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The NIH Catalyst from the Associate Director for Clinical Research

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The NIH Catalyst from the Associate Director for Clinical Research ? 9 F os tering Communication and Collaboration The nih A PublicationCatalystfor NIH Intramural Scientists National Institutes of Health a Office of the Director e Volume 2, Issue 6 a November - December 1994 Medical Pathological Waste Disposal Celebrity Scientists: Think Twice Before You Throw It Out Perspectives from NIEHS Newsmakers by Occupational Safety and Health Branch Staff by Seema Kumar lthough most biomedical re- ince NIH shut down before placing it with its incinerators last uncontaminated A searchers labor in quiet obscu- gloves spring, medical path- and labware in the dis- rity, fame is no stranger to some S members of the NIH intramural ological waste (MPW) posable-labware box a # 5-01-154- community. Two of the latest disposal has become (NSN 811 growing and expen- for as intramural scientists to catapult — 2305) removal sive problem. Cur- general waste. For rou- into the headlines are from NIEHS: — rently, scientists and tine tissue culture and Martin Rodbell, who shared the others generating MPW bacteriology, autoclaved 1994 Nobel Prize in physiology or package the waste in waste can be discarded medicine with Alfred Gilman of the MPW “burn box,” as general waste. MPW the University of Texas Southwest- which is then handled boxes should be used ern Medical Center as infectious waste — only for disposal of non- at Dallas for work even if the items inside radioactive, biologically on G proteins, and are not contaminated. contaminated materials; postdoc P. Andrew Every day, NIH trans- sealed “sharps” contain- Futreal, who, along ports an average of 719 boxes of ers (3/4 full); and small animal carcasses. with Senior Staff MPW, weighing about 5 metric tons, Newspapers, food and beverage Fellow Roger Wise- to a private waste incinerator for dis- containers, and office paper should be man, was part of posal at a cost of more than $500 per disposed of in regular trash cans or the group that iso- ton. In an era of budget crunches, recycling containers, where available. lated the long- the high cost of off-site MPW dispos- You might consider stocking up on sought breast can- al has intensified the need to mini- reusable labware (especially unbreak- Martin Rodbell cer susceptibility mize the volume of MPW. able plasticware), which reduces gene, BRCA1. The Here are a couple things that intra- waste and supply costs over time. NIH Catalyst recently conducted mural scientists should keep in mind. The Guide to NIH Waste Disposal, interviews with these two scien- First, all lab waste does not have to be often referred to as the Waste Calen- tists to see how they’re handling disposed of in an MPW box. Surveys continued on page 15. their sudden notoriety. of NIH use of MPW boxes have shown that the boxes often contain CONTENTS Q: How does it feel to become an materials that could be appropriately 10-11 overnight celebrity disposed of in other, less costly ways. From the Associate Hot Methods Clinic: Secondly, research labs themselves Director For Clinical Tissue Microdissection Research Rodbell: There’s no sensation more can often decontaminate MPW and 13 bizarre than receiving a phone call dispose of the treated waste by non- Recently Tenured Science Ethics Forum at 6 a.m. from someone who says MPW routes. With a few exceptions, 13 that you’ve been selected for the MPW can be decontaminated by using New NINDS Director Seminar Highlights: Nobel Prize. If my wife, daughter, methods like chemical treatment or 18 Reciprocal Imprinting, HIV/AIDS in the two granddaughters, and son-in-law steam sterilization, and then safely Igf2 and HI Workplace discarded in the general waste, dis- hadn’t been there with me, I might 6-9 19 have considered the whole thing posable-labware box, or sink. For Commentary Cartoons example, it is often possible to decon- a New Cell Motility Mechanism continued on page 14. taminate used disposable labware 20 a Arfs, Master Mem- FAX-BACK with bleach or Wescodyne solution brane Regulators The NIH Catalyst From the Associate Director for Clinical Research Gazing Into the Crystal Ball: NIH’s Clinical Research Future, Part I here has never been a scientific resource like rigorous quality review by the intramural Boards of the Clinical Center. Therapies incubated here Scientific Counselors. These changes have been a T have had far-reaching impacts on the quality of tremendous morale booster for the scientists and world health for more than 40 years. As the scope and health-care providers at the Clinical Center. An addi- sophistication of clinical research have increased over tional incentive for improving the efficiency of Clini- the past decades, so have the requirements of a physi- cal Center operations is a new policy that earmarks a cal plant to house that research. And as scientific percentage of money saved in service functions to be inquiry and medical care have evolved, so has the applied to research activities. Other efforts to breathe vision of what the Clinical Center needs to provide. new life into clinical research here include develop- This evolution is central to revitalizing clinical ment of a program to identify and recruit minority research within the NIH intramural programs. patients, a step crucial to achieving diversity in our At the core of our current plans to revitalize clinical patient populations. research is the construction of a new 250-bed research A revitalization of medical information systems is hospital. The Department of Health and Human Ser- opening doors for innovative patient evaluation and vices, acting on recommendations from the External consultation. Digitized images such as X-rays will Advisory Committee, is considering funding a competi- soon be available on desk-top computers for patient- tion to develop a concept for this facility. The complex care providers throughout the Clinical Center. This will include a prominent day hospital; technology can also extend the digital contiguous laboratory space — a hall- images to remote locations, allowing mark of the Clinical Center since its PATIENT-CARE referring physicians to follow the care inception; and access to the current of patients here. The system will also Ambulatory Care Research Facility, as UNIT CONSOLIDA- be able to transmit other clinical data, well as diagnostic and surgery suites. As such as retinal photographs and elec- currently conceived, the $380 million TIONS WILL RESULT trocardiograms, to in-house computers needed for this facility would come from and to monitors in the offices of refer- existing and future intramural funds. IN ANOTHER ring physicians. In preparing for the new facility, we Developing strategies for electronic must streamline current Clinical Center MAJOR SHIFT — A transmission of clinical images will programs. Consolidations of patient-care pave the way for another innovative units now under way are designed to CULTURAL ONE. aspect of medical care, remote assess- reduce the number of beds from 416 to ment and monitoring of patients. 325 over the next few years. Telemedicine technology could enable This reduction will help alleviate another pressing patients to go to nearby regional centers to be inter- concern for intramural researchers: shortage of labora- viewed and examined by NIH physicians via video tory space. Cutting the number of patient beds will links, thereby reducing travel-related expenses, always free an additional 15,000 square feet of space through- a substantial component of clinical-care costs. out the building for reassignment. We plan to move We are in a unique position to help define the offices that now encroach on laboratory space into the roles of computer technology in clinical research, newly vacated areas. Laboratories can then be added roles that will strengthen protocol monitoring and the and expanded, contributing to a much-needed NIH interactions between extramural and intramural Director’s reserve of space to support new recruitment research. A regional linkage will establish a frame- and scientific initiatives. We have also initiated a mas- work for clinical trials not previously possible. It will sive program to provide essential maintenance and enhance patient and data monitoring, as well as repair to the existing facility. increase the involvement by referring, primary-care The patient-care unit consolidations will result in physicians. This direct interaction between the princi- another major shift — a cultural one. Institutes will, by pal investigators and the primary-care physicians will necessity, share space for patient care, an arrangement help provide consistency of clinical decisions during that should foster a new era of intellectual cross-fertil- trials and improve the quality of clinical research. ization, a concept that has traditionally served as the It makes sense to place these regional centers in foundation for creativity here at NIH. the existing network of General Clinical Research Cen- We are also exploring ways to control the cost of ters. I am exploring this possibility with the Directors providing Clinical Center services. One new policy of the National Center for Research Resources and the allows us to structure an accurate, detailed measure of Division of Computer Research and Technology. how much it costs for the Clinical Center to support We will continue to develop these and other ideas an institute’s protocol. Those accounting steps, cou- to strengthen research at the Clinical Center. In the pled with efforts to better coordinate with the insti- next issue of The NIH Catalyst, we will discuss the tutes to anticipate support needs, should enable us to second part of NIH’s clinical research future: a major work more efficiently. new training initiative that the Clinical Center plans to The Clinical Center does more than provide ser- launch later this winter. vices for the institutes. Staff members also conduct their own high-quality research, which has yielded John I. Gallin, M.D.
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