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Division of Intramural Research (DIR)
Led by NINR Scientific Director, Dr. Ann Cashion, DIR consists of two offices (Office of the Clinical Director and Office of the Training Director) and three branches (Biobehavioral Branch, Symptom Management Branch, and Tissue Injury Branch).
Office of the Clinical Director
The Office of the NINR Clinical Director, led by Dr. Suzanne Wingate, is responsible for the safety, clinical, administrative, regulatory, and research-related support services for the NINR DIR program. The functions of this office are to ensure safe and competent clinical and research care of research participants, perform clinical competency assessment of staff and trainees, and liaise with the Clinical Center to perform professional credentialing of clinical providers. Additionally, the office executes pre-Institutional Review Board as well as ongoing protocol reviews, implements and oversees the regulatory and quality management of protocols, evaluates resource use for protocols, and participates in collaborations with other Institutes and Centers for shared resources.
Carolyn Allen DNP, FNP-BC
Joy Kreskow MSN, FNP-BC
Nurse Specialists (Research):
Mary Ley BSN, RN
Shavonne Pocock BSN, RN
Alexander Ross BSN, RN
Karen Taylor BSN, RN
Patient Care Coordinator:
Quality Management Specialist:
Xuemin Zhang, PhD
Office of the Training Director
The development of a strong cadre of nurse scientists has been a primary goal of NINR since its establishment. Led by Dr. Pamela Tamez, NINR’s Office of the Training Director (OTD) prepares a diverse and talented research workforce and supports a variety of training opportunities for scientists at all career levels.
OTD provides research opportunities for PhD nursing students and research intensives for nurse scientists, including the Summer Genetics Institute, the Graduate Partnerships Program and the Methodologies Boot Camp. The office oversees and supports the career development and training of intramural fellows, including summer interns, postbaccalaureate, predoctoral, and postdoctoral scholars.
The Biobehavioral Branch supports research into the interplay of behavioral, biological, and environmental determinants of health and wellness across populations. The research focuses on the following areas:
This research focuses on improving the understanding of the mechanisms involved in symptom distress related to digestive disorders, specifically the biobehavioral relationships between inflammation and patient symptoms. The long-term goal of this research is to identify genetic or other biologic/physiologic factors to improve diagnoses and predict patient-related clinical outcomes.
Sensory Science and Metabolism Unit (Principal Investigator: Dr. Paule Joseph)
This research is focused on understanding the integral process underlying the primary senses—principally chemosensation. The goal is to understand the fundamental molecular, behavioral, and neural mechanisms associated with chemosensory symptoms (taste and smell alterations) in metabolic conditions such as type 2 diabetes, obesity, and related comorbidities.
Symptom Management Branch
Developing new and better ways to manage adverse symptoms is vital to improving quality of life for those living with acute and chronic illness. The Symptom Management Branch is dedicated to improving the understanding of the underlying biological mechanisms of a range of symptoms, their effect on patients, and the biological and behavioral bases for how patients respond to interventions. The research focuses on the following areas:
Genomic and Clinical Biomarkers Unit (Principal Investigator: Dr. Ann Cashion)
This research seeks to discover biomarkers, within an environmental and clinical context, to predict patient outcomes and guide therapies specifically in solid organ transplant recipients, but also expanding to other diseases/disorders and patient populations. For solid organ transplant recipients, the goal is to discover biomarkers that will identify those patients most at risk for weight gain, and which can be used to provide personalized strategies to prevent weight gain and resulting co-morbidities (e.g., diabetes and cardiovascular disease). This research also seeks to identify underlying molecular and biologic pathways that contribute to poor outcomes.
Symptom Biology Unit (Principal Investigator: Dr. Leorey Saligan)
Research in this area examines the nature and causes of fatigue in relation to cancer and its treatments. The purpose is to understand and identify biobehavioral mechanisms of fatigue in order to develop more effective ways to manage it and, as a result, improve patient outcomes.
Tissue Injury Branch
The Tissue Injury Branch conducts clinical and laboratory-based studies on the mechanisms of tissue injury, including the identification of molecular targets and pathways activated in response to cellular damage, to provide greater understanding of the pathophysiology associated with tissue injury and identify novel targets for therapeutic intervention. The research focuses on the following areas:
Brain Injury Unit (Principal Investigator: Dr. Jessica Gill)
This research program examines the risks for neurological and behavioral symptoms following traumatic brain injuries (TBIs) and concussions through the discovery of blood-based biomarkers. The research is focused on identifying biomarkers in military personnel, athletes, and civilians to improve the clinical care provided to individuals with brain injuries and concussion. The goal of this research area is to develop and improve monitoring and intervention methods to prevent the risks posed from brain injuries, and to improve the care of these individuals if they develop chronic neurological or behavioral symptoms and deficits.
Neuromuscular Symptoms Unit (Principal Investigator: Dr. Katy Meilleur)
This unit investigates ways to measure and treat symptoms of congenital muscle disease, particularly ryanodine receptor 1-related myopathies (RYR1-RM). Many congenital muscle diseases have no FDA-approved treatments and are associated with severe morbidity and mortality. The unit completed a formal natural history study and double blind, randomized control trial in RYR1-RM. The unit also studies pathomechanisms behind associated symptoms, such as muscle weakness, hypotonia, and fatigue.
Advanced Visualization Branch
The Advanced Visualization Branch (AVB) develops and evaluates augmented and virtual reality (AR/VR) experiences to engage the participant in multi-sensory experiences and examine the impact on health behavior.
Adjunct Investigator: Dr. Patti Brennan
This unit develops interactive virtual reality simulations that present health information to patients with a variety of complex health conditions. These simulations enable patients to rehearse problem-solving behaviors to foster improved health outcomes within home-based care environments. This research also seeks to define methodologies for AR/VR technology as a health tool to aid disease-management nursing strategies in the transition from acute care settings to outpatient environments. Additionally, this research seeks to identify recommendations for how to best deliver this type of technology to patients.
Symptom Science Center
The trans-NIH, NINR-led Symptom Science Center (SSC) addresses the need for a more comprehensive approach to understand the phenotype and biology of symptoms. The mission of the SSC is to promote the understanding of the biologic and bio-behavioral mechanisms of symptoms to improve patient outcomes. The SSC is aligned with NINR’s commitment to training nurse scientists with an interest in symptom science. Dr. Leorey Saligan is currently leading the SSC within DIR.