Performance Improvement 1998. National Institute of Health

02/01/1998

Contents

The Status of Biomedical Research Facilities 1996

Evaluation of the National Research Service Award Research Training Programs

National Heart, Lung, and Blood Institute Article Citation and Patent Reference Study: An Analysis of Article Citations and Patent References to Journal Articles Supported by the National Heart, Lung, and Blood Institute

Rare Diseases Clinical Research Data base

The National Survey of Laboratory Animal Use, Facilities, and Resources

Promoting Safe and Effective Genetic Testing in the United States: Final Report of the Task Force on Genetic Testing

National Cancer Institute: Characterization of User Population and User Satisfaction of the PDQ Data base-- Documentation for Tracking System

Bridges to the Future: Program Evaluation

Academic Research Instruments and Instrumentation Needs in the Biological Sciences

A Study to Determine the Changes of Physician Prescribing of Antimicrobial Agents, Omeprazole, and H2-Receptor Antagonists for Peptic Ulcer Disease Two Years Following the NIH Consensus Conference on Helicobacter pylori

Toxicology and Environmental Health Information Resources: The Role of the National Library of Medicine

Evaluation of the International Cooperative Biodiversity Groups (ICBG)

Federal Interagency Forum on Aging-Related Statistics: Data Base News In Aging

Finding the Balance: Report of the National Institute of Mental Health Intramural Research Program (IRP) Planning Committee

TITLE: The Status of Biomedical Research Facilities 1996

ABSTRACT: Since 1986, the National Science Foundation and the National Institutes of Health (NIH) have collected and reported to the Congress biennial information on the quantity and quality of biomedical research space. This report describes findings from the 1996 Survey of Scientific and Engineering Research Facilities at Colleges and Universities. The survey collected data from colleges and universities with research and development (R&D) expenditures exceeding $50,000, from Historically Black Colleges and Universities (HBCUs) with any R&D expenditures, and from a sampling of academic and nonprofit research organizations that received extramural research funding from NIH. The report found that (1) institutions performing biomedical research devoted approximately 67.4 million net assignable square feet to this work; (2) roughly half of survey respondents classified their medical science research space and/or biological science research space as inadequate; (3) expenditures to construct, renovate, and repair biomedical research space declined for the first time since NSF and NIH began collecting data; (4) the largest proportion of new construction was funded by State and local governments, while almost half of all institutions funded their own repair/renovation projects; and (5) 36 percent of all institutions with biomedical research space reported repair renovation projects that had to be deferred because funds were not available. In addition, the survey reported that HBCUs: (1) comprised 12 percent of the Nation's research-performing institutions, but contained only 1.8 percent of the national biomedical research space; (2) reported that 8 percent of their biomedical research space needed major repair/renovation to be used effectively; (3) have experienced a steady decline in new construction funding since the first survey in 1986 which reported expenditures of $42 million, to $0.2 million in 1994-5. (Final report: variously paginated.)

AGENCY SPONSOR: Office of the Director

FEDERAL CONTACT: Charles L. Coulter

PHONE NUMBER: (301) 435-0766

PIC ID: 3562.2

PERFORMER ORGANIZATION: National Science Foundation, Arlington, VA

TITLE: Evaluation of the National Research Service Award Research Training Programs

ABSTRACT: This project had several objectives. First, it conducted an evaluation design study, developing a detailed plan for a comprehensive evaluation of career outcomes of pre- and post-doctoral trainees and fellows and of the National Research Service Act (NRSA) programs in which they have participated. The evaluation developed recommendations promoting approaches that are successful in order to improve the return on Federal investment in research training. The second objective of the project was to characterize the nature and quality of the training actually experienced by the present and former trainees and fellows and to differentiate between a good training program and simply having good trainees. The project's third objective was to tap the perceptions of National Institutes of Health (NIH) staff, present and former NRSA trainees and fellows, and university employees about the nature and impact of the training program. The study developed performance indicators so that future evaluations may be based on data that are consistent across separate awards. The final report for this study will not be available until the Evaluation of NIH Post-doctoral Trainees and Fellows is completed in the summer of 1998. See PIC ID No. 6285.

AGENCY SPONSOR: Office of the Director

FEDERAL CONTACT: Walter Schaffer

PHONE NUMBER: (301) 435-2770

PIC ID: 5571

PERFORMER ORGANIZATION: The Lewin Group, Fairfax, VA

TITLE: National Heart, Lung, and Blood Institute Article Citation and Patent Reference Study: An Analysis of Article Citations and Patent References to Journal Articles Supported by the National Heart, Lung, and Blood Institute

ABSTRACT: The primary objective of all National Institutes of Health (NIH) activities is to improve the health of the American public. However, it is generally impossible to demonstrate the impact of basic research in terms of reductions in disease mortality or morbidity. Therefore, alternative measures must be relied upon. The objectives of this project were to (1) introduce the concept of examining patents as an additional measure for assessing the impact of NIH-supported research; (2) develop a methodology to use patents in evaluation research; and (3) apply this methodology to a National Heart, Lung, and Blood Institute (NHLBI) project in order to compare the outcomes for individual research project grants (R01s) funded under a Request for Applications (RFA) with individual research project grants funded from unsolicited applications. The methods, data bases, software, and results of this project will be used by other Institutes, Centers, and Divisions to evaluate their own funding mechanisms. The project examines the impact of NHLBI grants during the period 1982 through 1994 with respect to the number of biomedical research articles associated with grant programs, the number of subsequent citations to these articles, and the number of patent references to the original articles. The report finds that (1) about 12,500 grants resulted in over 90,000 research articles cited in over 2 million later articles; (2) 3,000 of the original articles are referred to in over 1,000 patents; (3) half of all cited articles are cited no more than 12 times over the 14-year period studied, although a few were cited over 1,000 times each; (4) two-thirds of articles referenced in patents appeared only once, although 3 articles are each referenced in over 20 patents; and (5) new RFAs result in higher than normal numbers of citations, but lower than normal number of patent references. (Final report: 11 pages, plus appendices.)

AGENCY SPONSOR: National Heart, Lung, and Blood Institute

FEDERAL CONTACT: Carl A. Roth

PHONE NUMBER: (301) 496-3620

PIC ID: 5577

PERFORMER ORGANIZATION: National Heart, Lung, and Blood Institute, Bethesda, MD

TITLE: Rare Diseases Clinical Research Data base

ABSTRACT: The Rare Disease Clinical Research Data base (RDCRD) has been established by the Office of Rare Diseases (ORD), Office of the Director, National Institutes of Health (NIH). NIH made a commitment to the rare disease community and to the Congress to develop a mechanism for identifying and monitoring rare disease research supported by the NIH. The data base is similar in format to the Physician Data Query (PDQ) System of the National Cancer Institute. The International Cancer Information Center of NCI provided assistance in the development of the data base. Contact was made with 520 principal investigators and the 75 General Clinical Research Centers managers to determine those clinical trials in active states. The ORD retrieved 291 protocols from ongoing clinical trials to be included in the data base. Information from these protocols has been placed in abstracts and will be available from ORD's home page on the Internet. This development activity will continue, and the next two phases will include the development of information from clinical trials receiving support from the voluntary patient support organizations and the pharmaceuticals and biotechnology industries. ORD will continue to seek information from newly supported clinical trials receiving support from NIH. Information on specific rare diseases is difficult to locate; and, in many cases, the public, confronted with penetrating the NIH information system, reported difficulties gaining access to it. The RDCRD will eliminate this problem by providing an easy-to-use interface between the user and the data base information system. The data base contains up-to-date information that is easily accessible to a diverse user population. This information will facilitate patient and physician access to this information and lead to improved recruitment of patients with rare diseases or conditions into NIH-sponsored clinical trials. (Final report: 8 pages.)

AGENCY SPONSOR: Office of the Director

FEDERAL CONTACT: Stephen C. Groft

PHONE NUMBER: (301) 443-6156

PIC ID: 6043

PERFORMER ORGANIZATION: Oak Ridge Associated Universities, Oak Ridge, TN

TITLE: The National Survey of Laboratory Animal Use, Facilities, and Resources

ABSTRACT: This report summarizes the results of the survey conducted by the National Institutes of Health (NIH) on animal-based research for fiscal year (FY) 1993. NIH is responsible for oversight of the nationwide infrastructure required to pursue basic biomedical and behavioral research including laboratory animals, as well as the resources and facilities required to ensure their availability, appropriate use, and humane care. This study updates information gathered in the last national survey conducted in 1978. For FY 1993, the report finds that (1) of the 626 respondents, roughly half were academic institutions, and half consisted of research laboratories, independent hospitals, and government agencies; (2) there is a total census of approximately 2.5 million animals; (3) facilities reported acquiring 8.3 million animals, of which 29 percent were acquired through the facilities' own breeding; (4) respondent facilities made approximately 9 million vertebrate animals available for research, education or training, and testing, and animal species were used predominantly for research; (5) among directors of animal care and use programs, 74 percent had a doctoral-level degree; (6) among respondent facilities, 34 percent reported having space in need of renovation, 15 percent reported having space in need of replacement, and enclosed animal housing was the category most frequently cited as in need of replacement; and (7) the 559 respondents who provided cost information spent $521 million on animal care and reported that their costs had increased since FY 1991 by 25 percent. This report contributes to the understanding of the effects of Federal, State, and local laws, regulations, and policies enacted to ensure humane care and to regulate the supply and cost of laboratory animals. See also PIC ID Nos. 1506 and 2675. (Final report: 55 pages.)

AGENCY SPONSOR: National Center for Research Resources

FEDERAL CONTACT: Anne Summers

PHONE NUMBER: (301) 496-5572

PIC ID: 6048

PERFORMER ORGANIZATION: Analytical Sciences, Incorporated, Durham, NC

TITLE: Promoting Safe and Effective Genetic Testing in the United States: Final Report of the Task Force on Genetic Testing

ABSTRACT: Genetic testing is the analysis of human DNA, RNA, chromosomes, proteins, and certain metabolites in order to detect heritable diseases. The Task Force on Genetic Testing was created by the NIH-DOE Joint Working Group on Ethical, Legal, and Social Implications of Human Genome Research (ELSI Working Group) to review genetic testing in the United States and to design policies to minimize the potential negative effects of genetic testing. Their final report recommends that (1) an advisory committee be established on genetic testing in the Office of the Secretary to implement the Task Force recommendations and to determine which genetic tests require stringent scrutiny; (2) protocols for the development of genetic tests that can be used to predict future disease in healthy people receive the approval of an institutional review board (IRB) when the intention is to make the test readily available for clinical use; (3) test developers submit their validation and clinical utility data to external reviewers as well as to interested professional organizations in order to permit informed decisions about their routine use; (4) the newly created genetics subcommittee of the Clinical Laboratory Improvement Advisory Committee consider the creation of a specialty in genetics that would encompass all predictive tests that satisfy criteria for stringent scrutiny; (5) curricula on genetics be incorporated into medical school and residency training; (6) hospitals and managed care organizations require evidence of competence before permitting providers to order predictive genetic tests or counsel about them; and (7) physicians have access to accurate information to enable them to diagnose rare diseases, to know where to turn for assistance in clinical and laboratory diagnosis, and to locate laboratories that competently test for rare diseases. (Final report: 88 pages, plus appendices.)

AGENCY SPONSOR: Office of the Director

FEDERAL CONTACT: Jean McKay

PHONE NUMBER: (301) 594-2740

PIC ID: 6090

PERFORMER ORGANIZATION: Johns Hopkins Medical Institution, Baltimore, MD

TITLE: National Cancer Institute: Characterization of User Population and User Satisfaction of the PDQ Data base-Documentation for Tracking System

ABSTRACT: This study examines the user population and users' satisfaction with the Physician Data Query (PDQ) data base. PDQ was originally targeted to physicians only, but the information included in the data base was recognized to be of value to the larger community of nurses, researchers, health educators, and librarians, as well as patients, their families, and friends. PDQ is distributed to these audiences by the original on-line services, CD-ROM, facsimile, hard copy, and electronic networks, including the Internet. The users surveyed for the study include both primary users, or those who access the PDQ data base to fulfill their own research needs, and secondary users, who only conduct searches for others. The report finds that (1) the data base is widely and repeatedly used and is highly regarded; (2) physicians, other health care professionals, and librarians/information specialists predominate among the user population; (3) patients and their families and friends are also recipients of the PDQ information, even when the National Cancer Institute (NCI) toll-free information center phone service is excluded; (4) users consistently see PDQ as an authoritative and dependable source of cancer information; (5) no sections of the data base are negatively regarded or go unused; and (6) many users share the information they access through PDQ with others. Several recommendations are developed as a result of this report. The report recommends that NCI's International Cancer Information Center should (1) establish formal licensing structures to strengthen its ability to require access to users from the vendors, (2) repeat this survey within three years, (3) consider creating a CD-ROM version of the data base on its own in order to reduce costs to consumers, and (4) work with distributors and intermediaries to develop mechanisms for gathering data on user access. (Final report: variously paginated, plus appendices.)

AGENCY SPONSOR: National Cancer Institute

FEDERAL CONTACT: Bonnie J. Harding

PHONE NUMBER: (301) 496-7406

PIC ID: 6092

PERFORMER ORGANIZATION: Aspen Systems Corporation, Silver Spring, MD

TITLE: Bridges to the Future: Program Evaluation

ABSTRACT: In February 1992, the National Institute of General Medical Sciences (NIGMS) and the National Institutes of Health Office of Research on Minority Health announced the implementation of the Baccalaureate and Doctoral Bridge programs. The objective of the Baccalaureate Bridge program is to facilitate the transition of minority students at two-year colleges into colleges with baccalaureate degree programs in the sciences. The Doctoral Bridge program seeks to facilitate the transition of students into Ph.D. programs when they complete the M.S. degree. Two program outcomes that are particularly relevant to the goals of the Bridges program were examined in this study: (1) the transition of students from two-year to four-year institutions, or from M.S. to Ph.D. programs; and (2) the retention of students in the educational pathway both prior to and after making the transition from one institution to another. Although the quantity and quality of the comparison data is not high, rates of transfer among Bridges students appear to be higher than rates among other students. Success in completing the baccalaureate degree among those students who have transferred is high, and is comparable to the rate found among other minority students in an evaluation of the NIGMS Minority Access to Research Careers program. At the baccalaureate level, approximately 70 percent of the students are majoring in such fields as biology, chemistry and biochemistry, molecular biology, and microbiology. From the current data, it is difficult to develop good estimates of the eventual outcomes of participants in the Doctoral Bridges program. The early cohorts of students were small. Of the 21 students in the first two cohorts, about half have transferred to a doctoral program. While the rate of Bridges student attrition from graduate programs is below the national average, it is still too soon to predict their rate of completing their doctoral programs.

AGENCY SPONSOR: National Institute of General Medical Sciences

FEDERAL CONTACT: James Onken

PHONE NUMBER: (301) 594-2764

PIC ID: 6093

PERFORMER ORGANIZATION: Turner Consulting Group and TYC Associates, Rockville, MD

TITLE: Academic Research Instruments and Instrumentation Needs in the Biological Sciences

ABSTRACT: This report examines the fourth cycle of a national instrumentation survey concerning scientific research instruments and the academic units in which they are found for a range of scientific fields. Conducted in 1994, the survey analyzes data from two distinct populations of institutions. The first population consists of 318 institutions performing more than $3 million in research and development (R&D) in 1991. The second population consists of 44 historically black colleges and universities (HBCUs) that reported R&D expenditures in 1994. The study, in results generalized to the first group, finds that in 1993 (1) expenditures for biological research instrumentation totaled $283 million; (2) Federal funding as a percent of total funds for the purchase of biological research instrumentation declined from 48 percent in 1983 to 39 percent: NIH was the single largest Federal funding source providing $85 million; (3) 67 percent of respondents reported an increase in instrumentation needs between 1992 and 1994; (4) the price tag for the three highest priority research instruments was $363 million; (5) 20,978 research instruments in the biological sciences had a purchase price of $20,000 or more; and (6) principal investigators report that only 28 percent of the biological instruments were state-of-the-art in meeting researchers' needs. For HBCUs, the study finds that (1) the purchase price of research equipment in 1993 was $4.9 million, of which 48 percent was spent on maintenance, repair, and operation costs of the instrumentation; (2) Federal funding provided 85 percent of funding, $4.2 million, to purchase research instrumentation, and NIH was the largest source of funds; and (3) 65 percent of respondents reported inadequate research equipment. See also PIC ID Nos. 2382, 2382.1, and 4659. (Final report: 99 pages, plus appendices.)

AGENCY SPONSOR: Office of the Director

FEDERAL CONTACT: Paul Seder

PHONE NUMBER: (301) 496-4418

PIC ID: 6121

PERFORMER ORGANIZATION: National Science Foundation, Arlington, VA

TITLE: A Study to Determine the Changes of Physician Prescribing of Antimicrobial Agents, Omeprazole, and H2-Receptor Antagonists for Peptic Ulcer Disease Two Years Following the NIH Consensus Conference on Helicobacter pylori

ABSTRACT: This study evaluates physicians' prescribing patterns for the treatment of peptic ulcer disease (PUD). Its particular focus is whether recommendations of a February 1994 National Institutes of Health (NIH) Consensus Development Conference advocating the use of antimicrobial agents for peptic ulcer patients with Helicobacter pylori infection were coincident with a change in physician prescribing patterns. The study uses computerized Pennsylvania Medicaid administrative data from January 1993 through February 1996 to evaluate prescribing patterns in the year prior and the two years following the NIH conference (12,737 patient records in all). Seven major therapeutic drug classes were analyzed: antimicrobial agents, H2-receptor antagonists, antisecretory agents, bismuth subsalicylate, sucralfate, misoprostol, and antacids. The report finds that (1) only 10 percent of prescriptions contained an antimicrobial agent, while 62 percent were for an H2-receptor antagonist only; (2) the two- and three-drug regimens recommended by the NIH conference were infrequently prescribed (1.1 percent and 0.9 percent, respectively); (3) younger and non-white PUD patients were more likely to receive a prescription for antimicrobial agents than older and white patients; (4) duodenal ulcer patients were more likely than non-duodenal ulcer patients to receive an antimicrobial prescriptions; and (5) the prescription of antimicrobial agents for the treatment of PUD significantly increased from 7 percent to 14.2 percent over the study period, while prescriptions for H2-receptor antagonists significantly decreased. The report concludes that, while there were increases in the prescription of antimicrobial agents to treat PUD over the study period, these could not be directly attributed to the NIH conference. Physicians do not appear to be using national recommendations.

AGENCY SPONSOR: National Institute of Diabetes, Digestive and Kidney Diseases

FEDERAL CONTACT: Charles Sherman

PHONE NUMBER: (301) 496-5641

PIC ID: 6284

PERFORMER ORGANIZATION: Medical Technology and Practice Parameters Institute, Washington, DC

TITLE: Toxicology and Environmental Health Information Resources: The Role of the National Library of Medicine

ABSTRACT: This report examines the utility and accessibility of the National Library of Medicine's (NLM) Toxicology and Environmental Health Information Program (TEHIP). The TEHIP program encompasses 16 online data bases that contain bibliographic and factual information on environmental contaminants, including chemical properties, carcinogenicity, exposure levels, adverse health effects, emergency treatment protocols, and Federal regulations. The report notes that Federal appropriations for the TEHIP program have remained relatively constant over the past 29 years. However, the program's reimbursements from other agencies for collaborative projects have fluctuated. The report also notes that the TEHIP data base represents only a small subset of the many data bases containing information related to toxicology and environmental health. With this in mind, the report recommends that NLM consider expanding its traditional library services by organizing and cataloging the full spectrum of online toxicology and environmental health information resources. The report also recognizes that the health professional community does not have homogenous information needs and that there is wide variation in access to online data bases and other information resources. It recommends that the TEHIP program should set priorities that would allow efforts to be focused on those data bases that meet the information needs of the greatest number of health professionals and that NLM's training and outreach efforts be increased to improve awareness of the TEHIP program. The report notes that access to the data bases and difficulties in navigating the user interfaces are the two primary factors limiting use of the TEHIP data bases. The report also provides recommendations on programmatic issues and future directions for the TEHIP program. (Final report: 139 pages, plus appendices.)

AGENCY SPONSOR: National Library of Medicine

FEDERAL CONTACT: Susan Buyer

PHONE NUMBER: (301) 496-2311

PIC ID: 6534

PERFORMER ORGANIZATION: National Academy of Sciences, Institute of Medicine, Washington, DC

TITLE: Evaluation of the International Cooperative Biodiversity Groups (ICBG)

ABSTRACT: This report evaluates the International Cooperative Biodiversity Groups (ICBG) program. Funded by the National Institutes of Health and the National Science Foundation, the ICBG is a program designed to protect human health, advance the conservation of biologically diverse ecosystems, and promote sustainable economic development through the search for drugs to control diseases of concern to both developed and developing countries. Since 1993, the program has funded five individual cooperative biodiversity groups around the world. The study design attempts to (1) accommodate the varied and nonstandard implementations of the ICBG concept, (2) obtain broad coverage in terms of respondents, (3) maximize response rates and data quality, (4) minimize burden on ICBG Group Leaders and other respondents, and (5) incorporate cost and time efficiencies wherever possible. Among the benefits for source countries, the report finds (1) that scientific capacity has been developed through training and equipment, (2) development of economic activities, (3) equitable financial return and the protection of intellectual property rights of source-country people, and (4) the potential sustainability of the individual ICBG projects is one of the strengths of the overall program. The report recommends that the ICBG program (1) develop systems of technical assistance based on a combination of outside expertise and lessons learned across programs; (2) improve communications among the ICBGs; (3) consider developing a cross-ICBG data base that includes work being done in collection, extractions, and drug development techniques; and (4) bring in the expertise of social scientists and source-country legal experts to the ICGB to ensure that the consensus-building, benefit sharing, and economic goals of this project are achieved as well. (Final report: 177 pages, appendices bound separately.)

AGENCY SPONSOR: Fogerty International Center

FEDERAL CONTACT: J. Kirby Weldon

PHONE NUMBER: (301) 496-2571

PIC ID: 6641

PERFORMER ORGANIZATION: Battelle Corporation, Arlington, VA

TITLE: Federal Interagency Forum on Aging-Related Statistics: Data Base News In Aging

ABSTRACT: This annual report highlights the aging-related surveys and products currently available from member agencies of the Federal Interagency Forum on Aging-Related Statistics. All Federal agencies are invited to contribute to the report and to participate in the Forum. Contributors to this report are (1) Department of Agriculture: Economic Research Service; (2) Department of Commerce: Bureau of the Census; (3) Department of Health and Human Services: Administration on Aging, Centers for Disease Control and Prevention, National Institutes of Health (NIH), Health Care Financing Administration, Agency for Health Care Policy and Research, and Office of the Assistant Secretary for Planning and Evaluation; (4) Department of Housing and Urban Development: Office of Policy Development and Research; (5) Department of Labor: Bureau of Labor Statistics; (6) Department of Veterans Affairs; (7) Federal Reserve System, Board of Governors; (8) Social Security Administration; and (9) the United Nations. Each survey or data base is listed with its sponsoring organization, purpose, description, current activity, plans for future activity, public use data files, and associated reports, if any. The report ends with a tabular listing of the data bases and surveys described in the report, which gives the latest year data were collected or whether data collection is ongoing, the year for which the most recent data were released, whether public use tapes or printed reports are planned or available, and information on the person to contact about the data base or survey. (Final report: 117 pages.)

AGENCY SPONSOR: National Institute on Aging

FEDERAL CONTACT: Gail Jacoby

PHONE NUMBER: (301) 496-3121

PIC ID: 6652

PERFORMER ORGANIZATION: Bureau of the Census, Washington, DC

TITLE: Finding the Balance: Report of the National Institute of Mental Health Intramural Research Program (IRP) Planning Committee

ABSTRACT: The Intramural Research Program (IRP) of the National Institute of Mental Health (NIMH) must be positioned to make scientific advances crucial to easing the burden of mental disorders. This report represents an active effort by the NIMH IRP Planning Committee to help the program make these advances. The Committee evaluated the rationale for the program's continuance, as well as its strengths and weaknesses. It solicited confidential letters from almost 1,000 IRP scientists and staff and met with National Institutes of Health (NIH) leadership, the IRP's past and present leadership, and advocacy organizations. It found strong justification for the continued existence of the IRP, as long as the research it produces is of the highest quality. The Committee also offered recommendations to revitalize the IRP. The report finds that (1) stable scientific leadership is crucial to revitalizing IRP science, thus the program must recruit a Scientific Director for the program; (2) the overall quality of IRP science has declined from its previous place at the top of the scientific endeavor-while there are some areas of research brilliance, some research is of lesser quality, according to members of the Board of Scientific Counselors and intramural and extramural scientists; (3) recruitment and retention of talented scientists is essential, but over the past five years, the program has recruited from outside of NIH only one of its four newly-tenured scientists; (4) the quality of the program's intramural training efforts is uneven; (5) the program should address the fact that post-doctoral fellows have difficulty competing for positions when they leave NIH due to a lack of sufficient grantsmanship and teaching experience; and (6) NIMH's IRP's clinical research program needs to be sustained and revitalized.

AGENCY SPONSOR: National Institute of Mental Health

FEDERAL CONTACT: Emily Gause

PHONE NUMBER: (301) 443-4335

PIC ID: 6697

PERFORMER ORGANIZATION: National Institute of Mental Health, Rockville, MD

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