EXPIRED
National Institutes of Health (NIH)
National Institute on Aging (NIA)
Collaborative Networks to Advance Delirium Research (R24)
R24 Resource-Related Research Projects
New
RFA-AG-16-009
None
93.866
Delirium, defined as an acute impairment of cognition and attention, is a common complication of severe illness and surgery in older adults. It is associated with multiple adverse outcomes including increased morbidity, mortality, functional and cognitive decline, and institutionalization. Delirium remains markedly underdiagnosed. Moreover, the underlying mechanisms, and thereby potential treatment or prevention targets, are inadequately understood, as is prognosis. Addressing important research gaps may improve approaches for appropriate prevention and management, especially as studies of multicomponent interventions suggest that delirium may be at least 30-40% preventable. This FOA is intended to support a collaborative network to advance scientific research on the causes, mechanisms, outcomes, diagnosis, prevention, and treatment of delirium in older adults.
May 27, 2015
December 12, 2015
December 12, 2015
January 12, 2016, by 5:00 PM local time of applicant organization. All types of non-AIDS applications allowed for this funding opportunity announcement are due on this date.
Applicants are encouraged to apply early to allow adequate time to make any corrections to errors found in the application during the submission process by the due date.
September 2016
January 13, 2016
Not Applicable
Required Application Instructions
It is critical that applicants follow the instructions in the SF424 (R&R) Application Guide, except where instructed to do otherwise (in this FOA or in a Notice from the NIH Guide for Grants and Contracts). Conformance to all requirements (both in the Application Guide and the FOA) is required and strictly enforced. Applicants must read and follow all application instructions in the Application Guide as well as any program-specific instructions noted in Section IV. When the program-specific instructions deviate from those in the Application Guide, follow the program-specific instructions. Applications that do not comply with these instructions may be delayed or not accepted for review.
Part 1. Overview Information
Part 2. Full Text of the Announcement
Section
I. Funding Opportunity Description
Section II. Award Information
Section III. Eligibility Information
Section IV. Application and Submission
Information
Section V. Application Review Information
Section VI. Award Administration Information
Section VII. Agency Contacts
Section VIII. Other Information
Delirium, defined as an acute impairment of cognition and attention, is a common complication of severe illness and surgery in older adults. Delirium is associated with multiple adverse outcomes including increased morbidity, mortality, functional and cognitive decline, and institutionalization. While more than 7 million hospitalized Americans suffer from delirium annually, older adults, especially those in ICU and post-operative settings, are more vulnerable than younger patients to developing delirium and its sequelae. Delirium cases are rapidly increasing as more seniors undergo major surgeries and hospitalization for critical illness from underlying multiple chronic conditions. In 2004, hospital-related costs for delirium were estimated at over $8 billion, with post-hospitalization costs topping $150 billion annually. These figures are likely underestimates, as delirium remains markedly underdiagnosed. Moreover, the underlying mechanisms, and thereby potential treatment or prevention targets, are inadequately understood, as is prognosis. Addressing important research gaps may improve approaches for appropriate prevention and management, especially as studies of multicomponent interventions suggest that delirium may be at least 30-40% preventable.
The underlying pathophysiology of delirium remains elusive. As a quintessential geriatric syndrome, delirium represents the convergence of multiple interacting pathways from both diagnosed and sub-clinical conditions culminating in impairment. Further complicating our understanding is the lack of clarity between causal and associated factors for conditions believed to underlie delirium. A variety of hypotheses have been advanced ranging from brain and systemic inflammation to amyloid deposition leading to at-risk brains. In addition, risk for morbidity is increased significantly when delirium and dementia interact, but the mechanistic link is unclear. Delirium occurs in 66-89% of persons with Alzheimer's disease (AD) during acute illness and hospitalization and is often dismissed as an inevitable, but transient, condition in AD patients during hospitalization. However, cognitive and functional decline, morbidity, and other adverse outcomes are increased more in the setting of concomitant AD and delirium compared to either condition alone. Moreover, delirium episodes may be misdiagnosed as dementia, resulting in improper care, treatment, and long-term adverse outcomes for patients and caregivers.
In February, 2014, the NIA and AGS supported a research conference titled, Delirium in Older Adults: Finding Order in the Disorder. This conference brought together a multidisciplinary group of investigators including neurologists, geriatricians, neuroradiologists, basic science researchers, anesthesiologists, critical care specialists, psychiatrists, immunologists, and psychologists with a shared interest in delirium research. In brief, the conference highlighted several key attributes of delirium: 1) delirium is a common, costly and morbid condition primarily impacting older adults; 2) current multipronged interventions only improve a minority of patients; 3) the basic pathophysiology of delirium is poorly understood, but recent efforts in specialized fields, such as immunology, neuroimaging, and geriatrics, may lead to improved prevention, diagnosis and treatment; 4) delirium is a truly multidisciplinary condition uniting specialists who do not frequently interact; 5) delirium research could be markedly accelerated by creation of a research network/collaboratory which could unify the resources, expertise, and effort of these specialists. The outcomes of the conference are described in greater detail and published as: AGS/NIA Delirium Conference Writing Group, Planning Committee and Faculty. The American Geriatrics Society/National Institute on Aging Bedside-to-Bench Conference: Research Agenda on Delirium in Older Adults. J Am Geriatr Soc 2015; doi: 10.1111/jgs.13406.
This FOA is intended to support a collaborative network to advance scientific research on the causes, mechanisms, outcomes, diagnosis, prevention, and treatment of delirium in older adults. This FOA will support the establishment and initial operations of a network over the 5-year grant period. As this R24 mechanism is not renewable, the collaborations, resources, and infrastructure built through this opportunity will need to be maintained after the award period through more traditional NIH mechanisms (e.g., R01, R03, R21, P01, K07), other Federal agencies (e.g., VA, CMS, AHRQ), or other public or private sources.
Investigators
Investigators should have sufficient expertise, commitment of effort, organizational structure, and operational effectiveness to successfully implement a plan for this undertaking. It is expected that investigators from a variety of professional backgrounds and research expertise across multiple institutions will form an interdisciplinary consortium. Examples of the kinds of investigators who could be included in this network include neuroscientists, immunologists, -omics / biomarker specialists, epidemiologists, biostatisticians, clinical trialists, neurologists, geriatricians, intensive care specialists, surgeons, anesthesiologists, nurses, physical/occupational therapists, and social workers, to name a few. Where appropriate, involvement of collaborators or consultants from industry or other private sector organizations is permissible. A multiple Program Director/Principal Investigator model of leadership may be proposed if warranted.
Organization
Applicants are expected to propose a network of investigators and resources that span multiple institutions. A successful network will likely have an organizational structure that effectively addresses the proposed aims and integrates the personnel, resources, and infrastructure across institutions. Examples of the organizational components that could contribute to a successful network include a leadership or steering body to coordinate planning, evaluation, resource allocation, and administrative oversight; a data coordination body that oversees standardization of data, houses informatics resources, and coordinates exchange of data, biospecimens, and other research resources; a mentorship body that facilitates involvement of junior investigators into the research activities of the network; and a dissemination body that coordinates timely and effective information sharing with relevant stakeholders. Applicants may also consider establishment of an external advisory committee. These are merely examples and are not intended to prescribe a specific organizational structure. Investigators may propose the components and functions that best suit the aims of the network.
Activities
Activities suitable for the proposed collaborative delirium research network could include, but are not limited to:
Pilot studies within the network could provide a means to jumpstart new areas in delirium research. For example, basic and clinical research approaches to investigate the mechanisms of delirium are greatly needed to advance prevention, treatment, and care. Use of neuroimaging to develop CNS markers of risk or to develop neural profiles of the impact of delirium on the brain would be a significant step for the field. Pilot studies could involve a variety of approaches including secondary data analyses, ancillary studies to ongoing projects, and independent prospective studies. Such projects can provide both junior and senior investigators with preliminary data for future investigations that could be the topic of future research grant applications.
A webinar with NIH staff is planned to provide prospective applicants the opportunity to receive information and ask questions about the scientific scope of this announcement and technical details for applying. Please see the NIA webpage
www.nia.nih.gov/research/dgcg/webinar-delirium-rfa
] for information about timing and access to the webinar.
Grant: A support mechanism providing money, property, or both to an eligible entity to carry out an approved project or activity.
New
The OER Glossary and the SF424 (R&R) Application Guide provide details on these application types.
NIA intends to commit up to $750,000 in FY2016 to fund 1 award.
Application budgets are limited to $500,000 in annual direct costs.
The maximum project period is 5 years.
NIH grants policies as described in the NIH Grants Policy Statement will apply to the applications submitted and awards made in response to this FOA.
Higher Education Institutions
The following types of Higher Education Institutions are always encouraged to apply for NIH support as Public or Private Institutions of Higher Education:
Nonprofits Other Than Institutions of Higher Education
For-Profit Organizations
Governments
Other
Non-domestic (non-U.S.) Entities (Foreign Institutions) are
not eligible to apply.
Non-domestic (non-U.S.) components of U.S. Organizations are not eligible
to apply.
Foreign components, as defined in
the NIH Grants Policy Statement, are allowed.
Applicant Organizations
Applicant organizations must complete and maintain the following registrations as described in the SF 424 (R&R) Application Guide to be eligible to apply for or receive an award. All registrations must be completed prior to the application being submitted. Registration can take 6 weeks or more, so applicants should begin the registration process as soon as possible. The NIH Policy on Late Submission of Grant Applications states that failure to complete registrations in advance of a due date is not a valid reason for a late submission.
Program Directors/Principal Investigators (PD(s)/PI(s))
All PD(s)/PI(s) must have an eRA Commons account. PD(s)/PI(s) should work with their organizational officials to either create a new account or to affiliate their existing account with the applicant organization in eRA Commons. If the PD/PI is also the organizational Signing Official, they must have two distinct eRA Commons accounts, one for each role. Obtaining an eRA Commons account can take up to 2 weeks.
Any individual(s) with the skills, knowledge, and resources necessary to carry out the proposed research as the Program Director(s)/Principal Investigator(s) (PD(s)/PI(s)) is invited to work with his/her organization to develop an application for support. Individuals from underrepresented racial and ethnic groups as well as individuals with disabilities are always encouraged to apply for NIH support.
For institutions/organizations proposing multiple PDs/PIs, visit the Multiple Program Director/Principal Investigator Policy and submission details in the Senior/Key Person Profile (Expanded) Component of the SF424 (R&R) Application Guide.
This FOA does not require cost sharing as defined in the NIH Grants Policy Statement.
Applicant organizations may submit more than one application, provided that each application is scientifically distinct.
The NIH will not accept duplicate or highly overlapping applications under review at the same time. This means that the NIH will not accept:
Applicants must download the SF424 (R&R) application package associated with this funding opportunity using the Apply for Grant Electronically button in this FOA or following the directions provided at Grants.gov.
It is critical that applicants follow the instructions in the SF424 (R&R) Application Guide, including Supplemental Grant Application Instructions except where instructed in this funding opportunity announcement to do otherwise. Conformance to the requirements in the Application Guide is required and strictly enforced. Applications that are out of compliance with these instructions may be delayed or not accepted for review.
For information on Application Submission and Receipt, visit Frequently Asked Questions Application Guide, Electronic Submission of Grant Applications.
Although a letter of intent is not required, is not binding, and does not enter into the review of a subsequent application, the information that it contains allows IC staff to estimate the potential review workload and plan the review.
By the date listed in Part 1. Overview Information, prospective applicants are asked to submit a letter of intent that includes the following information:
The letter of intent should be sent to:
Molly V. Wagster, PhD
Telephone: 301-496-9350
Fax: 301-496-1494
Email: [email protected]
All page limitations described in the SF424 Application Guide and the Table of Page Limits must be followed.
The following section supplements the instructions found in the SF424 (R&R) Application Guide and should be used for preparing an application to this FOA.
All instructions in the SF424 (R&R) Application Guide must be followed.
All instructions in the SF424 (R&R) Application Guide must be followed.
All instructions in the SF424 (R&R) Application Guide must be followed.
All instructions in the SF424 (R&R) Application Guide must be followed.
All instructions in the SF424 (R&R) Application Guide must be followed.
All instructions in the SF424 (R&R) Application Guide must be followed.
All instructions in the SF424 (R&R) Application Guide must be followed.
All instructions in the SF424 (R&R) Application Guide must be followed, with the following additional instructions:
Resource Sharing Plan: Individuals are required to comply with the instructions for the Resource Sharing Plans as provided in the SF424 (R&R) Application Guide, with the following modification:
Appendix: Do not use the Appendix to circumvent page limits. Follow all instructions for the Appendix as described in the SF424 (R&R) Application Guide.
When conducting clinical research, follow all instructions for completing Planned Enrollment Reports as described in the SF424 (R&R) Application Guide.
When conducting clinical research, follow all instructions for completing Cumulative Inclusion Enrollment Report as described in the SF424 (R&R) Application Guide.
Part I. Overview Information contains information about Key Dates. Applicants are encouraged to submit applications before the due date to ensure they have time to make any application corrections that might be necessary for successful submission.
Organizations must submit applications to Grants.gov (the online portal to find and apply for grants across all Federal agencies). Applicants must then complete the submission process by tracking the status of the application in the eRA Commons, NIH’s electronic system for grants administration. NIH and Grants.gov systems check the application against many of the application instructions upon submission. Errors must be corrected and a changed/corrected application must be submitted to Grants.gov on or before the application due date. If a Changed/Corrected application is submitted after the deadline, the application will be considered late.
Applicants are responsible for viewing their application before the due date in the eRA Commons to ensure accurate and successful submission.
Information on the submission process and a definition of on-time submission are provided in the SF424 (R&R) Application Guide.
This initiative is not subject to intergovernmental review.
All NIH awards are subject to the terms and conditions, cost principles, and other considerations described in the NIH Grants Policy Statement.
Pre-award costs are allowable only as described in the NIH Grants Policy Statement.
Applications must be submitted electronically following the instructions described in the SF424 (R&R) Application Guide. Paper applications will not be accepted.
Applicants must complete all required registrations before the application due date. Section III. Eligibility Information contains information about registration.
For assistance with your electronic application or for more information on the electronic submission process, visit Applying Electronically. If you encounter a system issue beyond your control that threatens your ability to complete the submission process on-time, you must follow the Guidelines for Applicants Experiencing System Issues.
Important reminders:
All PD(s)/PI(s) must include their eRA Commons ID in the Credential field of the Senior/Key Person Profile Component of the SF424(R&R) Application Package. Failure to register in the Commons and to include a valid PD/PI Commons ID in the credential field will prevent the successful submission of an electronic application to NIH. See Section III of this FOA for information on registration requirements.
The applicant organization must ensure that the DUNS number it provides on the application is the same number used in the organization’s profile in the eRA Commons and for the System for Award Management. Additional information may be found in the SF424 (R&R) Application Guide.
See more tips for avoiding common errors.
Upon receipt, applications will be evaluated for completeness and compliance with application instructions by the Center for Scientific Review and responsiveness by the National Institute on Aging (NIA), NIH. Applications that are incomplete, non-compliant and/or nonresponsive will not be reviewed.
In order to expedite review, applicants are requested to notify the NIA Referral Office by email at [email protected] when the application has been submitted. Please include the FOA number and title, PD/PI name, and title of the application.
Applicants are required to follow the instructions for post-submission materials, as described in NOT-OD-13-030.
Only the review criteria described below will be considered in the review process. As part of the NIH mission, all applications submitted to the NIH in support of biomedical and behavioral research are evaluated for scientific and technical merit through the NIH peer review system.
Reviewers will provide an overall impact score to reflect their assessment of the likelihood for the project to exert a sustained, powerful influence on the research field(s) involved, in consideration of the following review criteria and additional review criteria (as applicable for the project proposed).
Reviewers will consider each of the review criteria below in the determination of scientific merit, and give a separate score for each. An application does not need to be strong in all categories to be judged likely to have major scientific impact. For example, a project that by its nature is not innovative may be essential to advance a field.
Does the project address an important problem or a critical barrier to progress in the field? If the aims of the project are achieved, how will scientific knowledge, technical capability, and/or clinical practice be improved? How will successful completion of the aims change the concepts, methods, technologies, treatments, services, or preventative interventions that drive this field?
Are the PD(s)/PI(s), collaborators, and other researchers well suited to the project? If Early Stage Investigators or New Investigators, or in the early stages of independent careers, do they have appropriate experience and training? If established, have they demonstrated an ongoing record of accomplishments that have advanced their field(s)? If the project is collaborative or multi-PD/PI, do the investigators have complementary and integrated expertise; are their leadership approach, governance and organizational structure appropriate for the project?
Does the application challenge and seek to shift current research or clinical practice paradigms by utilizing novel theoretical concepts, approaches or methodologies, instrumentation, or interventions? Are the concepts, approaches or methodologies, instrumentation, or interventions novel to one field of research or novel in a broad sense? Is a refinement, improvement, or new application of theoretical concepts, approaches or methodologies, instrumentation, or interventions proposed?
Are the overall strategy, methodology, and analyses well-reasoned and appropriate to accomplish the specific aims of the project? Are potential problems, alternative strategies, and benchmarks for success presented? If the project is in the early stages of development, will the strategy establish feasibility and will particularly risky aspects be managed?
If the project involves human subjects and/or NIH-defined clinical research, are the plans to address 1) the protection of human subjects from research risks, and 2) inclusion (or exclusion) of individuals on the basis of sex/gender, race, and ethnicity, as well as the inclusion or exclusion of children, justified in terms of the scientific goals and research strategy proposed?
Will the scientific environment in which the work will be done contribute to the probability of success? Are the institutional support, equipment and other physical resources available to the investigators adequate for the project proposed? Will the project benefit from unique features of the scientific environment, subject populations, or collaborative arrangements?
As applicable for the project proposed, reviewers will evaluate the following additional items while determining scientific and technical merit, and in providing an overall impact score, but will not give separate scores for these items.
For research that involves human subjects but does not involve one of the six categories of research that are exempt under 45 CFR Part 46, the committee will evaluate the justification for involvement of human subjects and the proposed protections from research risk relating to their participation according to the following five review criteria: 1) risk to subjects, 2) adequacy of protection against risks, 3) potential benefits to the subjects and others, 4) importance of the knowledge to be gained, and 5) data and safety monitoring for clinical trials.
For research that involves human subjects and meets the criteria for one or more of the six categories of research that are exempt under 45 CFR Part 46, the committee will evaluate: 1) the justification for the exemption, 2) human subjects involvement and characteristics, and 3) sources of materials. For additional information on review of the Human Subjects section, please refer to the Guidelines for the Review of Human Subjects.
When the proposed project involves human subjects and/or NIH-defined clinical research, the committee will evaluate the proposed plans for the inclusion (or exclusion) of individuals on the basis of sex/gender, race, and ethnicity, as well as the inclusion (or exclusion) of children to determine if it is justified in terms of the scientific goals and research strategy proposed. For additional information on review of the Inclusion section, please refer to the Guidelines for the Review of Inclusion in Clinical Research.
The committee will evaluate the involvement of live vertebrate animals as part of the scientific assessment according to the following five points: 1) proposed use of the animals, and species, strains, ages, sex, and numbers to be used; 2) justifications for the use of animals and for the appropriateness of the species and numbers proposed; 3) adequacy of veterinary care; 4) procedures for limiting discomfort, distress, pain and injury to that which is unavoidable in the conduct of scientifically sound research including the use of analgesic, anesthetic, and tranquilizing drugs and/or comfortable restraining devices; and 5) methods of euthanasia and reason for selection if not consistent with the AVMA Guidelines on Euthanasia. For additional information on review of the Vertebrate Animals section, please refer to the Worksheet for Review of the Vertebrate Animal Section.
Reviewers will assess whether materials or procedures proposed are potentially hazardous to research personnel and/or the environment, and if needed, determine whether adequate protection is proposed.
Not Applicable
Not Applicable
Not Applicable
As applicable for the project proposed, reviewers will consider each of the following items, but will not give scores for these items, and should not consider them in providing an overall impact score.
Not Applicable
Reviewers will assess the information provided in this section of the application, including 1) the Select Agent(s) to be used in the proposed research, 2) the registration status of all entities where Select Agent(s) will be used, 3) the procedures that will be used to monitor possession use and transfer of Select Agent(s), and 4) plans for appropriate biosafety, biocontainment, and security of the Select Agent(s).
Reviewers will comment on whether the following Resource Sharing Plans, or the rationale for not sharing the following types of resources, are reasonable: 1) Data Sharing Plan; 2) Sharing Model Organisms; and 3) Genomic Wide Association Studies (GWAS) /Genomic Data Sharing Plan.
Reviewers will consider whether the budget and the requested period of support are fully justified and reasonable in relation to the proposed research.
Applications will be evaluated for scientific and technical merit by (an) appropriate Scientific Review Group(s) convened by NIA in accordance with NIH peer review policy and procedures, using the stated review criteria. Assignment to a Scientific Review Group will be shown in the eRA Commons.
As part of the scientific peer review, all applications:
Appeals of initial peer review will not be accepted for applications submitted in response to this FOA.
Applications will be assigned to the appropriate NIH Institute or Center. Applications will compete for available funds with all other recommended applications submitted in response to this FOA. Following initial peer review, recommended applications will receive a second level of review by the National Advisory Council on Aging. The following will be considered in making funding decisions:
After the peer review of the application is completed, the PD/PI will be able to access his or her Summary Statement (written critique) via the eRA Commons.
Information regarding the disposition of applications is available in the NIH Grants Policy Statement.
If the application is under consideration for funding, NIH will request "just-in-time" information from the applicant as described in the NIH Grants Policy Statement.
A formal notification in the form of a Notice of Award (NoA) will be provided to the applicant organization for successful applications. The NoA signed by the grants management officer is the authorizing document and will be sent via email to the grantee’s business official.
Awardees must comply with any funding restrictions described in Section IV.5. Funding Restrictions. Selection of an application for award is not an authorization to begin performance. Any costs incurred before receipt of the NoA are at the recipient's risk. These costs may be reimbursed only to the extent considered allowable pre-award costs.
Any application awarded in response to this FOA will be subject to terms and conditions found on the Award Conditions and Information for NIH Grants website. This includes any recent legislation and policy applicable to awards that is highlighted on this website.
All NIH grant and cooperative agreement awards include the NIH Grants Policy Statement as part of the NoA. For these terms of award, see the NIH Grants Policy Statement Part II: Terms and Conditions of NIH Grant Awards, Subpart A: General and Part II: Terms and Conditions of NIH Grant Awards, Subpart B: Terms and Conditions for Specific Types of Grants, Grantees, and Activities. More information is provided at Award Conditions and Information for NIH Grants.
Cooperative Agreement Terms and Conditions of Award
Not Applicable
When multiple years are involved, awardees will be required to submit the Research Performance Progress Report (RPPR) annually and financial statements as required in the NIH Grants Policy Statement.
A final progress report, invention statement, and the expenditure data portion of the Federal Financial Report are required for closeout of an award, as described in the NIH Grants Policy Statement.
The Federal Funding Accountability and Transparency Act of 2006 (Transparency Act), includes a requirement for awardees of Federal grants to report information about first-tier subawards and executive compensation under Federal assistance awards issued in FY2011 or later. All awardees of applicable NIH grants and cooperative agreements are required to report to the Federal Subaward Reporting System (FSRS) available at www.fsrs.gov on all subawards over $25,000. See the NIH Grants Policy Statement for additional information on this reporting requirement.
We encourage inquiries concerning this funding opportunity and welcome the opportunity to answer questions from potential applicants.
eRA Service Desk (Questions regarding ASSIST, eRA Commons registration, submitting and tracking an application, documenting system
problems that threaten submission by the due date, post submission issues)
Telephone: 301-402-7469 or 866-504-9552 (Toll Free)
Finding Help Online: http://grants.nih.gov/support/index.html
Email: [email protected]
Grants.gov
Customer Support (Questions
regarding Grants.gov registration and submission, downloading forms and
application packages)
Contact CenterTelephone: 800-518-4726
Web ticketing system: https://grants-portal.psc.gov/ContactUs.aspx
Email: [email protected]
GrantsInfo (Questions regarding application instructions
and process, finding NIH grant resources)
Email: [email protected] (preferred method of contact)
Telephone: 301-710-0267
Molly V. Wagster, PhD
National Institute on Aging (NIA)
Telephone: 301-496-9350
Email: [email protected]
Susan Zieman, MD, PhD
National Institute on Aging (NIA)
Telephone: 301-496-6761
Email: [email protected]
Ramesh Vemuri, PhD
National Institute on Aging (NIA)
Telephone: 301-496-9666
Email: [email protected]
Jessi Perez
National Institute on Aging (NIA)
Telephone: 301-402-7739
Email: [email protected]
Recently issued trans-NIH policy notices may affect your application submission. A full list of policy notices published by NIH is provided in the NIH Guide for Grants and Contracts. All awards are subject to the terms and conditions, cost principles, and other considerations described in the NIH Grants Policy Statement.
Awards are made under the authorization of Sections 301 and 405 of the Public Health Service Act as amended (42 USC 241 and 284) and under Federal Regulations 42 CFR Part 52 and 45 CFR Part 75.