Goal 4: Develop Workforce and Resources

Making R01 funding work for the Medical Sciences

We need to spread R01 funding around more to ensure that the best science has funding adequate to move forward. To do this I believe changing how we think about R01 funding and expenditures can be used to put the NIH funds to better use. Too often successful researchers have the majority of their salaries on R01s and the institutions have little skin in the game. PI salaries can be a large part of the escalating budget ...more »

Submitted by (@wjones7)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Critical Challenge (CC)

Details on the impact of addressing this CQ or CC :

The impact of spreading the funding would be to improve funding rates, improve funding of new investigators, and supporting more diverse science. Negative impacts would include reduced funding some large labs. In my experience, in some cases, this would be a good thing. There could be special programs and exceptions for large labs that make significant important contributions and serve as resources to reduce negative impact. Review of grants should include information on manuscript retractions and large labs with many retractions should be carefully scrutinized for defunding.

Feasibility and challenges of addressing this CQ or CC :

Such changes would have to be made incrementally over time since this will require states and institutions to pick up some of the cost of science and therefore must be phased in to allow for time to adjust the workforce in specific places to align with budgetary constraints. Institutions might be encouraged to do more fundraising to actually support science to fill gaps.

Name of idea submitter and other team members who worked on this idea : Keith Jones with major input from Pieter de Tombe

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44 up votes
16 down votes
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Goal 1: Promote Human Health

Promoting health through simultaneous prevention of obesity and eating disorders

How to best promote healthy weight while also not stigmatizing obesity and creating risk for eating disorders (i.e., weight concern and body dissatisfaction) in youth. How to tackle both without contributing in unwitting way to development of either.

Submitted by (@tantillo)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Details on the impact of addressing this CQ or CC :

Studies show that diets do not lead to sustained health benefits for the majority of people and several studies indicate that dieting is actually a consistent predictor of future weight gain. Repeated cycles of losing and gaining weight are linked to heart disease, stroke, diabetes and altered immune function. Children and adolescents are especially vulnerable to the impact of dieting. Several long-term research studies show that girls and boys who use unhealthy weight control practices (including dieting) in early teen years are more likely to become overweight five years later, even if they started out at normal weight. These studies also show that early teen boys and girls who use unhealthy weight control practices are at greater risk for binge eating, use of severe weight control practices ( vomiting, diet pills, laxatives and water pills), and eating disorders compared with adolescents not using weight-control behaviors.

 

Since our culture tends to create weight bias and obesity stigmatization, it is not surprising to see our children become increasingly fearful of becoming “fat.” Weight concern can be experienced by underweight, average weight and overweight children and teens. Studies have shown that body dissatisfaction, especially weight concern (for early teen boys and girls), can lead to overweight, binge eating, severe weight control practices, and eating disorders. Weight teasing by family members and peers can also increase the risk for eating disorders.

Feasibility and challenges of addressing this CQ or CC :

Challenges include creating teams of researchers who will collaborate across the two fields. I believe if we could create such teams we could

move both fields ahead with regard to prevention and a focus on health (behaviors that are health promoting), not BMI (a number) or an emphasis on intake.

 

The key to both health problems involves the ecology in which youth are located b/c this ecology influences body image, intake, activity, self regulation and self care.

Name of idea submitter and other team members who worked on this idea : Mary Tantillo PhD PMHCNS-BC FAED

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62 net votes
116 up votes
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Goal 2: Reduce Human Disease

Single thing needed to prevent obesity: control the mouth

The cause of obesity is clear and simple: eating > needs, or in > out; that is, energy intake is greater than energy use. For the majority of the public, there is little genetic component to cause obesity or over weight. Rather, personal determination is the single thing that is needed to control body weight. Just control the mouth. Simple and easy, and free. Even for the most favorite food, the amount to eat should be ...more »

Submitted by (@eastcastlegeastcastle007)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Name of idea submitter and other team members who worked on this idea : eastcastle007

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-82 net votes
11 up votes
93 down votes
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Goal 4: Develop Workforce and Resources

Similar changes to those in modern manufacdturing are required through our new technical society inlcuding medicine.

Attitudes to Mistakes. Changing prescription and protocol philosophy. As an older patient, I am 89, I have one thing many others do not have, experience. As an engineer with much experience in manufacturing industry I have seen great recent changes in manufacturing sociology. Now, even top management comes to listen to “the Gemba” (the shop floor) and what could be regarded as mistakes are seen as opportunities to improve ...more »

Submitted by (@khop00)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Critical Challenge (CC)

Details on the impact of addressing this CQ or CC :

As an engineer with considerable experience in manufacturing industry I have seen great changes in manufacturing sociology. We have come to listen to the Gemba (the shop floor) and inappropriate procedures are now regarded as opportunities to improve not something to be punished. Perhaps I can mention that my writing has been praised on this subject, for example for the book, "The Puritan Gift” by Kenneth and Will Hopper. “This is one of the best books I have ever read in my long life, and I don’t just mean books on business” Foreword: by Russ Ackoff, Wharton Business School. “late in their lives (the Hoppers) have given us an extraordinary gift” (translated from Chinese) Promise Hsu, Vista Magazine

Feasibility and challenges of addressing this CQ or CC :

I suggest as a subject for discussion, that a change to a more aggressive use of antibiotics could save antibiotics. There is an old saying that the best time to hit a man is when he is down. The same surely applies to harmful bacteria.

Name of idea submitter and other team members who worked on this idea : Kenneth Hopper

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2 up votes
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Goal 4: Develop Workforce and Resources

Benefits to the US in funding global health research in LMICs

What are the benefits to the US in funding global health research in low-to-middle-income countries?

Submitted by (@tracywolbach)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Details on the impact of addressing this CQ or CC :

Non-communicable diseases (NCDs) are the leading cause of death and disability worldwide. The four leading NCDs are cardiovascular diseases, cancer, chronic respiratory diseases, and diabetes. The most common risk factors are tobacco use, physical inactivity, unhealthy diet, and alcohol use. NCDs and risk factors are shared globally and offer many opportunities and benefits to US funders and academia, such as implementing treatments in under resourced populations that could benefit US under resourced populations; identifying effective treatment for diseases with low incidence and prevalence in the US; and expanding physician training by caring for patients with diseases in early stages that are not commonly seen in the US until they are quite advanced The United Nations recognized the NCD global burden and held a high-level meeting on NCDs September 19-20, 2011. NHLBI should consider increase funding of global collaborations between the US and LMICs to address this increasing global health burden. Funding for these collaborations would help merge the fields of communicable and non-communicable diseases and provide opportunities for HICs to adopt some of the successful health care interventions implemented in LMICs. NHLBI should also consider a strategy to better inform politicians and taxpayers about the importance and benefits of global NCD research and increase their funding for NCD programs at academic institutions to train young chronic disease professionals.

Name of idea submitter and other team members who worked on this idea : Nancy Dianis

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-1 net votes
4 up votes
5 down votes
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Goal 3: Advance Translational Research

Recognizing that HLB are components of a whole person

RASopathies is one of a group of syndromes that include heart, lung and blood issues, but these are not all the concerns. Recognizing that these organs are part of a functional network (called the human body), partnering with other Institutes could help expedite knowledge of these systems. Leveraging small pockets of funds through mechanisms such as R13 grants where the primary institution is not NHLBI is an inexpensive ...more »

Submitted by (@lschoyer)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Feasibility and challenges of addressing this CQ or CC :

Not hard, no cost.

Name of idea submitter and other team members who worked on this idea : Lisa Schoyer, President, RASopathies Network USA

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Goal 1: Promote Human Health

Evaluation of large-scale regulatory efforts in the US and elsewhere

A number of cities(e.g Berkeley), states and countries (e.g Mexico's SSB tax, Chiles SSB and soon marketing controls and food package front of package label) will go into effect. Rigorous evaluations of the efforts will provide some sense of their potential to effect food purchase and dietary pattern and ultimately cardiometaboiic changes. Serious rigorous independent evaluations are needed to learn if these options--pushed ...more »

Submitted by (@popkin)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Details on the impact of addressing this CQ or CC :

We must learn what we can from the natural experiments not only in the US but globally about both the effects of these efforts on food industry behavior as well as household and individual food purchases and dietary patterns and subsequently their effects on obesity and key cardiometabolic outcomes. This requires serious rigorous teams of scholars to utilize a combination of commercial data sets on food purchases, individual diet, body composition measures of obesity and fat composition and biomarkers.

Feasibility and challenges of addressing this CQ or CC :

These efforts are occurring and will be accelerating across many countries in Asia and Latin America. At the same time many cities or states in the US are moving to implement limited sets of key changes. There is a pressing need to learn if these efforts truly will matter and what changes would be needed to enhance their impact, if any. Finding large-scale regulatory ways to reduce improve our diets, prevent/reduce the prevalence of obesity and all the diet and obesity-related NCD's is critical.

Name of idea submitter and other team members who worked on this idea : Barry Popkin

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22 net votes
42 up votes
20 down votes
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Goal 2: Reduce Human Disease

Improve vascular healing and extend long term benefit of interventions

How can we develop new approaches to improve vascular healing and extend the long term benefits of vascular interventions for more patients?

Submitted by (@societyforvascularsurgery)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Details on the impact of addressing this CQ or CC :

­The response to vascular injury, whether it be catheter interventions, bypass surgery, or chronic implants, is a reactive process characterized by inflammation, cell proliferation, and fibrosis leading to failure. Better understanding of the mechanisms of vessel remodeling, and restoring homeostasis, is needed to improve prediction, develop and translate new treatments. This remains the leading scientific problem in vascular medicine and surgery. New approaches such as proteomics, lipidomics, molecular imaging offer new opportunities in this realm.

Name of idea submitter and other team members who worked on this idea : Society for Vascular Surgery

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