiving as part of a strategically balanced research portfolio.  A potential topic of exploration is the genomics of symptom management.

Health Promotion and Disease Prevention

The Health Promotion and Disease Prevention (HPDP) program studies the key biological, behavioral, and social factors that promote health and healthy behaviors and prevent the development of disease to achieve long-term, positive health outcomes in individuals of all ages.  Research supported under this activity seeks scientific discoveries of health predictors and prevention strategies across conditions, diseases, and settings, often focusing on minority and/or underserved communities.  Under this broad scope of research, efforts range from promoting behavioral changes in individuals and evaluating health risks in diverse communities to assessing issues of patient safety. NINR currently sponsors an initiative to support the integration of behavioral and sociocultural research to prevent HIV transmission and infection. Another current initiative focuses on health promotion in racial and ethnic minority males, a population that continues to experience disparate health outcomes.  Recent research projects under the HPDP program include studies to: test the effectiveness of an online intervention to promote bone health and prevent osteoporosis; understand the biobehavioral mechanisms underlying preterm birth in minority women; and, develop an intervention to promote physical activity in Latinas.   

Budget Policy : The FY 2011 budget estimate for this program is $43.549 million, an increase of $1.266 million or 3 percent above the FY 2010 estimate.  NINR plans in FY 2011 to continue to address the many challenges and opportunities that exist in the areas of health promotion and disease prevention as part of a strategically balanced research portfolio.  A potential research initiative would examine the neurobehavioral genetics of health behaviors.

Research Capacity Development

Through its Research Capacity Development program, NINR emphasizes research training and career development to cultivate the next generation of nurse scientists, as well as other biobehavioral researchers whose work advances nursing science.  Under this program, NINR supports graduate and post-graduate research fellowships and career development awards, including awards to trainees from under-represented and disadvantaged backgrounds.  These programs provide the next generation of scientists with the necessary, interdisciplinary education and research skills that will enable them to further expand the evidence-base for clinical practice, improve quality of life for those with chronic illness, and support preventative health.  This research provides the scientific evidence to support many of the reforms that will take place in the health care system in the coming years.  For example, NINR supports investigators under the NIH K99/R00 Pathway to Independence (PI) program, in which promising postdoctoral scientists receive both mentored and independent research support for up to five years.  Research projects currently underway include studies exploring genetic contributions to diabetes, bone disease and coronary heart disease.  Collectively, NINR training activities address the national shortage of nurses by contributing to the development of the nursing faculty needed to teach and mentor individuals entering the field.

Budget Policy : The FY 2011 budget estimate for this program is $20.294 million, an increase of $590 thousand or 3 percent above the FY 2010 estimate. This proposed level of funding will allow NINR to cover its current commitments as well as allow new training grants to be awarded in FY 2011.  NINR plans in FY 2011 to continue its commitment to developing the next generation of investigators and enhance overall research capacity in strategically important areas of research as part of a balanced program portfolio.  These efforts will continue to include awards to encourage earlier entry into research careers and to expand the interdisciplinary backgrounds of new investigators. 

Technology Integration

The Technology Integration program builds on previous accomplishments and seizes opportunities to employ new technologies (e.g., genomics and nanotechnology) that improve self-management, short- and long-term symptom monitoring, and the application of telehealth. Continuing its focus on adapting existing or developing new technologies, NINR-supported science links underserved populations with available resources to sustain healthy lifestyles and eliminate health disparities. Current activities include: developing devices to facilitate clinical decision support for care providers in hospitals and clinics; creating software modules that assist patients with making decisions on advanced care planning; assessing potential web-based and digital technologies for improving patient-provider communications; and designing and testing next-generation, shared ventilation systems for responding to pandemic influenza needs. 

Budget Policy : The FY 2011 budget estimate for this program is $12.343 million, an increase of $359 thousand or 3 percent above the FY 2010 estimate. In FY 2011, NINR plans to continue supporting research on the use and development of novel technologies that address current and future clinical care and patient management needs, and their incorporation into standard practice. This level of funding will allow NINR to cover current commitments and fund additional awards in this emerging area of research as part of a balanced portfolio. A research initiative in FY 2011 could examine the use of new technologies in promoting healthy behaviors. 

End-of-Life

The End-of-Life research program applies interdisciplinary biological, behavioral, and social science strategies to advance understanding of the challenges of a life-threatening illness with respect to the needs of the individual and their caregivers. The program explores the dynamic interactions of various factors that influence end-of-life and palliative care, and develops interventions to optimize patient and caregiver quality of life across care settings and cultural contexts. Specific research topics and activities include: improving awareness and relief of pain, suffering, and distressing symptoms through effective palliative care; understanding  and facilitating decision-making by patients, caregivers, and providers, including through the use of advance directives; promoting wellness and self-management of symptoms through meaningful health activities; and developing new investigators in this area of science. Across all of these activities, end-of-life and palliative care research addresses the cultural, spiritual, setting, age, and disease-specific factors that make each person's experience with life-threatening illness unique. In FY 2009, NINR released a new funding announcement--Interventions to Improve Palliative Care at the End of Life--calling for research to improve palliative care and enhance the quality of life for dying patients and their caregivers. Projects under this initiative investigate such topics as palliation in various populations and settings, as well as end-of-life care in complex organizations. 

Budget Policy : The FY 2011 budget estimate for this program is $12.336 million, an increase of $359 thousand or 3 percent above the FY 2010 estimate.  Given the potential and need for improving the quality of life of dying patients and their caregivers, NINR plans to expand end-of-life research efforts in FY 2011 to build upon continuing accomplishments in this program area.  The proposed level of funding will allow NINR to support existing commitments and fund additional awards in this area of research, as part of a balanced program portfolio.  Efforts in FY 2011 could focus on improving patient-provider communication in end-of-life care and building research capacity in palliative care and end-of-life research.

Portrait of a Program: Enhancing the End of Life and Palliative Care through Research

FY 2010 Level: $11.977 million
FY 2011 Level: $12.336 million  
Change:             $  .359 million

The life expectancy of the American people has reached a historic high, but along with increased life expectancy comes an increase in the number of people living with, and dying from, debilitating illnesses. There is an urgent need for ways to improve quality of life for those with life-limiting conditions through evidence-based palliative and end-of-life care. In 1997, the Director of NIH designated NINR as the lead NIH Institute for end-of-life research, providing an important opportunity for nursing science to lead the way in this crucial area.  In the ensuing years, NINR has sponsored numerous research initiatives to advance the field of end-of-life and palliative care science.

The Institute maintains a broad, transdisciplinary research portfolio in end-of-life and palliative care that extends across the human life span and focuses on building evidentiary knowledge to improve health care practice and increase public understanding of these important issues.  NINR investigators recently published studies that: tested interventions that effectively reduced stress in caregivers of family members with life-limiting illness; reported on a program that successfully converted hospice patients’ end-of-life treatment preferences into physician orders; and described organizational factors that influence the quality of hospice care in assisted-living facilities.  In addition, an emerging area of research focuses on the development of new health information technologies and biomedical innovations to better understand and improve end-of-life care. 

In 2009, NINR established the NINR Office of Research on End-of-Life Science and Palliative Care, Investigator Training, and Education (OEPC) to coordinate research efforts in these critical areas of science. The Institute also published a brochure entitled “Palliative Care: The Relief You Need when You’re Experiencing the Symptoms of Serious Illness” that explores the benefits of palliative care and answers common questions. The brochure is available at http://www.ninr.nih.gov. In FY 2011, NINR will continue to build research capacity and support efforts to develop effective intervention strategies for end-of-life and palliative care.

Intramural Research Program

The Intramural Research Program (IRP) supports research to understand the underlying biological mechanisms of a range of symptoms, their effect on patients, and how patients respond to interventions.  Recent scientific efforts include evaluating the efficacy of novel interventions for managing symptoms associated with cancer treatment, and exploring the molecular and genetic mechanisms that influence an individual's response to analgesic treatment for acute pain. The IRP also supports research training opportunities through programs such as the NINR Career Transition Award, the NINR Summer Genetics Institute, and by participating in the NIH Graduate Partnerships Program. In FY 2009, the NINR participated in two new interdisciplinary research collaborations.  The BNC Fellowship, supported by the Bravewell Collaborative, in collaboration with NINR and the NIH Clinical Center, trains individuals to address key issues in integrative medicine research and encourages multi-disciplinary collaboration to optimize health and healing for individuals and society. The Center for Neuroscience and Regenerative Medicine (CNRM) is a joint initiative between NIH and the U.S. Department of Defense with a mission to discover methods to better intervene and prevent the long-term consequences resulting from traumatic brain injury.  NINR is responsible for oversight of the CNRM Biomarkers Program, two of the nine currently approved Biomarkers projects, and patient recruitment.

Budget Policy : The FY 2011 budget estimate for this program is $5.056 million, an increase of $157 thousand or 3.2 percent above the FY 2010 estimate.  In FY 2011, this program will build on the recent accomplishments of the IRP and continue to support innovative research to address the scientific challenges of understanding and managing adverse symptoms such as acute and chronic pain.  This program will also continue to support important training and career development opportunities for innovative investigators.

Portrait of a Program: Advancing the Science of Symptom Research through Genetics

FY 2010 Level:     $4.899 million

FY 2011 Level:     $5.056 million

Change:     $0.157 million

It is difficult to overstate the impact that rapid advances in genetics research have had across the biomedical and behavioral sciences, and the science supported by NINR is no exception.  Across the Nation, NINR-supported investigators are using genetics research and tools to discover: biological markers that indicate an individual’s susceptibility to adverse symptoms such as pain; identify molecular targets for new drug therapies to manage illnesses and symptoms; and understand individual variations in ability to recover from the symptoms of events such as traumatic brain injury.  Incorporating genetics methodology into research on symptom management has been a priority for the Institute for many years, given the NINR’s ongoing strategic focus of expanding biobehavioral research.  For example, since 2000 the NINR Intramural Research Program (IRP) has sponsored the NINR Summer Genetics Institute (SGI).  This intensive summer training program provides graduate students and faculty with a foundation in molecular genetics to enhance their research and clinical practice. SGI graduates number more than 180, and are successfully building programs of research in genetics related to nursing; disseminating findings through publications; and integrating genetics content in nursing school curricula across the country.  In addition, researchers from the NINR IRP continue to publish important research findings that integrate comparative studies of variations in genetics, biomarkers and personal characteristics to understand individual variations in responses to analgesic treatments for acute and chronic pain.  Finally, a recently launched study from an NINR-supported extramural investigator is using advanced genetic techniques to discover genes associated with the development of oral mucositis, a painful condition experienced by many cancer patients undergoing chemotherapy.  This research could help identify patients at the greatest risk for developing mucositis and allow clinicians to tailor dosages to potentially spare cancer patients from developing this debilitating condition.

Research Management and Support

Research Management and Support (RMS) activities provide administrative, budgetary, logistical, and scientific support in the review, award, and monitoring of research grants, training awards and research and development contracts.  The functions of RMS also encompass strategic planning, coordination, and evaluation of the Institute's programs, as well as communication and coordination with other federal agencies, Congress, and the public.

Budget Policy : The FY 2011 budget estimate for this program is $11.942 million, an increase of $569 thousand or 5 percent above the FY 2010 estimate.  In FY 2011, NINR plans to continue addressing the challenges and opportunities that exist in strategically managing a research portfolio that addresses areas of science critical to public health.

Portrait of a Program: Recovery Act Implementation
Recovery Act Funding: $35.877 million

In FY 2009, NINR received $35.9 million under the Recovery Act.  Of this amount, $17.6 million was obligated in FY 2009 and $18.3 million will be obligated in FY 2010.  Much of this funding supports innovative new research projects deemed capable of making significant advances with two years of funding provided by the Recovery Act.  Some of this funding augments existing projects to potentially accelerate progress or expand the initial scope of research.  All funds support areas of science central to the NINR mission, including: enhancing palliative care and end-of-life research; improving the translation of research to practice; and advancing knowledge on the management of symptoms.  In addition, NINR’s Recovery Act funds support the development of the scientific workforce through summer research experiences for new scientists, faculty development opportunities, and the promotion of interdisciplinary research partnerships.

Under the NIH’s “Grand Opportunity” initiative supported by the Recovery Act, NINR also supports research to foster creative discoveries that will accelerate advancements to the 'science of health.' The 'science of health' is the pursuit of knowledge about health that centers on the nature and behavior of living systems interacting with their environments to promote healthy lifestyles, extend quality and years of life, and reduce or eliminate illness, disability, and health disparities. For example, under this program, one NINR-supported study addresses oral mucositis, a painful symptom experienced by many cancer patients undergoing chemotherapy due to their immune-compromised state. Mucositis presents as redness and/or ulcerative sores in the soft tissues of the mouth and can significantly impair chewing and swallowing. Using advanced genetic techniques, this study could yield a precise mucositis-predictive model that could effectively identify patients according to their risk for severe mucositis. This knowledge could allow health care providers to monitor and individually tailor doses of chemotherapeutic agents to potentially spare at-risk patients the development of this debilitating adverse symptom.

Top


NATIONAL INSTITUTES OF HEALTH
National Institute of Nursing Research

Budget Authority by Object

 FY 2010 EnactedFY 2011 PBIncrease or DecreasePercent Change
Total compensable workyears:    
Full-time employment51533.9
Full-time equivalent of overtime and holiday hours0000.0
Average ES salary$0$0$00.0
Average GM/GS grade12.212.20.00.0

Average GM/GS salary
$89,184$90,789$1,6051.8

Average salary, grade established by act of
July 1, 1944 (42 U.S.C. 207)
  $51,984  $57,910$5,92611.4
Average salary of ungraded positions  121,257  125,0153,758  3.1
     
OBJECT CLASSESFY 2010 EstimateFY 2011 Estimate Increase or DecreasePercent Change
Personnel Compensation:    
11.1 Full-time permanent$4,497,000$4,267,000($230,000)-5.1

11.3 Other than full-time permanent
  1,193,000  1,123,000    (70,000)-5.9

11.5 Other personnel compensation
      264,000      250,000     (14,000)-5.3
11.7 Military personnel      149,000      139,000     (10,000)-6.7

11.8 Special personnel services payments
       514,000       480,000(34,000)-6.6
Total, Personnel Compensation 6,617,0006,259,000(358,000)-5.4

12.0 Personnel benefits

  1,599,000  1,514,000  (85,000)  -5.3
12.2 Military personnel benefits       63,000       59,000   (4,000) -6.3
13.0 Benefits for former personnel0000.0
Subtotal, Pay Costs 8,279,000 7,832,000 (447,000) -5.4
21.0 Travel and transportation of persons194,000243,00049,000 25.3
22.0 Transportation of things  12,000  15,000  3,00025.0

23.1 Rental payments to GSA
0000.0

23.2 Rental payments to others
103,000117,00014,00013.6

23.3 Communications, utilities and
miscellaneous charges
69,00089,00020,00029.0

24.0 Printing and reproduction
33,00042,0009,00027.3

25.1 Consulting services
50,00064,00014,00028.0

25.2 Other services
1,662,0002,047,000385,00023.2

25.3 Purchase of goods and services from
government accounts
8,779,0009,475,000696,0007.9
25.4 Operation and maintenance of facilities107,000139,00032,00029.9

25.5 Research and development contracts
66,000355,000289,000437.9

25.6 Medical care
0000.0

25.7 Operation and maintenance of equipment
59,00072,00013,00022.0
25.8 Subsistence and support of persons0000.0
25.0 Subtotal, Other Contractual Services 10,723,000 12,152,000 1,429,000 13.3
26.0 Supplies and materials259,000301,00042,000 16.2

31.0 Equipment
560,000669,000109,000 19.5 

32.0 Land and structures
0000.0

33.0 Investments and loans
0000.0

41.0 Grants, subsidies and contributions
125,368,000128,738,0003,370,0002.7
42.0 Insurance claims and indemnities0000.0
43.0 Interest and dividends0000.0
44.0 Refunds0000.0
Subtotal, Non-Pay Costs 137,321,000 142,366,000 5,045,000 3.7
Total Budget Authority by Object 145,600,000 150,198,000 4,598,000 3.2
Includes FTEs which are reimbursed from the NIH Roadmap for Medical Research

Top


NATIONAL INSTITUTES OF HEALTH
National Institute of Nursing Research

Salaries and Expenses

OBJECT CLASSESFY 2010 
Enacted
FY 2011
PB
Increase or
Decrease
Percent
Change
Personnel Compensation:     
Full-time permanent (11.1)$4,497,000$4,267,000($230,000)-5.1
Other than full-time permanent (11.3)  1,193,000  1,123,000(70,000)-5.9 
Other personnel compensation (11.5)264,000250,000(14,000)-5.3
Military personnel (11.7)149,000139,000(10,000)-6.7 
Special personnel services payments (11.8)514,000480,000(34,000)-6.6
Total Personnel Compensation (11.9) 6,617,000 6,259,000 (358,000) -5.4
Civilian personnel benefits (12.1)1,599,0001,514,000(85,000)-5.3
Military personnel benefits (12.2)     63,000     59,000(4,000)-6.3
Benefits to former personnel (13.0)0000.0
Subtotal, Pay Costs 8,279,000 7,832,000 (447,000) -5.4
Travel (21.0)194,000243,000   49,00025.3
Transportation of things (22.0)  12,000  15,000     3,00025.0
Rental payments to others (23.2)103,000117,000   14,00013.6
Communications, utilities and
miscellaneous charges (23.3)
 69,000  89,000   20,00029.0
Printing and reproduction (24.0)33,000  42,000     9,00027.3
Other Contractual Services:     
Advisory and assistance services (25.1)50,00064,000  14,00028.0
Other services (25.2)1,662,0002,047,000385,00023.2
Purchases from government accounts (25.3)4,920,0005,408,000488,000 9.9
Operation and maintenance of facilities (25.4)  107,000  139,000  32,00029.9 
Operation and maintenance of equipment (25.7)    59,000    72,000  13,00022.0
Subsistence and support of persons (25.8)0000.0
Subtotal Other Contractual Services 6,798,000 7,730,000 932,000 13.7
Supplies and materials (26.0)   259,000   301,000   42,00016.2 
Subtotal, Non-Pay Costs   7,468,000 8,537,0001,069,00014.3 
     
Total, Administrative Costs 15,747,000 16,369,000    622,000   3.9

Top


NATIONAL INSTITUTES OF HEALTH
National Institute of Nursing Research

Authorizing Legislation

 PHS Act /Other CitationU.S. Code Citation2010 Amount AuthorizedFY 2010 Estimate2011 Amount AuthorizedFY2011 PB
Research and InvestigationSection 30142§241Indefinite
$145,600,000
Indefinite
$150,198,000
National Institute of Nursing ResearchSection 402(a)42§281IndefiniteIndefinite
       
Total, Budget Authority   145,600,000 $150,198,000

Top


NATIONAL INSTITUTES OF HEALTH
National Institute of Nursing Research

Appropriations History

Fiscal YearBudget Estimate to CongressHouse AllowanceSenate AllowanceAppropriation
2002117,686,000116,773,000125,659,000120,451,000
Rescission        (23,000)
2003129,768,000131,438,000131,438,000131,438,000
Rescission      (854,000)
2004134,579,000134,579,000135,579,000135,555,000
Rescission      (831,000)
2005139,198,000139,198,000140,200,000138,198,000
Rescission   (1,126,000)
2006138,729,000138,729,000142,549,000138,729,000
Rescission   (1,387,000)
2007137,342,000136,550,000137,848,000137,404,000
Rescission                  0
2008137,800,000139,527,000140,456,000139,920,000
Rescission(2,244,000)
Supplemental 
2009137,609,000142,336,000141,439,000141,879,000
Rescission                  0
2010143,749,000146,945,000144,262,000145,660,000
Rescission                  0
2011150,198,000   
1/ Reflects enacted supplementals, rescissions, and reappropriations.  
2/ Excludes funds for HIV/AIDS research activities consolidated in the NIH Office of AIDS Research.  

Top


NATIONAL INSTITUTES OF HEALTH
National Institute of Nursing Research

Details of Full-Time Equivalent Employment (FTEs)

OFFICE/DIVISIONFY 2009 ActualFY 2010 EnactedFY 2011 PB
Office of the Director55
Office of Administrative Management131313
Division of Intramural Research121214
Office Associate Director of Scientific Programs27 2121
    
Total57 5153
Includes FTEs which are reimbursed from the NIH Roadmap for Medical Research
FTEs supported by funds from Cooperative Research
and Development Agreements
(0)(0)(0)
FISCAL YEARAverage GM/GS Grade
200712.2
200812.2
200912.1
201012.2
201112.2

Top


NATIONAL INSTITUTES OF HEALTH
National Institute of Nursing Research

Detail of Positions

GRADEFY 2009 ActualFY 2010 EnactedFY 2011 PB
Total, ES Positions000
Total, ES Salary000
GM/GS-1555
GM/GS-1420 1618
GM/GS-13866
GM/GS-12677
GM/GS-11233
GM/GS-10133
GM/GS-91177
GM/GS-8100
GM/GS-7111
GM/GS-6122
GM/GS-5000
GM/GS-4111
GM/GS-3000
GM/GS-2000
GM/GS-1000
Subtotal575153
Grades established by Act of July 1, 1944 (42 U.S.C. 207):   
Assistant Surgeon General000
Director Grade000
Senior Grade111
Full Grade000
Senior Assistant Grade000
Assistant Grade000
Subtotal111
Ungraded181818
Total permanent positions616161
Total positions, end of year808080
Total full-time equivalent (FTE)
employment, end of year
575153
Average ES salary000
Average GM/GS grade12.112.212.2
Average GM/GS salary90,14889,18490,789
Includes FTEs which are reimbursed from the NIH Roadmap for Medical Research.  

Top


NATIONAL INSTITUTES OF HEALTH
National Institute of Nursing Research

New Positions Requested

 
FY 2011
  GradeNumberAnnual
Salary
Clinical DirectorAD-680 1  $86,800
Special Assistant to the DirectorGS-151  123,758 
    
Total Requested 2
$210,558           

Top