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APA Comments on Buprenorphine Guidelines
It’s rare that new pharmacotherapies for the treatment
of drug dependence actually make it to market, so it was very exciting to
see buprenorphine gain FDA approval for the treatment of opiate dependence
in office-based settings. On December 10, the Substance Abuse and Mental
Health Services Administration (SAMHSA) held a joint press conference with
representatives of the Drug Enforcement Agency and the National Institute
on Drug Abuse to debut the new medication. During the press conference,
Mr. Odis Rivers, heroin-dependent for 30 years, provided a touching and
impassioned account of his life, including the impact that APA member Bob
Schuster had on him during buprenorphine treatment. He closed with a
tribute to Bob saying, "Wayne State and Dr. Robert Schuster had been
a tremendous, tremendous part of my life.” For additional information,
see the SAMHSA website:
http://www.samhsa.gov/news/click_bupe.html.
Many APA members have contributed to our understanding of
this medication via preclinical and clinical psychopharmacology research
as well as research demonstrating the importance of combining behavioral
and psychosocial interventions in the treatment of opiate dependence. That
story will be told in an upcoming edition of the APA Monitor. In December,
Science Policy Staff were invited to review SAMHSA’s Buprenorphine
Clinical Treatment Guidelines, and this provided an opportunity for
another successful science/practice translation activity. We are grateful
to Geoff Reed, PhD, APA Practice Directorate’s Assistant Executive
Director for Professional Development; Division 50 President, Rudy
Vuchinich, PhD; and Division 50 member Reid Hester, PhD, for their help in
facilitating/conducting the review. The guidelines should now reflect, at
multiple points, opportunities for physicians to access appropriately
trained psychologists as treatment referral resources (a point we tried to
address as buprenorphine legislation was under consideration). In
addition, APA’s College of Professional Psychology and State Advocacy
staff have expressed their willingness to help SAMHSA continue outreach to
APA members interested in patient referral. Click here for additional
background on buprenorphine: http://www.apa.org/ppo/issues/buprepsa.html.
APA President Sternberg Visits the CIA
On December 12, APA Senior Scientist Susan Brandon and
Science Policy Director Geoff Mumford arranged for Robert Sternberg, PhD,
President of APA, to provide a presentation on intelligence and cognitive
assessment to a group of psychologists from the Intelligence Community who
are directly involved in operations. As most of our readers know Dr.
Sternberg, is the IBM Professor of Psychology and Education, Department of
Psychology, Yale University and Director, Center for the Psychology of
Abilities, Competencies, and Expertise (PACE). Dr. Sternberg addressed
cross- cultural assessment issues and summarized his research on
successful intelligence. The Central Intelligence Agency hosted the
presentation. To view Dr. Sternberg's Powerpoint presentation see: http://www2.apa.org/ppo/psych.ppt.
National Children’s Study Holds Planning Meeting
On December 16-18, the National Children’s Study (NCS)
convened a meeting of its Federal Advisory Committee, 22 working groups,
and consumer and scientific organizations to discuss the progress being
made on the study’s design and the development of several core
hypotheses. Earlier this year, the working groups submitted approximately
50 proposed hypotheses to the Advisory Committee. The approved core
hypotheses are organized around five cross-disciplinary themes, which are
framed in terms of outcomes and will be augmented by future hypotheses
developed by the working groups. As of now, the general priority outcomes
are: 1) pregnancy; 2) altered neurobehavioral development; 3) injury; 4)
asthma; 5) and obesity.
Duane Alexander, M.D., Director of the National Institute
of Child Health and Human Development, added that these areas are by no
means final and will be augmented by behavioral, developmental, and women’s
health outcomes. APA and other social and behavioral science organizations
have expressed concern over the lack of inclusion of behavioral outcomes
and the availability of funding for the study, which will cost over $100
million a year during its peak enrollment by FY06. The NCS will examine
the effects of environmental influences on the health and development of
more than 100,000 children across the United States, following them from
before birth until age 21. More information on the study is available
online at: http://www.nationalchildrensstudy.gov.
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NSF “Doubling” Authorization Bill Signed into Law
On December 19th President Bush signed H.R. 4664, a five-year
reauthorization of the National Science Foundation (NSF) that sets funding
ceilings and lays out educational programs for the agency. APA Science
Policy staff lobbied hard for the bill as part of the broader Coalition
for National Science Funding. Though the bill calls for almost doubling
the NSF budget within five years, reaching a total of $9.84 billion in
FY2007, actual funds appropriated to NSF are not likely to reach these
authorized limits, at least in FY 2003 and 2004. Congress has yet to pass
an FY03 funding bill for NSF, and the Administration’s FY04 budget,
scheduled for release in February, will probably contain a relatively
small increase for the agency. To view the bill, use this link from the
NSF website: http://www.nsf.gov/od/lpa/congress/107/final_authorization_language.pdf.
VA Appoints New Chief of Research and Development
In December, Secretary of Veterans Affairs Anthony J.
Principi announced the appointment of Nelda P. Wray, MD, as the new Chief
of Research and Development for the Department of Veterans Affairs (VA),
replacing the retiring John R. Feussner, MD. Wray has served as chief of
general medicine at the Houston VA Medical Center and as a professor and
the chief of health services research at the Baylor College of Medicine.
Board certified in internal medicine and pulmonary medicine, Wray has
conducted research showing that patients with osteoarthritis of the knee
who underwent placebo arthroscopic surgery were just as likely to report
pain relief as those who received the real procedure. In her new role,
Wray will oversee the research programs at 115 VA medical centers. PPO
staff Heather Kelly will invite a group of APA members who conduct
research within the VA to meet with Dr. Wray this spring.
Organizing the New Senate Delays Action on
Appropriations
Members of the 108th Congress arrived in Washington this
month with Republicans controlling both the House and Senate. But before
work can begin on the legislative front, congressional leaders are
spending their first few days organizing committee memberships and
appointing new chairmen where necessary. While the House has completed its
committee organization, new Senate Majority Leader Senator Bill Frist
(R-TN) is still in negotiations with Democrats regarding the organization
and funding of Senate committees.
Once the organization is complete, it is hoped that the
House and Senate can approve the remaining eleven appropriations bills,
including the bill that funds the National Institutes of Health, before
the end of the month. The government is currently being funded at last
year’s levels through a continuing resolution that will expire on
January 31. As Congress left office last year, the final 15% increase of
$3.6 billion for NIH was included in the proposed FY03 Labor, Health and
Human Services, and Education appropriations bill that would meet the
bipartisan goal of doubling the NIH budget. On January 8, however, the
Senate and House leadership agreed to cut the overall Labor-HHS-Education
bill by $2.7 billion, putting NIH funding and other programs at risk. The
House version of the bill includes a $689 million cut to the proposed $3.6
billion increase for NIH, reducing the increase to 13% over FY02 funding.
Other public health and education programs, however, will be faced with
even greater cuts during the last minute rush to complete the FY03 funding
bills before the President introduces his FY04 budget in February.
Sostek Updates Coalition on Peer Review at NIH
Peer review of behavioral and social science grant
applications at the National Institutes of Health (NIH) is in very good
shape, according to Anita Miller Sostek of NIH’s Center for Scientific
Review (CSR). Dr. Sostek, a developmental psychologist who was recently
named Director of CSR’s Division of Clinical and Population Studies,
spoke in early December to a coalition of behavioral and social science
advocacy organizations in which APA is an active member (the Coalition for
the Advancement of Health Through Behavioral and Social Sciences
Research).
Most of the review of behavioral and social science grants
is done in one of the five Integrated Review Groups (IRGs) within Dr.
Sostek’s division: (1) Social Sciences, Nursing, Epidemiology and
Methods; (2) Risk, Prevention and Health Behavior; (3) Behavioral and
Biobehavioral Processes; (4) Surgery, Radiology and Bioengineering; and
(5) Brain Disorders and Clinical Neuroscience. IRGs are groups of related
study sections. Additional information links can be found below.
Behavioral and social science study sections at NIH were
reorganized in 1999, with the participation of many psychologists inside
and outside the NIH. Dr. Sostek said that the process of reorganizing
improved communication among the behavioral and social scientists at NIH
and helped increase their influence within that organization. The
painstaking process through which study sections were reorganized also led
to improved grant review, as measured by CSR evaluations of grant
applicants and study section members. Dr. Sostek credited NIH’s Peer
Review Oversight Group, which directed the reorganization, as well as the
Advisory Council for the Center for Scientific Review (which included
psychologists Karen Matthews and Leonard Epstein) for these improvements.
She noted that, in addition, the NIH Office of Behavioral and Social
Sciences Research has nurtured the teamwork that developed during the
study section reorganization.
Dr. Sostek and her colleagues at CSR believe they have a
good set of study sections but will continue to re-evaluate and tinker as
problems arise. The goals are to make sure there is consistency in the
review process and that the study sections are responsive and adaptive to
changes in science. According to CSR records, there are about 46,000 grant
applications a year. CSR reviews about 35,000 of them (the rest are
reviewed by the institutes or returned for one reason or another).
About half of the applicants request review by a
particular IRG. Dr. Sostek commented that the CSR staff “won’t let
anyone hurt themselves,” and that she and her colleagues will contact
applicants to suggest a better fit if the requested IRG is not
appropriate. There is a lot of interchange and discussion among the study
section administrators to make sure the grants end up in the right place.
Dr. Sostek pointed out that all of the study section members are listed on
the website for the three most recent rounds of review, and that
scientists should certainly recognize some of the names in the review
committees that are appropriate for their grant.
Dr. Sostek encouraged the behavioral and social scientific
societies to nurture a culture of service within their disciplines.
Scientists should feel it’s important to serve on study sections and
that their service is highly valued.
There are many resources for scientists on the Center for
Scientific Review’s web page. Information on review policy can be found
at: http://www.csr.nih.gov/review/policy.asp.
Information about how scientists are chosen for study
section membership, and the assignment of grants to study sections, can be
found at: http://www.csr.nih.gov/EVENTS/bestpractices.htm.
Study section rosters can be found at: http://www.csr.nih.gov/Committees/rosterindex.asp.
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Any questions?
If you have any questions regarding SPIN or specific
science policy issues, please feel free to contact any of APA’s Science
PPO staff.
Geoff
Mumford, Ph.D., Director of Science Policy
Pat
Kobor, Senior Science Policy Analyst
Heather
O'Beirne Kelly, Ph.D., Senior Legislative and Federal Affairs Officer
Karen
Studwell, J.D., Legislative and Federal Affairs Officer
LaTonya Wesley, Legislative Assistant
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