The Funding of Social Knowledge Production and Application A Survey of Federal Agencies (1978) / Chapter Skim
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'DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE: HEALTH AGENCIES'
'DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE: HEALTH AGENCIES'
Pages 139-194
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From page 139... ...
. More than 37 percent, or $268 million, of HEW'S total social knowledge production and application obligations in fiscal 1977 were made by health agencies.
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From page 140... ...
5. The Health Resources Administration is responsible for identifying and correcting imbalances, inefficiencies, and deficiencies in thte health service delivery system.
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From page 141... ...
While the above agencies are considered the "health agencies" of HEW, social knowledge production and application activities in the health policy area are also funded by other HEW agencies: the Office of the Assistant Secretary for Planning and Evaluation; the Office of Human Development Services; the Social and Rehabilitation Service; and the Social Security Administration.1 These agencies are discussed in Chapter 11. Table 9-1 also presents the predominant goal or audience for each of the HEW health agencies.
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From page 142... ...
Knowledge Production Activities Knowledge Application Activities Policy Policy FormulaProgram General Implemen- DevelopFiscal Retion DemEvaluPurpose tation Dem- ment of DissemYear search onstrations ation Statistics Total onstrations Materials ination Total TOTAL 1975 57.624 16.915 1.
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From page 143... ...
Fiscal Year 1976; The ADAMHA Publication List, or write Alcohol, Drug Abuse, and Mental Health Administration, Department of Health. Education, and Welfare, 5600 Fishers Lane, Rockville, Md.
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From page 144... ...
NIAAA is also responsible for accumulating and disseminating knowledge on the risks and dangers associated with irresponsible drinking. Research As part of its research programs, NIAAA supports research on the behavioral and social aspects of alcohol use and abuse.
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From page 145... ...
Knowledge Production Activities Knowledge Application Activities Policy Policy Formula- Program General Implemen- DevelopFiscal Re- tion Dem- Evalu- Purpose tation Dem- ment of DissemYear search onstrations ation Statistics Total onstrations Materials ination Total TOTAL 1975 18.216 16.915 700 779 36.610 750 2.125 2375 39.485 1976 19.475 16.720 •73 801 37.871 too 2.954 3.754 41.625 1977 20.100 16.337 834 750 38.021 700 3.050 3.750 41.771 The National Institute on Drug Abuse (NIDA) conducts a wide range of drug abuse prevention activities.
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From page 146... ...
Studies have been supported on personality correlates and behavioral factors that may predispose individuals to abuse drugs; longitudinal research studies concerned with medical and psychological factors that may be predictive of subsequent drug abuse; investigations of personality factors determining the choice of drug abuse as an adaptive attempt or as a manifestation of psychopathology; and studies of familial factors and the influence of peers on the abuse of drugs. HAZARDS Another component of the NIDA research program includes studies to determine the adverse effects of drugs on the physical and mental health of the individual and the consequences of drug abuse on society.
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From page 147... ...
For Further Information See Findings of Drug Abuse Research, a publication of NIDA, or write National Institute on Drug Abuse; Alcohol, Drug Abuse, and Mental Health Administration; Department of Health, Education and Welfare; 5600 Fishers Lane; Rockville, Md.
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From page 148... ...
BEHAVIORAL SCIENCE PROGRAM Research is funded on the early detection of language and learning disabilities and the prevention of secondary emotional and interpersonal problems; early emotional and personality development and the factors relating to maladaptive behavior; and the mental health effects of changing sexual roles, alternative family styles, and rapid cultural and social change. EPIDEMIOLOGY This program supports research on the causative factors associated with mental illness.
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From page 149... ...
SERVICE DEVELOPMENT This program supports research on mental health services and delivery. Its research priorities include financing and quality standards, children's mental health services, services of the chronically and aged mentally ill, planning and evaluation technology, and capacity building for integration with other human services.
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From page 150... ...
Knowledge Production Activities Knowledge Application Activities Policy Policy Formula- Program General Implemen- DevelopFiscal Re- tion Dem- Evalu- Purpose tation Dem- men t of DissemYear search onstrations ation Statistics Total onstrations Materials ination Total TOTAL 1975 1.043 1.043 1.043 1976 1.660 1.660 1.660 1977 1.660 1.660 1.660 The Office of the Assistant Secretary for Health provides guidance, leadership, and direction to the Public Health Service agencies on all health and health-related activities. The office coordinates all health activities of other departments and agencies and provides advice and assistance as requested.
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From page 151... ...
For Further Information Write Office of the Assistant Secretary for Health, Department of Health, Education, and Welfare. 5600 Fishers Lane.
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From page 152... ...
Predominant Organizational Predominant Localion of Total Social Social Social Knowledge Knowledge Knowledge Production Production Production and and and Application Application Applicalion Predominant Agency Obligations Activity Activity Goal or Audience* Bureau of Health 2.7 Policy Operating Knowledge for Education formulation agency third demonstrations parties National Institute 2.2 Statistics Operating Improvement for Occupational agency of federal Safety and programs Health TOTAL 4.9 "See Chapter 2 for a more detailed discussion.
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From page 153... ...
Examples include an examination of smoking intervention techniques, a study of hospital-based health education programs, and a longitudinal study of school health education curriculum projects. Policy Formulation Demonstrations The aim of the bureau's demonstrations is to test health education programs geared to meet the specific needs of special target populations -- minority groups, inner city and rural poor, industrial workers, etc.
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From page 154... ...
Knowledge Production Activities Knowledge Application Activities Policy Formula- Program tion Dem- Evaluonstrations ation Policy Implementation Demonstrations Fiscal Year Research General Purpose Statistics Development of DissemMaterials inatton Total Total TOTAL 1975 1976 512 532 553 2.336 1.369 1.600 2.848 1.901 2.153 27 28 27 22 28 2.875 1.929 2.181 28 The mission of the National Institute for Occupational Safety and Health (NIOSH) is to ensure safe and healthful working conditions for all working people.
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From page 155... ...
Knowledge Production Activities Knowledge Application Activities Policy Formulation Demonstrations Policy Implementation Demonstrations Fiscal Year Research Program Evaluation General Purpose Statistics Total Development of Materials Dissemination Total TOTAL 1975 1976 1977 2,752 2.616 3.036 159 162 225 1.230 1.185 4.141 3.963 4.421 432 605 416 1.144 1.177 1.217 1.576 1.782 1.633 5.717 1.160 5.745 6.054 The Food and Drug Administration (FDA) is a scientific regulatory agency whose mission is protecting the nation's health against impure and unsafe foods, drugs, cosmetics, and other potential hazards.
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From page 156... ...
The agency's dissemination activities largely consist of the publication and distribution of materials concerning consumer protection and public health. For Further Information Write Food and Drug Administration, Department of Health, Education, and Welfare, 5600 Fishers Lane, Rockville, Md.
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From page 157... ...
The agency carries out its mission by measuring and analyzing current status and trends; defining, testing, and evaluating alternative means of meeting problems; and promoting innovative strategies and targeted resource development designed to improve areas of imbalance and inefficiency. Table 9-3 lists agencies included within the Health Resources Administration and their total social knowledge production and application obligations for fiscal 1977.
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From page 158... ...
BUREAU OF HEALTH MANPOWER Social Knowledge Production and Application Obligations (Sthousands) Knowledge Production Activities Knowledge Application Activities Policy Policy Formula- Program General Implemen- DevelopFiscal Re- tion Dem- Evalu- Purpose tation Dem- men t of DissemYear search onstrations ation Statistics Total onstrations Materials ination Total TOTAL 1975 2.041 209 1976 2.000 200 1977 2.000 200 2.250 7.932 2.200 7.900 2.200 7.900 1.031 146 1.000 150 1.000 150 9.109 11.359 9.050 11.250 9.050 11.250 The Bureau of Health Manpower is responsible for planning, developing, and administering programs in support of the development and use of the nation's health manpower.
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From page 159... ...
Policy Implementation Demonstrations The bureau supports a series of demonstration projects with the aim that they will serve as a model to be implemented by other appropriate health service organizations. One demonstration deals with the establishment of a training program for registered nurses to become geriatric nurse practitioners.
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From page 160... ...
Knowledge Production Activities Knowledge Application Activities Policy Policy Formula- Program General Implemen- DevelopFiscal Re- tion Dem- Evalu- Purpose tation Dem- ment of DissemYear search onstrations ation Statistics Total onstrations Materials ination Total TOTAL 1975 23.605 6.923 820 301 31.649 562 193 265 1.020 32.669 1976 19.802 3.890 677 251 24.620 I50 200 350 24.970 1977 17.594 3.456 602 223 21.875 133 178 311 22.186 The National Center for Health Services Research plans, develops, and administers a broad program of health services research, demonstrations, and evaluation on virtually all aspects of health services delivery in this country. The center makes awards to health service providers and researchers, conducts and coordinates health services research within the Public Health Service, and disseminates research findings and provides technical assistance to other federal programs and health service providers.
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From page 161... ...
HEALTH MANPOWER This research has examined questions related to the supply of primary and specialty services and their geographic distribution; increased substitution of nurses and medical corpsmen for physicians; the nonphysician labor market; and employment practices and the growth of collective bargaining in the health sector. QUALITY OF CARE This research emphasizes the improvement of techniques for assessing the quality of health care; the formulation of measures of health status; the evaluation of technological innovations in the delivery system that might improve care; and the identification of mechanisms to deal with malpractice insurance problems.
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From page 162... ...
The center will provide training and retraining for health administrators and will attempt to develop leaders, planners, and policy analysts for the health sector. Policy Formulation Demonstrations Another major activity of the center is the support of demonstrations to learn about alternative methods of health care delivery.
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From page 163... ...
Knowledge Production Activities Knowledge Application Activities Policy Policy Formula- Program General Implemen- DevelopFiscal Re- tion Dem- Evalu- Purpose tation Dem- ment of DissemYear search onstrations ation Statistics Total onstrations Materials ination Total TOTAL 1975 1.521 20.339 21.860 21.860 1976 265 25.636 25.901 25.901 1977 24.000 24.000 24.000 The National Center for Health Statistics is responsible for providing timely and accurate statistical information on the status of the nation's health and providing its official vital statistics. The national center is one of the five major general purpose statistical agencies in the federal government.
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From page 164... ...
. For more information on the statistical activities of the center, see Current Listing and Topical Index to the Vital and Health Statistics Series, a publication of the National Center for Health Statistics, or write National Center for Health Statistics, Department of Health.
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From page 165... ...
The goal of the bureau is to assist state and local agencies in developing and implementing health planning in accordance with the National Health Planning and Resources Development Act of 1974. Research During fiscal 1975, the bureau supported research projects on ways to improve planning methodology for health services.
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From page 166... ...
Knowledge Production Activities Knowledge Application Activities Policy Policy Formula- Program General Implemen- DevelopFiscal Re- tion Dem- Evalu- Purpose tation Dem- ment of DissemYear search onstrations ation Statistics Total onstrations Materials ination Total TOTAL 1975 2.286 987 439 3.712 3.712 1976 634 670 1.304 1.304 1977 490 sio 1.000 1.000 The Office of Planning, Evaluation, and Legislation serves as the principal adviser to the administrator of the Health Resources Administration on long- and short-range planning to meet the health resources needs of the nation. The office develops plans, establishes evaluation requirements, and designs legislative proposals to support departmental goals.
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From page 167... ...
Knowledge Production Activities Knowledge Application Activities Policy Policy Formula- Program General Implemen- DevelopFiscal Re- tion Dem- Evalu- Purpose tation Dem- ment of DissemYear search onstrations ation Statistics Total onstrations Materials ination Total TOTAL 1975 14.683 4.213 1* 13 20.739 16.757 346 2.655 19.758 40.497 1976 15.273 3.397 2,264 20.934 27.621 472 3.183 31.276 52,210 1977 9.440 500 3.862 2.315 16.117 25.769 350 3.178 29.297 45.414 The primary objectives of the Health Services Administration (HSA)
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From page 168... ...
BUREAU OF COMMUNITY HEALTH SERVICES Social Knowledge Production and Application Obligations (Sthou sands) Knowledge Production Activities Knowledge Application Activities Policy Formula- Program General Fiscal Re- tion Dem*
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From page 169... ...
Table 9-6 lists those programs and their total social knowledge production and application obligations for fiscal 1977. Rural Health The bureau encourages integrated health care delivery in rural areas through the support of policy implementation demonstrations, which show new approaches and concepts directed at combining, coordinating, and strengthening health service delivery in rural areas.
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From page 170... ...
In addition to its research activities, the program also obligates approximately $2.5 million for a variety of dissemination activities concerning maternal and child health. Family Planning The bureau administers grants for family planning services.
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From page 171... ...
Knowledge Production Activities Knowledge Application Activities Policy Policy Formula- Program General Implemen- DevelopFiscal Re- tion Dem- Evalu- Purpose tation Dem- ment of DissemYear search onstrations ation Statistics Total onstrations Materials ination Total TOTAL l»75 6.446 438 331 7.215 250 119 53 422 7.637 1976 6.991 450 385 7.826 265 122 55 442 8,268 1977 730 38« 1.116 25 25 1.141 The Bureau of Medical Services administers the largest direct medical care program in the Public Health Service. Direct health care is provided to merchant seamen and other designated federal beneficiaries.
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From page 172... ...
Prior to fiscal 1977, the bureau was the second-largest funder of social knowledge production and application within the Health Services Administration. In fiscal 1977, the Ford administration announced plans to close public health service hospitals and hence did not request any research funds for the bureau.
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From page 173... ...
Knowledge Production Activities Knowledge Application Activities Policy Policy Formula- Program General Implemen- DevelopFisca1 Re- tion Dem- Evalu- Purpose tation Dem- ment of DissemYear search onstrations ation Statistics Total onstrations Materials ination Total TOTAL 1977 500 1.000 1.500 1.500 The Health Standards and Quality Bureau, formerly the Bureau of Quality Assurance, provides national leadership and direction to efforts to ensure that health care services provided under the Medicare, Medicaid, and other federal programs are medically necessary and furnished in the most economic manner consistent with recognized professional standards of care. The bureau is currently administering professional standards review organizations (PSROS)
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From page 174... ...
Knowledge Production Activities Knowledge Application Activities Policy Policy Formula- Program General Implemen- DevelopFiscal Re- tion Dem- Evalu- Purpose tation Dem- ment of DissemYear search onstrations ation Statistics Total onstrations Materials ination Total TOTAL 1975 2.800 2.800 2.800 1976 1.685 1.685 1.685 1977 1.600 1.600 1.600 The Office of Planning, Evaluation and Legislation reports directly to the administrator of HSA. It is responsible for both long-range program
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From page 175... ...
Knowledge Production Activities Knowledge Application Activities Policy Policy Formula- Program General Implemen- DevelopFiscal Re- tion Dem- Evalu- Purpose tation Dem- ment of DissemYear search onstrations ation Statistics Total onstrations Materials ination Total TOTAL 1975 36.782 8.086 467 1976 34.557 6.750 526 1977 37.065 6.648 490 45.335 59 6 1.642 18.993 21.231 66.566 41.833 1.182 1.846 19.218 22.246 64.079 44.203 1.182 1.795 20.912 23.889 68.092 The National Institutes of Health (NIH) is the sixth-largest funder of research and development in the feder-al government.
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From page 176... ...
Knowledge Production Activities Knowledge Application Activities Policy Policy Formula- Program General Implemen- DevelopFiscal Re- tion Dem- Evalu- Purpose tation Dem- ment of DissemYear search onstralions ation Statistics Total onstrations Materials ination Total TOTAL 1975 12.289 6.468 204 1976 12.289 4.913 227 1977 12,289 4.913 208 18.961 596 17.429 1.182 17.410 1.182 81 89 82 677 19.638 1471 18.700 1.264 18.674
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From page 177... ...
The National Cancer Act of 1971 directed NCI to "plan and develop an expanded, intensified, and coordinated research program encompassing the programs of the National Cancer Institute, related programs of other research institutions and other federal and nonfederal programs." A major part of that program is the cancer control program, which demonstrates and communicates to both the medical community and the general public the latest advances in cancer prevention and management. The Cancer Control and Rehabilitation Program was the only program in NCI found to support social knowledge production and application activities.
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From page 178... ...
Biomedical demonstrations represent a grey area that the Study Project was never able to clarify fully. The remainder of this section will discuss those parts of the cancer control program that were included in the Study Project survey.
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From page 179... ...
Policy Formulation Demonstrations As noted above, a decision was made to include only demonstrations that had a clear behavioral component or that were primarily aimed at demonstrating a new service delivery mechanism. Thus, the following demonstration programs were included in the survey.
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From page 180... ...
In contrast to some of the more experimental programs classified as policy formulation demonstrations, this demonstration was intended to "show off' a successful technique that could be implemented in other cancer treatment programs. For Further Information Write National Cancer Institute, National Institutes of Health, Department of Health, Education, and Welfare, 9000 Rockville Pike, Bethesda, Md.
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From page 181... ...
Policy Formulation Demonstrations The institute supports several comprehensive sickle-cell disease centers. The centers combine research and demonstration projects to launch a coordinated attack on the disease.
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From page 182... ...
Knowledge Production Activities Knowledge Application Activities Policy Policy Formula- Program General Implemen- DevelopFiscal Re- tion Dem- Evalu- Purpose tation Dem- ment of DissemYear search onstrations ation Statistics Total onstrations Materials ination Total TOTAL 1975 12.137 12.137 140 140 12.277 1976 10.336 10.336 135 135 10.471 1977 10.956 10.956 130 130 11.086 The mission of the National Institute of Child Health and Human Development is to contribute to the health of citizens through efforts to understand the many factors, both biological and behavioral, related to the adaptation of the world's population to available resources and the expansion of knowledge on family planning, child health, maternal health, and human development. The institute serves as a focal point for major scientific research
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From page 183... ...
These objectives are interdependent with a broad understanding of family structure, the dynamics of human population, and the reasonable regulation of its growth. The institute is interested in all problems affecting human development.
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From page 184... ...
Knowledge Production Activities Knowledge Application Activities Policy Policy Formula- Program General Implemen- DevelopFiscal Re- tion Dem- Evalu- Purpose tation Dem- ment of DissemYear search onstrations ation Statistics Total onstrations Materials ination Total TOTAL 1975 3.457 3/57 259 259 3.716 1976 3.284 3.284 271 271 3.555 1977 3.547 3.547 279 279 3.826 The mission of the National Institute of Neurological and Communicative Disorders and Stroke is the identification, stimulation, and support
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From page 185... ...
Knowledge Production Activities Knowledge Application Activities Policy Policy Formula- Program General Implemen- DevelopFisca1 Re- tion Dem- Evalu- Purpose ution Dem- ment of DissemYear search onstrations ation Statistics Total onstrations Materials ination Total TOTAL 1975 1.321 1,321 500 16.887 17.387 18,708 1976 1421 1.321 550 16.945 17.495 18.816 1977 1.585 1.585 570 18.740 19.310 20.895 The National Library of Medicine (NLM) is the world's largest research library in a single scientific and professional field.
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From page 186... ...
The Health Services Research Act of 1974 authorized a number of new programs for the National Library of Medicine leading to better access and utilization of health information. The programs assist the health community in finding ways for more rapid and widespread communication of biomedical information.
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From page 187... ...
For Further Information Write National Library of Medicine, National Institutes of Health, Department of Health, Education, and Welfare, Bethesda.
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From page 188... ...
For Further Information Write Fogarty International Center for Advanced Study in the Health Sciences, National Institutes of Health, Department of Health, Education, and Welfare, 9000 Rockville Pike, Bethesda, Md.
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From page 189... ...
Knowledge Production Activities Knowledge Application Activities Policy Policy Formula- Program General Implemen- DevelopFiscal Re- tion Dem- Evalu- Purpose tation Dem- ment of DissemYear search onstralions ation Statistics Total onstrations Materials ination Tota! TOTAL 1975 110 110 110 1976 110 110 110 1977 179 179 179 The National Institute on Aging was created in 1974 to conduct and support biomedical and behavioral research to increase knowledge of the aging process.
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From page 190... ...
Knowledge Production Activities Knowledge Application Activities Policy Policy Formula- Program General Implemen- DevelopFiscal Re- tion Dem- Evalu- Purpose t.inon Dem- ment of DissemYear search onstrations ation Statistics Total onstrations Materials ination Total TOTAL 1975 806 806 806 1976 806 MK M6 1»77 919 919 919 The National Institute of Allergy and Infectious Diseases conducts and supports research that will contribute to a better understanding of the causes of allergic, immunologic, and infectious diseases and to the development of better means of preventing, diagnosing, and treating these illnesses. The institute is concerned with the following infectious diseases: venereal diseases, hepatitis, influenza, and other viral respiratory infections.
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From page 191... ...
Knowledge Production Activities Knowledge Application Activities Policy Policy Formula- Program General Implemen- DevelopFiscal Re- tion Dem- Evalu- Purpose tation Dem- ment of DissemYear search onstrations ation Statistics Total onstrations Materials ination Total TOTAL 1975 397 1976 385 1977 412 397 385 412 397 385 412 The National Institute of Dental Research conducts research on the causes, prevention, diagnosis, and treatment of oral and dental diseases and conditions. The institute has a small program of pain control and behavioral studies.
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From page 192... ...
20014, National Institute of Environmental Health Sciences Social Knowledge Production and Application Obligations (Sthousands) Knowledge Production Activities Knowledge Application Activities Policy Policy Formula- Program General Implemen- DevelopFiscal Re- tion Dem- Evalu- Purpose tation Dem- ment of DissemYear search onstrations ation Statistics Total onstrations Materials ination Total TOTAL 1975 1.189 1.189 1.189 1976 1.154 1.154 1.154 1977 1.569 1.569 I.5W The National Institute of Environmental Health Sciences serves as a national resource and focal point for environmental health research.
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From page 193... ...
Knowledge Production Activities Knowledge Application Activities Policy Policy Formula- Program General Implemen- DevelopFiscal Re- tion Dem- Evalu- Purpose tation Dem- meni of DissemYear search onstrations ation Statistics Total onstrations Materials ination Total TOTAL 1975 665 665 59 59 724 1976 705 705 705 1977 797 191 797 The director of the National Institutes of Health provides overall leadership to NIH activities and maintains close liaison with the assistant secretary for health on matters related to medical research, research training, health professional education and training, manpower resources, and biomedical communications. The office is also responsi
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From page 194... ...
For Further Information Write Office of the Director, National Institutes of Health, Department of Health, Education, and Welfare, 9000 Rockville Pike, Bethesda, Md.
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