NIH Guide - Vol. 17, No. 39 - November 25, 1988

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NOTICE OF MAILING CHANGE 0 Check here if you wish t o discontinue receiving this publication 0 Check here if your address has NIH Guide changed and you wish to con­ tinue receiving this publication. Make corrections below and mail this page to: Distribution Center National Institutes o f Health Room B3BE07, Building 31 Bethesda, Mayland 20892 US. DEPARTMENT OF HEMTH AND HUMAN SERVICES OFFICIAL IX'SINESS Penalv for Private lhe, $300 Postages & Fees Paid PHS/NIH/OD Permit No. (3-291 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 Vol. 17, No. 39, November 25, 1988 J 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 Development Index: CHILD HEALTH AND HUMAN DEVELOPMENT TOXICOLOGY OF TWO STEROIDAL ESTERS (RFP) ......................... National Institute of Child Health and Human Development Index: 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 AND MAINTENANCE 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 Aging Index: AGIhj: 1 1 2 2 3 3 .................... 5 MOLECULAR BIOLOGY DATA; REPRESENTATIONAL ANALYSIS BY COMPUTER (RFA) ................................................... National Library of Medicine Index: NATIONAL LIBRARY OF 3EDICINE GERIATRIC RESEARCH INSTITUTIONAL TRAINING (GRIT) AWARD (T32) National Institute on Aging Index: AGING GERIATRIC ACADEMIC PROGRAM (GAP) AWARD (K12) National Institute of Aging Index: AGING 6 ..... 7 ..................... 9 HIV-RELATED ILLNESSES: TOPICS FOR HEALTH SERVICES RESEARCH National Center for Health Services Research Index: HEALTH SERVICES RESEARCH .....12 DATED ANNOUNCEMENTS (RFPs AND RFAs) N I H SMALL INSTRUMENTS GRANTS PROGRAM P.T. 34; 'J K.W. 0 7 3 5 0 0 0 F e b r u a r y 13, 1989 National I n s t i t u t e s of Health Application Receipt Date: 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 i n c l u d e d a t o t a l o f $16 m i l l i o n t o b e s p e n t by t h e r e s p e c t i v e Bureaus/Institutes/Divisions ( B I D S ) f o r t h e f u n d i n g o f g r a n t s t o p u r c h a s e s m a l 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 r e s p o n s e 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 o f o b s o l e t e b i o m e d i c a l 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 o v e r 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 b i o m e d i c a l 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 r a n g e o f a p p r o x i m a t e l y $5,000 t o $60,000. Approximately $16 m i l l i o n w i l l b e a v a i l a b l e a g a i n f o r s m a l l i n s t r u m e n t a t i o n grants t h i s year. 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 s u p p o r t under t h e Biomedical R e s e a r c h S u p p o r t Grant (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 s u b m i t t e d from e a c h 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 may e s t a b l i s h i t s own p r o c e d u r e s 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 b e included. The s m a l l i n s t r u m e n t a t i o n award w i l l b e r e s t r i c t e d t o t h e p u r c h a s e 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 o f t h e award w i l l b e b a s e d 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 S u p p o r t 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 f u n d i n g 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 . M T O OF APPLYING EH D L e 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 b e m a i l e d on o r a b o u t November 2C. 1988. Completed a p p l i c a t i o n s must b e r e c e i v e d by F e b r u a r y 13, 1989. Investigators interested i n participating i n t h e i r institution's application must c o n t a c t t h e i n s t i t u t i o n ' s Biomedical R e s e a r c h S u p p o r t Grant Program D 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 e x p e c t t o b e i n v o l v e d 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 contacting NIH . 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 C h i l d 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, C e n t e r f o r P o p u l a t i o n R e s e a r c h , N a t i o n a l I n s t i t u t e o f C h i l d H e a l t h and Human Development, h a s a Small B u s i n e s s Set-Aside r e q u i r e m e n t 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 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 data on t h e a n t a g o n i s t i n o r d e r t o p e r m i t f i l i n g o f a N o t i c e 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 Drug A d m i n i s t r a t i o n (FDA) i n s u p p o r 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 s u p p o r t r a b b i t 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 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. 1 7 , No. 39, November 25, 1988 - Page 1 a b i l i t y t o u n d e r t a k e a l l c h e m i c a l 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 a n i m a l s and i n i t i a t e s t u d i e s w i t h i n 60 d a y s 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 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 b e i s s u e d on o r a b o u t December 1 , 1988, w i t h a due d a t e a p p r o x i m a t e l y 90 d a y s t h e r e a f t e r . Copies o f t h e RFP may b e o b t a i n e d by s e n d i n g 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 . Please enclose a self-addressed l a b e l . P a u l 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 Development E x e c u t i v e P l a z a North, Room 610 B e t h e s d a , Maryland 20892 TOXICOLOGY OF TWO STEROIDAL ESTERS RFP AVAILABLE: P.T. 34; NICHD-CD-89-8 K.W. 1007009, 0750020 N a t i o n a l I n s t i t u t e o f C h i l d 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, C e n t e r f o r P o p u l a t i o n R e s e a r c h , N a t i o n a l I n s t i t u t e o f C h i l d H e a l t h and Human Development, h a s a r e q u i r e m e n t 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 e s t e r s . The o b j e c t i v e o f 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 e s t e r and a t e s t o s t e r o n e e s t e r i n o r d e r t o p e r m i t f i l i n g o f a N o t i c e 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 Drug A d m i n i s t r a t i o n (FDA) i n s u p p o r 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 s u p p o r 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 L a b o r a t o r y 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 P r a c t i c e s (GLP) r e g u l a t i o n s . u n d e r t a k e a l l c h e m i c a l 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 a n i m a l s and i n i t i a t e s t u d i e s w i t h i n 6 0 d a y s 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 c o n d u c t i n g 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 b e i s s u e d on o r a b o u t Copies o f December 1 , 1988 w i t h a due d a t e a p p r o x i m a t e l y 90 d a y s t h e r e a f t e r . t h e RFP may b e o b t a i n e d by s e n d i n g 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 . Please enclose a self-addressed label. P a u l 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 C h i l d H e a l t h and Human Development E x e c u t i v e P l a z a North, Room 610 B e t h e s d a , 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 r e q u i r e m e n t t o e s t a b l i s h AIDS v a c c i n e evaluation u n i t s t o e v a l u a t e candidate AIDS vaccines. T h i s NIAID-sponsored p r o j e c t w i l l t a k e a p p r o x i m a t e l y t h r e e ( 3 ) y e a r s t o c o m p l e t e . 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 . I t is a n t i c i p a t e d t h a t t e n ( 1 0 ) awards w i l l b e made. T h i s i s an announcement f o r a n a n t i c i p a t e d Request f o r P r o p o s a l (RFP). RFP-NIH-NIAID-AIDSP-90-01 s h a l l be i s s u e d on o r a b o u t 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 R e q u e s t s 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 C o n t r a c t Management Branch 5333 Westbard Avenue Westwood B u i l d i n g , Room 707 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 National I n s t i t u t e of Health B e t h e s d a , Maryland 20892 Telephone: ( 3 0 1 ) 496-0192 To r e c e i v e a copy o f t h e RFP, p l e a s e s u p p l y 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 considered. T h i s a d v e r t i s e m e n t d o e s n o t commit t h e Government t o award a c o n t r a c t . . J RFP AVAILABLE: P.T. 34; NIH-NINDS-89-05 0740045 K.W. N a t i o n a l I n s t i t u t e o f N e u r o l o g i c a 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 o f N e u r o l o g i c a l D i s o r d e r s and S t r o k e h a s a r e q u i r e m e n t t o d e v e l o p 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, i n d e x 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 s h o u l d 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 w e a r a b l e t r a n s d u c e r s i s d e s i r e d . T h i s i s a n announcement o f 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 b e i s s u e d on o r a b o u t 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 F e b r u a r y 10, 1989. T h i s r e q u i r e m e n t 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 o f a c u r r e n t c o n t r a c t w i t h Case Western R e s e r v e U n i v e r s i t y and t h e incumbent i s e x p e c t e d 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 s u p p l y t h i s o f f i c e w i t h two 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 N e u r o l o g i c a l D i s o r d e r s and S t r o k e , N I H F e d e r a l B u i l d i n g , Room 901 7550 Wisconsin Avenue B e t h e s d a , Maryland 20892 A t t n : RFP-NIH-NINDS-89-05 FJ T RFA AVAILABLE: P.T. 34; 89-DK-03 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 l which s h a l l b e c o n s i d e r e d by t h e agency. 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 R e c e i p t Date: A p r i l 21, 1989 , J The D i v i s i o n o f Kidney, U r o l o g i c and Hematologic D i s e a s e s (DKUHD), N a t i o n a l I n s t i t u t e of D i a b e t e s 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 t a p p l i c a t i o n s f o r s u p p o r 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 o f inflammatory m e d i a t o r s 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 o f t h i s program i s on r e s e a r c h w i t h specimens from p e r s o n s 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 a n i m a l s 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 s h o u l d b e 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 u l t i m a t e g o a l s o f t h i s p r o j e c t a r e t o d e v e l o p 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. 1 7 , No. 39, November 25, 1988 - Page 3 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 inflammatory 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 b a s e d 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 a r e u r i n a r y f r e q u e n c y and u r g e n c y . P a t h o l o g i c a l f i n d i n g s from b i o p s y a r e 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 p r o p o s e d b u t none have been s u b s t a n t i a t e d with 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 NIDDK sponsored Workshop on I n t e r s t i t i a l C y s t i t i s was p u b l i s h e d i n t h e J o u r n a l o f 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 s h o u l d b e u s e d o n l y 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 a r e n o t meant t o be used a s 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 , a s p u b l i s h e d , a r e 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 s h o u l d 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 r e v a l e n c e o f p a i n a s 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 r e s e n c e o f mast c e l l s i n b i o p s y specimens o f b l a d d e r s i n p a t i e n t s w i t h I C s u g g e s t t h a t t h e d i s o r d e r i s m e d i a t e d by i n f l a m m a t o r y mechanisms. I n f l a m m a t o r y m e d i a t o 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, b e e n 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 anti-inflammatory a g e n t s on t h e p a t h o l o g y and symptomatology o f t h e d i s e a s e . OBJECTIVES AND SCOPE OF RESEARCH R e s e a r c h 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 inflammatory d i s o r d e r , 2 . t h e p r e s e n c e o f 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 s w i t h 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 p r o m o t i n g and m a i n t a i n i n g t h e c h r o n i c inflammation, 3. t h e p r e s e n c e 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 e inflammatory mediators i n I C , i n f l a m m a t o r y m e d i a t o 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 m e d i a t o r s i n t h e c h r o n i c inflammatory 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 d e v e l o p 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 p a t h o g e n e s 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 i n f l a m m a t o r y d i s o r d e r o f 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 t h e urinary bladder. 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 t h 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 b e expanded f o r f u t u r e s t u d i e s . By u s i n g e i t h e r e x p e r i m e n t a l a n i m a l s o r c e l l c u l t u r e s , r e l i a b l e e x p e r i m e n t a l models w i l l b e d e v e l o p e d which c a n b e c o r r e l a t e d w i t h 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 w i t h o t h e r i n s t i t u t i o n s i s a l s o e n c o u r a g e d , when n e c e s s a r y , t o expand t h e c l i n i c a l d a t a base. APPLICATION AND SUPPORT PROCEDURES E i g h t hundred t h o u s a n d d o l l a r s h a s been d e s i g n a t e d t o s u p p o r 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 f u n d s t o b e awarded w i l l , however, depend on t h e merit and s c o p e 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 f u n d s . Funding o f t h e g r a n t s w i l l b e t h r o u g h t h e i n d i v i d u a l R e s e a r c h P r o j e c t Grant ( R o l l mechanism. A p p l i c a t i o n s must b e s u b m i t t e d 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 R e s e a r c h G r a n t s , 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 . 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 a r e e n c o u r a g e d . A p p l i c a t i o n s w i l l b e r e v i e w e d f o r s c i e n t i f i c and t e c h n i c a l m e r i t i n a c c o r d a n c e w i t h t h e u s u a l N I H p e e r r e v i e w p r o c e d u r e s by a s p e c i f i c a l l y convened i n s t i t u t e r e v i e w c o m m i t t e e . F o l l o w i n g t h a t f i r s t r e v i e w , t h e a p p l i c a t i o n s w i l l b e g i v e n a s e c o n d a r y r e v i e w by t h e N I D D K A d v i s o r y C o u n c i l . A p p l i c a t i o n s must b e r e c e i v e d by A p r i l 21, 1989 t o b e c o n s i d e r e d f o r f u n d i n g t h r o u g h t h i s RFA. 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 V o l . 17, No. 39, November 25, 1988 - Page 4 -.I (* ' THE RFA LABhi CONTAINED I N THE APPLICATION K I T M S BE AFFIXED T THE BOTTOM UT O OF THE FACE PAGE OF THE O R I G I N A L COPY OF THE APPLICATION. FAILURE TO USE THIS LABEL COULD RESULT I N DELAYED PROCESSING OF YOUR A P P L I C A T I O N . FOR PURPOSES OF IDENTIFICATION AND PROCESSING, THE RFA NUMBER AND T I T L E "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 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 o f t h e a p p l i c a t i o n s h o u l d b e s e n t o r d e l i v e r e d to: D i v i s i o n o f Research Grants Westwood B u i l d i n g , Room 240 National I n s t i t u t e s of Health 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 s h o u l d b e s e n t t o : C h i e f , Review Branch D i v i s i o n o f Extramural A c t i v i t i e s , NIDDK National I n s t i t u t e s of Health Westwood B u i l d i n g , Room 406 B e t h e s d a , Maryland 20892 L e t 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 o f 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 a r e r e q u e s t e d f o r t h e p u r p o s e o f p r o v i d i n g a n 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 e x p e c t e d . 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 It is not a necessary review o f any a p p l i c a t i o n s u b s e q u e n t l y s u b m i t t e d . r e q u i r e m e n t f o r a p p l c a t i o n . The l e t t e r o f i n t e n t s h o u l d be r e c e i v e d by J a n u a r y 13, 1989. L e t t e r s o f i n t e n t and any i n q u i r e s a b o u t t h i s RFA s h o u l d b e 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 National I n s t i t u t e s of Health F e d e r a l B u i l d i n g , Room 102 B e t h e s d a , Maryland 20892 Telephone: ( 3 0 1 ) 496-8248 GERIATRIC RESEARCH AND TRAINING CENTERS (P30) I b , f RFA AVAILABLE: P.T. 04; 89-AG-01 0710010, 0720005, 0710030 K.W. 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 R e c e i p t Date: 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 g e r o n t o l o g y and t r a i n i n g o 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 m e d i c i n e . A G e r i a t r i c R e s e a r c h and T r a i n i n g C e n t e r ( G R T C ) 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 b u d g e t s may n o t e x c e e d $800,000 direct costs. 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 g e r o n t o l o g y , 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 b e s u p p o r t e d i n GRTCs: r e s e a r c h c o r e s , l e a d e r s h i p / a d m i n i s t r a t i v e c o r e s and r e s e a r c h development c o r e s . R e s e a r c h c o r e s p r o v i d e f u n d s 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 s u p p o r t e d r e s e a r c h . iIy' March 17, 1989 The leadership/administrative c o r e p r o v i d e s f u n d s 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 b e r e q u e s t e d h e r e . V o l . 17, No. 39, November 25, 1988 - Page 5 The r e s e a r c h development c o r e p r o v i d e s f u n d s f o r p i l o t p r o j e c t s t o b e c o n d u c t e d by j u n i o r f a c u l t y members. S u p p o r t f o r s a l a r y , equipment and o t h e r r e s e a r c h e x p e n s e s may be r e q u e s t e d . Mechanism and S c a l e o f S u p p o r t G e r i a t r i c R e s e a r c h and T r a i n i n g C e n t e r s w i l l b e s u p p o r t e d t h r o u g h t h e customary g r a n t - i n - a i d mechanism. P l a n s a r e 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 upon a v a i l a b i l i t y of funds. The A p p l i c a t i o n The a p p l i c a n t s h o u l d 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 a r e 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 b e o b t a i n e d from P l e a s e n o t e t h a t s p e c i a l GRTC t h e D i v i s i o n o f Research Grants, N I H . G u i d e l i n e s s h o u l d b e u s e d t o c o m p l e t e t h e a p p l i c a t i o n . ( S e e below) T i m e t a b l e f o r R e c e i p 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 a r e due i n t h e D i v i s i o n o f R e s e a r c h G r a n t s on o r b e f o r e March 1 7 , 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 R e c e i p t O ffic e D i v i s i o n o f Research Grants National I n s t i t u t e s of Health Westwood B u i l d i n g ? Room 240 B e t h e s d a , Maryland 20892nn A t t h e same t i m e t h e a p p l i c a t i o n i s s u b m i t t e d t o t h e D i v i s i o n o f R e s e a r c h G r a n t s , 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 : C h i e f , 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 Aging Room 5C12, B u i l d i n g 31 9000 R o c k v i l l e P i k e B e t h e s d a , Maryland 20892 A copy o f t h e c o m p l e t e RFA and t h e GRTC G u i d e l i n e s may b e o b t a i n e d from: Stanley 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 Program 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 Aging B u i l d i n g 31, Room 5C27 9000 R o c k v i l l e P i k e B e t h e s d a , Maryland 20892 Telephone ( 3 0 1 ) 496-6761 ..- MOLECULAR BIOLOGY; DATA REPRESENTATION/ANALYSIS BY COMPUTER RFA AVAILABLE: 89-LM-01 1002008, 0755018, 1004008, 0755045, 0790010, 1215018, 1004000 P.T. 34; K.W. 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 R e c e i p t Date: F e b r u a r y 1 0 , 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 s u b m i s s i o n o f 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 from i n v e s t i g a t o r s who a r e 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 m o l e c u l a r 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 i s 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 our understanding of 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 i m p o r t a n t m o l e c u l e s , i n o r d e r t o d i a g n o s e , and t r e a t human d i s o r d e r s . R e s e a r c h t o p i c s i n c l u d e d a t a - b a s e d e s i g n and q u e r y 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 s y s t e m s , m a t h e m a t i c a l 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 a n d / o r f u n c t i o n b a s e d on p r i m a r y s e q u e n c e s . 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 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 submitting applications f o r support. 'Y' A p p l i c a t i o n s s h o u l d b e s u b m i t t e d on t h e new Form PHS 398 ( r e v . more i n f o r m a t i o n , a p p l i c a n t s may c o n t a c t : 9/86). For D r . Roger W. Dahlen C h i e f , Biomedical I n f o r m a t i o n S u p p o r t Branch E x t r a m u r a l Programs N 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: ( 3 0 1 ) 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 R e c e i p t Date: May 10, 1989 Subsequent A p p l i c a t i o n R e c e i p t Dates: September 10, 1989; and J a n u a r y 10, May 10, and September 10 o f e a c h 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 s u p p o r t o f G e r i a t r i c R e s e a r c h 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 ef 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 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 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 s u c h l e a d e r s , and t h a t t h i s c o u l d b e s t b e 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 t h o r o u g h 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 s u p p o r 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 o f 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 , f o l l o w e d by a s u b s t a n t i a l amount o f 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 with 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 support ( N I A c o n t i n u e s t o encourage a n 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. a 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 s u p p o r t one t o two y e a r s o f 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 o f f e l l o w s as i n d e p e n d e n t 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 g e r o n t o l o g y i s 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 among p 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 s u p p o r t e d by t h i s award i s p a r t i c u l a r l y e n c o u r a g e d . Because a continuum o f s u p p o r 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 s u b s e q u e n t s t a g e s . I n t e r e s t e d p a r t i e s a r e 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 Application1' (below) f o r f u r t h e r information. 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 Program Award 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 e a 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 b e s u p p o r t e d by a c o m b i n a t i o n 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 H e a l t h 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 , V e t e r a n s 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. 1 7 , No. 39, November 25, 1988 - Page 7 STRUCTURE OF AWARD The mechanism of s u p p o r t w i l l b e t h e i n s t i t u t i o n a l N a t i o n a l R e s e a r c h 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 s u p p o r t t o t h e g r a n t e e i 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 s u p p o r t f o r two t o s i x f e l l o w s h i p p 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 p p o s i t i o n s i n any g i v e n award y e a r . S u p p o r t may b e 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 e x p e n s e s s u c h 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 l o w a n c e 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 g is provided. ELIGIBILITY REQUIREMENTS A p p l i c a n t i n s t i t u t i o n s must h a v e : 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 . F e l l o w s t o b e s u p p o r t e d by t h i s award must have completed a t l e a s t It is not 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 . 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 a n a d e q u a t e 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 c o n d u c t e d by two o r more i n s t i t u t i o n s a r e e l i g i b l e f o r s u p p o r t . M T O OF APPLICATION EH D A p p l i c a t i o n s s h o u l d b e p r e p a r e d 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 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 of R e s e a r c h G r a n t s , 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 s h o u l d e n t e r : I n s t i t u t i o n a l NRSA: N I A G e r i a t r i c R e s e a r c h 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 s h o u l d a l s o r e f e r 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, J u n e 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 i s n o t a p r e r e q u i s i t e f o r a p p l y i n g ; 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 e a s t one month b e f o r e s u b m i s s i o n 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 s h o u l d b e s e n t t o : Application Receipt 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 H e a l t h Westwood B u i l d i n g , Room 240 B e t h e s d a , Maryland 2 0 8 9 2 H The N I A c o n t a c t o f f i c e l i s t e d below s h o u l d b e 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 s u b m i s s i o n . I n q u i r i e s and c o r r e s p o n d e n c e s h o u l d b e directed to: 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 Aging B u i l d i n g 31, Room 5C-27 B e t h e s d a , Maryland 20892 ( 3 0 1 ) 496-6761 Telephone: The a p p l i c a t i o n s h o u l d 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 s h o u l d d e s c r i b e p l a n s f 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 t e r t h e completion o f f e l l o w s h i p support. 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 s p o n s o r s ' p a s t and p r e s e n t r e s e a r c h s h o u l d b e d e s c r i b e d , a s w e l l a s 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 Vol. 17, No. 39, November 25, 1988 - Page 8 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 undertaken, p r o v i s i o n of ex p eri en ce i n o t h e r laboratories t o l e a r n pertinent techniques, etc. Plans f o r providing other t r a i n i n g t o fellows i n addition t o laboratory experience, e . g . didactic t r a i n i n g i n basic sciences, 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 s y s t e m - t i c e x p o s u r e t o c u r r e n t knowledge i n g e r o n t o l o g y i s e n c o u r a g e d . P l a n s 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 s h o u l d b e conducted once y e a r l y , and p r o v i d e w r i t t e n r e p o r t s t o b e s u b m i t t e d t o NIA w i t h t h e awardeels annual p r o g r e s s r e p o r t s . Plans f o r e f f o r t s t o r e c r u i t minority trainees, consistent with N I H l s p o l i c y o f e n c o u r a g i n g such r e c r u i t m e n t . Such p l a n s a r e 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 i n f o r m a t i o n 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 b e found i n t h e N I H Guide f o r G r a n t s and C o n t r a c t s V o l . 15, No. 4, March 28, 1986. EVALUATION CRITERIA A p p l i c a t i o n s w i l l b e 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 s p o n s o r s 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 s p o n s o r s i n t r a i n i n g f e l l o w s i n a g i n g research. 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 g e r o n t o l o g y ) and r e s e a r c h methodology. Q u a l i t y o f p r o p o s e d 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. Availability of research support. L i k e l i h o o d 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 b e 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 fellows i n g e r i a t r i c research. REVIEW PROCEDURES AND CRITERIA A p p l i c a t i o n s w i l l b e 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 R e s e a r c h G r a n t s 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 b e a s s i g n e d t o a n a p p r o p r i a t e group f o r r e v i e w . A p p l i c a t i o n s w i l l b e reviewed i n a c c o r d w i t h t h e u s u a l NiH p e e r r e v i e w p r o c e d u r e s . F o l l o w i n g s t u d y s e c t i o n r e v i e w , t h e a p p l i c a t i o n s w i l l b e e v a l u a t e d by t h e N a t i o n a l Advisory C o u n c i 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 R e s e a r c h and T r a i n i n g Program N a t i o n a l I n s t i t u t i o n on Aging B u i l d i n g 31, Room 5C27 9000 R o c k v i l l e P i k e B e t h e s d a , MD 20892 Telephone: ( 3 0 1 ) 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 R e c e i p t Date: J u n e 1 , 1989 Subsequent A p p l i c a t i o n R e c e i p t Dates: October 1 , 1989; and F e b r u a r y 1 , J u n e 1 , and October 1 o f e a c h y e a r t h e r e a f t e r . Vol. 17, No. 39, November 25, 1988 - Page 9 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 s u p p o r 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 T h e r e 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 p e r s o n n e l i n g e r i a t r i c s . A committee s p o n s o r e d 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. G e r i a t r i c s 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 s u c h l e a d e r s , and t h a t t h i s c o u l d b e s t b e done i n a n 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 t h o r o u g h 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 s u p p o r 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 t h r o u g h s e v e r a l programs, i n c l u d i n g N I A ' s G e r i a t r i c R e s e a r c h 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 H e a l t h R e s o u r c e s 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 , V e t e r a n s 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 i s a l s o e x t r e m e l y i m p o r t a n t i n e s t a b l i s h i n g academic c a r e e r s . 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 p r o v i d e d by N I A ' s Academic Award ( 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 . 10, No. 5, March 27, 19811, and by i t s 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 G r a n t s and C o n t r a c t s , Vol. 13, No. 8, J u n e 29, 1 9 8 4 ) . N I A c o n t i n u e s t o e n c o u r a g e 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 a n 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 i s appropriate 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 with a s t a b l e base of 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 a s 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 g e r o n t o l o g y i s 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 among c l i n i c a l , b a s i c , e p i d e m i o l o g i c , 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 gerontology 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 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 , 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 a r e 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 a r e encouraged t o c o n s i d e r d e v e l o p i n g comprehensive c a r e e r development programs which may be s u p p o r t e d by a c o m b i n a t i o n o f N I A and o t h e r i n s t i t u t i o n a l a w a r d s . 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 i m e 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 s u p p o r t e d 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 e a s t one y e a r o f 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 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 o f Added Q u a l i f i c a t i o n s i n G e r i a t r i c 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 . I t i s 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 . A p p l i c a n t 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 a d e q u a t e environment f o r t h e development o f 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 c o n d u c t e d by two o r more i n s t i t u t i o n s a r e e l i g i b l e f o r support. STRUCTURE OF SUPPORT The mechanism o f s u p p o r t w i l l b e 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 e x p e n s e s 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 e a c h j u n i o r f a c u l t y member so s p o n s o r e d , 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 e a c h s p o n s o r ' s s a l a r y and f r i n g e b e n e f i t s f o r t h e f i r s t t h r e e y e a r s o f 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 s p o n s o r e d i n d i v i d u a l s ' Vol. 17, No. 39, November 25, 1988 - Page 10 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 p e r s o n n e l , o r a n i m a l 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 e f f e c t i v e n e s s . Up t o f i v e y e a r s o f r e n e w a b l e s u p p o r t may b e r e q u e s t e d 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 s p o n s o r e d by t h e program may b e s u p p o r t e d 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 p e r s o n s a t a n awardee i n s t i t u t i o n may b e g i n t h e i r s p o n s o r e d a c t i v i t i e s i n any y e a r l y b u d g e t p e r i o d o f t h i s award, and none may b e g i n s p o n s o r e d 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 s p o n s o r e d 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 i m i n i s h thereafter. M T O OF APPLYING EH D A p p l i c a t i o n s s h o u l d b e p r e p a r e d on form PHS 398. A p p l i c a n t s s h o u l d f o l l o w t h e s u p p l e m e n t a 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 G e r i a t r i c s 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 R e s e a r c h G r a n t s , 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 s h o u l d e n t e r : N I A G e r i a t r i c 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 a p p l y i n g ; 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 p r o p o s e d p r o j e c t . T h i s l e t t e r s h o u l d b e 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 s u b m i s s i o n d e a d l i n e . A c o m p l e t e d 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 s h o u l d b e s e n t t o : Application Receipt D i v i s i o n o f Research Grants National I n s t i t u t e s o f Health Westwood B u i l d i n g , Room 240 B e t h e s d a , 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 s h o u l d 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 s u b m i s s i o n . I n q u i r i e s and c o r r e s p o n d e n c e s h o u l d b e directed 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 Aging b B u i l d i n g 31, Room 5C-27 ’ B e t h e s d a , Maryland 20892 Telephone: (301) 496-6761 The a p p l i c a t i o n s h o u l d 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 s h o u l d 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 s p o n s o r e d , 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 s p o n s o r e d i n d i v i d u a l s t o a g i n g r e s e a r c h a f t e r t h e completion o f support. F a c u l t y s p o n s o r s . The s p o n s o r s ’ 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 described, as w e l l as t h e i r previous experience i 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 e x p e r i e n c e f o r s p o n s o r e d 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 s o f r e s e a r c h p r o j e c t s t o be u n d e r t a k e n , p r o v i s i o n o f 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 , needed d i d a c t i c t r a i n i n g i n g e r o n t o l o g y , 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 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 where a p p l i c a b l e , c o n s i s t e n t Such p l a n s a r e a r e q u i r e d with N I H ’ s policy o f encouraging such recruitment. 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 i n f o r m a t i o n 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 b e f o u n d i n t h e N I H Guide f o r G r a n t s and C o n t r a c t s V o l . 15, No. 4, March 28, 1986. REVIEW PROCEDURES -,W A p p l i c a t i o n s w i l l b e 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 R e s e a r c h G r a n t s 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 b e a s s i g n e d t o a n a p p r o p r i a t e g r o u p f o r r e v i e w . 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 A p p l i c a t i o n s w i l l b e reviewed i n a c c o r d w i t h t h e u s u a l N I H p e e r review procedures. Following 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 C o u n c i l on Aging. A 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 P 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 R e s e a r c h and T r a i n i n g Program N a t i o n a l I n s t i t u t e on Aging B u i l d i n g 31, Room 5C27 9000 R o c k v i l l e P i k e B e t h e s d a , Maryland 20892 Telephone: ( 3 0 1 ) 496-6761 HIV-RELATED ILLNESSES: P.T. 3 4 ; TOPICS FOR HEALTH SERVICES RESEARCH " I K.W. 0715008, 0730050, 0408006, 0730030, 0413000 N a t i o n a l C e n t e r 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 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 H e a l t h S e r v i c e m e e t i n g 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 for i l l n e s s e s related t o HIV. I t a l s o recommended b r o a d e n i n g t h e s c o p e 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 H e a l t h S e r v i c e , NCHSR h a s been a s k e d 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 H I V - r e l a t e d i l l n e s s e s . I n r e s p o n s e , 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 o f 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 d e c i s i o n m a k e r s i n v o l v e s d i f f e r e n t r i s k g r o u p s , p o p u l a t i o n s , g e o g r a p h i c 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 . R e s e a r c h 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 . C u r r e n t e p i d e m i o l o g i c and economic i n f o r m a t i o n a b o u t 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 c o m p l e x i t y o f i s s u e s and g a p s i n knowledge t h a t s h o u l d b e a d d r e s s e d i n h e a l t h s e r v i c e s r e s e a r c h . R e s e a r c h t o p i c s and q u e s t i o n s a r e d i s c u s s e d b r i e f l y i n s u b s e q u e n t 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 s y s t e m s , access and b a r r i e r s t o care, q u a l i t y o f c a r e , h e a l t h s y s t e m s 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 : T o p i c s 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 , " a program n o t e p u b l i s h e d i n October 1988 t h a t i s a v a i l a b l e from NCHSR. PRIORITY RESEARCH ISSUES Cost and F i n a n c i n g 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 H I V - r e l a t e d i l l n e s s e s h a s f o c u s e d 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 b e 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 e a 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 researchable questions follow: o What i s 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 a n 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 H I V - r e l a t e d 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 a r e 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 a r e 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 , c h a r g e s , 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 c o v e r a g e 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 other factors? o What i s 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 a r e t h e s e c o s t s a b s o r b e d ? Vol. 17, No. 39, November 25, 1988 - Page 1 2 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 r e s p o n s e 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 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 I n f o r m a t i o n s y s t e m s a r e needed t o produce a c c u r a t e , t i m e l y , and comprehensive d 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 e p i d e m i o l o g i c 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 y i 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 m e d i c a l r e c o r d s s y s t e m s t o p e r m i 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 order t o develop s e v e r i t y indices, p a t t e r n s of 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 r e c o r d k e e p i n g s y s t e m s t h a t can a c q u i r e and i n t e g r a t e i n f o r m a t i o n from i n f o r m a l 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 p e r m i 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 f o c u s e d and e f f i c i e n t c l i n i c a l and e p i d e m i o l o g i c i n v e s t i g a t i o n s , and more r i g o r o u s a s s e s s m e n t o f medical t e c h n o l o g i e s . o What a r e t h e e f f e c t s o f t h e H I V epidemic on p o l i c i e s and p r o c e d u r e s i n health care settings? o How c a n 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 m e a s u r e s , and measures o f i l l n e s s s e v e r i t y b e 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 b e a d o p t e d o r improved? Access and Barriers t o Care Access t o care may b e 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 may be more l i k e l y t o p o s s e s s no i n s u r a n c e 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 . F u r t h e r m o r e , 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 s include : i l l n e s s e s , and how do t h e y v a r y by g e o g r a p h i c a r e a s , r i s k g r o u p s , 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 u s e d 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 o f 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 c o v e r a g e 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 s u p p l y o f p r a c t i t i o n e r s and 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 s e r v i c e s a r e a v a i l a b l e and u s e d f o r t r e a t m e n t o f HIV-related o What i s t h e q u a l i t y o f c a r e p r o v i d e d 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 b e d e f i n e d by such measures as patient s a t i s f a c t i o n , increased longevity, quality-adjusted s 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 a b o u t 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 f e c t p a t i e n t compliance, s a t i s f a c t i - n , and funct i o n i n g? o How d o e s p a t i e n t p r e f e r e n c e a f f e c t t r e a t m e n t ? How i s p a t i e n t p 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 d o e s 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 s u p p l y 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 1,-f The AIDS e p i d e m i c i s l i k e l y t o have f a r - r e a c h i n g e f f e c t s 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 f o r m a l and i n f o r m a l 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 H I V - r e l a t e d i l l n e s s e s include : Vol. 17, No. 39, November 25, 1988 - Page 13 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 c a l v i a b i l i t y o f 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 a r e 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 a r e t h e s p i l l o v e r e f f e c t s 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 a r e involved i n resource 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, n e e d s 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 u s e 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 c a r e 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 s u c h as o w n e r s h i p , 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 c o m p a r a t i v e c o s t e f f e c t i v e n e s s o f 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 b e d s a more cost-effective strategy? o How h a s t h e e p i d e m i c a f f e c t e d h e a l t h c a r e f a c i l i t i e s w i t h a l a r g e number 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 a r e 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 e a c h o t h e r and w i t h t h e f o r m a l h e a l t h c a r e d e l i v e r y system? What i s t h e p o t e n t i a l f o r t h e expanded u s e and e f f e c t i v e n e s s o f 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 ? Provider Issues P o t e n t i a l p r o v i d e r e x p o s u r e 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 y i n c r e a s e d s a f e g u a r d s t h a t may b e i n c o n v e n i e n t and may i n c r e a s e r e l u c t a n c e t o treat HIV patients. 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 engage i n s u b s t a n c e a b u s e 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 a l m o s t 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 c o n c e r n 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 H I V - r e l a t e d 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 include : o How a r e 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 e p i d e m i c 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 b u r n o u t 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 f e c t p r o v i d e r b u r n o u t ? 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 health care professionals? o What i s t h e e f f e c t o f 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 l s k i l l s on t r e a t m e n t o f H I V - r e l a t e d 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 n groups? o How i s t h e e p i d e m i c 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 ? ’ 1 APPLICATION AND REVIEW PROCEDURES A p p l i c a t i o n s may b e s u b m i t t e d 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 b e s u b m i t t e d on P u b l i c H e a l t h S e r v i c e Form 398, Grant A p p l i c a t i o n , e x c e p t f o r a p p l i c a t i o n s from 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 p r o g r a m s ) . 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 Program 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 5600 F i s h e r s Lane, Room 18A-20 R o c k v i l l e , Maryland 20857 Telephone: ( 3 0 1 ) 443-3091 Vol. 17, No. 39, November 25, 1988 - Page 1 4 A p p l i c a t i o n m a t e r i a l s may b e 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 c a n 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 o f H e a l t h , D i v i s i o n o f R e s e a r c h G r a n t s ( D R G ) , whose a d d r e s s a p p e a r s below. L d 1, 2 The a p p l i c a n t s h o u l d c h e c k t h e box on t h e a p p l i c a t i o n f o r m ' s face s h e e t ( l i n e 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 i s i n r e s p o n s e 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 H e a l t h 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 s h o u l d e n c l o s e a c o v e r 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 s c h e d u l e f o r s u b m i s s i o n and review o f a p p l i c a t i o n s i s a s f o l l o w s : NIHIDRG Submission June 1 October 1 February 1 Study S e c ti o n Review October February June Earliest Start Date December 1 April 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 s h o u l d b e s e n t o r delivered t o : National I n s t i t u t e s o f Health 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 B e t h e s d a , 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 r e v i e w 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 b e reviewed by t h e a p p r o p r i a t e NCHSR s t u d y s 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 i e w p o i n t , adequacy o f t h e methodology p r o p o s e d 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 s c h e d u l e f o r o r g a n i z i n g and c o m p l e t i n g t h e p r o j e c t , q u a l i f i c a t i o n s o f 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 b u d g e t , and adequacy o f t h e p r o p o s e d 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 p r o p o s e d p r o j e c t s on HIV-related i l l n e s s e s a r e 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 review. P r o j e c t s intended f o r a c c e l e r a t e d r e v i e w must b e s e n t d i r e c t l y t o NCHSR (Room 18A-20). Because o f a m o d i f i e d r e v i e w 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 f u n d i n g d e c i s i o n s w i t h i n a p p r o x i m a t e l y 120 d a y s . D e a d l i n e s 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 i r s t working day of t h e f o l l o w i n g months: J a n u a r y , 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 b e o b t a i n e d from: i l l n e s s e s may D i v i s i o n of Extramural Research N a t i o n a l C e n t e r 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 Room 18A-19, Parklawn B u i l d i n g 5600 F i s h e r s Lane R o c k v i l l e , Maryland 20857 Telephone: ( 3 0 1 ) 443-7352 AIDS R e s e a r c h C o o r d i n a t i o n S t a f f I r a E . Raskin, Ph.D. A copy o f t h e program n o t e on HIV-related i l l n e s s e s c a n b e o b t a i n e d from: P u b l i c a t i o n s and I n f o r m a t i o n 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 H e a l t h 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 *U. S.GOVfRNmfNT - Page 15 P R I N T I N G O f f ICE:1986-241-215r60019

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