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Minutes of the National Advisory Council for Nursing Research, January 17-18, 2012

Department of Health and Human Services
National Institutes of Health
National Institute of Nursing Research
Minutes of the National Advisory Council for Nursing Research

January 17–18, 2012

The 76th meeting of the National Advisory Council for Nursing Research (NACNR) was convened on Tuesday, January 17, 2012, at 1:00 p.m. in Conference Room 6C, Building 31, National Institutes of Health (NIH), Bethesda, Maryland. The first day of the meeting was an open session and adjourned that same day at approximately 5:08 p.m. The closed session of the meeting, which included consideration of grant applications, was convened on Wednesday, September 21, 2011 at 9:00 a.m. and continued until adjournment at 1:00 p.m. Dr. Patricia A. Grady, Chair, NACNR, presided over both sessions of the meeting.



Dr. Grady called the 76th meeting of the NACNR to order, welcoming all Council members, visitors, and staff. She announced that Drs. Marion Broome, Stanley Finkelstein, Diana Lake, and Marla Salmon would be rotating off the Council, and she noted that NINR would miss not only their scientific expertise, but also the broad experience these members have brought to the Council.

Conflict of Interest and Confidentiality Statement

Dr. Bryan noted that the NACNR meeting would be taped for purposes of the minutes and that tapes would be destroyed once the minutes are completed. She referred Council members to the Conflict of Interest and Confidentiality Statement. Briefly, Council members should determine whether they have a tangible role in the proposal, a vested interest in the proposal (for example financial gain), or an appearance of a conflict in deciding whether they should review applications. To avoid conflicts of interest, or even the perceptions of such, Council members should leave the room during a discussion of applications submitted by their institutions, family members, close associates, or persons with whom they have had longstanding differences. The Conflict of Interest and Confidentiality Statement also notes that material furnished for review purposes and discussion during the closed session is privileged and can only be discussed with NINR staff under appropriate circumstances.

Dr. Bryan added that she would provide additional instructions on conflicts of interest and confidentiality during the closed session on January 24. She also reminded Council members of their status as special Federal employees while serving on the Council and that as special employees, Council members cannot engage in lobbying activities while receiving payment from the government.

Minutes of the Previous NACNR Meeting

Council members received the minutes of the September 20–21, 2011 NACNR meeting by email. A motion to accept these minutes was forwarded, seconded, and approved unanimously. Council members were asked to forward comments, corrections, or changes identified at a later time to Drs. Grady or Bryan.

Dates of Future Council Meetings
Council members were asked to confirm their calendars for the following meeting dates and to contact Drs. Grady and Bryan about any conflicts or expected absences.

May 15–16 (Tuesday–Wednesday)
September 18–19 (Tuesday–Wednesday)

January 22–23 (Tuesday–Wednesday)
May 21–22 (Tuesday–Wednesday)
September 17–18 (Tuesday–Wednesday)

II.                REPORT OF THE DIRECTOR, NINR—Dr. Patricia Grady, Director, NINR

The Director’s report focused on the NIH and NINR budgets and on activities and news occurring within NINR, NIH, and the Department of Health and Human Services (HHS) since the last Council meeting.

Budget Update—Dr. Grady reported that an omnibus budget is now in place for 2012 and that the budget for NINR and NIH reflect small increases over 2011. Dr. Grady also indicated that the increases in the NINR budget over the past 11 years have been slightly above the mean increase for NIH overall.

Dr. Grady reviewed NINR pattern of expenditures and noted that there were no major changes. Extramural programs consume the largest proportion of NINR funds in the form of research project grants, centers, and P01 awards. “Other research,”  2% , research and development 3%, and research management and support 10%. Training remains a sizable percentage of the budget, at 6%, but because NINR has committed to increasing the amount of stipends, the number of awards will decrease. The intramural program consumes 4% of the NINR budget.

HHS News—The Department has a new initiative called Partnership for Patients Initiative to Improve Hospital Care, which provides funds and implements trial programs across agencies to improve patient care across the country. Another initiative focuses on efforts to speed the use of health information technology (IT) to lower costs, improve quality, and create jobs. This includes promotion of the electronic health record. Increasing use of the electronic health record can facilitate the standardization of health information on patients across the country, and researchers can access standard datasets, with appropriate permissions, to examine, for example, access to care or responses to interventions.

HHS is also focusing on its responsibilities in implementing the Affordable Care Act (ACA). The ACA focuses not only on prevention and improved access to primary care, but also on quality improvement. Several agencies within the Department, including the Centers for Medicare and Medicaid Services, have been charged with determining the best way to measure quality and its improvement. Another ACA initiative focuses on lessons learned from the successes in infection control and ways to apply these lessons in fighting chronic diseases. Increasing community efforts are focusing on ways to address chronic diseases early on.

Other recent HHS activities include the announcement of refined survey standards to eliminate health disparities and the allocation of $224 million to support evidence-based home visiting programs to help parents and children.

NIH News—Dr. Grady reported that the omnibus bill includes language officially establishing the National Center for Advancing Translational Sciences (NCATS). As a result, the National Center for Research Resources no longer exists, and the shifting of programs and infrastructure is under way. The legislative language conveys the intent that NCATS will facilitate and complement, but not duplicate, translational research activities that are already ongoing across NIH. NCATS should reinforce, not reduce, NIH’s commitment to basic research.

Dr. Grady reported that Secretary of State Hillary Rodham Clinton visited NIH in October 2011. During this visit, Senator Clinton expressed that because of increased information and advances in both prevention and treatment, the dream of an AIDS-free generation is now achievable. Dr. Grady also reported that Ambassador Eric Goosby, United States Global AIDS Coordinator, spoke at NIH. In his remarks, Dr. Goosby discussed the President’s Emergency Plan for AIDS Relief, which has combined research, translation, education, and intervention to move the science from the laboratory to programs and into people’s lives.

Dr. Grady also reported that:

  • The trans-NIH Pain Consortium, in which NINR participates, is accepting proposals to develop Centers of Excellence in Pain Education. Dr. Grady encouraged all attendees  to apply for these Center grants, which will include efforts to train the next generation of researchers.
  • The NIH Clinical Center has co-sponsored a conference of the International Association of Clinical Research Nurses.
  • NIH is working with the Centers for Disease Control and Prevention on the National Diabetes Education Program, which aims to move information from scientific journals and textbooks to the people who need it.
  • The Census Bureau has published a report describing the oldest Americans. This report notes that, compared with older people 10 years ago, older people today are living more active and interactive lives, are more activist, and demanding better treatment and care.
  • The NIH Sleep Disorders Research Plan has been updated. This plan outlines priorities in sleep research for the next 5 years, and it is of interest to NINR, which has a sleep research program that has had a high impact. Dr. Grady encouraged Council members and attendees to review the updated plan.
  • NIH, and in particular the National Institute of Environmental Health Sciences (NIEHS), has launched a research program to explore health effects from climate change. NIEHS has been involved in responding to the Gulf Coast Oil Spill and other disasters over the years, and this research program marks a shift from a reactive to proactive stance.
  • Dr. Chris Kaiser, formerly of Harvard University, has been appointed Director of the National Institute of General Medical Sciences (NIGMS). Although he will not start officially until Spring, he has long been active at NIH, having been a member of the NIGMS Advisory Council and on several review committees. Dr. Grady reminded Council members that NIGMS is the basic science Institute at NIH, that it houses several special training programs such as the Minority Access to Research Careers program and programs devoted to emergency medicine, and that it is the only Institute that does not have an intramural research program.
  • Dr. Pinn, Founding Director of the NIH Office of Research on Women’s Health, retired at the end of 2011. Dr. Grady, who is serving on the search committee for a new director, invited ideas on potential candidates from Council members.

NINR News—Dr. Grady noted that 2011 was a busy year for NINR as it celebrated its 25th anniversary. The silver anniversary celebrations culminated in a concluding scientific symposium, at which Dr. Rita Caldwell served as the master of ceremonies and NINR presented a plaque to Senator Daniel Inouye, which has long supported NINR and NIH. The plaque was accepted on the senator’s behalf by Lieutenant Colonel Maureen Charles. Dr. Grady noted the outstanding coverage of the symposium by Nursing Spectrum. She also noted that Dr. Marjana Tomic-Canic, who spoke at the symposium, will be at the NIH Director’s Wednesday Afternoon Lecture Series speaker on March 7, 2012, at 3:00 p.m.

Council members received a copy of the new NINR strategic plan, which is now available on the NINR web site. The strategic plan has proven popular, with almost 30,000 downloads within the first 2 to 3 weeks after the plan was posted. NINR has also released a Spanish-language version of its Palliative Care brochure, which is also popular. Council members were provided a web link to the brochure.

Dr. Grady also reported that NINR has expanded the 2012 Graduate Partnership Program (GPP), where predoctoral students complete coursework with their respective institutions and conduct research both with their faculty and NINR researchers. Dr. Grady emphasized that NINR works with institutions to provide unique research experiences. Students from any qualified doctoral program are eligible; previously only students from institutions that held a T32 grant were eligible. Students in the program can work in NINR or in other programs on the NIH campus. Dr. Grady noted that alumni of the GPP have done well and achieved early successes, and she encouraged Council members to check the web site to learn about changes to eligibility rules. She also noted a YouTube video in which Dr. Dawn Betters, an alumna of the GPP, describes the program and what she liked about it. Applications for the 2012 GPP are due January 31, 2012.

Dr. Grady announced that the NINR Summer Genetics Institute will take place June 4–29, 2012. NINR is also offering a symptom boot camp on fatigue and sleep research methodologies. This is the third in a series of intensive camps that assist students in learning state-of-the-art methodologies for symptom measurement. The first two boot camps focused on pain. The boot camp on fatigue and sleep will take place July 23–27, 2012 on the NIH campus, and it can accommodate approximately 50 students. However, NINR has had waiting lists for its boot camps in the past. Dr. Grady noted that the faculty for the sleep and fatigue boot camp come from several NIH Institutes or Centers and that the boot camps and Summer Genetics Institute continue to be popular. Many well-known sleep researchers will serve as guest lecturers at the boot camp.

Dr. Grady closed her report by noting new staff appointments. Dr. Lynda Hardy has joined the Office of Extramural Programs and will manage the Extramural AIDS Program. She brings a long history of expertise in research administration and AIDS research. Drs. Mary and Marguerite Engler have joined the NINR Intramural Research Program. Both have had successful research careers, most recently at the University of California, San Francisco, and bring an expertise in mentorship and cardiovascular health research. Dr. Grady informed Council members that a handout on NINR outreach activities was available and invited them to visit the NINR web page.

III.             BEHAVIORAL AND SOCIAL SCIENCE RESEARCH—Dr. Robert Kaplan, Director, Office of Behavioral and Social Science Research (OBSSR)

Dr. Kaplan began his presentation with an introduction to OBSSR. This Office, which is part of the Division of Program Coordination, Planning, and Strategic Initiatives within the NIH Office of the Director, coordinates behavioral and social science research (BSSR) across the NIH campus. A substantial amount of such research, constituting approximately $3.1 billion in research funding, is ongoing at NIH, and NINR is one of the leading Institutes in this area. Dr. Kaplan noted that he looked forward to a continuing partnership with NINR.

Over the next few years, OBSSR will be planning for the next generation of BSSR. One theme in this planning is the next generation of measurement and data. The way research is conducted will likely change in the coming decades, with a shift toward more analysis of existing datasets. Such a shift will be facilitated through initiatives such as mHealth, electronic health records, systems science, masses of data, and new methods for analysis. However, “Big Data,” where datasets will contain hundreds of thousands of data points, will present a challenge. Many researchers will not know how to approach such datasets, and the statistical methods learned in the past will no longer be relevant. OBSSR is working to learn more about new analytical techniques and pattern recognition, and it is working with other groups to determine what standard behavioral and social data should be collected. 

Dr. Kaplan pointed to health care delivery as another them in the Office’s planning for the next generation of BSSR. He noted that the health care system has evolved from one that first focused on acute care and infectious disease to the current era of focusing on chronic care. The next era in health care will integrate public health, and the directions of BSSR will depend on an understanding of how health care is restructured. Dr. Kaplan also noted that OBSSR is also focused on education and training for the next generation of scientists. He pointed out that the Association of American Medical Colleges aims to revise the medical school curriculum, that the new Medical College Admission Test® will include a stronger emphasis on behavioral and social science, and that future Ph.D. programs will include a focus on data analysis.

Dr. Kaplan then turned his remarks to health care costs and health outcomes. As noted by the President, health care costs will form the largest controllable part of the nation’s debt and deficit and will have important implications for all aspects of the economy. However, as noted by Congressional Budget Office Director, the Institute of Medicine, and many other groups, about $700 billion is spent each year on health services that produce no benefit in terms of outcomes. How to identify those services will be a challenge.

It is well known that the cost of health care varies across geographic regions. For example, health care spending in San Diego is twice as much as that in New Mexico, with no evidence of better outcomes in San Diego. In a better-known example, health care spending in Boston is 80% higher than that in New Haven, again with no evidence of better outcomes. As Dr. Kaplan and colleagues at Dartmouth College found when constructing an atlas of health care, spending on health care is much higher in Los Angeles than in San Diego, although the two cities are similar demographically and insurance coverage is similar.

Further work by Dr. Kaplan and colleagues within the Dartmouth group suggests that health care costs in Los Angeles are not higher simply because there are more doctors, more use of health care services, differences in socioeconomic status, or a sicker population in Los Angeles.  Dr. Kaplan’s work suggests instead that the differences in costs can be explained partly by the use of inpatient end-of-life care in Los Angeles, versus the use of hospice care in San Diego, and by supplier-sensitive decision-making. Thus many of the explanations for the differences between Boston and New Haven do not apply to the differences between Los Angeles and San Diego.

IV.              FINANCIAL CONFLICT OF INTEREST—Dr. Sally Rockey, Deputy Director for Extramural Research, NIH

Dr. Rockey described updates to NIH and HHS regulations governing financial conflicts of interest. She emphasized that, contrary to concerns that were expressed when the initial regulations were implemented, the Department and NIH does not wish to inhibit relationships between academic investigators and industry. The agencies recognize that academic researchers conduct the majority of basic research underpinning advances in medicine and that industry depends and builds on basic research as it develops drugs, therapeutics, and devices. However, the agencies do wish to maintain objectivity in research, because doing so preserves public trust, provides transparency, and preserves the integrity of investigators, data, institutions, NIH, and HHS.

Thus, in 1995, NIH published regulations for grants and contracts to promote objectivity in research. The standards in these regulations provide a reasonable expectation that the design, conduct, and reporting of research supported by the Public Health Service is free from bias resulting from investigators’ financial conflicts of interest. Significant financial conflict of interest is defined as a financial interest of the investigator, and those of his or her spouse and dependent children, that reasonably appear to be related to the investigator’s institutional responsibilities and consists of interests identified as significant financial interest in the regulations. The regulation does not address institutional conflicts of interest, but it does hold institutions responsible for implementing conflict of interest policies, identifying and evaluating potential conflicts, and managing and reporting conflicts when they occur. A financial conflict of interest is an investigator’s significant financial interest determined by the institution to directly and significantly affect the design, conduct, or reporting of Public Health Service-funded research.

Dr. Rockey addressed common misconceptions about financial conflicts of interest. She pointed out, for example, that financial interest does not always constitute misconduct or a conflict of interest. She also noted that NIH does not manage investigators’ financial interest; instead, NIH ensures that institutions are managing potential conflicts of interest. However, in 2008, after the HHS Office of the Inspector General released a report on extramural financial conflicts of interest, concerns from the media, a request from congress that NIH monitor its grants more closely, and legislative language requiring NIH to strengthen its regulation, NIH issued an advanced notice of proposed rule-making, and based on responses to this and a subsequent notice, NIH published a final rule in August 2011. Following publication of the rule, institutions have 1 year to implement changes in reporting. Institutions must revise their conflict-of-interest policies, establish procedures in compliance, and train investigators, and NIH must provide best practices and examples.

For the most part, the regulation framework remains the same. However, the minimal threshold for a significant financial conflict of interest is now $5,000 in payment and equity interest, including equity interest in non-publicly traded entities. This threshold is a decrease from the previous $10,000 threshold. Compensation from seminars, lectures, teaching, service on advisory or review panels, institutions of higher education, academic teaching hospitals, medical centers, or research institutions is excluded from this threshold. In addition, investigators must now disclose all significant financial interests related to their responsibilities, not just the interests related to their research alone. Institutions, not investigators, are responsible for determining whether a financial interest is related to investigators’ responsibilities, and institutions are required to report more detail related to identified conflicts of interest.

Dr. Rockey also reported a separate development, the Sunshine Act, which requires industry to post on public web sites the amount of payments to physicians, as well as a requirement by NIH for institutions to post their policies on their web sites. If institutions identify a financial conflict of interest, they must post the significant financial interest that generated that conflict, or they must make that information available upon request. Privacy and administrative concerns can be considered in determining how to make that information available. In addition, NIH has added that reimbursed travel be classified as a significant financial interest. Dr. Rockey added, however, that NIH is providing clear guidance on the revised regulation and allowing institutions flexibility in developing policies.

Dr. Rockey concluded by providing Council members with additional resources. She invited them to visit and subscribe to her blog, Rock Talk, and to follow her on Twitter.

Questions, Comments, and Discussion included:

A clarification that the Sunshine Act, which was passed as part of health care reform, is separate from the revised NIH rule. Dr. Rockey further noted that the Act targets industry’s payments to physicians and might not apply to many NIH grantees. She also clarified that if results of clinical trials are pending, actual payments do not have to be posted online. A question about when changes in the policies can be evaluated; Dr. Rockey responded that new policies will be posted by the end of 2012 and that NIH will evaluate differences between the old and new rule, the kinds of conflicts that occur, and best practices in managing conflicts. Those best practices will be disseminated to the community.
A question of how the 12-month reporting period is determined. Dr. Rockey responded that this might depend on the anniversary of the grant but that institutions can try to fit it into their general reporting schedule. Each grant should have had a report by its anniversary.

V.                 OPPNET UPDATE—Dr. Linda Weglicki, Chief, Office of Extramural Programs, NINR

Dr. Weglicki presented the progress and future goals of the Opportunities in Networking (OppNet), an NIH-wide initiative whose mission is to create shared opportunities to strengthen basic BSSR. OppNet’s specific goals are to foster activities and initiatives on basic social processes and mechanisms of behavior and to expand NIH’s funding of basic BSSR with additional investments that complement the current portfolio. OppNet operates under the OBSSR definition of BSSR as research that furthers understanding of the fundamental mechanisms and patterns of behavioral and social functioning, is relevant to the nation’s health and well-being, and examines interactions among these patterns and mechanisms and between these, biology, and the environment. OppNet focuses on several areas that fall into the categories of: behavioral and social processes; interactions between biology, behavior, and social processes; and methodology and measurement.

OppNet was supported by $12 million in funds in FY2010: $10 million from the American Recovery and Reinvestment Act, and $2 million from the NIH Office of AIDS Research. The budget increased slightly in FY2011 and FY2012 with the 2012 budget coming solely from a fixed percentage of each Institute or Center’s base appropriation. OppNet’s leadership comprises a steering committee composed of Institute and Center directors, an executive committee of nominated and selected members from NIH, a coordinating committee of representatives from each OppNet Institute or Center, and working groups in strategic planning, communications, and concepts. NINR has had representation on all these committees and working groups.

In 2010, OppNet released one request for applications (RFA) for short-term mentored career development awards for mid-career and senior investigators. NINR was the lead Institute on one of the first awards, which supported an investigator exploring end-of-life decisions. OppNet also issued a request for information to solicit input on challenges and opportunities in BSSR and priorities for OppNet. Responses to this request informed the strategic planning for new funding and scientific opportunities, as well as the scientific focus of an open meeting held in October 2010 with the external scientific community. Suggested priorities were grouped into 12 scientific themes, 10 of which were developed into funding opportunity announcements (FOAs) for FY2011. At the same time, OppNet also planned and hosted a 2-day workshop with invited scholars who spoke on scientific issues that had not moved forward for 2011, and breakout sessions focused on other topics in BSSR.

In 2011, OppNet released its 10 FOAs. NINR served as the lead Institute for two applications responding to an FOA for scientific meetings for creating interdisciplinary research teams in emerging BSSR. One application focused on advancing transdisciplinary translation to prevent high-risk behaviors, and the second focused on behavior change and cardiopulmonary disease. Other FOAs released during 2011 included a second announcement for short-term mentored career development awards and announcements focused on sleep and the environment, psychosocial stress and behavior, and behavior maintenance. Over 2010 and 2011, all FOAs totaled $21.5 million supporting more than 100 extramural research projects focused on the three core areas of behavioral and social processes, advances in biopsychosocial research, and advances in methodology and measurement. In 2011, OppNet also began a quarterly scientific symposia series and a forum that provided lectures on disease.

OppNet has released two initiatives for FY2012, one focused on mechanistic pathways linking psychosocial stress and behavior, and another focused on cognitive, affective, and developmental perspectives in decision-making. Strategic planning is also under way to support investigators and develop research initiatives to build a collective body of knowledge about behavior and social systems and deepen understanding of basic mechanisms. This planning also aims to expand disciplinary perspectives and highlight the relevance of basic BSSR to the overall NIH mission. An OppNet symposium will be held March 20, 2012 at Natcher Auditorium to explore the social regulation of gene and endocrine expression in human and non-human primates.

Questions, Comments, and Discussion include:

A comment and reminder that OppNet was supported by funds set aside in Congressional legislation. Council members and attendees were reminded of the importance of submitting proposals. Dr. Grady noted NINR’s continued interest in OppNet.

VI.              SCIENCE OF BEHAVIOR CHANGE (SOBC) UPDATE—Dr. Lois Tully, Health Scientist Administrator, Office of Extramural Programs, NINR

Dr. Tully reviewed the background for and launch of the SOBC program, recent activities in the SOBC program, and next steps. She reminded the Council and attendees that approximately 40% of all preventable premature deaths arise from specific patterns of behavior, such as smoking, drinking, or inactivity. Although changing such behaviors can have an enormous behavior for society, sustained behavior change is difficult to achieve. NIH and NINR have long supported research on behavior change, for example with projects examining increased physical activity in persons with rheumatoid arthritis or osteoarthritis of the knee, weight loss and weight maintenance in older rural women, sustained weight loss among obese persons, and physical activity adherence among African American women.

The SOBC program was launched by the NIH Common Fund as a trans-NIH effort to improve understanding of human behavior change across a broad range of health-related behaviors. The program is co-chaired by Dr. Grady, National Institute on Aging (NIA) Director Richard Hodes, and Dr. Richard Suzman, also of the NIA, and it is coordinated by Dr. John King, also of the NIA. The SOBC program has representation from several Institutes and Centers, including NINR.

Foundational work for the SOBC program included a trans-NIH conference on behavior change. The planning meeting for this conference was held in February 2009, with participation by experts from several fields and representatives from various Institutes and Centers. The planning meeting focused on the themes of trans-disease processes, developmental perspectives, structural and mediating influences on behavior change, and methodological and measurement development. The conference, held in June 2009, included experts from 130 fields and focused on three key aspects of behavioral change. All these efforts resulted in an RFA, issued in February, 2010, that would support projects to improve understanding of basic mechanisms of behavior change by bridging work in the laboratory and the field.

Ten R01 grants, which focused on behavioral economics, genetics, social and policy approaches, and emotional self-regulation, were awarded under the SOBC RFA. One  project is examining financial incentives for smoking cessation among more than 2,000 Walgreens employees. Another project is studying 600 college freshmen to determine the predictive value of tobacco or alcohol use as displayed on Facebook profiles and to identify intervention strategies that could exploit Facebook in steering college students away from these behaviors. Yet another project is studying food- and non-food-related self-regulation and excess weight gain among 200 toddlers. Although these projects are still in their beginning stages, two related papers have been published by respective principal investigators. One presents evidence that appropriately structured incentive programs for smoking cessation programs can improve public health, but this paper also cautions on the need to be cognizant of the risks such programs pose. The other paper presents data from twins on potential genetic and environmental influences on exercise behavior during adolescence.

The first annual meeting of SOBC investigators was held June 2011, with a keynote presentation by Dr. Matthew Nock. A second investigators meeting is planned for June, 2012, and future research directions are in the planning stages. Dr. Tully concluded by referring Council members to the SOBC web site, which posts meeting reports, information on funded grants, and other information.

VII.           SOBC EXTRAMURAL SCIENTIST PRESENTATION: INVESTIGATING AFFECTIVE AND GENOMIC MEDIATORS OF SUSTAINED BEHAVIOR CHANGE—Dr. Barbara Frederickson, Kenan Distinguished Professor, Director of the Positive Emotions and Psychophysiology Laboratory (PEPLab), University of North Carolina at Chapel Hill

Dr. Frederickson presented her SOBC-funded project, which examines how positive emotions alter bodily systems in ways that ultimately reinforce sustained behavior change. This project was inspired by previous studies in which Dr. Frederickson and her colleagues found that individuals who learned loving-kindness meditation (LKM) experienced subtle increases in their trait positive affect and, individuals who experienced an immediate positive response to LKM were more likely to keep performing that meditation later on. Further work by Dr. Frederickson’s group found that individuals with higher levels of vagal tone were more likely to experience that “early blast” of positive effect when learning LKM. Moreover, individuals randomly assigned to LKM showed improvements in resting vagal tone 3 months following the study.

Work done by Dr. Steve Cole, Director of the UCLA Social Genomics Core and one of Dr. Frederickson’s collaborators, has also influenced the SOBC-funded project. Dr. Cole’s group has used genomic methods to identify genes that are differentially expressed between lonely and socially integrated individuals. Across the entire human genome, approximately 200 genes are differentially expressed, and most, if not all, of these genes are connected to inflammation, suggesting that stress or emotional experiences can ultimately change who individuals are at the cellular level. This work ties in with the Cytokine Theory of Depression, which suggests that inflammatory challenges trigger wide-ranging changes in motivation and social behavior. Moreover, Dr. Cole’s work suggests that the reciprocal is also true and that the interaction between depressed states and inflammation can create a downward spiral.

Dr. Frederickson’s SOBC-funded project examines the hypothesis that anti-inflammatory process regulates wellness behaviors through which individuals become more active, curious, and socially engaged. Dr. Frederickson and colleagues also hypothesize that when internal biological systems register health and opportunity, such wellness behaviors might become increasingly rewarding by amplifying their positive emotional yield, thus creating an upward cycle.

VIII.        REVIEW OF THE MEMORANDUM OF UNDERSTANDING—Dr. Yvonne Bryan, Acting Executive Secretary, NACNR; Special Assistant to the Director, NINR

Dr. Grady reminded the Council that the Memorandum of Understanding (MOU) serves as a contract between NINR and Council members about what is presented during close session. She also noted that NINR and NACNR must review the MOU each year. Dr. Bryan reported that in Section 1B under “Expedited En Bloc Concurrence,” the priority score applications being brought to Council has been changed. Otherwise, the MOU remains the same. The Council accepted the revised MOU, and members were encouraged to submit any subsequent questions to Dr. Bryan.


Dr. Grady thanked participants and attendees for their time and engagement and adjourned the open session of the meeting.


This portion of the meeting was closed to the public in accordance with the determination that this session was concerned with matters exempt from mandatory disclosure under Sections 552b(c)(4) and 552b(c)(6), Title 5, U.S. Code, and Section 10(d) of the Federal Advisory Committee Act, as amended (5, USC Appendix 2). Members absented themselves from the meeting during discussion of and voting on applications from their own institutions or other applications in which there was a potential conflict of interest, real or apparent. Members were asked to sign a statement to this effect.


The members of the NACNR considered 127 research and training grant applications on which NINR was the primary Institute; these applications requested a total of $32,188,920 (direct costs year 01). The Council also considered 483 applications on which another Institute/Center was primary and NINR was secondary. These applications requested a total of $118,933,314 (direct costs year 01). The Council concurred with the IRG recommendations on these 610 applications.


The 76th meeting of the NACNR was adjourned at 1:00 p.m. on January 18, 2012.


I hereby certify that the foregoing minutes are accurate and complete


Patricia A. Grady, Ph.D., R.N., F.A.A.N.
National Advisory Council for Nursing Research


Yvonne E. Bryan, Ph.D.
Acting Executive Secretary
National Advisory Council for Nursing Research


Dr. Patricia A. Grady, Chair
Dr. Yvonne Bryan, Executive Secretary
Dr. Anna Alt-White
Dr. Marion Broome
Dr. Everette Freeman
Dr. Kenton Kaufman
Dr. Diana Lake
Dr. Elaine Larson
Dr. Courtney Lyder
Dr. Marla Salmon
Dr. Gail Stuart
Dr. James Tulsky
Dr. Janet Williams


Ms. Halima Al-Khattab, Indiana University
Dr. Barbara Frederickson, University of North Carolina at Chapel Hill
Ms. Katherine Heinze, Johns Hopkins University
Ms. Dana Hines, Indiana University-Indianapolis
Dr. Jill Kilanowski, Cincinnati Children’s Hospital
Ms. Mei Ching Lee, Johns Hopkins University
Dr. Suzanne Miyamoto, American Association of Colleges of Nursing
Ms. Cheryl Peterson, American Nurses Association
Dr. Rita Pickler, Cincinnati Children’s Hospital
Ms. Amy Walker, Association of Rehabilitation Nurses
Ms. Christine Zambricki, American Association of Nurse Anesthetists

Mr. Brian Albertini, NINR/NIH
Dr. David Banks, NINR/NIH
Ms. Melissa Barrett, NINR/NIH
Ms. Adrienne Burroughs, NINR/NIH
Dr. Ann Cashion, NINR/NIH
Dr. Paul Cotton, NINR/NIH
Dr. Robert David, VA
Dr. Glenna Dowling, NINR/NIH
Dr. Chris Hafner Eaton, NINR/NIH
Dr. Marguerite Engler, NINR/NIH
Dr. Mary Engler, NINR/NIH
Ms. Crystal Esler, NINR/NIH
Ms. Ana Ferreira, NINR/NIH
Dr. John Grason, NINR/NIH
Dr. Amanda Green, NINR/NIH
Dr. Lynda Hardy, NINR/NIH
Dr. Rebecca Hawes, NINR/NIH
Dr. Wendy Henderson, NINR/NIH
Dr. Karen Huss, NINR/NIH
Mrs. Deborah Jennings, NINR/NIH
Dr. Robert Kaplan, OBSSR/NIH
Ms. Mary Kelly, NINR/NIH
Ms. Reyna Landis, NINR/NIH
Dr. Weiqun Li, NINR/NIH
Dr. Yujing Liu, NINR/NIH
Dr. Sue Marden, NINR/NIH
Mrs. Angela Marshall, NINR/NIH
Dr. Donna Jo McCloskey, NINR/NIH
Dr. Jessica McIlvane, OD/NIH
Ms. Archana Mohale, NINR/NIH
Ms. Mary Murray, NINR/NIH
Dr. Masooda Omeri, NINR/NIH
Ms. Swarnalatha Reddy, NINR/NIH
Dr. Mario Rinaudo, NINR/NIH
Dr. Sally Rockey, OER/OD/NIH
Dr. Denise Russo, NINR/NIH
Dr. Leorey Saligan, NINR/NIH
Dr. Xenia Tigno, NINR/NIH
Dr. Catherine Timura, OD/NIH
Dr. Lois Tully, NINR/NIH
Dr. Joan Wasserman, NINR/NIH
Dr. Linda Weglicki, NINR/NIH
Mr. Kevin Wilson, NINR/NIH

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