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Council Minutes - May 1996

NATIONAL ADVISORY COUNCIL ON AGING

The Sixty-Eighth Meeting

Summary Minutes:
May 22-23, 1998

National Institutes of Health
Building 31, Conference Room 6
Bethesda, Maryland 20892

CONTENTS

  1. Call to Order
    1. Director's Status Report
    2. Consideration of Minutes of Last Meeting
    3. Future Meeting Dates
  2. Review of NIA Program
  3. Center for Inherited Disease Research
  4. Discussion: Working Group on Program
  5. Minority Task Force Report
  6. Review of Applications
  7. Future Directions at NINDS
  8. Adjournment
  9. Certification

Department of Health and Human Services
Public Health Service
National Institutes of Health
National Institute on Aging

NATIONAL ADVISORY COUNCIL ON AGING
SUMMARY MINUTES
May 22-23, 1996

The 68th meeting of the National Advisory Council on Aging (NACA) was convened on Wednesday, May 22, in Building 31, Conference Room 10, National Institutes of Health (NIH), Bethesda, Maryland. Dr. Richard J. Hodes, Director, National Institute on Aging (NIA), presided as Chairperson.

In accordance with the provisions of Public Law 92-463, the meeting was open to the public on Wednesday, May 22, from 8:00 a.m. to 2:30 p.m. and on Thursday, May 23, from 8:30 a.m to 12:00 p.m. The meeting was closed on Wednesday, May 22, from 2:30 to recess for the review, discussion, and evaluation of grant applications in accordance with the provisions set forth in Sections 552(b)(c)(4) and 552(b)(c)(6), Title 5, U.S. Code, and Section 10(d) of Public Law 92-463. 1

Council Participants:

Dr. Walter R. Allen
Dr. Carol A. Barnes
Dr. Robert N. Butler
Ms. Norma M. Downey
Mr. Jorge J. Lambrinos
Dr. Gerald E. McClearn
Dr. Ruth Sager
Dr. John Q. Trojanowski
Dr. Robert B. Wallace
Dr. Eugenia Wang
Dr. Anne B. Young

Ex Officio Participant:

Dr. John F. Eisold

The Council Roster, which gives titles, affiliations, and terms of appointment, is appended to these minutes as Supplement A.

Members of the Public Present:

George Abraham, M.D., University of Rochester Medical Center
Marilyn Albert, Ph.D., Massachusetts General Hospital
Nancy Aldrich, Aging Research and Training News
Shirley V. Brown, Gerontology News
Judith Campisi, Ph.D., University of California - Berkeley
Sharon Cargo, Row Sciences

Anne Harrison-Clark, Population Association of America/APC
John Papaconstantinou, Ph.D., University of Texas Medical Branch
Paula Skedsvold, Society for the Psychological Study of Social Issues and American Psychological Society

In addition to NIA Staff, other Federal employees attending were:

Sarah Carr, OD/OSP
Dr. Zach W. Hall, Director, NINDS
Dr. Robert Nussbaum, NCHGR

I. Call to Order

A. Director's Status Report

The Director's Status Report is appended to these minutes as Supplement B. In his remarks, Dr. Hodes named the individuals who have been invited to join Council. He also described the NIH reauthorization and appropriation hearings.

Invitees

Dr. Hodes announced that six persons have been invited to become members of Council and that all invitees have accepted. (They are Helen M. Blau, Ph.D., Professor, Department of Pharmacology, Stanford University School of Medicine; Jeffrey A. Bluestone, Ph.D., Professor, Department of Pathology, University of Chicago; Mr. Hugh Downs, Newscaster, Capital Cities/ABC, Inc.; William R. Hazzard, M.D., Professor, Department of Internal Medicine, Bowman Gray School of Medicine; James S. Jackson, Ph.D., Professor, Program for Research on Black Americans, Institute for Social Research, University of Michigan; and David A. Wise, Ph.D., Professor of Political Economy, John F. Kennedy School of Government, Harvard University). It is anticipated that the appointment process will be completed and that they will attend the September 1996 meeting.

Budget

Dr. Hodes briefed the Council on the budget for the current year and projections for next year. After many uncertainties, NIH received a 5.7% overall increase. NIA's portion of that increase was approximately $20 million, for a fiscal year 1996 budget of $453 million. Of the $20 million increase, $17 million was allocated to Research Project Grants which constitute 62% of the NIA budget in recent years. Most of the remaining $3 million increase went to the intramural research program. At the same time that there were increases to research programs, a decrease of 7.5% in research management and services expenditures was mandated by Congress.

For fiscal year 1997, the President's Budget Request includes funding for the proposed new Clinical Center. The proposed budget for research for FY 1997 includes an inflationary increase only, and no increase is projected for fiscal years 1998, 1999, and 2000. In addition, the SBIR/STTR share of the budget is mandated to increase in FY 1997. For FY 1997, it is projected that NIA will fund 985 research project grants compared to 960 in fiscal year 1996. Of these, approximately 260 will be competing awards; the remainder will be noncompeting continuations.

In response to an inquiry from a Council member, Dr. Hodes provided a breakdown of research support by mechanism: for FY 1996, 63% of research funds are allocated to Research Project Grants, 13% to Centers, 9% to intramural research, 5% to contracts, 3% to training, and 3% to other research. In addition, 5% of NIA's budget is for research management and support.

Council inquired about NIA's space in the planned new Clinical Center, and about plans for use of the current building. Dr. Hodes responded that there has been no rendering of institute-specific space at this time, but it has been decided that the current building will not be demolished. Council requested that NIA present its position with respect to use of the new Clinical Center at the September meeting.

Reauthorization and Appropriations Hearings:

Reauthorization Hearings provided an opportunity to showcase NIH research. Four panels of Institute Directors presented research highlights around themes: Chronic Disabling Diseases , (National Institute on Aging, National Heart, Lung, and Blood Institute, National Institute of Arthritis and Musculoskeletal and Skin Diseases); Infectious Diseases, (National Institute of Allergy and Infectious Diseases, National Institute of Child Health and Human Development, Office of Aids Research); Cancer and Genetics (National Cancer Institute, National Center for Human Genome Research, National Institute of Environmental Health Sciences); Neuroscience (National Institute of Neurological Disorders and Stroke, National Eye Institute, National Institute on Drug Abuse); and Infrastructure (Deputy Director, NIH, National Center for Research Resources, National Library of Medicine). The format generated discussion and questions from Members of Congress and congressional staff. Council asked to see the agenda and membership of the four panels that testified at the Reauthorization Hearings as well as a copy of the testimony Dr. Varmus presented about scientific issues and questions.

Dr. Hodes testified as part of a panel before the House Appropriations Subcommittee. Senate Appropriations hearings had not been held.

Staff Changes:

Dr. Hodes announced that Dr. Katrina Johnson has accepted a position with the Office of Research on Women's Health and that Dr. Deborah Claman has resigned from NNA because of illness. He noted that the search for Associate Director, NNA, is progressing, that three candidates will be interviewed in June, and that an appointment is expected shortly thereafter.

Consideration of Minutes of Last Meeting

The minutes of the February 1, 1996 meeting were approved as submitted.

Future Meeting Dates

  • September 26-27, 1996 (Thursday-Friday)
  • January 30-31, 1997 (Thursday-Friday)
  • May 22-23, 1997 (Thursday-Friday)
  • September 25-26, 1997 (Thursday-Friday)
  • February 5-6, 1998 (Thursday-Friday)
  • May 21-22, 1998 (Thursday-Friday)
  • September 24-25, 1998 (Thursday-Friday)

II. Review Of Nia Program

The Working Group on Program had previously discussed with Council whether it would be useful to Council to review and advise the Institute on NIA's programs overall in addition to its review of each program area. Program staff prepared options for the conduct of such a review. With the prior concurrence of the Working Group on Program, staff structured the discussion around NIA's scientific planning process and identifying opportunities for input to that process from members of Council and the extramural community. An overview of the planning process was presented, with emphasis on its integration with budget planning and the appropriations process, and in NACA's contributions to the planning process.

Dr. Wetle pointed out that the scientific planning process at NIA is a complex, multiyear process. It is informed by program source books, individual program area reviews, council program reviews, winter retreat, summer retreat, working groups, trans-NIH special interest groups, and the NIA program database. Five goals relating to scientific opportunities were articulated, and each component of the NIA Planning Process was described along with its related activities.

Program Source books present an overview of each program, its accomplishments, scientific advances made by program grantees, and planned initiatives. Source books are used as reference volumes to prepare for the budget hearings. They contribute to program planning. They help staff prepare responses to inquiries about program objectives and activities, and are used to share information about each program among NIA staff. After looking at an adaptation of the Behavioral and Social Research (BSR) Program source book that is sent to all grantees of that program, Council members requested that other program source books be adapted similarly and be made available to Council members.

Internal Program Reviews are designed to bring together intramural and extramural staff. At the program reviews there is presentation of a program overview, program goals and resource allocation, scientific advances, research in progress, and problematic areas of research. The internal program reviews are a somewhat formal opportunity to discuss program progress and critique ideas for proposed initiatives.

The Council Review of Program includes presentations by program, dissemination of information about program, and discussion. Reviewers learn about program goals, scientific advances, and program accomplishments. They advise program on its portfolio overall or on that portion presented in the review, advise on program management and administration, assure that NIA is responsive to public needs, and encourage initiatives. The Council was reminded that at its request, the Institute has been experimenting with different modes of program review during the last 2-3 years. The format is evolving to include an evaluation/review of proposed initiatives, a review of ongoing initiatives, a review of the entire program or of a subset of program activities, and a discussion of program-wide issues.

Each of NIA's extramural programs made a brief presentation. The Biology of Aging Program (BAP), in its last review, emphasized maximization of resource use during times of limited resources. Council discussion considered coordination of extramural activities with intramural, particularly for translational research so that in the near future, when the field is ready to translate current leads, the field will be ready to conduct state-of-the-art science.

The BSR Program is charged with supporting research in the full range of behavioral and social sciences. The Office of Demography coordinates demographic research on aging conducted by the Federal Government and manages the Federal Forum on Aging Statistics. Areas of current program development were identified: behavior genetics, social cognition, standard measuring instruments for cognitive aging; research plasticity in the robust oldest -old; older patients and their doctors; aging and health care in a changing environment; aging, health and religion; socioeconomic position aging and health and biodemography. The BSR model for its last program review was to invite both Council members and extramural scientists to consider a limited portion of the program. The reviewers assessed research agendas of the recent past and near future, and consulted on specific aspects of program development.

The Neuroscience and Neuropsychology of Aging (NNA) Program outlined its structure and recent priority areas. It noted that it is unique among NIA programs in having a vertical organization; that is, it deals with a full range of science from basic to clinical in one program. It was noted that the program has had a role in the recently initiated Inter-Institute Working Group on Alzheimer's Disease that includes the National Institute on Aging, National Institute of Mental Health, National Institute of Neurological Disorders and Stroke, and the National Institute of Nursing Research.

The Geriatrics Program (GP) presented its organizational structure and demonstrated the wide range of clinical research it supports. Current priorities include menopause, musculoskeletal physiology and disorders, cardiovascular issues in aging, nutrition and metabolism, cancer and aging, infectious diseases and training in geriatrics. In its most recent program review GP had asked Council members for recommendations on a focused subset of the research areas and mechanisms supported by the program.

Council members raised some questions about why a particular research area is supported by one program rather than another. It was emphasized that there are many areas of aging research that cross program boundaries, and that it is quite common for Institute programs to jointly support research projects in cross-cutting areas.

The Institute as a whole engages in further planning activities through two retreats. At the Winter Retreat, the focus is on opportunities for scientific advances that involve collaboration among programs or that are too costly for a single program to support. Program staff present the rationale for a topic. The topic generally is assigned to a working group that makes a recommendation to the NIA Planning Group.

At the Summer Planning Retreat, programs and working groups generate the topics that will be discussed. Based on written materials and retreat discussions, participants evaluate the relative importance of programmatic requests. The Director, NIA, follows up by approving development of initiatives. Requests to undertake program initiatives with set- aside funds also are considered at the Summer Planning Retreat.

In Council discussion of how ideas for initiatives develop, it was noted that they may emerge from promising topics at workshops that are then developed by a program and are coordinated across programs. If the topics are cross-cutting, the workshop tends to be planned by a Working Group involving representatives from several or all NIA programs. Council members commented that executive summaries of workshops are useful. Council requested that summaries, commissioned papers, and workshop reports be made available on the World Wide Web.

The planning and review processes governing the NIA Intramural Programs differ from those for the extramural programs. The Board of Scientific Counselors (BSC) has primary responsibility for review of the NIA intramural programs. Twice a year the Board of Scientific Counselors, bolstered by ad hoc reviewers in relevant subject areas, does on-site reviews. The Epidemiology, Demography and Biometry Program (EDB), an intramural program of NIA, historically, has been semi-autonomous. An ad hoc advisory committee has reviewed and advised the EDB program. However, personnel actions, including promotions, require formal review by the BSC. It has been recommended and accepted that the EDB program be reviewed routinely by the BSC. Each laboratory is reviewed in depth about once every 4 years, and a separate review is conducted of the program overall. Recent NIH policy dictates that once every 4-6 years, an ad hoc committee of the Council is to evaluate the Scientific Director's administrative leadership. The Council ad hoc committee is to prepare a report for the Council, and the Scientific Director is invited to respond to that report.

Dr. Dan Longo, NIA Scientific Director, was introduced. He announced that changes are expected in the Laboratory of Neurosciences and in the Laboratory of Clinical Physiology as new Chiefs are appointed to succeed Drs. Rapoport and Andres who are stepping down. Dr. Longo would like to establish a Laboratory of Genetics and to initiate clinical trials and other clinical intervention studies. He noted that the Baltimore Longitudinal Study of Aging DNA bank is poised to address research questions concerning putative biomarkers of aging, e.g., mitochondrial DNA deletions, DNA repair decline, and advanced glycation end products. It is already collecting data on these measures.

Council members urged careful planning and monitoring as issues ranging from the dangers of storage artifacts, through the pitfalls of generalizing from animal to human studies, make these areas of research particularly challenging.

In addition to review and subsequent planning that emerges from the review process, the intramural programs hold an annual scientific retreat. At the most recent intramural retreat, 150 presentations were offered. These presentations inform intramural and extramural NIA scientists of issues and problems their colleagues are working on and generate research collaborations.

Council members requested that one of its members serve as liaison with the Board of Scientific Counselors and attend both the BSC and NACA meetings on an ad hoc basis.

In discussion, a member noted that extramural scientists, when they prepare grant applications, look back at what they proposed in relation to what they accomplished. The issue of evaluation and of comparing plans to outcomes was raised. Council members also queried whether the planning process itself was being reviewed and evaluated. Dr. Hodes responded that this type of comparison is addressed in individual program reviews, but it is not clear that it takes place across the NIA overall. He pointed out that it is too soon to provide feedback on outcomes related to set-asides and sought Council members' input on valuable outcome measures.

Council members also discussed their advocacy role in educating the public about aging research. They indicated a desire for more information on Institute initiatives on training and thanked NIA staff for publications available at the NACA meeting. Members stressed the need for coordination across NIH and other government agencies and the need for greater participation from professional organizations at NACA meetings.

Council discussion of planning process

In an extended discussion, Council members identified specific information and actions they would like to have available or help to initiate.

On informational needs, Council members indicated a desire for:

  • Edited Program sourcebooks. Electronic availability is preferred.
  • E-mail addresses and FAX numbers of NACA members and NIA staff available (with restricted access) on the NIA Home page. It was noted that NIA staff e-mail addresses are already listed on the NIH Home page.
  • Information about scientific findings - the cutting edge issues - to help them to perform their role as advocates for aging research. One model suggested was for individual NACA members to present findings at Council meetings.

On Institute planning and initiative development

  • Council members wanted to have the Winter Retreat discussion topics available for individual comment.
  • Members indicated they would like an opportunity to discuss the results of the Winter Retreat at May Council so that input could be introduced into the Summer Retreat discussions.

On NACA review of NIA intramural programs

  • NACA members agreed to Dr. Hodes' suggestion that they receive annually a report of the Board of Scientific Counselors' Review and the Intramural program response.
  • Members also requested that the Scientific Director present to NACA annually.
  • One NACA member also suggested the possible use of a liaison member of Council serving on the Board of Scientific Counselors.
  • One NACA member expressed a desire to see the Intramural sourcebook.

Dr. Hodes indicated that NIA should have Sourcebook material available electronically by January 1997. He indicated that NACA members may participate in intramural program review by having a NACA member serve in an ad hoc capacity during review of individual laboratories.

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