BOWEL AND BLADDER MANAGEMENT

NIH GUIDE, Volume 21, Number 21, June 5, 1992



RFA AVAILABLE:  HD/NR-93-05



P.T. 34



Keywords:

  Digestive System 

  Urogenital System 

  Pathophysiology 



National Institute of Child Health and Human Development

National Center for Nursing Research



Application Receipt Date:  August 7, l992



THE REQUEST FOR APPLICATIONS (RFA) ANNOUNCED IN THIS NOTICE CONTAINS

ESSENTIAL INFORMATION FOR THE PREPARATION OF AN APPLICATION.  POTENTIAL

APPLICANTS MAY OBTAIN THE RFA FROM THE CONTACT NAMED IN INQUIRIES,

BELOW.



PURPOSE



The National Center for Medical Rehabilitation Research, the National

Institute of Child Health and Human Development (NICHD), and the

National Center for Nursing Research (NCNR) invite research grant

applications to develop new knowledge in the area of management of

bowel and bladder functioning following disease, injury, and congenital

conditions that alter normal function.  The goal of this RFA is to

encourage research that may lead to enhanced functioning of bowel and

bladder and to improved management techniques for the treatment and

care of the dysfunctioning bowel and bladder.  Interdisciplinary,

collaborative projects that focus on bowel or bladder function are

encouraged.



HEALTHY PEOPLE 2000



The Public Health Service (PHS) is committed to achieving the health

promotion and disease prevention goals of "Healthy People 2000," a

PHS-led national activity for setting priorities.  This RFA, Bowel and

Bladder Management, is related to the priority areas of nutrition,

physical activity and fitness, heart disease and stroke, cancer,

diabetes, and chronic disabling conditions.  Potential applicants may

obtain a copy of "Healthy People 2000" (Full Report:  Stock No.

017-001-474-0), or "Healthy People 2000" (Summary Report:  Stock No.

017-001-00473-1) through the Superintendent of Documents, Government

Printing Office, Washington, DC 20402-9325, telephone  (202) 783-3238.



ELIGIBILITY REQUIREMENTS



Applications may be submitted by domestic and foreign, public and

private nonprofit and for-profit organizations such as universities,

colleges, hospitals, laboratories, units of state and local

governments, and eligible agencies of the Federal Government.  Women

and minority investigators are encouraged to apply.



MECHANISM OF SUPPORT



The support mechanism for this RFA is the individual research grant

(R01).  Policies that govern are those of the grant-in-aid award

programs covered by the PHS.



Project support may be requested for between one and five years and may

be renewed according to the conventional procedures that pertain to PHS

grants-in-aid.



FUNDS AVAILABLE



Applications submitted in response to this announcement will compete

for approximately $1,000,000 in grant money that has been made

available for this purpose in Fiscal Year l993.  It is expected that

four to six awards will be made.  The number of awards depends upon the

overall scientific merit of the applications, the relevance to the

stated goal of the announcement, and the availability of funds.



RESEARCH OBJECTIVES



This RFA invites scientists to submit grant applications for research

that will lead to better understandings of the normal and

dysfunctioning bladder and bowel, restitution of function, and

improvement in current management techniques.  Development of new

management strategies should consider such factors of the individual as

work environment, recreational life, travel, geographic location, and

access to medical assistance.  The list of research areas cited below

is representative, not exhaustive, of the topics solicited by this

announcement and shall serve as a guide for applicants submitting a

response to this RFA.



o  improved test parameters and classification schema for neurogenic

bowel and bladder



o  bowel and bladder self-care techniques for populations with other

impairment (cognitive limitation or mobility impairment), such as those

with spina bifida, hydrocephalus, or quadriplegia



o  development of outcome measures of the effectiveness of management

programs



o  assessment of management procedures for children and elderly adults

with disabilities including adherence to management techniques and

impact on social integration



o  new design of urine collection devices for females with disabilities

and assessment of optimal bladder management in females



o  identification and resolution of management problems in females with

disabilities during pregnancy, childbirth, and postpartum



o  physiological changes associated with aging with a disability or

with the duration of impairment and the effect on bowel and bladder

management



o  improved techniques for treatment of detrusor-sphincter dyssynergia;

assessment of long-term morbidity following sphincterectomy



o  assessment of the use of tests for pyuria in identifying bacteriuric

individuals who require treatment for urinary tract infection



o  mechanisms of bacterial adherence to catheter and bladder;

development of interventions



o  improved methods for localizing site of urinary tract infection in

paralyzed individuals, especially for those with sepsis or kidney

involvement



o  assessment of use of cranberry juice, ascorbic acid, or distilled

water to prevent urinary tract infection in spinal cord injured people



o  criteria for failed conservative management and long-term assessment

of bowel or bladder diversion procedures



o  long-term evaluation of treatments for gastroenteritis and lower

bowel dysfunctions, including assessment of levels of function,

impairment, and disability



o  assessment of physiologic effectiveness, and the impact on

lifestyle, of the use of pharmacologic treatments for bowel and bladder

care



o  control and management of autonomic dysreflexia through bowel and

bladder management



o  neurologic mechanisms of control of bowel or bladder function in the

impaired state as related to a rehabilitation treatment approach



o  evaluation of neuromuscular prosthetics or orthotics for management

of bladder or bowel and testing of physiologic effectiveness and

acceptance by user for activities of daily living



STUDY POPULATIONS



SPECIAL INSTRUCTIONS FOR INCLUSION OF WOMEN AND MINORITIES IN CLINICAL

RESEARCH STUDY POPULATIONS



For projects involving clinical research, NIH requires applicants to

give special attention to the inclusion of women and minorities in

study populations.  If women or minorities are not included in the

study populations for clinical studies, a special justification for

this exclusion must be provided.  Applications without such

documentation will not be accepted for review.



APPLICATION PROCEDURES



Applications are to be submitted on form PHS 398 (rev. 9/91). This

application form is available in the business or grants and contracts

office at most academic and research institutions and from the Office

of Grants Inquiries, Division of Research Grants, National Institutes

of Health, Westwood Building, Room 449, Bethesda, MD 20892, telephone

(301) 496-7441.  The receipt deadline for applications prepared in

response to this RFA is August 7, 1992.  Late applications will be

returned to the applicant without review.



REVIEW CONSIDERATIONS



Applications will be reviewed by staff of the NICHD staff for

responsiveness to the RFA.  Applications deemed non-responsive will be

returned to the applicant.  In the event that an application is

returned, the applicant has the option to resubmit the application to

the Division of Research Grants as an unsolicited application during

one of the three yearly review cycles (February 1, June 1, and October

1).



Responsive applications may be evaluated for a preliminary triage by a

peer review group to determine scientific merit relative to other

applications received in connection with this RFA.  NICHD officials

will withdraw from competition those applications judged to be

non-competitive.  The Principal Investigator and his/her institutional

business official will be notified in such instances.  Those

applications judged to be competitive will be further evaluated for

technical and scientific merit by a peer review panel convened for this

purpose by the Division of Scientific Review, NICHD.



Review criteria will be those customarily used by NIH to evaluate

investigator-initiated R01 applications.



Following evaluation by the initial review group, all applications will

be reviewed by the National Advisory Child Health and Human Development

Council or the National Advisory Council for Nursing Research.



INQUIRIES



Requests for additional information and descriptions of proposed

research projects may be addressed to:



Cheryl M. Chanaud, Ph.D.

Applied Rehabilitation Medicine Research Branch

National Center for Medical Rehabilitation Research

National Institute of Child Health and Human Development

Executive Plaza South, Room 450W

6120 Executive Boulevard

Rockville, MD  20892

Telephone:  (301) 402-2242



or



Laura A. James, Ph.D., R.N.

Nurse Scientist Administrator

Acute and Chronic Illness Branch

National Center for Nursing Research

Building 31, Room 5B03

Bethesda, MD  20892

Telephone:  (301) 496-0523



For fiscal and administrative inquires regarding this announcement,

potential applicants may write or call:



E. Douglas Shawver

Office of Grants and Contracts

National Institute of Child Health and Human Development

Executive Plaza North, Room 501

6130 Executive Boulevard

Rockville, MD  20892

Telephone:  (301) 496-1303



or



Sally Nichols

Grants Management Officer

National Center for Nursing Research

Building 32, Room 5B06

Bethesda, MD  20892

Telephone:  (301) 496-0237



AUTHORITY AND REGULATIONS



This program is described in the Catalog of Federal Domestic Assistance

No. 93.929, Medical Rehabilitation Research, and No. 93.335, Nursing

Research.  Awards are under made authorization of the Public Health

Service Act, Title IV, Part A (Public Law 78-410, as amended by Public

Law 99-158, 42 USC 241 and 285) and administered under PHS grants

policies and Federal Regulations 42 CFR 52 and 45 CFR Part 74.  This

program is not subject to the intergovernmental review requirements of

Executive Order 12372 or Health Systems Agency review.



.

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