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Seeking Support From the NIH for Pediatric Critical Care Research

Seeking Support From the NIH for Pediatric Critical Care Research. Carol E. Nicholson, MD, MS,FAAP NIH/NICHD/NCMRR. National Institutes of Health Bethesda, MD. NIH consists of 27 Institutes and Centers. NHLBI. NINR. OD. NCCAM. NIEHS. NCI. NIAMS. CIT. NIDA. NEI. NIMH. CC. NIDDK.

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Seeking Support From the NIH for Pediatric Critical Care Research

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  1. Seeking Support From the NIH for Pediatric Critical Care Research Carol E. Nicholson, MD, MS,FAAP NIH/NICHD/NCMRR

  2. National Institutesof Health Bethesda, MD

  3. NIH consists of 27 Institutes and Centers NHLBI NINR OD NCCAM NIEHS NCI NIAMS CIT NIDA NEI NIMH CC NIDDK NLM NINDS NHGRI NIDCR NCMHD NIBIB NIA NIDCD NIAAA NICHD NIAID CSR NCRR NIGMS FIC = Extramural only

  4. What will the future hold for PCCM Research? Advanced Technologies – New approaches to studying protein structure and function will bring great insights into the study of diseases and the design of new drugs

  5. The National Center for Medical Rehabilitation Research Program for Pediatric Critical Care and Rehabilitation Research PCCR And, Brought to you by NICHD…….

  6. NIH (FY 2001 $20.3 billion) ResearchManagement and Support 3% Research Grants 71% All Other 6% IntramuralResearch10% R&DContracts 7% ResearchTraining 3% Over 80% of NIH funds support extramural research

  7. The Future for Pediatric Acute Care Research www.nih.gov

  8. NIH is our Federal Government’s primary agency for support of Biomedical Research.

  9. Funding Mechanisms • Most $ go to investigator –initiated proposals • Training • Career Development • Research Grants • Contracts

  10. NICHD Priorities for Research • Cells to Selves • Developmental Biology • Biobehavioral Development • Reproductive Health • Genetics of Disease Susceptiblity • Health Disparities

  11. Relating NICHD Research Priorities • To the acutely ill and injured child who is an outpatient: Pediatric Emergency Medicine • To the acutely ill and injured child who is an inpatient: Pediatric Critical Care Medicine • To the increasing number of children with special needs beyond acute care:Pediatric Rehabilitation and Physical Medicine

  12. ALL pediatric subspecialties fit into the PCCR research program • Linking what we do to outcomes for children • Mortality is not an adequate outcome measure, in pediatric research

  13. Cells to Selves-I • Neuroplasticity after traumatic or asphyxial brain injury: what acute and rehabilitation strategies will: • Maximize neurodevelopmental outcome for every child • Ensure families of injured children are supported and not exploited

  14. Cells to Selves-II Maximizing Outcomes: • Breaking the guilt/blame/family breakup cycle

  15. Developmental Biology • Mechanisms of age related responses to : • Drugs(pressors, inotropes) • Sepsis(SIRS , genomics may change with development) • Ventilation(susceptibility to infection in special needs kids) - Ischemia and Anoxia(prognosis in the young? Rehabilitation?) • Trauma (neuroplasticity after brain injury)

  16. Biobehavioral Development-I • High Risk Behaviors: Our adolescent trauma victims: manipulation of the young by marketing, exploitation by criminal and legitimate enterprise.

  17. Biobehavioral Development-II • Line sepsis:Compliance with complex regimes in outpatient management of serious illness: realistic in special needs kids? • Child Abuse and Neglect:826,000 children were victims in 1999! Our physical findings and conclusions are constantly attacked due to inadequate supporting research. * Child Maltreatment 1999: DHHS

  18. Health Disparities:Bridging the Gap-I • PICU’s and ER’scontinue to be disproportionately populated by the poorest and sickest of children. • Could we identify 5 diagnoses that bring most of them to our understaffed units? Using this data to seek the assistance of policymakers.

  19. Health Disparities;Bridging the Gap-II • Culturally Sensitive Care: Can we prove it reduces morbidity and mortality?

  20. Reproductive Health for the 21st Century • Infertility;etiologies? Risk factors related to health/illness events in early life? • Maternal Lifestyle Parameters:age, physical parameters, comorbidities, demographics of situations which are risk predictors for serious childhood illness and injury.

  21. Genetics and Fetal Antecedents of Disease Susceptiblity • Genetic polymorphisms in critical illness:Sepsis and trauma: IL-6 responses now characterized by a polymorphism in a promoter gene: How should therapy be designed, how should triage be affected by genotype? Heeson, Critical Care Medicine March, 2002

  22. Targeting Sudden Infant Death Syndrome • Preventive Strategies: dramatic incidence decline initially • Pathophysiology:still poorly understood. Genomics? • Targeted Education/Outreach:Could the incidence be reduced to zero through preventive strategies? If not, why not?

  23. Six Topics linking PCCM with Rehabilitation Medicine • Resuscitation Outcomes • ICU Myopathy • Near Drowning • Respiratory Failure • Shock, hypoperfusion states • Triage of Critically Ill Children

  24. Research Project Award: R01 • Focus on specific set of aims • Investigator-initiated applications , usually…many exceptions • Research plan hypothesis driven • Budget: typically $150-250,000 per year • May request up to 5 years • Renewable

  25. Small Grants: R03 and R21 • Pilot studies; planning and feasibility; innovative, high-risk approaches • Development of new methodology or technology • New investigators especially encouraged

  26. R03’s and R21’s • Not renewable • Can’t be used to supplement funded projects • Budget: R03: $50,000/yr R21: $275,00/2 years • Please contact program staff before you choose a funding mechanism!

  27. SBIR/STTR in Pediatric Critical Care Research • We are proud to be gadget freaks in the PICU, OR, ED or wherever the kids need innovation !

  28. STTR: Phase I: $100,000 (1 year) Phase II: $500,000 (2 years) SBIR: Phase I: $100,000 (6 months) Phase II: $750,000 (2 years Small Business Technology Transfer (STTR, R41/42) and Small Business Innovation Research (SBIR, R43, R44)

  29. Training and Career Development • Individual Fellowships Graduate students (F31) or Postdoc (F32) • Institutional Training Grants (T32) Support graduate training, postdocs, fellows in clinical and basic science investigation • Career Development Mechanisms Emerging basic science and clinical investigators Fully trained clinicians now entering research

  30. Loan Repayment • http://www.lrp.nih.gov/NIHLRP/about/index.htm

  31. Special Research Initiatives • Request for Applications (RFA) • Program Announcements (PA) • Request for Proposals (RFP)

  32. Useful NIH Websites: • NIH Home page:www.nih.gov • CRISP (searchable database of all NIH-funded grants): www.commons.cit.nih.gov/crisp/

  33. Useful NIH Websites: • Center for Scientific Review (study section descriptions and rosters): www.csr.nih.gov • NIH Guide (research initiatives, policy announcements): www.grants.nih.gov/grants/guide/index.html

  34. What happens if………. • My RFA responsive Application is not funded? • The NIH Guide doesn’t solicit the kind of research I want to do?

  35. Proposal may be resubmitted ! • As an investigator initiated proposal, new number, new or modified clock! • Discuss with program staff: policy not yet published!

  36. Progress in Medicine Depends on Your Vision; Don’t stop making things better, EVER….

  37. For Many in Acute Care Medicine, this is a New Journey • Every journey begins with a single step • Contact me for “Seven Steps” • PCCR’s availability to you: “Walk Together.”

  38. NIH/NICHD…. • Welcome your projects in the clinical and basic sciences! • Contact us often….you will make our day! • Carol E. Nicholson, MD, MS, FAAP 301-435-6843 Nicholca@mail.nih.gov

  39. California Dreamin’

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