4.3: Applied Research
Conduct and oversee applied research to improve health and well-being. Other Information:
The application of basic scientific findings in the health and human service areas marks the next step along the continuum
from basic research to practice. Numerous divisions within HHS conduct and provide oversight of applied research. These activities
range from clinical trials for promising new pharmaceuticals and vaccines to behavioral research to identify effective approaches
for reducing risky behaviors associated with infectious and chronic diseases. The performance indicators highlight clinical
trials focused on improving treatment to those with both cardiovascular disease and diabetes and/or chronic kidney disease.
Birth Defects/Developmental Disabilities: CDC conducts a variety of applied research studies to advance the understanding
of factors associated with birth defects and developmental disabilities in both children and adults. Over the next 5 years,
CDC will identify and evaluate the role of new factors for birth defects and developmental disabilities. CDC also will initiate
new and continue existing studies of candidate risk and protective factors associated with birth defects and developmental
disabilities to identify potential intervention strategies. Substance Abuse Treatment: Although research has demonstrated
that substance abuse treatment can be effective in reducing substance use and addiction, few science-based interventions have
been developed and tested widely within the health care field. The reasons for this are, in part, related to cultural and
institutional barriers. In an effort to narrow the substance abuse treatment gap, recent substance abuse treatment studies
have focused on deploying interventions in communities. NIH has adapted and is testing three substance abuse treatment approaches
in an effort to bring research-based treatments to communities more rapidly. These substance abuse treatment protocols, Brief
Strategic Family Therapy, Seeking Safety, and Motivational Enhancement Treatment, are designed to reach specialized populations
that are frequently underrepresented in drug and alcohol abuse research and are often underserved in drug and alcohol abuse
treatment centers. The populations served include adolescents at high risk for substance addiction and their families and
abused women, as well as members of minority groups. Lung Cancer: Lung cancer is one of the leading causes of death in the
United States, with an estimated 160,000 deaths occurring annually and an estimated incidence of 173,000 newly diagnosed cases
each year. Only one-third of newly diagnosed cases are identified at a stage early enough to allow for effective therapeutic
intervention, while more advanced stages of the disease are characterized by a median survival rate of less than 1 year. The
development of new drug treatments for lung cancer has been slowed by difficulty in both early detection and measurement of
early therapeutic drug response. NIH is supporting research to evaluate, validate, and compare varying functional imaging
methods that could serve as more sensitive approaches to the measurement of early drug response than standard or conventional
anatomic imaging techniques that are based on significant tumor shrinkage. NIH is striving to validate and to compare three
imaging methods that could offer increased sensitivity over computed tomography as a means of assessing lung cancer response
to therapy. Obesity: Obesity is associated with numerous serious diseases, including type 2 diabetes, heart disease, stroke,
osteoarthritis, gallstones, breathing problems, and certain cancers. Type 2 diabetes, formerly viewed as a disease of older
adults, has been increasingly reported among children. NIH is exploring lifestyle-based approaches to obesity prevention,
including behavioral or environmental interventions, in settings such as schools, communities, and homes. NIH will support
at least two studies that will evaluate the effects on weight control of worksite interventions that include environmental
components, and at least three studies will evaluate the effects of interventions delivered in primary care settings to treat
and/or prevent obesity in children. Because maintenance of weight loss is a critical yet particularly difficult element of
obesity treatment and prevention, NIH also will investigate novel ways to help individuals who have intentionally lost weight
to keep the weight off for at least 2 years. Complementing these areas of investigation relevant to lifestyle interventions
is research to evaluate the efficacy of different types of diets and physical activities. Cardiovascular Disease: To improve
the treatment of cardiovascular disease, NIH is working to develop and clinically apply one new imaging technique that will
enable tracking the mobility of stem cells within cardiovascular tissues. Scientists are now devoting considerable effort
to understanding the role of cytokine production by stem cells rather than focusing solely on assessing their differentiation
state and location in vivo. Despite the new focus on cytokine production, the importance of understanding stem cell differentiation
remains a basic, important problem in regenerative medicine. A promising new approach for assessing differentiation has recently
been reported in the literature. Scientists have inserted a reporter of calcium transients into stem cells, allowing scientists
to determine whether stem cells are coupled productively to the normal heart during the regeneration process. Control of differentiation
will be critical for the eventual success of cardiovascular cell-based therapy. Imaging methods to detect and monitor the
differentiation process are now the focus of efforts in numerous laboratories. NIH is undertaking a multimodality imaging
effort to develop tools to track cardiovascular stem cells in vivo, and ultimately in patients. Public Health Protection:
CDC’s applied research portfolio targets four interrelated areas: healthy people in every stage of life, healthy people in
healthy places, people prepared for emerging health threats (infectious, occupational, environmental, and terrorist threats),
and healthy people in a healthy world. In support of the goals directed research strategy, CDC has developed the Advancing
the Nation’s Health: A Guide to Public Health Research Needs, 2006-2015. This Research Guide is a comprehensive resource of
critical national and global public health research priorities that will advance science and practice toward greater health
impact. The array of public health research priorities includes infectious diseases, public health preparedness, chronic diseases
and disabilities, safety of environments, global public health, health information and communication, crosscutting research,
and health disparities. Over the next 5 years, CDC will progress toward achievement of the health protection goals and will
address the research themes in the Research Guide. Within the infectious disease area, research will focus on antimicrobial
resistance; bioterrorism-related environmental microbiology, and zoonotic and vectorborne diseases; vaccines and immunization
programs, including vaccine supply issues; and special populations. Within the preparedness area, research will focus on vulnerable
populations, including predictive strategies for risk and recovery after an extreme event, infrastructure and workforce preparedness,
and detection and diagnosis of hazards and their medical consequences. The chronic disease applied research portfolio will
focus on pregnancy planning and preconception care; optimal child and adolescent development; identification of effective
health promotion strategies; and reduction of the burden of, disparities in, and risk factors for, chronic disease among older
adults. In order to create safe places to live, work, and play, CDC will conduct research on environmental risk factors such
as lead exposure and health, safe workplace design, effective strategies to prevent injuries and violence, and risk and protective
factors for interpersonal violence and suicidal behavior. Food, Drug, and Device Safety: Under its Critical Path Initiative,
FDA will stimulate and facilitate a national effort to modernize the scientific process through which a potential human drug,
biological product, or medical device is transformed from a discovery or “proof of concept” into a medical product. FDA will
continue to conduct research on resistance of foodborne pathogens to antimicrobial drugs and to provide for the safe use of
antimicrobials in food animals, while ensuring that the usefulness of critical human drugs is not compromised or lost. FDA’s
National Center for Toxicological Research (NCTR) will undertake applied research studies that support and anticipate current
and future regulatory needs, including integrated toxicological research and support for the Critical Path Initiative.
Indicator(s):
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