One of the Centers at the National Institutes of Health (NIH) changed its name. The newly christened National Center for Complementary and Integrative Health was formerly known as the National Center for Complementary and Alternative Medicine. The change was implemented as part of the massive budget bill just signed by President Obama.
The ‘alternative medicine’ in the Center’s (now) former name has raised my eyebrow on occasion. Certainly the U.S. government doesn’t approach alternative therapies the same way as in the U.K. (where homeopathy can be espoused by Members of Parliament). Here’s the official explanation for its absence:
Why does the new name include “Integrative Health” instead of “Alternative Medicine”?
Large population-based surveys have found that the use of “alternative medicine”—unproven practices used in place of conventional medicine—is actually rare. By contrast, integrative health care, which can be defined as combining complementary approaches into conventional treatment plans, has grown within care settings across the nation, including hospitals, hospices, and military health facilities. The goal of an integrative approach is to enhance overall health, prevent disease, and to alleviate debilitating symptoms such as pain and stress and anxiety management that often affects patients coping with complex and chronic disease, among others. However, the scientific foundation for many complementary approaches is still being built.
As the research mission of the center will not change, the name change may be strictly cosmetic. But if my eyebrow-raising at the mention of ‘alternative medicine’ in the context of a federal research institute is common, a name change may make a lot of public relations sense.
In what passes for a breakthrough, the Senate managed to pass a controversial nominee for the position of Surgeon General. Vivek Murthy was confirmed as the newest Surgeon General, roughly 13 months after he was nominated and nearly a year and a half after his predecessor stepped down.
While his age (37) may have given Senators cause to balk at confirming him, Murthy’s statements on guns – that gun violence should be considered a public health concern – brought strong opposition courtesy of the National Rifle Association. The logjam on Murthy’s nomination (and the nominations of others) broke as a result of complicated procedural wrangling that the Senate seems to prefer to passing legislation.
Murthy has said in advance of his confirmation that he intends to focus on obesity while Surgeon General. That will likely not dissuade those concerned about any effort to regulate guns, and if the NRA carries through on its threats, Senators that supported the confirmation will be targeted by the organization when they are next up for election.
Amidst its seemingly perennial budget fumbling, the Senate managed to confirm a few more people into positions that most were waiting months to hear about. Last week I noted that one senior Department of Energy official was confirmed, and that another, Ellen Williams, was up for a vote. She was confirmed to be the latest head of the Advanced Research Projects Agency – Energy.
Also of note was another confirmation at the Nuclear Regulatory Commission. In October the head of the Commission, Allison Macfarlane, resigned. This was just a month after the Commission was finally back at its full strength of five Commissioners. Acting relatively quickly, the Obama Administration opted to elevate one of the newly confirmed Commissioners, Jeffrey Baran, to lead the Commission (there appears to be a difference of opinion as to whether Baran is replacing Macfarlane or just had his term extended). He was confirmed on December 8th. I cannot find whomever has been nominated to fill the fifth spot on the Commission, likely not yet announced. The Administration is likely waiting for the new Congress to start next month.
While he was nominated back in July, Dr. Willie May, the nominee for Director of the National Institute for Standards and Technology (NIST), was placed on the Senate calendar for his confirmation vote just yesterday. There remains a significant backlog of nominees awaiting confirmation, so it’s quite possible Dr. May might start over with the new Congress. As he’s currently serving as acting head of NIST, it would make sense if May’s nomination is lower on the list.
(Besides removing the acting from his current title, if confirmed, May would also serve as Commerce Undersecretary for Standards and Technology.)
Like his predecessor, Patrick Gallagher, May has extensive experience as an employee of NIST. He has been associate director for laboratory programs since 2011, and has worked for NIST since 1982, mainly in chemistry and biology measurement services.
In 2011 the Obama Administration announced the Materials Genome Initiative in connection with its Advanced Manufacturing Partnership. The initiative, administered by a subcommittee of the National Science and Technology Council and involving seven federal agencies, is focused on coordinating public and private sector activity in developing and commercializing new materials. Most of this effort would focus on developing the infrastructure necessary to support increased activity in developing new materials – whatever might be the next Kevlar, battery material or superconducting ceramic.
Last week the Initiative released its first Strategic Plan. The plan describes four strategic goals for the initiative, how the initiative supports various national objectives, and grand challenges in materials science. The Strategic Goals:
- Enable a Paradigm Shift in Culture – In order to reduce the time for developing new materials and transferring them to market, there will have to be shifts in how communities conduct research and development as well as the commercial activities that would use the resulting materials.
- Integrate Experiments, Computation and Theory – The integration described here is between research and development and commercial application. Ideally this integration would make it easier to identify replacements for critical materials and facilitate introducing them into manufacturing processes.
- Facilitate Access to Material Data – A suite of data repositories for materials data, with community-developed standards, can help identify gaps in data and areas of redundant research efforts.
- Equip the Next Generation Materials Workforce – The incoming workforce needs to be trained in the new skills and process encouraged by the Initiative.
Within each of the strategic goals are a series of milestones that should guide Initiative activity until the next Strategic Plan. It all reads quite well, but I’m still stuck on the use of genome in the initiative’s name. Perhaps I’m suffering from metaphor lock.
The National Institutes of Health (NIH) has issued a request for comments on a draft policy concerning Institutional Review Boards (IRB). The NIH proposes allowing multi-site research studies to use a single IRB for approval. The idea is that concentrating the human subjects review approval to one IRB would reduce the administrative burden. It is even possible that a single IRB review for multi-site research might increase protections by focusing the oversight to a single body.
Comments are accepted on the policy through January 29, 2015.
This draft policy reflects changes proposed in 2011 when the Department of Health and Human Services proposed changes to the Common Rule – the suite of regulations on oversight of human subjects research. IRB approval is just one facet of those changes, so maybe there are additional policy proposals coming. Even in today’s dysfunctional environment, 3 years is a long time to wait.
It took more than a year, but the Senate has moved to confirm at least one of the nominees for senior science positions at the Department of Energy. On Thursday the Senate confirmed Franklin Orr as the undersecretary for science. On Monday the Senate is scheduled to vote to confirm Ellen Williams as the new head of Advanced Research Projects Agency – Energy. Mark Kastner, nominee to head the Office of Science, is on the calendar, but no vote has been scheduled. With Congress ending sometime this month, the process would need to start over for Kastner and all others not confirmed. All because the Senate is challenged to vote on much of anything, much less pass legislation.
After the budgetary process, I consider the nominations and confirmation of appointees to be the biggest area of dysfunction in the Congress. While I can be persuaded that there are likely too many positions that require full vetting by a Senate committee followed by a confirmation vote, it remains inexcusable to me that it should take more than a year to fill senior level positions once an Administration has found a willing person. A wait of that length can tax the most patient of people interested in serving, and while people can serve in an acting capacity, it’s far from the same.