GALVESTON, Texas - In many ways, creating a biobehavioral research laboratory from scratch is like starting any business. You begin with a good idea or product, secure adequate financing and work tirelessly to get it off the ground.

The basic idea behind the Center for Nursing Research and Evaluation at the UTMB School of Nursing is to establish a nationally known institute for biobehavioral training that will attract talented researchers, produce research that can be used in clinical settings and be self-sustaining through research grants.

Elizabeth Reifsnider, associate dean for research in the School of Nursing, is also looking at ways that researchers outside of UTMB could use the lab on a pay-as-you-go basis and she holds out the hope that a generous donor may be found. It's a lot to ask but it's all in the CNRE's five-year plan.

A presentation developed by researchers Jeanne Ruiz and Kyungeh An outlines the development plan, starting with seed grants during the first year through establishment of a self-sustaining biobehavioral research center by 2012. Major developmental milestones include pilot projects, sponsorship of an annual conference and the hiring of a permanent, full-time laboratory technician. Ruiz was interviewing several candidates in late August.

"We've had some intramural funding for seed grants in the School of Nursing to do biobehavioral work and we're getting that started so that people will be able to get their pilot work going to submit to NIH, and that's how we hope to grow it through NIH grants," Reifsnider said. "Of course, we're also looking for foundation funding. We're shopping this around."

Laboratories aren't created in a vacuum. When it comes to scientific funding, NIH is the biggest game in town. NIH believes that interdisciplinary work is a key to solving the puzzle of complex diseases and conditions. Important investigative areas include genetics, behavior, nutrition, infectious agents and the environment. In the past, the National Institute of Nursing Research, an NIH agency, focused on the traditional behavioral and social science measures that generally characterized nursing research. Now the agency expects these measures to be combined with biomedical disciplines that are not the traditional domain of nursing research.

Building a research team

Ruiz, the first researcher recruited to work in the lab, came to UTMB in June 2005 with a $1.6 million R01 grant from NIH and ongoing bench research on the effects of prenatal stress on Hispanic mothers and fetuses. Pamela G. Watson, dean of the School of Nursing and the driving force behind the lab, secured the initial $500,000 in funding from the University of Texas System. The money was used to convert what had been an anatomy lab used by the School of Allied Health Sciences into the state-of-the-art 1,800-square-foot CNRE. Additional funds have since been used to expand non-laboratory space and acquire equipment.

The lab has been Ruiz's home since it opened in December 2005. Joining her this year is An, who came to UTMB earlier this year and is looking at stress and acupuncture and its effect on coronary heart disease.

"We've recruited Patricia Crane who is studying intimate partner violence and she wants to look at the effects of stress on women years after they've been in an abusive situation," Reifsnider said. "We're going to have Dr. Martina Gallagher here in December. She's done a post-doc at the University of Washington and is looking at sleep patterns of young children and what effect that has on their body size."

Robin Fleschler recently completed a post-doctoral fellowship at the Summer Genetics Institute at the NINR/NIH. "She's geared toward genomics work," Reifsnider said. Fleschler currently has a complementary and alternative medicine pilot grant to look at the protective factors for stress in pregnant women; and is proposing to investigate the relationship between serotonin transporter polymorphisms and anxiety in women with eating disorders.

The recruitment of Gallagher from the University of Washington is something of a coup as UW has one of the top labs in the country operated by a nursing school. In 2005, UW received more than $10 million from NIH. NIH listed UTMB's SON with $554,302 in 2005.

Focus on vulnerable populations

A recurring theme of research at the UTMB lab is stress, particularly stress in pregnancy. Ruiz studies it. Fleschler studies it. Crane studies it.

"We're looking at biological markers for the psychological and social things that we've always worked with because nursing research has pretty much always been biologically focused and trying to help people deal with their diseases or improve their health or prevent disease," Reifsnider said. "We want to look at how we can improve the health of vulnerable populations, people who are minorities or who are low income or who have chronic diseases."

Building a successful lab takes more than a few researchers, Reifsnider said. "Part of the problem has been that at so many schools, it's just one or two researchers and if they leave then it kind of dies. We want to have a fairly large cadre of people working in our lab so that doesn't happen here."

That approach dovetails well with what NIH and NINR want. The funding agencies place importance on the development of interdisciplinary research teams that include nurses, physicians and basic science researchers. The agencies want more emphasis placed on interdisciplinary and multi-disciplinary research, more translational research in basic and applied science and correspondingly improved efficiency when conducting complex clinical studies.

"Step No. 1 is to get more people doing this kind of work and step No. 2 is to get the grants from NIH," Ruiz emphasized.

Ruiz has published several papers since arriving at UTMB. Obstetrics&Gynecology asked for revisions for a paper she submitted recently. "That's going to be a heavy hitter," she said. The journal rarely publishes articles by nurses.

"Basically, we want to get enough research to where we get funding and then we hold a conference to show that we have these kinds of capabilities as we build it," Ruiz said. "Then we start developing, No.1, a statewide reputation. You build it once you get enough funded people, then you build the center and you get a national reputation."

A biobehavioral conference sponsored by the lab is a milestone during the third year of the five-year plan.

Starting a lab from scratch has been a learning experience for Reifsnider. "I've learned that there is so much more to learn," she said.

Reifsnider said she has relied on advice from Dr. David G. Gorenstein to move the lab along. Gorenstein is associate dean for research in the UTMB School of Medicine.

"I've been talking to him a lot," she says. "I say, ‘What do we do here; now what do we do here; now what's the next step for the lab.' People in the graduate school have been really helpful and, of course, Research Services. We've been using them a lot, too."

With the five-year clock starting just this year, Reifsnider and her team of researchers are building their case for funding one milestone at a time. When she talks to colleagues at other universities about what the UTMB School of Nursing is doing, she says, "it's something that people really want to hear about. There's a lot of excitement about it."