Resources for healthcare research-both human and monetary-are finite. Competition for these resources is fierce. Bench scientists compete with clinicians; trials of potentially therapeutic drugs, surgical treatments, or genetic and immune modulation compete with outcomes trials; evidencebased protocols compete with everyone (and everything) else. How then, as neuroscience nurses, do we play a role in assuring that these resources are best used for our patients and their unique needs and are "spent" wisely?
Although the private sector and charitable, nonprofit organizations support a great deal of research in the neurosciences, the U.S. government, under the aegis of the National Institutes of Health (NIH), remains a primary source of funding. In addition to studies supported by the National Institute of Neurological Disorders and Stroke (NINDS), neuroscience-related research takes place within the National Institute of Mental Health (NIMH), the National Institute on Aging (NIA), the National Institute of Dental and Craniofacial Research (NIDCR), the National Institute of Nursing Research (NINR), and the Office of Behavioral and Social Sciences Research (ONSSR) among many others. To better align the objectives of these many individual institutes and best use resources efficiently and collaboratively, the NIH has launched two distinct-but interrelated- initiatives, both of which provide avenues for neuroscience nurses to effect change and influence policy.
The NIH Blueprint for Neuroscience Research brings together scientists from all 16 NIH institutes, centers, or offices that conduct and support neuroscience research (National Institutes of Health, n.d.). One of the primary goals of this coordinated, collaborative framework is to accelerate the pace of neuroscience research in hopes of reducing the patient burden that so often is a part of nervous system disorders. No single nervous system disorder is targeted within the Blueprint; instead, the research partners attempt to identify pervasive challenges in neuroscience and the technological barriers that inhibit their solutions. The Blueprint helps coordinate the disorder-specific work of each partner by creating resources that can be used across the spectrum of neuroscience. The Blueprint identifies shared features in disease causation and outcomes as well as possible shared tools for assessment, treatment, and bench research.
During the last 4 years, the Blueprint has supported the creation of the Neuroscience Information Framework (a Web-based resource bank for neuroscientists), the creation of the NIH Toolbox for Assessment of Neurological and Behavioral Function, the Pediatric MRI Study of Normal Brain Development, and the Gene Expression Nervous System Atlas (GENSAT). In addition, in each year from 2007 to 2009, the Blueprint focuses on one of three themes: (a) neurodegeneration during disease and aging in 2007, (b) neurodevelopment throughout the lifespan in 2008, and (c) neuroplasticity from the molecular to the behavioral level in 2009. The Blueprint provides us with a model of cooperation, collaboration, and collective work, all of which is directed toward our patients.
A second federally sponsored initiative is the NINDS Blue Sky Vision for the Future of Neuroscience. In 2007 the NINDS launched the first stage of the strategic planning process. The "vision," or goals, will serve as the underpinning for NINDS project planning for the next 15 years. Many of you participated in this first step of the process as the NINDS sought input from neuroscience researchers, clinicians, patients, students, and other members of the general public with a special interest in the future of the neurosciences. Participants answered the following six questions:
* What advances should we expect in clinical care for neurological disorders over the next 15 years, based on anticipated progress in biomedical research?
* Which major questions need to be answered in order to revolutionize how we understand the nervous system and prevent, diagnose, and treat nervous system disorders?
* What new technical capabilities have the potential to revolutionize neuroscience research and clinical practice in the next 15 years?
* What will the neuroscience research landscape look like in 15 years, and how can NINDS best contribute?
* What, if any, infrastructural resources are needed to advance clinical or basic neuroscience research?
* What ethical, legal, and social issues are likely to arise from advances in basic and clinical neuroscience over the next 15 years, for which the NINDS should be prepared? (National Institute of Neurological Disorders and Stroke, 2007)
Each of these questions tries to elicit the ways in which we will better understand the brain and how it works-for example, how we learn; how our brains self-assemble as we develop; how language is encoded; how neurobiology influences human traits such as creativity, honesty, shyness, and loyalty; and how we define consciousness biologically. The answers to these questions will most likely raise others. As neuroscience research potentially encompasses more neural grafting, tissue and cell transplantation, and gene-focused interventions, social policy issues and questions may also emerge to challenge us. The Blue Sky Vision for the Future of Neuroscience may lead us to examine informed consent in the specific research context of altered cognition or consciousness or to address the potential regulation of clinical procedures. What might be the impact on not only policy, but healthcare funding and clinical practice as well?
The NINDS Blue Sky Vision for the Future of Neuroscience aims to review basic, translational, and clinical opportunities to study and, ultimately, recommend better, more effective interventions for all neurological conditions. This includes the interventions and care provided by neuroscience nurses. Providing feedback to the questions asked by the initiative's framers, encouraging nonprofit support organizations and our patients to provide feedback, and carefully tracking plans and progress are ways in which each of us can affect the future of our specialty practice and our patients. We can seek funding for research projects that underscore the importance of highly skilled, expert practice in affecting patient outcomes by either prevention or early intervention or through acute and long-term care practice.
Significantly, both of the NIH initiatives discussed here include the word "blue" in their names. The Blue Sky Vision for the Future of Neuroscience reminds us how vast the sky is-on a clear day it seems endless. The "blue" in the Blueprint for Neuroscience Research reminds us of the depths of the sea-again, seemingly endless. These initiatives challenge us to look at the limitless possibilities of neuroscience research and the extent of the potential changes in our practice and for our patients. Sail and soar on.
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