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Minutes of the National Advisory Council for Nursing Research, September 20-21, 2011

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

September 20-21, 2011

The 75th meeting of the National Advisory Council for Nursing Research (NACNR) was convened on Tuesday, September 20, 2011, 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 5:11 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 12:00 p.m. Dr. Patricia A. Grady, Chair, NACNR, presided over both sessions of the meeting.


OPEN SESSION

I. CALL TO ORDER, OPENING REMARKS, COUNCIL PROCEDURES, AND RELATED MATTERS

Dr. Grady called the 75th meeting of the NACNR to order, welcoming all Council members (including new Council members), visitors, and staff.  She informed members that Dr. Yvonne Bryan, Special Assistant to the Director, is serving as the Executive Secretary for the NACNR.

Conflict of Interest and Confidentiality Statement

Dr. Bryan reminded attendees that the standard rules of conflict of interest (COI) applied throughout the Council meeting.  Briefly, all closed session material is privileged, and all communications from investigators to Council members regarding any actions on applications being considered during the Council should be referred to National Institute of Nursing Research (NINR) staff.  In addition, during either the open or the closed session of the meeting, Council members with a COI with respect to any topics or any application must excuse themselves from the room and sign a statement attesting to their absence during the discussion of that application.  Dr. Bryan also reminded NACNR members of their status as special Federal employees while serving on the Council, and that the law prohibits the use of any funds to pay the salary or expenses of any Federal employee to lobby or otherwise influence state legislatures or Congress.  Specific policies and procedures were reviewed in more detail at the beginning of the closed session and were available in electronic materials provided to the Council.

Minutes of Previous NACNR Meeting

Standing Council members received a copy of the minutes of the May 17-18, 2011, NACNR meeting by electronic mail.  A motion to accept the minutes of the May 17-18, 2011, Council meeting was proposed, seconded, and approved unanimously.  Any comments, corrections, and changes to the September 2011 meeting minutes identified at a later time should be forwarded to Drs. Grady or Bryan.  The approved minutes of each quarterly NACNR meeting become part of the Institute’s permanent record and are posted on the NINR Web Site (www.ninr.nih.gov).

Dates of Future Council Meetings

Dates of future meetings in 2012 and 2013 have been approved and confirmed.  Council members were asked to confirm their calendars for these meeting dates and contact Drs. Grady or Bryan regarding any conflicts or expected absences.

2012

January 17-18 (Tuesday-Wednesday)
May 15-16 (Tuesday-Wednesday)
September 18-19 (Tuesday-Wednesday)

2013

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 updates since the last Council meeting and on current and impending activities and initiatives related to the NIH and NINR budgets, the NIH overall, and the NINR.

Budget Update—

Dr. Grady provided an update on the current status of appropriations and projections for the NINR budget.  The Institute is operating under a Continuing Resolution for fiscal year (FY) 2011, with a budget of $144.381 million, reflecting a 0.9 percent decrease from the FY 2010 level.  The NIH budget for FY 2011 of $30.687 billion reflects a similar reduction of 1 percent.  Dr. Grady acknowledged the difficult economic times for the country and informed Council members that the FY 2012 budget is not yet known.

Dr. Grady next reviewed NINR’s expenditures for FY 2011, which included:  research program grants (RPGs) (72%), of which P01 grants comprise 1.6 percent; Centers (3%); research management and support (9%); training (6%); research and development (3%); intramural research (5%); and other research (2%).  The NINR has a strong commitment to training, and ranks as second highest among NIH Institutes and Centers (ICs) in percent of budget committed to training.  The budget trends for the NINR during the past 10 years mirrors the overall trend for the NIH appropriations.

HHS, NIH, and NINR News—

Dr. Grady reported on news items of interest within the Department of Health and Human Services (HHS), NIH, and NINR communities.   The HHS has published new financial COI rules for researchers in academic settings who receive HHS grants; the universities have the responsibility for COI disclosures to the NIH.  The HHS also has posted revisions to protocol guidelines regarding the protection of human subjects, with a period for public comments which closes October, 26, 2011.  Recent HHS awards in the health care arena include:  $40 million to help sign children up for health coverage; preventive services (e.g., mammograms and dexa scans) for women at no additional cost; $71.3 million per the Affordable Care Act to increase or further educate nurse practitioners; the Act also will help improve data collection regarding underserved minorities as well as gender and disability issues; and $100 million to create healthier communities.  Dr. Grady noted the fight against AIDS started 30 years ago, and much progress has been made in turning a life-threatening terminal illness into a chronic disease.  She pointed out HHS’ early involvement against the disease, including pioneering work in the development of testing and early therapeutics.

Regarding NIH news, Dr. Grady reported that a science paper identifies gaps in funding success rates for African-American researchers; the NIH is working diligently to develop strategies to address any issues in the review process.  The Office of Behavioral and Social Sciences Research (OBSSR) and Division of Program Coordination, Planning, and Strategic Initiatives (DPCPSI) has commissioned a group to develop best practices for combining quantitative and qualitative research.  Dr. Grady expressed sadness at the passing of Dr. Bernadine Healy, a former NIH Director, who was responsible for the first NIH Strategic Plan and the Women’s Health Initiative, and incorporated the concept of diversity, among other accomplishments.  Dr. Richard Nakamura, past Scientific, Deputy, and Acting Director of the National Institute of Mental Health (NIMH) has been named the Acting Director of Center for Scientific Review (CSR).  Dr. Judith Greenberg is the Acting Director, National Institute of General Medical Sciences (NIGMS). NINR’s Dr. Bryan received the NIH Director’s award for her work in equal employment opportunity (EEO) programs and equity across programs.  The National Institute of Environmental Health Sciences (NIEHS) is overseeing NIH-funded research to explore health effects resulting from the Gulf of Mexico oil spill and prevention of future effects.  The NIH and Centers for Disease Control and Prevention (CDC) are co-supporting a Diabetes Education Program that addresses prevention and lifestyle adaptation.  The NIH has expanded the Clinical and Translational Science Awards (CTSA) to include the University of California, Los Angeles (UCLA) and University of Kansas, both of which have strong Schools of Nursing.

Dr. Grady told members that the front page of the NIH Web site features the NINR’s 25th Anniversary and upcoming Symposium in October.  The NINR recently convened a successful summit on the Science of Compassion:  Future Directions in End-of-Life (EOL) and Palliative Care (PC); the summit was attended by nearly 1,000 stakeholders representing the spectrum of EOL PC and enjoyed significant press coverage.  The NINR Strategic Plan is in preparation and will be released at the NINR 25th Anniversary Symposium.  Dr. Grady announced changes in staff:  Dr. Mary Kerr, former NINR Deputy Director is now the Dean at Case Western Reserve University Frances Payne Bolton School of Nursing; Dr. Ann Cashion, University of Tennessee, has joined the NINR Office of Director (OD) for one year; Dr. Linda Weglicki is the new Chief, Office of Extramural Programs; and Dr. Donna Jo McCloskey has joined the NINR Office of Extramural Programs as a Program Administrator.  NINR intramural investigator Dr. Arseime Del Vale-Pinero received an award from the Puerto Rican government as a promising new researcher.  Dr. Grady also congratulated Dr. Dawn Betters on her recent graduation from the NINR Graduate Partnership Program (GPP); the deadline for applications for 2012 GPP fellowships is January 31, 2012.  In addition, the Summer Genetics Institute (SGI) and the NINR Pain Methodologies Boot Camp both will be held in the summer of 2012.  Members were encouraged to visit the NINR Web site (www.ninr.nih.gov) to view NINR research funding opportunities as well as additional NINR news and recent outreach activities.

III.       UPDATE ON TRAINING—
Dr. David Banks, Program Director, Training, NINR

Dr. Banks provided an update report on NINR’s research training program.  The NINR has a strong commitment to training, which accounts for 6.2 percent of its budget; the Institute is second among the 27 NIH ICs in the percentage of budget allocated to training.  Approximately 20 percent of pre- and postdoctoral nurses receive training from the NINR.  The training programs and opportunities described included:  Scholars Training for the Advancement of Research (STAR), the Graduate Partnership Program (GPP), Summer Genetic Institute (SGI), Pain Boot Camp, and multiple training mechanisms (T32, F32, and R01 support under Principal Investigators [PIs], among others) for pre- and postdoctoral researchers, as well as career development (K) awards for new and career investigators.  Dr. Banks noted that 63 percent of all NINR-supported trainees are predoctoral researchers.  In FY 2010, individual predoctoral researchers aged 32-43 comprised the largest group of training awards (38%).  The NINR’s predoctoral portfolio encompasses many science topics, including adherence, EOL, health disparities and symptom management.  The investigators publish in high-impact, prestigious journals, including:  Journal of General Internal Medicine, Nursing Research, International Journal of Nursing Studies, Medical Care, Research in Nursing and Health, Journal of Clinical Oncology, and many others.  NINR’s career development portfolio includes areas such as cardiovascular, health disparities, infant development, and pain; among these awards, there is a clear focus across systems in NINR priority areas.

The NINR remains a leader in its commitment to research training and education.  Relevant activities include developing the culture of science and mentorship, supporting an early career focus on research, promoting retention and support for scientists, and recruiting nursing faculty.  Its investments in nurse scientists include support of new models for professional learning, rapid advancement from student to scientist, effective use of global training partnerships, continued expansion of research knowledge, and development of a diverse cadre of scientists.  In closing, Dr. Banks shared examples of successful former NINR trainees.

Questions & discussion were related to diversity of applicants and awards; composition of peer review groups; and training in specific areas of science.

  • It was also noted that the peer review study sections and Councils are chartered to include racial, geographic, population, gender, and scientific diversity.

IV.       INSTITUTIONAL TRAINING PROGRAM (T32)—
Dr. Suzanne Bakken, Columbia University

Dr. Bakken described an informatics training program to conduct interdisciplinary research that used informatics to reduce health disparities.  The program has four aims:  (1) establish an administrative structure for the program; (2) recruit and train a cadre of pre- and postdoctoral ethnically diverse nurses to facilitate evidence-based practice in underserved populations; (3) enhance the knowledge and skills of trainees in translating research findings into policy and practice; and (4) evaluate the training program structures, processes, and outcomes in a timely manner.  Dr. Bakken described the research conducted through the program, with topics spanning a broad spectrum such as automated risk assessment instrument for injuries from falls, electronic communication for antimicrobial prescribing, tailored interventions for management of depressive symptoms in persons living with HIV/AIDS, and self assessment via personal health records.  One project called Facebook PPALS uses social networking to encourage and monitor aerobics and other physical activity among neighborhood youth.  She introduced two of the researchers present at the Council meeting, Kenrick D. Cato and Roxana Maffei, whose research has addressed contextual decision support and shared decisionmaking in underserved populations, respectively.  Dr. Bakken said that this program, which is funded through the T32 mechanism with augmentation from other sources, has an interdisciplinary nature embedded in its curriculum, mentors, and research opportunities.  It has linkages to key organizational structures (e.g., NINR-funded Centers of Excellence and CTSAs) as well as ties to a local community and its significant health problems.  It underscores the importance of using a personal approach and pipelines in the recruitment and retention of underrepresented minorities into the health research enterprise.

V.        OVERVIEW OF STRATEGIC PLANNING RETREAT—
Dr. Stanley Finkelstein, Professor, Laboratory Medicine and Pathology/Health Informatics, University of Minnesota

Dr. Finkelstein noted that the NINR Strategic Planning Retreat was held in December 2010 to identify scientific gaps and develop a list of concepts based on research opportunities.  The entire concept development process that leads to Funding Opportunity Announcements (FOAs) takes 24 months, and the retreat covered 16 pre-concepts that were narrowed down to the 9 concepts presented at this meeting.  Each of the pre-concepts fell into one of the NINR’s four strategic plan areas:  health promotion and disease prevention; quality of life, self management, and symptom management; EOL; and health disparities.  Training is included in these areas as well.  The pre-concepts were discussed in terms of public health relevance, current science advances, and gaps and opportunities.  The retreat discussions considered the balance/mix of pre-concepts, past successes and failures, leveraging the strengths of the NINR and nursing research community, and opportunities for collaboration.

VI.       CONCEPT PRESENTATION AND DISCUSSION—
Dr. Linda Weglicki, Chief, Office of Extramural Activities, NINR

Council members reviewed and discussed nine new concepts during the September 2011 NACNR meeting.

Maternal Nutrition and Pre-Pregnancy Obesity: Effects on Mothers, Infants, and Children  (Dr. Marion Broome, discussant)

Discussant comments:

Dr.  Broome explained that this concept is focused on interdisciplinary research, with well-stated objectives.

Other comments/discussion points included:

  • A recognition that the role that the infant plays regarding obesity has been understudied and said that most researchers rely on body mass index (BMI);  was suggested that studies could address the infant’s initial 6 months and genetic susceptibility.          
  • The need to include epidemiologic data, particularly data about post-natal obesity.

Early Detection and Prevention of Mild Cognitive Impairment
(Dr. Kathleen A. Potempa, discussant)

Discussant comments:

Dr. Potempa noted that the literature is primarily focused on diagnostic measures of mild cognitive impairment (MCI) and prognosis, particularly in terms of Alzheimers.  Newer measures do not necessarily offer predictive validity.  Dementia incidence of MCI is 5 to 10 percent per year.  Because there are significant subsets of MCI that revert to normal and/or do not lead to dementia, biological and genetic markers would be helpful in determining predictors and thence preventing MCI; the literature provides an impression that measures are more established than they really are.  The topic is receiving much attention.  Current treatments for MCI are physical exercise and cognitive training; there are no known curative drugs, and the effect of nutrition is unclear.  Dr. Potempa commented that this is an important concept that should focus on correlative MCI of physiology and downward predictors.

The Role of Mitochondrial DNA Mutations in Symptom Expression and Heterogeneity (Dr. Janet K. Williams, discussant)

Discussant comments:

Dr. Williams said the literature on this topic, which is of international interest, focuses on basic science.  The concept incorporates multiple symptoms, and hence association of multiple genes and whole-genome sequencing. Nursing scholars see all of the factors in this arena:  genetic, epidemiological, and emotional, among others; thus the topic is appropriate for nursing research.  However, it may not be appropriate for the sole, new investigator, but rather would require multiple PIs from a variety of disciplines.  It could include pharmacogenetics, and the National Cancer Institute (NCI) would be an ideal co-sponsor because the topic lends itself to study of tumor development.

Other comments/discussion points included:

  • The concept will help get to source of symptom expressions but will require careful analyses of the picture, in which nursing scientists have a place.        
  • Support for pharmacogenetic and behavioral research that would assist in detection and prevention; also noted that the linkages between these likely would be useful in the interpretation of mtDNA findings.

In response to Dr. Grady’s query about the importance of the topic either now or in the future, Dr. Williams indicated that studies of this concept would take time before benefits would be realized, and that use of a consortium or team might be an ideal approach.

Application of Genomic Advances to Wound Repair (Dr. Elaine L. Larson, discussant)

Discussant comments:

Dr. Larson said that, despite the importance of the topic, only a few basic science papers are found in the literature.  It involves multi-disciplinary research, and nurses have an increasing niche in translational work.  Although few nursing schools require a genetics course in their nursing programs, NINR’s SGI likely has built an appropriate cadre of researchers to address the issue.  Reliable scoring (e.g., pH changes) in wound healing is needed.  The title could be expanded to “Application of Genomic and Other Advances to Wound Repair.”

Other comments/discussion points included:

  • An observation that the current dearth of evidence on wound repair and commented that the limited knowledge comes from animal models, but that scientists still do not know why wounds do or do not heal.
  • The concept lies closer to clinical application than many other concepts and warrants a broad perspective.

Dr. Grady asked whether the research is limited because of lack of interest or inadequate tools.  Dr. Larson said that the biology, as well as the genomics, related to wound repair should be examined.

Promoting Adherence to Maximize Health Benefits (Dr. Gail W. Stuart, discussant)

Discussant comments:

Dr. Stuart commented that adherence is a significant problem; literature abounds on the topic and shows that only about one-half of patients take their medications.  The Institute of Medicine (IOM) has listed adherence as a priority area for comparative effectiveness research (CER).  The concept’s rationale and impact focus on education, counseling, and reminders; however, a more solid alliance between clinicians and patients regarding trust, communication, treatment plan, and process may be necessary to ensure greater efficacy:  the goals of the clinician (positive health outcomes) and patient (QOL) must become allied.  Many treatments improve symptoms but not QOL, and decision-balanced strategies should be considered.  One option is to develop a model to catalog subjects into three groups:  those at risk of low adherence; those with compliant personality; and those who fall between those groups, with interventions developed that target this third group.  Dr. Stuart endorsed the concept and suggested that it be expand to include the family, social support, and community environment.

Other comments/discussion points included:

  • Suggestion that the issues of short- versus long-term adherence should be examined.
  • The concept should incorporate health literacy, such as defining patient profiles as those more likely or less likely to adhere and targeting interventions to vulnerable populations.
  • This is at the heart of what nurses should be doing but the current theoretical framework is not working well.

End of Life and Palliative Care in HIV/AIDS (Dr. Diana E. Lake, discussant)

Discussant comments:

Dr. Lake noted the many gaps in knowledge regarding AIDS.  The objective to identify predictors of mortality is key.  The concept also should identify factors that influence decision making, including a variety of thought processes, which are not well recorded in the literature.

Other comments/discussion points included:

  • Suggestion that it should involve social services, basic science, psychological, and spiritual fields.
  • Comment that a number of panelists at the EOLPC summit encouraged movement away from disease-specific research; thus, what was unique about HIV/AIDS to warrant a specific disease focus?
  • Observation about the lack of attention in the literature concerning some vulnerable populations
  • Suggestion that the concept be re-focused on how to care for underserved populations who are at EOL rather than on HIV/AIDS.

The Palliative Care Research Co-Operative:  Enhancing Sustainability (Capt. Maggie Richards, discussant)

Discussant comments:

Capt. Richards said the concept’s goal is to establish what has been accomplished in palliative care research.  The objectives should clarify the value of additional collaboration, including a reflection on the field in the past versus future directions.

Other comments/discussion point included:

  • Whether the concept was premature.

Capt. Richards responded that a baseline about deliverables from current cooperative groups is needed.

Mentored Research Scientist Development Award in Comparative Effectiveness Research (Dr. Stanley Finkelstein, discussant)

Discussant comments:

Dr. Finkelstein supported the concept overall.  He raised two questions:  (1) Is CER a tool to conduct a study or is the expectation that nursing researchers will develop new methods/tools to conduct CER?  (2) How will the concept be implemented?  Will mentors within or external to nursing be used?

Other comments/discussion points included:

  • Appreciation for the issue and what nursing should bring in a team approach.
  • Whether the nursing field will require training about CER, and when and where would training be appropriate.
  • Whether the SGI model would be an appropriate venue or whether the concept should include a mentoring component.
  • Support for the concept including the importance of translating past accomplishments.

Nurse Scientist Training for an Interdisciplinary Research Workforce (Dr. Barbara Guthrie, discussant)

Discussant comments:

Dr. Guthrie cited a recent IOM report that discusses the importance of training. There is a need to focus attention to the recruitment and training of nurse scientists, including at younger ages, such as junior and senior year of college, as well as the high school level.  Partnerships with nonacademic organizations would be beneficial, particularly in learning lessons from those organizations’ successful programs. The concept should consider a variety of models.

Other comments/discussion points included:

  • Recruitment into nursing and training at earlier stages of education;
  • Undergraduate pipeline might be possible if a dedicated effort to this cause is made.

VII.     EOLPC SUMMIT—
Dr. James Tulsky, Director, Center for Palliative Care, and Professor, Duke University School of Medicine

Dr. Tulsky provided a report on the Science of Compassion:  Future Directions in End-of-Life (EOL) and Palliative Care Summit, organized by Drs. Noreen Aziz and Jeri Miller and attended by more than 1,000 stakeholders.  He shared Dr. Grady’s words from the conference:  “Death comes to more than 2.5 million Americans each year and for many, they continue to die in ways that are unsatisfactory for themselves and their families.   As we seek to understand what it means to live well while dying, we know that our job is not yet done.”  The goals of the Summit were to reflect on NINR’s commitment to and leadership in the field, review the state of the field since the 2004 EOL conference; and stimulate new research and scientific solutions for palliative care issues.  The Summit commenced with a Town Hall meeting on ethics of science at the end of life, particularly the vulnerability of the patient.  Dr. Ira Byock, Keynote Speaker, affirmed the entirety of life, which includes the trajectories of illness as well as grief.  The Summit was organized around themes of identifying strengths, marshaling resources, and future directions, with findings presented from randomized clinical trials (RCTs) conducted during the past 7 years, as well as discussions held about parents and clinicians as partners in research.    Discussions throughout the panel and breakout sessions yielded several overarching recommendations, including:  (1) scientific and statistical methods should be strengthened, hierarchical linear modeling could be used more broadly, and research should emphasize symptom complexes or populations rather than specific diseases; and (2) the infrastructure for EOL palliative care research should be built and sustained, including individual training, mentorship, and physical infrastructure.  Since the 2004 conference, the field has advanced tremendously with the buildup of infrastructure for evidence-based science, but more work remains, including the development of valid measures and fragmented care.  Dr. Tulsky noted that the title of the 2011 Summit expanded the 2004 focus on EOL to incorporate palliative care, and he expressed the hope that the language continues to be restructured with the field’s focus on the spectrum of palliative care, which affirms the entirety of life.  In closing, he quoted Dr. Randy Curtis, Endnote Speaker:  “It is not enough to know what works if we can’t get it to happen at the bedside, in the home, in the community.”

Questions/Comments/Discussion points included:

  • What are the plans to disseminate the conference proceedings; Dr. Grady responded that publications will be forthcoming.
  • Observation that the changes in discourse language over the years show signs of progress in the field.

Following this update, Dr. Grady thanked participants and attendees for their time and active engagement and adjourned the open session of the meeting.

CLOSED SESSION

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.

REVIEW OF APPLICATIONS

The members of the NACNR considered 258 research and training grant applications on which NINR was the primary Institute; these applications requested a total of $63,043,576 (direct costs year 01).  The Council also considered 509 applications on which another Institute/Center was primary and NINR was secondary; these applications requested a total of $141,138,956 (direct costs year 01).  The Council concurred with the IRG recommendations on these 767 applications.

ADJOURNMENT

The 75th meeting of the NACNR was adjourned at 12:00 p.m. on September 20, 2011.

CERTIFICATION

I hereby certify that the foregoing minutes are accurate and complete.

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

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

MEMBERS PRESENT

Dr. Patricia A. Grady, Chair
Dr. Yvonne Bryan, Acting Executive Secretary
Dr. Marion Broome
Dr. Stanley Finkelstein
Dr. Everette Freeman
Dr. Barbara Guthrie
Dr. Kenton Kaufman
Dr. Diana Lake
Dr. Elaine Larson
Dr. Courtney Lyder
Dr. Kathleen Potempa
Capt. Maggie Richard, Ex Officio
Dr. Marla Salmon
Dr. Gail Stuart
Dr. James Tulsky
Dr. Anna Alt-White
Dr. Janet Williams

MEMBERS OF THE PUBLIC PRESENT

Suzanne Bakken, Columbia University
Kenrick D. Cato, Columbia University
Susan Dorsey, University of Maryland
Jill Kilanowski, Cincinnati Children’s Hospital
Karen Kane McDonnell, University of Virginia
Louise Kaplan, American Nurses Association
Roxana Maffei, Columbia University
Rita Pickler, Cincinnati Children’s Hospital
Mary Regan, University of Maryland
Cynthia Renn, University of Maryland
Elisabeth Smith, American Association of Colleges of Nursing
Darlene Summers, Consolidated Solutions and Innovations

FEDERAL EMPLOYEES PRESENT

Mr. Brian Albertini, NINR/NIH
Dr. Noreen Aziz, NINR/NIH
Dr. David Banks, NINR/NIH
Ms. Melissa Barrett, NINR/NIH
Mr. Raymond Bingham, NINR/NIH
Ms. Adrienne Burroughs, NINR/NIH
Dr. Ann Cashion, NINR/NIH
Dr. Paul Cotton, NINR/NIH
Mr. John Dahunsi, NINR/NIH
Ms. Jennifer Dine, NINR/NIH
Ms. Crystal Esler, NINR/NIH
Dr. John Grason, NINR/NIH
Dr. Amanda Greene, NINR/NIH
Mr. Lawrence Haller, NINR/NIH
Dr. Rebecca Hawes, NINR/NIH
Mr. Doug Hussey, NINR/NIH Ms. Deborah Jennings, NINR/NIH
Ms. Ellie Johnson, NINR/NIH
Ms. Annie Joseph, NHLBI/NIH
Dr. Weiqun Li, NINR/NIH
Dr. Yujing Liu, NINR/NIH Dr. Susan Marden, NINR/NIH
Ms. Angela Marshall, NINR/NIH
Dr. Donna Jo McCloskey, NINR/NIH
Dr. Jessica McIlvane, OD/NIH
Dr. Jeri Miller, NINR/NIH
Ms. Mary Murray, NINR/NIH
Dr. Mario Rinaudo, NINR/NIH Dr. Denise Russo, NINR/NIH
Ms. Alyson Spore, NINR/NIH
Dr. Tamizchelvi Thyagarajan, 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
Dr. Marie Zeimetz, NINR/NIH

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