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Page 1: DEPARTMENT HEMTH HUMAN SERVICES - grants.nih.gov · AND HUMAN SERVICES OFFICIAL IX'SINESS Penalv for Private lhe, ... National Institute of Child Health and Human Development Index:

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US. DEPARTMENTOF HEMTH AND HUMAN SERVICES

OFFICIAL IX'SINESS Penalv for Private lhe, $300

The NIH Guide announces scientific initiatives and provides policy and administrative inbrmation t o indivi duak and organizationswho need to bt. kept informed ofopportunities, requirements, and changes in extra mum1 programs administered by the

'"'& National Institutes ofllealth.

Vol. 1 7 , No. 39 November 25, 1988

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NIH Guide Distribution Center National Institutes o f Health Room B3BE07, Building 31 Bethesda, Mayland 20892

Postages & Fees Paid PHS/NIH/OD

Permit No. (3-291

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Vol. 17, No. 39, November 25, 1988

DATED ANNOUNCEMENTS (RFPs AND RFAS)

NIH SMALL INSTRUMENTS GRANTS PROGRAM ............................. National Institutes of Health Index: NATIONAL INSTITUTES OF HEALTH

TOXICOLOGY OF LHRH ANTAGONIST (RFP) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . National Institute of Child Health and Human DevelopmentIndex: CHILD HEALTH AND HUMAN DEVELOPMENT

TOXICOLOGY OF TWO STEROIDAL ESTERS (RFP) . . . . . . . . . . . . . . . . . . . . . . . . . National Institute of Child Health and Human DevelopmentIndex: CHILD HEALTH AND HUMAN DEVELOPMENT

AIDS VACCINE EVALUATION UNITS (RFP) ..............................National Institute of Allergy and Infectious Diseases Index: ALLERGY AND INFECTIOUS DISEASES

PROSTHETIC SENSORY TRANSDUCERS (RFP) .............................National Institute of Neurological Disorders and Stroke Index: NEUROLOGICAL DISORDERS AND STROKE

THE ROLE OF INFLAMMATORY MEDIATORS IN THE INITIATION ANDMAINTENANCE OF CHRONIC INTERSTJITIAL CYSTITIS OF THE URINARY BLADDER (RFA) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . National Institute of Diabetes, Digestive and Kidney Diseases Index: DIABETES, DIGESTIVE AND KIDNEY DISEASES

ONGOING PROGRAM ANNOUNCEMENTS

GERIATRIC RESEARCH AND TRAINING CENTERS (P30) ....................National Institute on AgingIndex: AGIhj:

MOLECULAR BIOLOGY DATA; REPRESENTATIONAL ANALYSIS BY COMPUTER (RFA) ................................................... National Library of Medicine Index: NATIONAL LIBRARY OF 3EDICINE

J

1

1

2

2

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3

5

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GERIATRIC RESEARCH INSTITUTIONAL TRAINING (GRIT) AWARD (T32) ..... 7National Institute on AgingIndex: AGING

GERIATRIC ACADEMIC PROGRAM (GAP) AWARD (K12) ..................... 9 National Institute of AgingIndex: AGING

HIV-RELATED ILLNESSES: TOPICS FOR HEALTH SERVICES RESEARCH .....12 National Center for Health Services ResearchIndex: HEALTH SERVICES RESEARCH

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DATED ANNOUNCEMENTS (RFPs AND RFAs)

N I H SMALL INSTRUMENTS GRANTS PROGRAM

P.T. 34; K.W. 0735000

'J Nat iona l I n s t i t u t e s o f Heal th

A p p l i c a t i o n Rece ip t Date: February 13, 1989

BACKGROUND

I n i t s a p p r o p r i a t i o n f o r t h e N I H f o r F i s c a l Year 1987, t h e Congress inc luded a t o t a l o f $16 m i l l i o n t o be s p e n t by t h e r e s p e c t i v eBureaus/Institutes/Divisions ( B I D S ) f o r t h e funding of g r a n t s t o purchasesmal l i n s t r u m e n t s c o s t i n g between $ 5 , 0 0 0 and $ 6 0 , 0 0 0 . T h i s a c t i o n was i n response t o s e v e r a l r e c e n t s t u d i e s o f t h e problem of o b s o l e t e biomedical r e s e a r c h i n s t r u m e n t a t i o n , i n d i c a t i n g t h a t t h e s t a t e o f biomedical r e s e a r c h i n s t r u m e n t a t i o n had s e r i o u s l y eroded over t h e l a s t t e n y e a r s and t h a t t h i s s i t u a t i o n i s r e t a r d i n g t h e p r o g r e s s o f biomedical r e s e a r c h . The most s i g n i f i c a n t need i d e n t i f i e d i n t h e s e s t u d i e s i s f o r t h e r e l a t i v e l y low-cost p i e c e s of equipment i n t h e p r i c e range o f approximately $5,000 t o $60,000.

Approximately $16 m i l l i o n w i l l be a v a i l a b l e a g a i n f o r smal l i n s t r u m e n t a t i o n g r a n t s t h i s y e a r .

E L I G I B I L I T Y AND TERMS OF AWARD

Each i n s t i t u t i o n t h a t r e c e i v e d suppor t under t h e Biomedical Research SupportGrant (BRSG) Program i n F i s c a l Year 1988 and c u r r e n t l y h a s a c t i v e N I H r e s e a r c h g r a n t s i s e l i g i b l e t o a p p l y . Only one a p p l i c a t i o n may be submi t ted from each e l i g i b l e i n s t i t u t i o n o r o r g a n i z a t i o n a l component. Each i n s t i t u t i o n maye s t a b l i s h i t s own procedures f o r i d e n t i f y i n g equipment r e q u e s t s t o be i n c l u d e d .

The smal l i n s t r u m e n t a t i o n award w i l l be r e s t r i c t e d t o t h e purchase o f equipment c o s t i n g between $ 5 , 0 0 0 and $ 6 0 , 0 0 0 . Awards w i l l be made on o r b e f o r e September 30, 1989. The amount of t h e award w i l l be based upon a p e r c e n t a g e o f t h e i n s t i t u t i o n ' s Biomedical Research Support Grant award f o r F i s c a l Year 1988 o r $ 5 , 0 0 0 , whichever i s g r e a t e r . S p e c i f i c funding d e c i s i o n s w i l l depend on a v a i l a b l e B I D a p p r o p r i a t i o n s a s w e l l a s t h e a p p r o p r i a t e n e s s df t h e r e q u e s t . I n s t i t u t i o n s w i l l be n o t i f i e d o f t h e maximum amount f o r which t h e y may a p p l y .

METHOD OF APPLYING

Le t t e r s o f i n s t r u c t i o n t o e l i g i b l e i n s t i t u t i o n s w i l l be mai led on o r about November 2C. 1988.

Completed a p p l i c a t i o n s must be r e c e i v e d by February 13, 1989.

I n v e s t i g a t o r s i n t e r e s t e d i n p a r t i c i p a t i n g i n t h e i r i n s t i t u t i o n ' s a p p l i c a t i o n must c o n t a c t t h e i n s t i t u t i o n ' s Biomedical Research Support Grant ProgramD i r e c t o r . I n s t i t u t i o n a l o f f i c i a l s who expec t t o be involved i n p r e p a r i n g an a p p l i c a t i o n are r e q u e s t e d t o review t h e l e t t e r o f i n s t r u c t i o n s p r i o r t o c o n t a c t i n g N I H .

TOXICOLOGY OF A LHRH ANTAGONIST

RFP AVAILABLE: NICHD-CD-89-9

P . T . 34; K . W . 1007009, 0750020, 0765035

N a t i o n a l I n s t i t u t e o f Chi ld H e a l t h and Human Development

The C o n t r a c e p t i v e Development Branch, Center f o r P o p u l a t i o n Research, N a t i o n a l I n s t i t u t e o f C h i l d Heal th and Human Development, h a s a Small Bus iness Set-Aside requirement f o r t o x i c o l o g y s t u d i e s on a LHRH A n t a g o n i s t . The o b j e c t i v e o f t h i s p r o j e c t is t o o b t a i n s u f f i c i e n t animal sa fe ty data on the a n t a g o n i s t i n o r d e r t o permi t f i l i n g of a Not ice o f Claimed I n v e s t i g a t i o n a lExemption f o r a N e w Drug ( I N D ) wi th t h e Food and Drug A d m i n i s t r a t i o n (FDA) i n suppor t o f Phase I and I1 c l i n i c a l i n v e s t i g a t i o n s .

'd O f f e r o r s must have in-house c a p a b i l i t i e s t o suppor t r a b b i t and r o d e n t s t u d i e s and be prepared t o conduct a l l s t u d i e s i n f u l l compliance w i t h Good L a b o r a t o r i e s P r a c t i c e s (GLP) r e g u l a t i o n s . I n a d d i t i o n , t h e y must have t h e

Vol. 17, No. 39, November 25, 1988 - Page 1

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a b i l i t y t o under take a l l chemical and p a t h o l o g i c a l a s p e c t s o f t h e p r o j e c t and t o a c q u i r e an imals and i n i t i a t e s t u d i e s w i t h i n 60 days o f c o n t r a c t award. The I n s t i t u t e e x p e c t s t o award one ( 1 ) c o n t r a c t .

T h i s is n o t a Request f o r P r o p o s a l s . The RFP w i l l be i s s u e d on o r about December 1 , 1988, w i t h a due d a t e approximately 90 days t h e r e a f t e r . Copies o f t h e RFP may be o b t a i n e d by sending w r i t t e n r e q u e s t s t o t h e f o l l o w i n g a d d r e s s . P l e a s e e n c l o s e a s e l f - a d d r e s s e d l a b e l .

Paul J . Duska, C o n t r a c t i n g Officer C o n t r a c t s Management S e c t i o n , OGC N a t i o n a l I n s t i t u t e of C h i l d H e a l t h and Human DevelopmentExecut ive P l a z a North, Room 610 Bethesda, Maryland 20892

TOXICOLOGY OF TWO STEROIDAL ESTERS

RFP AVAILABLE: NICHD-CD-89-8

P.T. 34; K.W. 1007009, 0750020

N a t i o n a l I n s t i t u t e o f Chi ld Heal th and Human Development

The C o n t r a c e p t i v e Development Branch, Center f o r P o p u l a t i o n Research, N a t i o n a l I n s t i t u t e o f C h i l d Heal th and Human Development, h a s a requirement f o r t o x i c o l o g y s t u d i e s on two s t e r o i d a l es ters . The o b j e c t i v e of t h i s p r o j e c t i s t o o b t a i n s u f f i c i e n t animal s a f e t y d a t a on a l e v o n o r g e s t e r e l es te r and a t e s t o s t e r o n e es ter i n o r d e r t o permi t f i l i n g o f a Not ice o f Claimed I n v e s t i g a t i o n a l Exemption f o r a N e w Drug ( I N D ) w i t h t h e Food and DrugA d m i n i s t r a t i o n (FDA) i n suppor t o f Phase I and I1 c l i n i c a l i n v e s t i g a t i o n s .

O f f e r o r s must have in-house c a p a b i l i t i e s t o suppor t p r i m a t e and r o d e n t s t u d i e s and b e p r e p a r e d to conduct all s t u d i e s i n f u l l compliance w i t h Good Labora tory P r a c t i c e s (GLP) r e g u l a t i o n s . I n a d d i t i o n , t h e y must have t h e a b i l i t y t o u n d e r t a k e a l l chemical and p a t h o l o g i c a l a s p e c t s o f t h e p r o j e c t and t o a c q u i r e animals and i n i t i a t e s t u d i e s w i t h i n 60 days o f c o n t r a c t award. Q u a l i f i e d o r g a n i z a t i o n s w i l l have t h e c h o i c e o f s u b m i t t i n g a p r o p o s a l f o r conduct ing t h e t o x i c o l o g y on a s i n g l e compound o r on b o t h . The I n s t i t u t e w i l l award a maximum o f two (2) c o n t r a c t s f o r t h i s a c t i v i t y .

T h i s i s n o t a Request f o r P r o p o s a l s . The RFP w i l l be i s s u e d on o r about December 1 , 1988 w i t h a due d a t e approximate ly 90 days t h e r e a f t e r . Copies o f t h e RFP may be o b t a i n e d by sending w r i t t e n r e q u e s t s t o t h e f o l l o w i n g a d d r e s s . P l e a s e e n c l o s e a s e l f - a d d r e s s e d l a b e l .

Paul J . Duska, C o n t r a c t i n g Officer C o n t r a c t s Management S e c t i o n , OGC N a t i o n a l I n s t i t u t e o f Chi ld Heal th and Human DevelopmentExecut ive P l a z a North, Room 610 Bethesda, Maryland 20892

AIDS VACCI NE EVALUATION UNITS

RFP AVAILABLE: RFP-NIH-NIAID-AIDSP-90-01 P.T. 34; K.W. o715008, 0740075

N a t i o n a l I n s t i t u t e o f A l l e r g y and I n f e c t i o u s Diseases

The AIDS Pmgram, N I A I D , N I H , h a s a requirement t o e s t a b l i s h AIDS v a c c i n e e v a l u a t i o n u n i t s t o e v a l u a t e c a n d i d a t e A I D S v a c c i n e s .

T h i s NIAID-sponsored p r o j e c t w i l l t a k e approximately t h r e e (3) y e a r s t o complete . A c o s t reimbursement c o n t r a c t is a n t i c i p a t e d . It is a n t i c i p a t e dt h a t t e n ( 1 0 ) awards w i l l be made.

T h i s is an announcement f o r an a n t i c i p a t e d Request f o r Proposa l (RFP).RFP-NIH-NIAID-AIDSP-90-01 s h a l l be i s s u e d on o r about December 19, 1988, w i t h a c l o s i n g d a t e t e n t a t i v e l y s e t f o r A p r i l 3, 1989.

Vol. 17, No. 39, November 25, 1988 - Page 2

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Reques ts f o r t h e RFP s h a l l b e d i r e c t e d i n w r i t i n g t o :

Lawrence M . B u t l e r Contrac t Management Branch 5333 Westbard Avenue Westwood B u i l d i n g , Room 707

.J N a t i o n a l I n s t i t u t e o f A l l e r g y & I n f e c t i o u s Diseases N a t i o n a l I n s t i t u t e o f Heal th Bethesda, Maryland 20892 Telephone: (301) 496-0192

To r e c e i v e a copy o f t h e RFP, p l e a s e supply t h i s o f f i c e w i t h two (2)s e l f - a d d r e s s e d l a b e l s . A l l r e s p o n s i b l e s o u r c e s may submit a p r o p o s a l which w i l l be c o n s i d e r e d .

T h i s a d v e r t i s e m e n t does n o t commit t h e Government t o award a c o n t r a c t .

RFP AVAILABLE: NIH-NINDS-89-05

P.T. 34; K.W. 0740045

N a t i o n a l I n s t i t u t e o f Neurologica l D i s o r d e r s and S t r o k e

The N a t i o n a l I n s t i t u t e of Neurologica l D i s o r d e r s and S t r o k e h a s a requirementt o develop and e v a l u a t e t r a n s d u c e r s o f thumb g r a s p f o r c e and thumb, index f i n g e r and w r i s t p o s i t i o n . O f f e r o r s should have e x p e r i e n c e i n t h e d e s i g n and f a b r i c a t i o n o f t r a n s d u c e r s o f f o r c e and p o s i t i o n . I n a d d i t i o n , e x p e r i e n c e i n t h e problems i n d e s i g n o f wearable t r a n s d u c e r s is d e s i r e d .

T h i s i s an announcement of an a n t i c i p a t e d Request f o r P r o p o s a l s .RFP-NIH-NINDS-89-05 w i l l be i s s u e d on o r about December 9 , 1988, w i t h a c l o s i n g d a t e f o r r e c e i p t o f p r o p o s a l s f o r February 10, 1989.

T h i s requirement r e p r e s e n t s t h e r e c o m p e t i t i o n of a c u r r e n t c o n t r a c t w i t h Case Western Reserve U n i v e r s i t y and t h e incumbent is expec ted t o r e a p p l y . The I n s t i t u t e e x p e c t s t o award one ( 1 ) c o n t r a c t as a r e s u l t o f t h i s r e c o m p e t i t i o n .

d To r e c e i v e a copy o f t h e RFP, you must supply t h i s o f f i c e w i t h two s e l f - a d d r e s s e d m a i l i n g l a b e l s . A l l r e s p o n s i b l e s o u r c e s may submit a p r o p o s a lwhich s h a l l be c o n s i d e r e d by t h e agency.

The RFP w i l l b e a v a i l a b l e upon w r i t t e n r e q u e s t t o :

C o n t r a c t i n g Officer C o n t r a c t s Management Branch N a t i o n a l I n s t i t u t e o f Neurologica l F e d e r a l B u i l d i n g , Room 901 7550 Wisconsin Avenue Bethesda, Maryland 20892 A t t n : RFP-NIH-NINDS-89-05

TJF

RFA AVAILABLE: 89-DK-03

D i s o r d e r s and S t r o k e , N I H

P.T. 34; K . W . 0715026, 0705075, 0710070

N a t i o n a l I n s t i t u t e o f D i a b e t e s and D i g e s t i v e and Kidney Diseases

A p p l i c a t i o n Rece ip t Date: A p r i l 21, 1989

The D i v i s i o n o f Kidney, Urologic and Hematologic D i s e a s e s ( D K U H D ) , N a t i o n a l I n s t i t u t e of Diabe tes and D i g e s t i v e and Kidney Diseases ( N I D D K ) i n v i t e s g r a n ta p p l i c a t i o n s f o r suppor t o f b a s i c and c l i n i c a l r e s e a r c h on t h e r o l e of inflammatory media tors i n t h e i n i t i a t i o n and maintenance o f Chronic I n t e r s t i t i a l C y s t i t i s ( I C ) of t h e u r i n a r y b l a d d e r . The emphasis of t h i s program i s on r e s e a r c h w i t h specimens from persons w i t h I n t e r s t i t i a l C y s t i t i s .When non-human models such a s an imals and c e l l c u l t u r e s a r e u t i l i z e d f o r i n v e s t i g a t i o n , t h e f i n d i n g s should be c o r r e l a t e d w i t h c l i n i c a l d a t a . The

,J u l t i m a t e g o a l s of t h i s p r o j e c t a r e t o develop knowledge which w i l l l e a d t o t h e e f f e c t i v e p r e v e n t i o n and/or t r e a t m e n t o f I n t e r s t i t i a l C y s t i t i s , and t o a c q u i r e a d a t a b a s e of p e r s o n s w i t h I C f o r f u t u r e s t u d i e s .

Vol. 17, No. 39, November 25, 1988 - Page 3

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BACKGROUND INFORMATION

I n t e r s t i t i a l C y s t i t i s i s a c h r o n i c inf lammatory d i s o r d e r o f t h e u r i n a r y b l a d d e r o f unknown e t i o l o g y . The most a c c u r a t e method o f d i a g n o s i s i s based p r i m a r i l y on t h e symptoms o f t h e d i s e a s e . The most p r e v a l e n t symptom i s p a i n ; o t h e r common symptoms are u r i n a r y f requency and urgency . P a t h o l o g i c a l f i n d i n g s from b iopsy are v a r i a b l e and most commonly i n c l u d e mononuclear c e l l and mast c e l l i n f i l t r a t e s . Other f i n d i n g s i n c l u d e c o l l a g e n d e p o s i t i o n , f i b r o s i s , g r a n u l a t i o n t i s s u e and, r a r e l y , mucosal u l c e r a t i o n s . Numerous e t i o l o g i c a l t h e o r i e s f o r t h i s d i s e a s e have been proposed bu t none have been s u b s t a n t i a t e d wi th c l i n i c a l f i n d i n g s . A r e p o r t o f t h e r e c e n t N I D D K sponsored Workshop on I n t e r s t i t i a l C y s t i t i s was pub l i shed i n t h e J o u r n a l of Urology 140 ( 1 ) : 203-206, J u l y , 1988. T h i s r e p o r t c o n t a i n s a t a b l e o f c r i t e r i a f o r t h e d i a g n o s i s o f I C which should be used on ly f o r t h e s t a n d a r d i z a t i o n o f i n c l u s i o n o f p a t i e n t s i n r e s e a r c h s t u d i e s . These c r i t e r i a are no t meant t o be used as c r i t e r i a f o r c l i n i c a l d i a g n o s i s o f t h e d i s e a s e . The c r i t e r i a , as pub l i shed , are p r e l i m i n a r y and i n v e s t i g a t o r s should c o n t a c t t h e Urology Program D i r e c t o r f o r any m o d i f i c a t i o n s p r i o r t o i n c l u d i n g them i n a g r a n t a p p l i c a t i o n .

The p reva lence o f p a i n as t h e major symptom m a n i f e s t a t i o n o f t h e d i s o r d e r and t h e p re sence o f mast c e l l s i n b iopsy specimens o f b l a d d e r s i n p a t i e n t s w i th I C sugges t t h a t t h e d i s o r d e r is mediated by inf lammatory mechanisms. Inf lammatory med ia to r s i n e i t h e r t h e u r i n e o r b l a d d e r specimens have n o t , however, been f r e q u e n t l y i n v e s t i g a t e d o r c o n s i s t e n t l y documented. N e i t h e r h a s t h e r e been a thorough i n v e s t i g a t i o n i n t o t h e effect o f an t i - inf lammatory a g e n t s on t h e pa thology and symptomatology o f t h e d i s e a s e .

OBJECTIVES AND SCOPE OF RESEARCH

Research areas f o r i n v e s t i g a t i o n i n c l u d e :

1 . t h e r o l e o f mast c e l l s and mast c e l l d e g r a n u l a t i o n i n t h i s c h r o n i c inf lammatory d i s o r d e r ,

2 . t h e p re sence of p r o s t a g l a n d i n s and l e u k o t r i e n e s i n b l a d d e r s o f p a t i e n t swi th I C and t h e r o l e o f t h e s e s u b s t a n c e s i n promoting and ma in ta in ing t h e c h r o n i c inf lammation,

3. t h e p re sence and r o l e o f c y t o k i n e s and complement d e r i v e d p e p t i d einf lammatory med ia to r s i n I C ,

4. f a c t o r s i n t h e u r i n e which e i t h e r a c t i v a t e o r d e a c t i v a t e t h e s e inf lammatory med ia to r s and t h e i n t e r a c t i o n s o f t h e s e v a r i o u s med ia to r s i n t h e c h r o n i c inf lammatory p r o c e s s o f I C .

The g o a l o f t h i s r e s e a r c h i s t o deve lop f u r t h e r i n s i g h t i n t o t h e e t i o l o g y and pa thogenes i s o f I n t e r s t i t i a l C y s t i t i s as a c h r o n i c inf lammatory d i s o r d e r o f t h e u r i n a r y b l a d d e r . It i s a n t i c i p a t e d t h a t t h e s e f i n d i n g s w i l l l e a d t o t h e development o f more e f f e c t i v e t r e a t m e n t m o d a l i t i e s and, u l t i m a t e l y , t o t h e p r e v e n t i o n and c u r e o f t h i s d i s o r d e r . By u t i l i z i n g c l i n i c a l p a t i e n t s w i th I C ,t h e d a t a b a s e o f I C p a t i e n t s w i l l be expanded f o r f u t u r e s t u d i e s . By u s i n ge i t h e r expe r imen ta l an ima l s o r c e l l c u l t u r e s , r e l i a b l e expe r imen ta l models w i l l be developed which can be c o r r e l a t e d wi th c l i n i c a l f i n d i n g s . It i s a n t i c i p a t e d t h a t r e s e a r c h a p p l i c a t i o n s w i l l i n c l u d e c o l l a b o r a t i o n between b a s i c s c i e n c e and c l i n i c a l i n v e s t i g a t o r s . C o l l a b o r a t i o n wi th o t h e r i n s t i t u t i o n s is a l s o encouraged, when necessa ry , t o expand t h e c l i n i c a l d a t a base.

APPLICATION AND SUPPORT PROCEDURES

E igh t hundred thousand d o l l a r s h a s been d e s i g n a t e d t o suppor t t h i s program f o r t h e c u r r e n t f i s c a l y e a r . The s p e c i f i c number o f g r a n t s and t h e t o t a l number o f funds t o be awarded w i l l , however, depend on t h e merit and scope o f t h e a p p l i c a t i o n s r e c e i v e d and on t h e a v a i l a b i l i t y o f funds .

Funding o f t h e g r a n t s w i l l be th rough t h e i n d i v i d u a l Research P r o j e c t Grant (Ro l l mechanism. A p p l i c a t i o n s must be submi t ted on t h e r e v i s e d (9186) form PHS-398, a v a i l a b l e i n t h e b u s i n e s s o r r e s e a r c h g r a n t s o f f i c e a t most academic o r r e s e a r c h i n s t i t u t i o n s , o r from t h e D i v i s i o n o f Research Grants , Na t iona l I n s t i t u t e s o f H e a l t h . A p p l i c a t i o n s from women and m i n o r i t y i n v e s t i g a t o r s are encouraged. A p p l i c a t i o n s w i l l b e reviewed f o r s c i e n t i f i c and t e c h n i c a l merit i n accordance wi th t h e u s u a l N I H p e e r rev iew p rocedures by a s p e c i f i c a l l yconvened i n s t i t u t e review commit tee . Fol lowing t h a t f i r s t review, t h e a p p l i c a t i o n s w i l l b e g iven a secondary rev iew by t h e N I D D K Advisory Counci l .

A p p l i c a t i o n s must be r e c e i v e d by A p r i l 21, 1989 t o be cons ide red f o r fundingth rough t h i s RFA.

V o l . 17, No. 39, November 25, 1988 - Page 4

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THE RFA LABhi CONTAINED I N THE APPLICATION KIT MUST BE AFFIXED TO THE BOTTOM OF THE FACE PAGE OF THE ORIGINAL COPY OF THE APPLICATION. FAILURE TO USE THIS LABEL COULD RESULT I N DELAYED PROCESSING OF YOUR APPLICATION. FOR PURPOSES OF IDENTIFICATION AND PROCESSING, THE RFA NUMBER AND TITLE "THE ROLE OF INFLAMMATORY MEDIATORS I N THE I N I T I A T I O N AND MAINTENANCE OF C H R O N I C INTERSTITIAL CYSTITIS OF THE URINARY BLADDER" SHOULD BE TYPED I N ITEM 2 ON THE

-'(-.*I FACE PAGE OF THE APPLICATION.

The o r i g i n a l and f o u r c o p i e s of t h e a p p l i c a t i o n should be s e n t o r d e l i v e r e d t o :

D i v i s i o n o f Research Grants Westwood B u i l d i n g , Room 240 N a t i o n a l I n s t i t u t e s o f Heal th Bethesda, Maryland 20892xn

Two a d d i t i o n a l c o p i e s o f t h e a p p l i c a t i o n should be s e n t t o :

Chief , Review Branch D i v i s i o n o f Extramural A c t i v i t i e s , N I D D K N a t i o n a l I n s t i t u t e s o f Heal th Westwood B u i l d i n g , Room 406 Bethesda, Maryland 20892

Let t e r o f I n t e n t : It i s r e q u e s t e d t h a t t h e p r o s p e c t i v e a p p l i c a n t submit a one page l e t t e r o f i n t e n t which w i l l g i v e a d e s c r i p t i v e t i t l e o f t h e r e s e a r c h , t h e name, a d d r e s s and t e l e p h o n e number of t h e p r i n c i p a l i n v e s t i g a t o r and t h e names o f o t h e r key p e r s o n n e l . Such l e t t e r s are r e q u e s t e d f o r t h e purpose o f p r o v i d i n g an i n d i c a t i o n o f t h e number and scope o f a p p l i c a t i o n s t o be expec ted . A l e t t e r o f i n t e n t i s n o t b i n d i n g and it w i l l n o t e n t e r i n t o t h e review o f any a p p l i c a t i o n subsequent ly submi t ted . I t is n o t a n e c e s s a r y requirement f o r a p p l c a t i o n . The l e t t e r of i n t e n t should be r e c e i v e d byJanuary 13, 1989.

Letters o f i n t e n t and any i n q u i r e s about t h i s RFA should be s e n t t o :

Leroy M . Nyberg, J r . , Ph.D., M . D . Urology Program D i r e c t o r , NIDDK/DKUHD N a t i o n a l I n s t i t u t e s o f Heal th F e d e r a l B u i l d i n g , Room 102

I b , f Bethesda, Maryland 20892 Telephone: (301) 496-8248

GERIATRIC RESEARCH AND TRAINING CENTERS (P30)

RFA AVAILABLE: 89-AG-01

P.T. 04; K . W . 0710010, 0720005, 0710030

N a t i o n a l I n s t i t u t e on Aging

A p p l i c a t i o n Rece ip t Date: March 17, 1989

INTRODUCTION

The N a t i o n a l I n s t i t u t e on Aging ( N I A ) i n v i t e s a p p l i c a t i o n s f o r s u p p o r t o f c e n t e r s o f e x c e l l e n c e i n r e s e a r c h i n g e r i a t r i c s and geronto logy and t r a i n i n go f g e r i a t r i c i a n s f o r l e a d e r s h i p i n academic medicine. A Geriatr ic Research and T r a i n i n g Center (GRTC) i n c l u d e s c o r e a c t i v i t i e s f o r s u p p o r t u f r e s e a r c h ,t r a i n i n g , and career development. F i r s t y e a r budgets may n o t exceed $800,000d i r e c t c o s t s .

Scope

To enhance t h e q u a l i t y o f r e s e a r c h i n g e r i a t r i c s and geronto logy , and p r o v i d e a s u i t a b l e environment f o r f e l l o w s and j u n i o r f a c u l t y t o a c q u i r e r e s e a r c h s k i l l s and e x p e r i e n c e , t h r e e g e n e r a l t y p e s o f a c t i v i t i e s w i l l be suppor ted i n GRTCs : r e s e a r c h c o r e s , leadership/administrative c o r e s and r e s e a r c h development c o r e s .

Research c o r e s p r o v i d e funds f o r p e r s o n n e l , equipment, and o t h e r r e s o u r c e s which w i l l enhance t h e q u a l i t y o f c u r r e n t l y suppor ted r e s e a r c h .

iIy' The leadership/administrative c o r e p r o v i d e s funds f o r t h e GRTC D i r e c t o r , GRTC A d m i n i s t r a t o r , and s u p p o r t s t a f f . C o s t s a s s o c i a t e d w i t h i n f o r m a t i o n t r a n s f e r and o u t r e a c h programs may a l s o be r e q u e s t e d h e r e .

Vol . 17, No. 39, November 25, 1988 - Page 5

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The r e s e a r c h development c o r e p r o v i d e s funds f o r p i l o t p r o j e c t s t o be conducted by j u n i o r f a c u l t y members. Support f o r s a l a r y , equipment and o t h e r r e s e a r c h expenses may be r e q u e s t e d .

Mechanism and S c a l e o f Support

Geriatr ic Research and T r a i n i n g C e n t e r s w i l l b e suppor ted through t h e customary g r a n t - i n - a i d mechanism. P l a n s are t o make up t o two awards i n f i s c a l y e a r 1989 and f u r t h e r awards i n f i s c a l y e a r 1990 depending upona v a i l a b i l i t y o f f u n d s .

The A p p l i c a t i o n

The a p p l i c a n t should submit t h e a p p l i c a t i o n u s i n g PHS 398 ( r e v i s e d 9 / 8 6 ) .A p p l i c a t i o n k i t s c o n t a i n i n g t h i s form and t h e n e c e s s a r y g e n e r a l i n s t r u c t i o n s are a v a i l a b l e i n most i n s t i t u t i o n a l b u s i n e s s o f f i c e s o r may be o b t a i n e d from t h e D i v i s i o n o f Research Grants , N I H . P l e a s e n o t e t h a t s p e c i a l GRTC G u i d e l i n e s should be used t o complete t h e a p p l i c a t i o n . (See below)

Timetable f o r Rece ip t and Review o f A p p l i c a t i o n s

The o r i g i n a l and f o u r c o p i e s o f t h e a p p l i c a t i o n are due i n t h e D i v i s i o n o f Research G r a n t s on o r b e f o r e March 17, 1989. A p p l i c a t i o n s must b e s e n t t o :

A p p l i c a t i o n Rece ip t Office D i v i s i o n o f Research Grants N a t i o n a l I n s t i t u t e s o f H e a l t h Westwood B u i l d i n g ? Room 240 Bethesda, Maryland 20892nn

A t t h e same time t h e a p p l i c a t i o n i s submi t ted t o t h e D i v i s i o n o f Research Grants , a copy o f t h e c o v e r i n g l e t t e r and two c o p i e s o f t h e a p p l i c a t i o n should be s e n t t o :

Chief , S c i e n t i f i c Review Office N a t i o n a l I n s t i t u t e on AgingRoom 5C12, B u i l d i n g 31 9000 R o c k v i l l e P ike Bethesda, Maryland 20892

A copy o f t h e complete RFA and t h e GRTC G u i d e l i n e s may be o b t a i n e d from:

S t a n l e y L . S l a t e r , M . D . D i r e c t o r , G e r i a t r i c Research and T r a i n i n g ProgramGeriatrics Branch N a t i o n a l I n s t i t u t e on AgingB u i l d i n g 31, Room 5C27 9000 R o c k v i l l e P ike Bethesda, Maryland 20892 Telephone (301) 496-6761

MOLECULAR BIOLOGY; DATA REPRESENTATION/ANALYSIS BY COMPUTER

RFA AVAILABLE: 89-LM-01

..-

P.T. 34; K.W. 1002008, 0755018, 1004008, 0755045, 0790010, 1215018, 1004000

N a t i o n a l L i b r a r y o f Medicine

A p p l i c a t i o n Rece ip t Date: February 10, 1989

The N a t i o n a l L i b r a r y o f Medicine i n v i t e s t h e submission o f Research g r a n ta p p l i c a t i o n s from i n v e s t i g a t o r s who are i n t e r e s t e d i n t h e computer and i n f o r m a t i o n s c i e n c e a s p e c t s o f molecular b i o l o g y d a t a management and a n a l y s i s .The o b j e c t i v e is t o promote h i g h q u a l i t y r e s e a r c h t h a t h a s v a l u e f o r f u r t h e r i n g o u r unders tanding o f s t r u c t u r e / f u n c t i o n r e l a t i o n s h i p s i n n u c l e i c a c i d s , p r o t e i n s , and o t h e r b i o l o g i c a l l y important molecules , i n o r d e r t o diagnose, and t r e a t human d i s o r d e r s . Research t o p i c s i n c l u d e da ta -base d e s i g nand query methods, a l g o r i t h m s t o improve e f f i c i e n c y o f i n f o r m a t i o n r e t r i e v a l , e x p e r t systems, mathematical t e c h n i q u e s and computer hardware d e s i g n f o r p a t t e r n r e c o g n i t i o n and a l g o r i t h m s f o r p r e d i c t i n g s t r u c t u r e and/or f u n c t i o n based on pr imary sequences . I n F i s c a l Year 1989 up t o one m i l l i v n d o l l a r s w i l l b e a l l o c a t e d t o t h e r e s e a r c h i n i t i a t i v e s d e s c r i b e d i n t h i s RFA.

Vol. 17, No. 39, November 25, 1988 - Page 6

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'Y'

ef

*-

INQUIRIES

P o t e n t i a l a p p l i c a n t s are s t r o n g l y a d v i s e d t o c o n t a c t NLM s t a f f b e f o r e s u b m i t t i n g a p p l i c a t i o n s f o r s u p p o r t .

A p p l i c a t i o n s should be submi t ted on t h e new Form PHS 398 ( r e v . 9 / 8 6 ) . For more informat ion , a p p l i c a n t s may c o n t a c t :

D r . Roger W. Dahlen C h i e f , Biomedical I n f o r m a t i o n Support Branch Extramural ProgramsN a t i o n a l L i b r a r y o f Medicine 8600 R o c k v i l l e P i k e B u i l d i n g 3 8 A , Room 5s-522 Bethesda, Maryland 20894 Telephone: (301) 496-4221

O N G O I N G PROGRAM ANNOUNCEMENTS

GERIATRIC RESEARCH INSTITUTIONAL TRAINING ( G R I T ) AWARD (T32)

P.T. 44; K . W . 0720005, 0710010

N a t i o n a l I n w t i t u t e on Aging

I n i t i a l A p p l i c a t i o n Rece ip t Date: May 10, 1989

Subsequent A p p l i c a t i o n Rece ip t Dates: September 10, 1989; and January 10, May10, and September 10 o f each y e a r t h e r e a f t e r .

The N a t i o n a l I n s t i t u t e on Aging ( N I A ) s o l i c i t s a p p l i c a t i o n s f o r t h e suppor t o f G e r i a t r i c Research I n s t i t u t i o n a l T r a i n i n g ( G R I T ) programs.

BACKGROUND AND GOALS

There is i n c r e a s e d r e c o g n i t i o n o f t h e growing need f o r t r a i n e d p e r s o n n e l i n g e r i a t r i c s . A N a t i o n a l Academy o f S c i e n c e s committee (J. Am. G e r i a t r i c s SOC. 35:773-91 ( 1 9 8 7 ) ) emphasized t h a t f i l l i n g t h i s need w i l l r e q u i r e enoughacademic l e a d e r s i n g e r i a t r i c s t o t r a i n t h e needed number o f g e r i a t r i c i a n s .The committee emphasized t h a t h i g h - q u a l i t y t r a i n i n g i n r e s e a r c h , t e a c h i n g , and c l i n i c a l p r a c t i c e were a l l n e c e s s a r y f o r t h e development o f such l e a d e r s , and t h a t t h i s could b e s t be done i n an environment where t h e r e were enoughg e r i a t r i c r e s e a r c h e r s , t e a c h e r s , and p r a c t i t i o n e r s t o p r o v i d e thoroughe x p e r i e n c e f o r f u t u r e academic l e a d e r s .

Developing academic l e a d e r s h i p r e q u i r e s a continuum o f suppor t from t h e f e l l o w s h i p t o t h e f a c u l t y l e v e l . The development o f g e r i a t r i c i a n s w i t h t h e r e s e a r c h a b i l i t i e s needed f o r academic l e a d e r s h i p w i l l g e n e r a l l y r e q u i r e a t l e a s t one y e a r of i n t e n s i v e r e s e a r c h e x p e r i e n c e a t t h e f e l l o w s h i p l e v e l ,fo l lowed by a s u b s t a n t i a l amount of r e s e a r c h a t t h e j u n i o r f a c u l t y l e v e l .

N I A ' s GRIT award s u p p o r t s r e s e a r c h t r a i n i n g f o r p h y s i c i a n s who have completed one o r more y e a r s o f c l i n i c a l g e r i a t r i c f e l l o w s h i p t r a i n i n g . T h i s award i s s u i t a b l e f o r i n s t i t u t i o n s w i t h s u f f i c i e n t a c t i v i t i e s i n g e r i a t r i c s t o suppor t an i n s t i t u t i o n a l r e s e a r c h t r a i n i n g program. ( N I A c o n t i n u e s t o encouragea p p l i c a t i o n s f o r i n d i v i d u a l r e s e a r c h f e l l o w s h i p s f o r p e r s o n s and i n s t i t u t i o n s where t h i s i s more a p p r o p r i a t e . ) The GRIT award w i l l suppor t one t o two y e a r sof i n t e n s i v e , s u s t a i n e d r e s e a r c h e x p e r i e n c e t o f a c i l i t a t e t h e development of f e l l o w s as independent r e s e a r c h e r s . S i n c e s t r e n g t h e n i n g t h e s c i e n c e b a s e o f g e r i a t r i c s and geronto logy is a g o a l o f t h i s award, c o l l a b o r a t i o n amongp e r t i n e n t b a s i c r e s e a r c h e r s , c l i n i c a l i n v e s t i g a t o r s , and e p i d e m i o l o g i s t s i n t h e t r a i n i n g o f f e l l o w s suppor ted by t h i s award i s p a r t i c u l a r l y encouraged.

Because a continuum o f suppor t f o r c a r e e r development i s needed from t h e f e l l o w s h i p t o t h e f a c u l t y l e v e l , N I A s u p p o r t s o t h e r awards f o r career development i n g e r i a t r i c s a t subsequent s t a g e s . I n t e r e s t e d p a r t i e s are encouraged t o c o n t a c t N I A s ta f f l i s t e d under "Method o f Application1' (below)f o r f u r t h e r in format ion . I n p a r t i c u l a r , N I A ' s G e r i a t r i c Academic ProgramAward s u p p o r t s career development i n t h e p o s t - f e l l o w s h i p p e r i o d . P r o s p e c t i v ea p p l i c a n t i n s t i t u t i o n s a r e encouraged t o c o n s i d e r comprehensive c a r e e r development programs which may be suppor ted by a combinat ion o f N I A and o t h e r i n s t i t u t i o n a l awards, i n c l u d i n g t h e Heal th Resources and S e r v i c e s A d m i n i s t r a t i o n ' s F a c u l t y T r a i n i n g P r o j e c t s i n G e r i a t r i c Medicine and D e n t i s t r y , Veterans A d m i n i s t r a t i o n programs, and o t h e r s o u r c e s .

Vol. 17, No. 39, November 25, 1988 - Page 7

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STRUCTURE OF AWARD

The mechanism of s u p p o r t w i l l be t h e i n s t i t u t i o n a l N a t i o n a l Research S e r v i c e Award. The award p r o v i d e s f i v e y e a r s o f renewable suppor t t o t h e g r a n t e ei n s t i t u t i o n . Support w i l l b e provided f o r i n s t i t u t i o n a l r e s e a r c h t r a i n i n g programs e x t e n d i n g from one t o two y e a r s a f t e r c l i n i c a l f e l l o w s h i p t r a i n i n g i n g e r i a t r i c s . A p p l i c a n t s may r e q u e s t suppor t f o r two t o s i x f e l l o w s h i pp o s i t i o n s p e r y e a r . No GRIT Award w i l l s u p p o r t more t h a n s i x f e l l o w s h i pp o s i t i o n s i n any g i v e n award y e a r . Support may be r e q u e s t e d f o r f e l l o w s a t t h e c u r r e n t l e v e l o f s u p p o r t f o r NRSA s t i p e n d s , and f o r i n s t i t u t i o n a l c o s t s o f up t o $2,500 p e r f e l l o w f o r t r a i n i n g r e l a t e d expenses such as s t a f f s a l a r i e s ,c o n s u l t a n t c o s t s , r e s e a r c h s u p p l i e s , equipment, and t r a v e l . An i n d i r e c t c o s t a l lowance o f 8 p e r c e n t of t o t a l a l l o w a b l e d i r e c t c o s t s f o r f e l l o w s h i p t r a i n i n gis provided .

ELIGIBILITY REQUIREMENTS

Appl icant i n s t i t u t i o n s must have:

o An e s t a b l i s h e d c l i n i c a l f e l l o w s h i p t r a i n i n g program i n g e r i a t r i c s .Fel lows t o be suppor ted by t h i s award must have completed a t l e a s t one y e a r o f c l i n i c a l f e l l o w s h i p t r a i n i n g i n g e r i a t r i c s . I t i s n o t r e q u i r e d t h a t t h i s t r a i n i n g have been a t t h e a p p l i c a n t i n s t i t u t i o n .

o F a c u l t y w i t h s u f f i c i e n t p e r t i n e n t r e s e a r c h e x p e r i e n c e t o s e r v e as mentors f o r f e l l o w s .

o Ongoing r e s e a r c h a c t i v i t i e s t o p r o v i d e an adequate environment f o r t h e r e s e a r c h development o f f e l l o w s .

I n a d d i t i o n t o programs a t i n d i v i d u a l i n s t i t u t i o n s , j o i n t programs conducted by two o r more i n s t i t u t i o n s are e l i g i b l e f o r s u p p o r t .

METHOD OF APPLICATION

A p p l i c a t i o n s should be prepared on form PHS 398, f o l l o w i n g t h e i n s t r u c t i o n s f o r i n s t i t u t i o n a l t r a i n i n g g r a n t a p p l i c a t i o n s . The PHS 398 a p p l i c a t i o n form is a v a i l a b l e a t most i n s t i t u t i o n a l b u s i n e s s o f f i c e s o r from t h e D i v i s i o n of Research Grants , N I H , (301) 496-7441. On i t e m 2 o f t h e f a c e page o f t h e a p p l i c a t i o n , a p p l i c a n t s should e n t e r : I n s t i t u t i o n a l NRSA: N I A Geriatr ic Research I n s t i t u t i o n a l T r a i n i n g Awards. A p p l i c a n t s should a l s o refer t o t h e N I H Guide t o G r a n t s and C o n t r a c t s , V o l . 16, No. 20, June 12, 1987, f o r background on i n s t i t u t i o n a l t r a i n i n g g r a n t s .

A l e t t e r o f i n t e n t is n o t a p r e r e q u i s i t e f o r apply ing; however, p r o s p e c t i v e a p p l i c a n t s a r e encouraged t o send a l e t t e r w i t h a d e s c r i p t i v e t i t l e t o t h e N I A c o n t a c t a t l eas t one month b e f o r e submission o f t h e p r o p o s a l .

The completed o r i g i n a l a p p l i c a t i o n and f o u r c o p i e s should be s e n t t o :

A p p l i c a t i o n Rece ip t D i v i s i o n o f Research Grants N a t i o n a l I n s t i t u t e s of Heal th Westwood B u i l d i n g , Room 240 Bethesda, Maryland 20892H

The N I A c o n t a c t o f f i c e l i s t e d below should be s e n t two c o p i e s o f t h e a p p l i c a t i o n a t t h e t i m e o f submiss ion . I n q u i r i e s and correspondence should be d i r e c t e d t o :

G e r i a t r i c s Branch N a t i o n a l I n s t i t u t e on AgingB u i l d i n g 31, Room 5C-27 Bethesda, Maryland 20892 Telephone: ( 3 0 1 ) 496-6761

The a p p l i c a t i o n should i d e n t i f y :

o A program d i r e c t o r who w i l l assume o v e r a l l r e s p o n s i b i l i t y f o r management o f t h e program. The a p p l i c a t i o n should d e s c r i b e p l a n sf o r q u a l i t y c o n t r o l o f t h e program and f o r maximizing commitment o f f e l l o w s t o a g i n g r e s e a r c h a f te r t h e complet ion o f f e l l o w s h i p s u p p o r t .

o The f a c u l t y s p o n s o r s who w i l l p r o v i d e t r a i n i n g f o r f e l l o w s . The sponsors ' p a s t and p r e s e n t r e s e a r c h should be d e s c r i b e d , as w e l l as t h e i r p r e v i o u s e x p e r i e n c e i n t r a i n i n g r e s e a r c h f e l l o w s , and t h e

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c u r r e n t s t a t u s o f a l l f e l l o w s p r e v i o u s l y t r a i n e d by t h e f a c u l t y sponsors .

The f a c u l t y and i n s t i t u t i o n ' s p l a n s f o r p r o v i d i n g r e s e a r c h e x p e r i e n c e t o f e l l o w s , i n c l u d i n g examples o f t h e t y p e s o f r e s e a r c h p r o j e c t s t o be under taken , p r o v i s i o n of e x p e r i e n c e i n o t h e r l a b o r a t o r i e s t o l e a r n p e r t i n e n t t e c h n i q u e s , e t c .

P l a n s f o r p r o v i d i n g o t h e r t r a i n i n g t o f e l l o w s i n a d d i t i o n t o l a b o r a t o r y e x p e r i e n c e , e . g . d i d a c t i c t r a i n i n g i n b a s i c s c i e n c e s , r e s e a r c h methodology, o r s t a t i s t i c s . P r o v i s i o n o f a sys tem-t ic exposure t o c u r r e n t knowledge i n geronto logy is encouraged.

P lans f o r e x t e r n a l review o f t h e s e l e c t i o n and p r o g r e s s o f f e l l o w s and t h e o v e r a l l conduct o f t h e program. T h i s review should be conducted once y e a r l y , and provide w r i t t e n r e p o r t s t o be submi t ted t o N I A w i t h t h e awardee ls annual p r o g r e s s r e p o r t s .

P l a n s f o r e f f o r t s t o r e c r u i t m i n o r i t y t r a i n e e s , c o n s i s t e n t w i t h N I H l s p o l i c y of encouraging such r e c r u i t m e n t . Such p l a n s are a r e q u i r e d component o f a p p l i c a t i o n s f o r N I H r e s e a r c h t r a i n i n g programs. A d d i t i o n a l in format ion on N I H ' s m i n o r i t y r e c r u i t m e n t p o l i c y may be found i n t h e N I H Guide f o r Grants and C o n t r a c t s Vol . 15, No. 4, March 28, 1986.

EVALUATION CRITERIA

A p p l i c a t i o n s w i l l be judged on:

The r e s e a r c h c a p a b i l i t i e s o f f a c u l t y sponsors i n areas r e l a t e d t o g e r i a t r i c s .

The a b i l i t i e s and r e c o r d o f f a c u l t y sponsors i n t r a i n i n g f e l l o w s i n a g i n g r e s e a r c h .

The i n s t i t u t i o n ' s p l a n s and commitment t o t h e development o f f e l l o w s ' a b i l i t i e s i n g e r i a t r i c r e s e a r c h , i n c l u d i n g t h e a c q u i s i t i o n o f background i n b a s i c s c i e n c e s ( i n c l u d i n g geronto logy) and r e s e a r c h methodology.

Q u a l i t y o f proposed t r a i n i n g o b j e c t i v e s and d e s i g n o f t r a i n i n g program.

A v a i l a b i l i t y o f r e s e a r c h s u p p o r t .

Likel ihood and/or p r e v i o u s r e c o r d o f a t t r a c t i n g h i g h - q u a l i t y t r a i n e e s .

Renewal a p p l i c a t i o n s w i l l a l s o be judged on t h e s u c c e s s o f p r e v i o u s l y t r a i n e d f e l l o w s i n g e r i a t r i c r e s e a r c h .

REVIEW PROCEDURES AND CRITERIA

A p p l i c a t i o n s w i l l be r e c e i v e d by t h e N I H D i v i s i o n o f Research Grants and w i l l be a s s i g n e d t o t h e N I A . Responsive a p p l i c a t i o n s w i l l be a s s i g n e d t o an a p p r o p r i a t e group f o r review. A p p l i c a t i o n s w i l l b e reviewed i n accord w i t h t h e u s u a l NiH p e e r review p r o c e d u r e s . Fol lowing s t u d y s e c t i o n review, t h e a p p l i c a t i o n s w i l l be e v a l u a t e d by t h e N a t i o n a l Advisory Counci l on Aging.

For f u r t h e r i n f o r m a t i o n and a copy o f t h e PA c o n t a c t :

S t a n l e y L . S l a t e r , M . D . D i r e c t o r , G e r i a t r i c Research and T r a i n i n g ProgramN a t i o n a l I n s t i t u t i o n on AgingB u i l d i n g 31, Room 5C27 9000 R o c k v i l l e P ike Bethesda, MD 20892 Telephone: (301) 496-6761

GERIATRIC ACADEMIC PROGRAM (GAP) AWARD WL2-I

P.T. 34; K . W . 0710010

N a t i o n a l I n s t i t u t e on Aging

I n i t i a l A p p l i c a t i o n Rece ip t Date: June 1, 1989

Subsequent A p p l i c a t i o n Rece ip t Dates: October 1, 1989; and February 1 , June 1 , and October 1 o f each y e a r t h e r e a f t e r .

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The N a t i o n a l I n s t i t u t e on Aging ( N I A ) s o l i c i t s a p p l i c a t i o n s f o r t h e suppor t o f academic career development programs f o r j u n i o r f a c u l t y i n g e r i a t r i c s .

BACKGROUND AND GOALS

There i s i n c r e a s e d r e c o g n i t i o n o f t h e growing need f o r t r a i n e d personnel i n g e r i a t r i c s . A committee sponsored by t h e N a t i o n a l Academy o f S c i e n c e s ( J .Am. Geriatrics SOC. 35:773-91, (1987) emphasized t h a t f i l l i n g t h i s need w i l l r e q u i r e enough academic l e a d e r s i n g e r i a t r i c s t o t r a i n t h e needed number o f g e r i a t r i c i a n s . The committee emphasized t h a t h i g h - q u a l i t y t r a i n i n g i n r e s e a r c h , t e a c h i n g , and c l i n i c a l p r a c t i c e were a l l n e c e s s a r y f o r t h e development o f such l e a d e r s , and t h a t t h i s could b e s t be done i n an environment where t h e r e were enough g e r i a t r i c r e s e a r c h e r s , t e a c h e r s , and p r a c t i t i o n e r s t o p r o v i d e thorough e x p e r i e n c e f o r f u t u r e academic l e a d e r s .

Developing academic l e a d e r s h i p r e q u i r e s a continuum o f suppor t from t h e f e l l o w s h i p t o t h e s e n i o r f a c u l t y l e v e l . Support f o r g e r i a t r i c f e l l o w s h i p s i s a v a i l a b l e through s e v e r a l programs, i n c l u d i n g N I A ' s Geriatr ic Research I n s t i t u t i o n a l T r a i n i n g (GRIT) award, t h e Heal th Resources and S e r v i c e s A d m i n i s t r a t i o n ' s F a c u l t y T r a i n i n g P r o j e c t s i n G e r i a t r i c Medicine and D e n t i s t r y , Veterans A d m i n i s t r a t i o n f e l l o w s h i p s , and o t h e r s o u r c e s . However,s t a b l e career development s u p p o r t a t t h e j u n i o r f a c u l t y l e v e l is a l s o ex t remely impor tan t i n e s t a b l i s h i n g academic careers.

Career development s u p p o r t f o r i n d i v i d u a l j u n i o r f a c u l t y i n g e r i a t r i c s i s provided by N I A ' s Academic Award ( N I H Guide t o Grants and C o n t r a c t s , V o l . 10,No. 5, March 27, 19811, and by i ts C l i n i c a l I n v e s t i g a t o r Award ( N I H Guide t o Grants and C o n t r a c t s , Vol. 13, No. 8, June 29, 1984) . N I A c o n t i n u e s t o encourage a p p l i c a t i o n s f o r t h e s e awards f o r s u i t a b l e c a n d i d a t e s and i n s t i t u t i o n s . T h i s announcement d e s c r i b e s an i n s t i t u t i o n a l form o f t h e Academic Award, t h e G e r i a t r i c Academic Program (GAP) Award. T h i s award is a p p r o p r i a t e f o r i n s t i t u t i o n s having s u f f i c i e n t f a c u l t y w i t h a s t a b l e b a s e o f ongoing r e s e a r c h i n g e r i a t r i c s and r e l a t e d d i s c i p l i n e s t o s e r v e as mentors f o r s e v e r a l j u n i o r f a c u l t y over a n extended p e r i o d .

S i n c e s t r e n g t h e n i n g t h e s c i e n c e b a s e o f g e r i a t r i c s and geronto logy i s a g o a lo f t h i s award, c o l l a b o r a t i o n among c l i n i c a l , b a s i c , ep idemiologic , b e h a v i o r a l ,and s o c i a l r e s e a r c h e r s i n s u p p o r t o f c a r e e r development a c t i v i t i e s i s p a r t i c u l a r l y encouraged. C o l l a b o r a t i o n w i t h b a s i c s c i e n c e r e s e a r c h e r s i n geronto logy is p a r t i c u l a r l y d e s i r a b l e .

Because a continuum o f s u p p o r t f o r c a r e e r development is needed from t h e f e l l o w s h i p t o t h e f a c u l t y l e v e l , t h e N I A s u p p o r t s o t h e r awards f o r career development i n g e r i a t r i c s a t o t h e r s t a g e s . I n t e r e s t e d p a r t i e s are encouraged t o c o n t a c t N I A s t a f f l i s t e d under "Method o f Applying" f o r f u r t h e r i n f o r m a t i o n . P r o s p e c t i v e a p p l i c a n t i n s t i t u t i o n s are encouraged t o c o n s i d e r deve loping comprehensive c a r e e r development programs which may be suppor ted by a combinat ion o f N I A and o t h e r i n s t i t u t i o n a l awards.

ELIGIBILITY

A p p l i c a n t s must have i n p l a c e a g e r i a t r i c f e l l o w s h i p program a t t h e t ime o f a p p l i c a t i o n . J u n i o r f a c u l t y t o be suppor ted by t h e program must have a h e a l t h p r o f e s s i o n a l d e g r e e i n t h e c l i n i c a l s c i e n c e s ( M . D . , D . O . , o r D.D.S, o r e q u i v a l e n t ) and must have e i t h e r completed a t l eas t one y e a r o f f e l l o w s h i pt r a i n i n g i n g e r i a t r i c s o r g e r o p s y c h i a t r y o r o b t a i n e d c e r t i f i c a t i o n of Added Q u a l i f i c a t i o n s i n Geriatric Medicine from t h e American Board o f I n t e r n a l MedicinelAmerican Board o f Family P r a c t i c e . It is n o t r e q u i r e d t h a t f e l l o w s h i p t r a i n i n g have been a t t h e a p p l i c a n t i n s t i t u t i o n .

Appl icant i n s t i t u t i o n s must have a s t r o n g and s t a b l e b a s e o f r e s e a r c h and c l i n i c a l a c t i v i t i e s r e l a t e d t o g e r i a t r i c s t o p r o v i d e an adequate environment f o r t h e development of academic g e r i a t r i c i a n s . I n a d d i t i o n t o programs a t i n d i v i d u a l i n s t i t u t i o n s , programs conducted by two o r more i n s t i t u t i o n s are e l i g i b l e f o r s u p p o r t .

STRUCTURE OF SUPPORT

The mechanism o f s u p p o r t w i l l be t h e i n s t i t u t i o n a l r e s e a r c h career award (K12). The award w i l l s u p p o r t a program p r o v i d i n g up t o f i v e y e a r s o f s a l a r y s u p p o r t and a l i m i t e d amount f o r r e s e a r c h expenses f o r j u n i o r f a c u l t y , under t h e l e a d e r s h i p o f a program d i r e c t o r who w i l l o v e r s e e t h e program, and f a c u l t y s p o n s o r s who w i l l s e r v e as mentors f o r i n d i v i d u a l j u n i o r f a c u l t y , t o o v e r s e e t h e i r academic development, and t o a r r a n g e a p p r o p r i a t e a c t i v i t i e s needed f o r f u r t h e r development. For each j u n i o r f a c u l t y member so sponsored, t h e award w i l l a l s o p r o v i d e up t o t e n p e r c e n t o f each s p o n s o r ' s s a l a r y and f r i n g eb e n e f i t s f o r t h e f irst t h r e e y e a r s of s p o n s o r s h i p . The award w i l l a l s o s u p p o r t a l i m i t e d amount o f c o r e r e s o u r c e s needed f o r sponsored i n d i v i d u a l s '

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career development ( e . g . key c l i n i c a l r e s e a r c h c e n t e r pe r sonne l , o r animal f a c i l i t i e s ) i f c e n t r a l a d m i n i s t r a t i o n improves t h e i r effect iveness .

Up t o f i v e y e a r s o f renewable suppor t may be r eques t ed by t h e g r a n t e e i n s t i t u t i o n . I n d i v i d u a l j u n i o r f a c u l t y sponsored by t h e program may be suppor ted from t h r e e t o f i v e y e a r s . No more t h a n t h r e e pe r sons a t an awardee i n s t i t u t i o n may beg in t h e i r sponsored a c t i v i t i e s i n any y e a r l y budget p e r i o d o f t h i s award, and none may beg in sponsored a c t i v i t i e s i n t h e f o u r t h and f i f t h y e a r s . The t o t a l number o f sponsored i n d i v i d u a l s may i n c r e a s e t o no more t h a n e i g h t i n t h e t h i r d y e a r o f t h e award, and remain c o n s t a n t o r d imin i sh t h e r e a f t e r .

METHOD OF APPLYING

A p p l i c a t i o n s should be p repa red on form PHS 398. A p p l i c a n t s should fo l low t h e supplementa l i n s t r u c t i o n s f o r a p p l i c a t i o n s f o r t h i s award, a v a i l a b l e from t h e Geriatrics Branch, N I A ( a d d r e s s on page 5). The PHS 398 a p p l i c a t i o n form i s a v a i l a b l e a t most i n s t i t u t i o n a l b u s i n e s s o f f i c e s o r from t h e D i v i s i o n o f Research Grants , N I H , (301) 496-7441. On i t e m 2 o f t h e f a c e page o f t h e a p p l i c a t i o n , a p p l i c a n t s should e n t e r : N I A Geriatr ic Academic Program Award.

A l e t t e r o f i n t e n t i s n o t a p r e r e q u i s i t e f o r apply ing; however, p r o s p e c t i v e a p p l i c a n t s are encouraged t o send a l e t t e r t h a t i n c l u d e s a d e s c r i p t i v e t i t l e and r e s o u r c e s o f t h e proposed p r o j e c t . T h i s l e t t e r should be s e n t t o t h e N I A c o n t a c t by t h r e e months b e f o r e t h e submission d e a d l i n e .

A completed o r i g i n a l a p p l i c a t i o n and f o u r c o p i e s should be s e n t t o :

A p p l i c a t i o n Rece ip t D i v i s i o n o f Research Gran t s Nat iona l I n s t i t u t e s o f Hea l th Westwood Bu i ld ing , Room 240 Bethesda, Maryland 20892xx

The N I A c o n t a c t o f f i c e l i s t e d below should be s e n t two c o p i e s o f t h e a p p l i c a t i o n a t t h e t i m e o f submiss ion . I n q u i r i e s and cor respondence should be d i r e c t e d t o :

Geriatr ics Branch Nat iona l I n s t i t u t e on Aging

b’ Bui ld ing 31, Room 5C-27 Bethesda, Maryland 20892 Telephone: (301) 496-6761

The a p p l i c a t i o n should i d e n t i f y :

A program d i r e c t o r who w i l l assume o v e r a l l r e s p o n s i b i l i t y f o r management o f t h e program. The a p p l i c a t i o n should d e s c r i b e p l a n s f o r r e c r u i t m e n t and s e l e c t i o n o f j u n i o r f a c u l t y t o be sponsored , q u a l i t y c o n t r o l o f t h e programand f o r maximizing commitment o f sponsored i n d i v i d u a l s t o ag ing r e s e a r c h a f t e r t h e comple t ion o f s u p p o r t .

F a c u l t y sponsor s . The sponsors ’ p a s t and p r e s e n t r e s e a r c h , c l i n i c a l and t e a c h i n g a c t i v i t i e s should be d e s c r i b e d , as w e l l as t h e i r p rev ious expe r i encei n t r a i n i n g f e l l o w s and j u n i o r f a c u l t y , and t h e c u r r e n t s t a t u s o f a l l f e l l o w s and o t h e r i n d i v i d u a l s whom t h e y have p r e v i o u s l y t r a i n e d .

The f a c u l t y and i n s t i t u t i o n ’ s p l a n s f o r p r o v i d i n g r e s e a r c h , c l i n i c a l and t e a c h i n g expe r i ence f o r sponsored i n d i v i d u a l s , i n c l u d i n g examples o f t h e t y p e so f r e s e a r c h p r o j e c t s t o be under taken , p r o v i s i o n o f expe r i ence i n o t h e r l a b o r a t o r i e s t o l e a r n p e r t i n e n t t echn iques , needed d i d a c t i c t r a i n i n g i n geronto logy , o t h e r b a s i c s c i e n c e s , r e s e a r c h methodology, s t a t i s t i c s , and c l i n i c a l and t e a c h i n g r e s p o n s i b i l i t i e s .

P l ans f o r e f f o r t s t o r e c r u i t m i n o r i t y t r a i n e e s where a p p l i c a b l e , c o n s i s t e n t w i th N I H ’ s p o l i c y o f encouraging such r e c r u i t m e n t . Such p l a n s are a r e q u i r e d component o f a p p l i c a t i o n s f o r N I H r e s e a r c h t r a i n i n g programs. Add i t iona l i n fo rma t ion on N I H ‘ s m inor i ty r e c r u i t m e n t p o l i c y may be found i n t h e N I H Guide f o r Grants and C o n t r a c t s V o l . 15, No. 4, March 28, 1986.

REVIEW PROCEDURES

A p p l i c a t i o n s w i l l be r e c e i v e d by t h e N I H D i v i s i o n o f Research Grants and w i l l be a s s i g n e d t o t h e N I A . Responsive a p p l i c a t i o n s w i l l be a s s i g n e d t o an

-,W a p p r o p r i a t e group f o r rev iew. A p p l i c a t i o n s judged by t h e N I A t o be non-responsive w i l l be t r e a t e d as r e g u l a r g r a n t a p p l i c a t i o n s .

Vol. 17, No. 39, November 25, 1988 - Page 1 1

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A p p l i c a t i o n s w i l l be reviewed i n accord w i t h t h e u s u a l N I H p e e r review procedures . Fol lowing s t u d y s e c t i o n review, t h e a p p l i c a t i o n s w i l l be e v a l u a t e d by t h e N a t i o n a l Advisory Counci l on Aging.

For f u r t h e r i n f o r m a t i o n and a copy o f t h e PA c o n t a c t :

S t a n l e y L . S l a t e r , M . D . "I

D i r e c t o r , G e r i a t r i c Research and T r a i n i n g ProgramN a t i o n a l I n s t i t u t e on AgingB u i l d i n g 31, Room 5C27 9000 R o c k v i l l e P ike Bethesda, Maryland 20892 Telephone: (301) 496-6761

HIV-RELATED ILLNESSES: TOPICS FOR HEALTH SERVICES RESEARCH

P.T. 34; K.W. 0715008, 0730050, 0408006, 0730030, 0413000

N a t i o n a l Center f o r H e a l t h S e r v i c e s Research and H e a l t h Care Technology Assessment (NCHSR)

BACKGROUND INFORMATION

The r e c e n t P u b l i c Heal th S e r v i c e meet ing i n C h a r l o t t e s v i l l e , VA, on t h e p r e v e n t i o n and c o n t r o l o f AIDS and t h e human immunodeficiency v i r u s ( H I V ) c a l l e d f o r s t u d i e s t h a t f o c u s on t h e c o s t e f f e c t i v e n e s s and f i n a n c i n g o f care f o r i l l n e s s e s r e l a t e d t o H I V . I t a l s o recommended broadening t h e scope o f h e a l t h s e r v i c e s r e s e a r c h beyond economic i s s u e s . A s p a r t o f t h e P u b l i c Heal th S e r v i c e , NCHSR h a s been asked t o i n v e s t i g a t e ways t o add t o e x i s t i n g knowledge on h e a l t h s e r v i c e s r e s e a r c h on HIV-related i l l n e s s e s .

I n response , NCHSR i s i n t e r e s t e d i n t h e s t u d y o f t h e a v a i l a b i l i t y , c o s t , and u t i l i z a t i o n of h e a l t h s e r v i c e s f o r H I V - r e l a t e d i l l n e s s e s . I n f o r m a t i o n needed by p o l i c y - and decis ionmakers involves d i f f e r e n t r i s k groups, p o p u l a t i o n s , geographic a r e a s , s t a g e s o f i l l n e s s , and t r e a t m e n t m o d a l i t i e s . Research t o p i c s i n c l u d e t h e f i n a n c i n g , o r g a n i z a t i o n , and management o f h e a l t h c a r e s e r v i c e s f o r HIV-related i l l n e s s e s .

Current ep idemiologic and economic i n f o r m a t i o n about AIDS and o t h e r HIV-related i l l n e s s e s h i g h l i g h t s t h e complexi ty o f i s s u e s and gaps i n knowledge t h a t should be addressed i n h e a l t h s e r v i c e s r e s e a r c h . Research t o p i c s and q u e s t i o n s are d i s c u s s e d b r i e f l y i n subsequent s e c t i o n s w i t h r e s p e c t t o h e a l t h s t a t u s measures and i n f o r m a t i o n systems, access and b a r r i e r s t o care, q u a l i t y o f care, h e a l t h systems a n a l y s i s , c o s t e f f e c t i v e n e s s o f a l t e r n a t i v e s e r v i c e and o r g a n i z a t i o n a l s t r a t e g i e s , and p r o v i d e r i s s u e s . For g r e a t e r d e t a i l , see "HIV-Related I l l n e s s e s : Topics f o r Heal th S e r v i c e s Research," a program n o t e p u b l i s h e d i n October 1988 t h a t is a v a i l a b l e from NCHSR.

PRIORITY RESEARCH ISSUES

Cost and Financing o f Care

H e a l t h s e r v i c e s r e s e a r c h on HIV-related i l l n e s s e s h a s focused on t h e c o s t s and e x p e n d i t u r e s f o r t r e a t m e n t , b u t a number o f r e s t r i c t i o n s have made it d i f f i c u l t t o estimate c u r r e n t and f u t u r e c o s t s . I n a d d i t i o n , t h e c o s t and f i n a n c i n g o f t r e a t m e n t w i l l be a f f e c t e d by t h e expanded d e f i n i t i o n o f AIDS, t h e p o s s i b i l i t y o f new d i a g n o s t i c t e c h n i q u e s t h a t a r e more s e n s i t i v e and can d e t e c t t h e p r e s e n c e o f t h e i l l n e s s e s much ea r l i e r t h a n c o n v e n t i o n a l s c r e e n i n g t e c h n i q u e s , and t h e expanded u s e o f AZT and o t h e r new t r e a t m e n t s . Examples o f r e s e a r c h a b l e q u e s t i o n s f o l l o w :

o What is t h e v a r i a t i o n i n c o s t s o f t r e a t i n g an e p i s o d e o f i l l n e s s ? o How do c o s t s f o r t r e a t m e n t o f HIV-related i l l n e s s e s v a r y by r e g i o n ,

r i s k f a c t o r s , demographics, and socioeconomic v a r i a b l e s ? o What are t h e i n d i r e c t c o s t s o f HIV-related i l l n e s s e s , and how do

t h e y v a r y f o r d i f f e r e n t t r e a t m e n t s , t y p e s o f s e r v i c e s , and p o p u l a t i o n groups?

o What are t h e p r o j e c t e d d i r e c t and i n d i r e c t c o s t s , charges , and e x p e n d i t u r e s f o r HIV-related i l l n e s s e s , and how do t h e y v a r y w i t h d i f f e r e n t assumptions?

o How h a s t h e a v a i l a b i l i t y and coverage o f i n s u r a n c e f o r HIV-related i l l n e s s e s been a f f e c t e d by l e g i s l a t i o n , employer s e l f - i n s u r a n c e , use o f s c r e e n i n g f o r H I V i n f e c t i o n by employers and i n s u r e r s , and o t h e r f a c t o r s ?

o What is t h e e x t e n t o f unreimbursed c a r e f o r HIV-related i l l n e s s e s and s e r o p o s i t i v e i n d i v i d u a l s , and how are t h e s e c o s t s absorbed?

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o How a r e f i n a n c i n g s o u r c e s o f H I V care p r o j e c t e d t o change i n response t o changes i n t h e p o p u l a t i o n w i t h HIV-related i l l n e s s e s ?

o What impact do v o l u n t e e r s e r v i c e s have on a c c e s s t o h e a l t h c a r e s e r v i c e s , q u a l i t y o f care, and f i n a n c i a l burden f o r t h e i n d i v i d u a l and community?

L c I J

1,-f

Heal th S t a t u s Measures and Informat ion Systems

Informat ion systems a r e needed t o produce a c c u r a t e , t i m e l y , and comprehensived a t a u s e f u l f o r h e a l t h s e r v i c e s r e s e a r c h and p o l i c y a n a l y s e s , f o r ep idemiologic i n q u i r i e s , and f o r c l i n i c a l i n v e s t i g a t i o n s . NCHSR i s e s p e c i a l l yi n t e r e s t e d i n i s s u e s and q u e s t i o n s t h a t i n c l u d e t h e f o l l o w i n g :

o Design o f medical r e c o r d s systems t o permi t t h e c o n f i d e n t i a l c o l l e c t i o n and a g g r e g a t i o n o f l o n g i t u d i n a l , p a t i e n t - s p e c i f i c d a t a i n o r d e r t o deve lop s e v e r i t y i n d i c e s , p a t t e r n s o f i l l n e s s , h e a l t h s t a t u s m e a s u r e s , and a n a l y s e s o f p r a c t i c e v a r i a t i o n s .

o Development o f recordkeeping systems t h a t can a c q u i r e and i n t e g r a t ei n f o r m a t i o n from informal c a r e g i v e r s and o r g a n i z a t i o n s .

o C o n s t r u c t i o n o f d a t a banks o r r e g i s t r i e s t o permi t more a c c u r a t e i d e n t i f i c a t i o n and comparisons o f d i f f e r e n t p r a c t i c e p a t t e r n s , more focused and e f f i c i e n t c l i n i c a l and ep idemiologic i n v e s t i g a t i o n s ,and more r i g o r o u s assessment o f medical t e c h n o l o g i e s .

o What are t h e e f fec ts of t h e H I V epidemic on p o l i c i e s and proceduresi n h e a l t h c a r e s e t t i n g s ?

o How can b e t t e r h e a l t h outcome i n d i c a t o r s , f u n c t i o n a l s t a t u s measures , and measures o f i l l n e s s s e v e r i t y be c o n s t r u c t e d ? Can e x i s t i n g i n s t r u m e n t s f o r o t h e r d i s e a s e s be adopted o r improved?

Access and Barriers t o Care

Access t o care may be l i m i t e d because p a t i e n t s w i t h HIV-related i l l n e s s e s maybe more l i k e l y t o p o s s e s s no insurance o r t o r e q u i r e p u b l i c a s s i s t a n c e . Both f a c t o r s may l i m i t t h e number o f h e a l t h care p r o v i d e r s f o r t h e s e p a t i e n t s .Furthermore, t h e i n f e c t i o u s n a t u r e o f t h e d i s e a s e may l i m i t t h e w i l l i n g n e s s of p r o v i d e r s t o g i v e a p p r o p r i a t e and s u s t a i n e d t r e a t m e n t . Examples o f q u e s t i o n si n c l u d e :

o What services a r e a v a i l a b l e and used f o r t r e a t m e n t o f HIV-related i l l n e s s e s , and how do t h e y v a r y by geographic a r e a s , r i s k groups,s e v e r i t y of i l l n e s s e s , and t h e n a t u r e o f t h e d i s e a s e ?

o How do t h e t y p e s o f a v a i l a b l e s e r v i c e s and c o n t i n u i t y o f s e r v i c e s used v a r y by h e a l t h care s e t t i n g and t h e f i n a n c i n g of care?

o How do a v a i l a b i l i t y o f s e r v i c e s , r e s o u r c e u t i l i z a t i o n , and c o n t i n u i t y of s e r v i c e s c o r r e l a t e w i t h i n s u r a n c e coverage o r m i n o r i t y and socioeconomic s t a t u s ?

o What community and i n d i v i d u a l f a c t o r s promote o r h i n d e r e s t a b l i s h m e n t o f HIV-related s e r v i c e s ?

Q u a l i t y o f Care

The many f a c t o r s a f f e c t i n g q u a l i t y o f c a r e i n c l u d e t h e supply o f p r a c t i t i o n e r sand s e t t i n g s equipped t o d e a l w i t h HIV-related i l l n e s s e s , t h e demand f o r t r e a t m e n t , and p a t i e n t c h a r a c t e r i s t i c s . Among t h e q u e s t i o n s t h a t need t o b e addressed:

o What is t h e q u a l i t y o f c a r e provided t o p a t i e n t s w i t h HIV-related i l l n e s s e s ? Q u a l i t y o f t r e a t m e n t may be d e f i n e d by such measures as p a t i e n t s a t i s f a c t i o n , i n c r e a s e d l o n g e v i t y , q u a l i t y - a d j u s t e ds u r v i v a l , reduced p a i n , and t h e e d u c a t i o n o f p a t i e n t s about t h e i r d i s e a s e and o p t i o n s f o r t r e a t m e n t .

o What i s t h e n a t u r e o f p a t i e n t and p r a c t i t i o n e r i n t e r a c t i o n s ? How do t h e s e i n t e r a c t i o n s a f fec t p a t i e n t compliance, s a t i s f a c t i - n , and f unc t i o n i n g ?

o How does p a t i e n t p r e f e r e n c e affect t r e a t m e n t ? How is p a t i e n tp r e f e r e n c e weighed a g a i n s t o t h e r f a c t o r s ?

o How does q u a l i t y of care v a r y by r e g i o n a l p r e v a l e n c e o f t h e d i s e a s e , t h e supply and t y p e s o f t r e a t m e n t s e t t i n g s , t h e p r a c t i t i o n e r s who t r e a t t h e d i s e a s e , and p a t i e n t c h a r a c t e r i s t i c s ?

Health Systems Analysis The AIDS epidemic is l i k e l y t o have f a r - r e a c h i n g e f fec ts on t h e d i s t r i b u t i o n of h e a l t h care r e s o u r c e s ; t h e o r g a n i z a t i o n and management o f formal and informal h e a l t h c a r e d e l i v e r y networks; and t h e d e t e c t i o n , t r e a t m e n t , and f i n a n c i n g o f o t h e r d i s e a s e s . Q u e s t i o n s on t h e impact o f HIV-related i l l n e s s e s i n c l u d e :

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o How have HIV-related i l l n e s s e s a f f e c t e d t h e s t r u c t u r e , f u n c t i o n s ,i n t e r r e l a t i o n s h i p s , and f i s ca l v i a b i l i t y of i n s t i t u t i o n a l and community-based h e a l t h care o r g a n i z a t i o n s ?

o What are t h e s i m i l a r i t i e s and d i f f e r e n c e s i n i n t e r n a t i o n a l e x p e r i e n c e s i n t h e p r e v e n t i o n , c o s t , f i n a n c i n g , q u a l i t y o f care,and access t o h e a l t h care f o r t h o s e a f f l i c t e d by HIV-related i l l n e s s e s ? A r e t h e s e e x p e r i e n c e s a p p l i c a b l e t o t h e United S t a t e s ?

o What are t h e s p i l l o v e r e f fec ts o f , and r e s o u r c e t r a d e o f f s between,HIV-related i l l n e s s e s and o t h e r i l l n e s s e s ? What e t h i c a l i s s u e s are involved i n r e s o u r c e t r a d e o f f s ?

Cost E f f e c t i v e n e s s o f A l t e r n a t i v e S e r v i c e and O r g a n i z a t i o n a l S t r a t e g i e s

The i d e n t i f i c a t i o n o f c o s t - e f f e c t i v e ways f o r o r g a n i z i n g , managing, and d e l i v e r i n g h e a l t h s e r v i c e s t o H I V p a t i e n t s i s c r i t i c a l . That a n a l y s i s ,however, needs t o d i s t i n g u i s h c o s t s from c h a r g e s , c o n s i d e r s e v e r i t y o f i l l n e s s and q u a l i t y sf l i f e , and use c o n s i s t e n t measures o f t h e r e l a t i v e e f f e c t i v e n e s s o f d i f f e r e n t s t r a t e g i e s f o r p r o v i d i n g h e a l t h care s e r v i c e s . NCHSR i s i n t e r e s t e d i n s t u d i e s t h a t examine:

o How do t r e a t m e n t and c o s t v a r y by o r g a n i z a t i o n a l c h a r a c t e r i s t i c s such as ownership, t e a c h i n g s t a t u s , s i z e , c o n c e n t r a t i o n o f H I V c a s e l o a d , and i n t e g r a t i m i n a m u l t i - i n s t i t u t i o n a l h e a l t h care system?

o What i s t h e comparat ive c o s t e f f e c t i v e n e s s of c e n t r a l i z a t i o n v e r s u s d e c e n t r a l i z a t i o n o f s e r v i c e d e l i v e r y a t t h e f a c i l i t y l e v e l ? Is t h e u s e o f d e d i c a t e d u n i t s i n h o s p i t a l s v e r s u s s c a t t e r e d beds a more c o s t - e f f e c t i v e s t r a t e g y ?

o How h a s t h e epidemic a f f e c t e d h e a l t h care f a c i l i t i e s w i t h a l a r g enumber o f cases i n terms o f s t a f f i n g r a t i o s , p e r s o n n e l mix, and p a t i e n t demand?

o How are v o l u n t e e r s e r v i c e s c o o r d i n a t e d w i t h each o t h e r and w i t h t h e formal h e a l t h c a r e d e l i v e r y system? What is t h e p o t e n t i a l f o r t h e expanded use and e f f e c t i v e n e s s of community-based v o l u n t e e r o r g a n i z a t i o n s i n d e a l i n g w i t h HIV-related i l l n e s s e s ?

P r o v i d e r I s s u e s

P o t e n t i a l p r o v i d e r exposure t o body f l u i d s o f p a t i e n t s n e c e s s i t a t e s g r e a t l yi n c r e a s e d s a f e g u a r d s t h a t may be inconvenient and may i n c r e a s e r e l u c t a n c e t o t r e a t H I V p a t i e n t s . Some p r o v i d e r s may h e s i t a t e t o c a r e f o r H I V p a t i e n t s who ’1

engage i n s u b s t a n c e abuse and homosexual a c t i v i t y . Moreover, t h e p r o g n o s i s o f t h e s e p a t i e n t s i s almost always t e r m i n a l . A l l o f t h e s e i s s u e s have l e d t o concern by h e a l t h c a r e p r a c t i t i o n e r s who a r e o r may b e t r e a t i n g HIV-related cases and may c o n t r i b u t e t o p r o f e s s i o n a l “burnout. l’ Q u e s t i o n s f o r r e s e a r c h i n c l u d e :

o How are h e a l t h c a r e p r a c t i t i o n e r s and v o l u n t e e r s r e a c t i n g t o t h e epidemic i n terms o f a v a i l a b i l i t y , t u r n o v e r , w i l l i n g n e s s t o t r e a t HIV-related i l l n e s s e s , and burnout from t r e a t i n g H I V v i c t i m s ? What f i n a n c i a l and o r g a n i z a t i o n a l f a c t o r s a f fec t p r o v i d e r burnout?

o Does t h e a b i l i t y t o e x e r c i s e d i s c r e t i o n a r y judgment i n t h e d e c i s i o n t o t r e a t H I V p a t i e n t s v a r y a c r o s s employment s e t t i n g s and t y p e s o f h e a l t h c a r e p r o f e s s i o n a l s ?

o What is t h e e f fec t of v a r i a t i o n s i n t h e mix o f h e a l t h p r o f e s s i o n a ls k i l l s on t r e a t m e n t o f HIV-related i l l n e s s e s ? What i s t h e most c o s t - e f f e c t i v e mix f o r v a r i o u s t r e a t m e n t s e t t i n g s and p o p u l a t i o ngroups?

o How i s t h e epidemic a f f e c t i n g p r o v i d e r c h o i c e o f s p e c i a l t y , c h o i c e o f l o c a t i o n , and o t h e r p r a c t i c e d e c i s i o n s ?

APPLICATION AND REVIEW PROCEDURES

A p p l i c a t i o n s may be submi t ted by any p u b l i c o r p r i v a t e n o n p r o f i t i n s t i t u t i o n o r u n i t o f S t a t e o r l o c a l government. A p p l i c a t i o n s must be submi t ted on P u b l i c Heal th S e r v i c e Form 398, Grant A p p l i c a t i o n , except f o r a p p l i c a t i o n sfrom S t a t e and l o c a l governments. The l a t t e r a r e r e q u i r e d t o submit Form DHHS 5161, A p p l i c a t i o n f o r F e d e r a l A s s i s t a n c e ( n o n c o n s t r u c t i o n programs) .

A p p l i c a t i o n materials a r e a v a i l a b l e from

John D . G a l l i c c h i o C h i e f , Review and Advisory S e r v i c e s ProgramN a t i o n a l Center f o r H e a l t h S e r v i c e s Research

and Heal th Care Technology Assessment 5600 F i s h e r s Lane, Room 18A-20 R o c k v i l l e , Maryland 20857 Telephone: (301) 443-3091

Vol. 17, No. 39, November 25, 1988 - Page 1 4

Page 17: DEPARTMENT HEMTH HUMAN SERVICES - grants.nih.gov · AND HUMAN SERVICES OFFICIAL IX'SINESS Penalv for Private lhe, ... National Institute of Child Health and Human Development Index:

A p p l i c a t i o n m a t e r i a l s may be a v a i l a b l e from b u s i n e s s , g r a n t s , and c o n t r a c t s o f f i c e s o f academic o r r e s e a r c h i n s t i t u t i o n s , and a l s o can b e o b t a i n e d from t h e N a t i o n a l I n s t i t u t e s of Heal th , D i v i s i o n o f Research Grants ( D R G ) , whose a d d r e s s a p p e a r s below.

The a p p l i c a n t should check t h e box on t h e a p p l i c a t i o n form's face s h e e t ( l i n e L d 21, i n d i c a t i n g t h a t t h e p r o p o s a l is i n response t o t h i s program announcement

o r t h e more d e t a i l e d NCHSR program n o t e and p r i n t ( n e x t t o t h e checked box)"NCHSR Program Note on Heal th S e r v i c e s Research and HIV-Related I l l n e s s e s . " The a p p l i c a n t a l s o should e n c l o s e a cover l e t t e r c i t i n g t h i s announcement o r t h e program n o t e .

The schedule f o r submission and review o f a p p l i c a t i o n s is as f o l l o w s :

N I H I D R G StudyS e c t i o n

E a r l i e s t S t a r t

Submission Review Date

June 1 October December 1 October 1 February 1

FebruaryJune

A p r i l 1 August 1

The o r i g i n a l and s i x c o p i e s o f t h e a p p l i c a t i o n should be s e n t o r d e l i v e r e d t o :

N a t i o n a l I n s t i t u t e s o f Heal th D i v i s i o n o f Research Grants Westwood B u i l d i n g , Room 240 5333 Westbard Avenue Bethesda, M,ryland 20892XX

A l l NCHSR r e s e a r c h g r a n t a p p l i c a t i o n s are reviewed f o r s c i e n t i f i c and t e c h n i c a l merit by a review p a n e l o r s t u d y s e c t i o n comprised o f non-Federal s c i e n t i s t s . Each a p p l i c a t i o n w i l l be reviewed by t h e a p p r o p r i a t e NCHSR s t u d ys e c t i o n a c c o r d i n g t o t h e f o l l o w i n g c r i t e r i a : s i g n i f i c a n c e and o r i g i n a l i t y o f t h e p r o j e c t from a s c i e n t i f i c and t e c h n i c a l v iewpoin t , adequacy o f t h e methodology proposed t o c a r r y o u t t h e p r o j e c t , a v a i l a b i l i t y o f d a t a and adequacy o f t h e d a t a c o l l e c t i o n p l a n , a p p r o p r i a t e n e s s o f t h e work p l a n and schedule f o r o r g a n i z i n g and complet ing t h e p r o j e c t , q u a l i f i c a t i o n s of t h e p r i n c i p a l i n v e s t i g a t o r ( s 1 and s t a f f , adequacy o f t h e f a c i l i t i e s a v a i l a b l e t o

&/ c a r r y o u t t h e p r o j e c t , r e a s o n a b l e n e s s o f t h e budget , and adequacy o f t h e proposed p r o t e c t i o n o f human and animal s u b j e c t s .

If t h e proposed p r o j e c t s on HIV-related i l l n e s s e s are no more t h a n 2 y e a r s i n l e n g t h and r e q u i r e no more t h a n $50,000 i n t o t a l d i r e c t c o s t s f o r t h e e n t i r e p r o j e c t p e r i o d , t h e y are e l i g i b l e f o r a c c e l e r a t e d rev iew. P r o j e c t s in tended f o r a c c e l e r a t e d review must be s e n t d i r e c t l y t o NCHSR (Room 18A-20). Because o f a modif ied review p r o c e s s t h a t i n v o l v e s b o t h F e d e r a l and non-Federal e x p e r t s , NCHSR i s a b l e t o n o t i f y a p p l i c a n t s o f funding d e c i s i o n s w i t h i n approximate ly 120 days . Deadl ines f o r r e c e i p t o f t h e s e a p p l i c a t i o n s a t NCHSR are t h e f irst working day of t h e f o l l o w i n g months: January , March, May, July,September, and November.

F u r t h e r i n f o r m a t i o n on h e a l t h s e r v i c e s r e s e a r c h and HIV-related i l l n e s s e s maybe o b t a i n e d from:

I ra E . Raskin, Ph.D. AIDS Research Coordina t ion S t a f f D i v i s i o n o f Extramural Research N a t i o n a l Center f o r Heal th S e r v i c e s Research

and Heal th Care Technology Assessment Room 18A-19, Parklawn B u i l d i n g5600 F i s h e r s Lane Rockvi l le , Maryland 20857 Telephone: (301) 443-7352

A copy o f t h e program n o t e on HIV-related i l l n e s s e s can be o b t a i n e d from:

P u b l i c a t i o n s and Informat ion Branch N a t i o n a l Center f o r H e a l t h S e r v i c e s Research

and Heal th Care Technology Assessment Parklawn B u i l d i n g , Room 18-12 R o c k v i l l e , Maryland 20857 Telephone: ( 3 0 1 ) 443-4100

Vol. 17, No. 39, November 25, 1988 - Page 15 *U. S.GOVfRNmfNT PRINTING O f f ICE:1986-241-215r60019


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