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Release Date:  September 21, 1999

RFA:  ES-00-003  

National Institute of Environmental Health Sciences
National Institute of Neurological Disorders and Stroke

Letter of Intent Receipt Date: November 5, 1999
Application Receipt Date: January 11, 2000 


The purpose of this Request for Applications (RFA) is to stimulate the career
development of physician-scientists engaged in research on the relative roles
of environmental, endogenous neurochemical, and modifying genetic factors in
the cause of Parkinson's Disease (PD).  Recent evidence from twin studies has
shown that genetics plays less of a role and environmental factors a
potentially greater role than previously thought in the development of
late-onset PD.  In response to this finding, the National Institute of
Environmental Health Sciences (NIEHS) and the National Institute of
Neurological Disorders and Stroke (NINDS) have issued an  RFA (ES-00-002) for
research project grants for research aimed at elucidating the role of the
environment in the development of PD.  The results of these immediate
investigations will contribute to clarifying the part environmental factors
play in the etiology of this disease.  It is recognized, however, that
long-term progress in research in this area is dependent on developing a cadre
of scientists who can carry the state of knowledge to the next level.  This is 
especially true of physician scientists who can relate fundamental and
laboratory findings concerning the role of the environment in PD to the human
disease state.  This RFA for career development applications addresses that
priority goal.


The Public Health Service (PHS) is committed to achieving the health promotion
and disease prevention objectives of "Healthy People 2000," a PHS-led national
activity for setting priority areas. This Request for Applications, The Role
of the Environment in Parkinson's Disease: Career Development Programs for
Physician-Scientists, is related to one or more of the priority areas.
Potential applicants may obtain a copy of "Healthy People 2000" at:


Applications may be submitted, on behalf of candidates, by domestic,
non-Federal organizations, public or private, such as medical or other
institutions of higher education.  Minorities, women and individuals with
disabilities are encouraged to apply.  At the time of award, candidates must 
be citizens or noncitizen nationals of the United States, or have been
lawfully admitted to the United States for permanent residence (i.e., in
possession of a currently valid Alien Registration Receipt Card I- 551, or
other legal verification of such status).  Noncitizen nationals are generally 
persons born in outlying possessions of the United States (i.e., American
Samoa and Swains Island).  Individuals on temporary or student visas are not
Applicants for both K08 and K23 awards must have a clinical doctoral degree or
its equivalent and hold a professional license to practice in this country. 
Candidates will generally hold the M. D., but other degrees may be appropriate
in selective circumstances.  Individuals holding other degrees should contact
the Institute Program Administrator listed below concerning their 
eligibility for the RFA. Candidates for the mentored patient-oriented research
career development award (K23) also must have completed their clinical
training, including specialty and, if applicable, sub-specialty training prior
to receiving an award.  However, candidates may submit an application prior to
the completion of clinical training.  Candidates must identify a mentor with
extensive research experience.  Candidates must be willing to spend a minimum
of 75 percent of full-time professional effort conducting research career
development and clinical research.

Ineligible individuals include current and former principal investigators on
NIH research project awards (R01), FIRST Awards (R29), comparable career
development awards (K01 or K07), subprojects of program project (P01) or
center grant (P50) awards, and the equivalent.  Former principal investigators
of NIH Small Grants (R03) or Exploratory/Developmental Grants (R21) remain
eligible.  Current and former recipients of Clinical Associate Physicians
Award (CAP) support may apply provided they have had no more than 3 years of
CAP support by the time of the award.  The combined total of CAP plus K23 or
K08 support must not exceed 6 years.  A candidate may not concurrently apply
for a CAP award or any other PHS award that duplicates the provisions of this
award nor have another application pending award.  K23 and K08 recipients are
encouraged to apply for independent research grant support during the period
of this award.  A candidate for the Mentored Patient-oriented Research Career
Development Award may not concurrently apply for any other PHS award that
duplicates the provisions of this award nor have another application pending


The total estimated funds available for support of the mentored clinical
career development (K08, K23) award mechanisms in this Request for
Applications are $520,000 per year.  This level of expenditure is dependent on
the type of applications received, the peer-reviewed merit evaluation and the
actual available funds. 

Awards made in response to this Request for Applications will be for
applications using the K08 and K23 mechanisms offered by the NIH.  The purpose
of the Mentored Clinical Scientist Development Award (K08) is to support the
development of outstanding clinician research scientists.  This mechanism
provides specialized study for individuals with a health professional 
doctoral degree committed to a career in laboratory or field based research. 
The K08 supports a three, four, or five-year period of supervised research
experience that may integrate didactic studies with laboratory or clinically
based research.  The purpose of the Mentored Patient-oriented Research Career
Development Award (K23) is to support the career development of investigators
who have made a commitment to focus their research endeavors on
patient-oriented research.  This mechanism provides support for three to five
years of supervised study and research for clinically trained professionals
who have the potential to develop into productive, clinical investigators
focusing on patient-oriented research.  The K08 and K23 mechanisms are 
described more fully in the NIH Program Training Home Page found at:  


While much of the previous research in Parkinson's disease (PD) has focused on
the underlying biological processes critical to disease manifestation in the
hopes of developing new treatments, the relative roles of environmental,
endogenous neurochemical and modifying genetic factors in the cause of
neurodegenerative diseases remain unclear.  For example, it is not clear
whether differences in prevalence rates of Parkinson's disease in various
communities are due to the differential distribution of a hypothetical
environmental toxicant or are more frequent where a heritable defect is more
common.  Moreover, analytic epidemiological studies have varied in case and
control selection methodology and venues (e.g., clinics, population bases,
different countries) partly accounting for the disparate conclusions reached
by investigators. 

New evidence from a recent study showed that there was no statistically
significant difference in the incidence of late-onset (over the age of 50) PD
between monozygotic and dizygotic twins.  This finding indicates a greater
role for environmental agents in the etiology of the disease than previously
appreciated.  However, the relative roles of genetic susceptibility and
environmental factors in triggering PD remain to be determined.  The reported
observation that cigarette smoking has a protective effect on the development
of PD illustrates the complex role that exogenous agents play in the
development of PD.  

Other epidemiological studies have implicated pesticide exposure and rural
living as risk factors for developing PD.  New evidence has emerged from one
study showing that long-term occupational exposure to certain combinations of
metals is significantly associated with developing Parkinson's Disease (PD). 
This is the first study to link a 20- year or more occupational exposure to
heavy metals with a chronic neurodegenerative disorder.  The study also found
a link to PD and occupational exposure to herbicides, insecticides and

Findings from research using animal models and in vitro techniques have begun
to support some of these epidemiological findings. For example, a study in
mice investigating the role of organochlorine pesticides in altering normal
dopaminergic function has led to the observation that the pesticide,
heptachlor, significantly inhibits vesicular uptake of dopamine making the 
striatial neurons more vulnerable to degeneration.


The NIEHS convened a Concept Forum on the Role of the Environment in
Parkinson's Disease on July 22, 1999 to evaluate the current evidence and
identify future research needs in three areas: basic research, epidemiological
research, and clinical research.  The Forum concluded that elucidating the
role of the environment in the etiology of PD is important in developing a
better understanding of the disease process for both its prevention and

Therefore, applications are solicited in, but not limited to, the following

o Research aimed at understanding the mechanism by which environmental
exposure, endogenous susceptibility factors, and increasing age contribute to
the etiopathology of PD. Of particular significance may be those approaches
that can be used across species from lower animals to humans.  Such approaches
permit a precise characterization in animal models of alterations arising from
defined environmental exposures which can serve as a cogent guide to 
underlying cellular and molecular mechanisms necessary to support
epidemiological studies.

o Epidemiological studies targeted to specific environmental agents and/or
combinations of factors associated with an increased risk for
neurodegenerative disorders.  These studies may target populations already
characterized in terms of the incidence and risks for neurodegenerative 
diseases (e.g., farmers with significant exposure to pesticides) and should
use advanced techniques in exposure assessment as well as biomarkers of
exposure and effect when possible.

o Development of biomarkers of preclinical disease to identify those at risk
for selected environmental toxicants, and to identify those who would benefit
from trials of possibly neuroprotective drugs.

o Studies focusing on early disease which help clarify the contributions and
attributable risks from environmental or gene/environmental interactions.

o Studies developing models of neurodegenerative disease from low-level and/or
chronic exposure to environmental agents and synergistic chemical interactions
leading to neuronal injury.

o Development of genetically modified transgenics or knockout animals to study
increased susceptibility to environmentally induced neurodegeneration and the
efficacy of therapeutic interventions.  

o Elucidation of gene-environment interactions using molecular epidemiology

o Studies of the cellular and molecular effect of environmental toxins on
alterations in oxidative stress, increased mitochondrial mutations and
dysfunction and altered protein metabolism including the metabolism of
a-synuclein and parkin.

o Toxicant-induced paradigms for studying the mechanism of formation and the
role of Lewy body and Lewy body-like inclusions and the comparisons of these
structures with those seen in idiopathic PD.

o Studies on the role of the inflammatory processes in toxicant-induced PD.

o Xenobiotics' potential influence on programmed cell death, neural
plasticity, or other processes critical to the maintenance of neuronal
viability and function.

o Potential role of dietary and life style factors, e.g., fat, fiber, iron,
antioxidants, alcohol, caffeine, and tobacco as either predisposing or
preventive influences.

o Studies on the disruption of dopamine function in the substantia nigra by
environmental contaminants.


It is the policy of the NIH that women and members of minority groups and
their subpopulations must be included in all NIH supported biomedical and
behavioral research projects involving human subjects, unless a clear and
compelling rationale and justification is provided that inclusion is 
inappropriate with respect to the health of the subjects or the purpose of the
research. This policy results from the NIH Revitalization Act of 1993 (Section
492B of Public Law 103-43).

All investigators proposing research involving human subjects should read the
"NIH Guidelines for Inclusion of Women and Minorities as Subjects in Clinical
Research," which have been published in the Federal Register of March 28, 1994
(FR 59 14508-14513) and in the NIH Guide for Grants and Contracts, Vol. 23,
No. 11, March 18, 1994 available on the web at the following URL address:


It is the policy of NIH that children (i.e., individuals under the age of 21)
must be included in all human subjects research, conducted or supported by the
NIH, unless there are scientific and ethical reasons not to include them. This
policy applies to all initial (Type 1) applications submitted for receipt
dates after October 1, 1998.

All investigators proposing research involving human subjects should read the
"NIH Policy and Guidelines on the Inclusion of Children as Participants in
Research Involving Human Subjects" that was published in the NIH Guide for
Grants and Contracts, March 6, 1998, and is available at the following URL
address: https://grants.nih.gov/grants/guide/notice-files/not98-024.html

Investigators also may obtain copies of these policies from the program staff
listed under INQUIRIES.  Program staff may also provide additional relevant
information concerning the policy.


The elements of K23 and K08 mentored career development programs which set
these types of awards apart from a research grant proposal include:

Environment:  The institution must have a well-established research and
clinical career development program and faculty qualified in clinical or basic
research to serve as mentors.  The institution must be able to demonstrate a
commitment to the development of the candidate as a productive, independent
investigator.  The candidate, mentor, and institution must be able to 
describe an in-depth, multi disciplinary career development program that will
utilize the relevant research and educational resources.

Program: K23 and K08 awards provide up to  five consecutive 12-month awards.
At least 75 percent of the recipient's full-time professional effort must be
devoted to the goals of this award.  The remainder may be devoted to clinical,
teaching, or other research pursuits consistent with the objectives of the
award. Both the didactic and the research phases of an award period must be 
designed to develop the necessary knowledge and research skills in scientific
areas relevant to the career goals of the candidate.  Candidates proposing
patient oriented research must demonstrate they have received or will
participate in courses such as: data management, epidemiology, study design,
hypothesis development, drug development, etc., as well as the legal 
and ethical issues associated with research on human subjects.

Because of the focus on progression to independence as a researcher, the
candidate for a mentored career development award should propose a period of
study and career development consistent with her or his previous research and
clinical experience.  For example, a candidate with limited experience in a
given field of research may find a phased developmental program lasting five
years that includes a designated period of didactic training followed by a
period of closely supervised research experience the most efficient means of
attaining independence. A candidate with previous research experience and
training may not require extensive additional didactic preparation and a
program that focuses on an intensive, supervised research experience 
may be appropriate. All programs must be tailored to meet the individual needs
of the candidate ensuring that he/she will gain the skills and knowledge
necessary to initiate and carry out high quality research.  The candidate and
the mentor are jointly responsible for the preparation of the plan for this
program. The sponsor may form an advisory committee to assist with the 
development of a program of study or to monitor the candidate?s progress
through the career development program.  The didactic and research components
of both phases must develop new knowledge and research skills in scientific
areas relevant to the career goals of the candidate.

Mentor(s): Candidates must name a primary sponsor (or mentor), who together
with the applicant is responsible for the planning, direction, and execution
of the program. The mentor should be recognized as an accomplished
investigator in the proposed research area and have a track record of success
in training independent investigators. The mentor should have sufficient
independent research support to cover the costs of the proposed research
project in excess of the allowable costs of this award. Candidates may also
nominate co-mentors as appropriate to the goals of the program.  Where
feasible, women, minority individuals and individuals with disabilities should 
be involved as mentors to serve as role models.  

Allowable Costs:

Salary:  The NIEHS and NINDS will provide salary offset of up to $75,000 per
year as well as associated fringe benefits for the career award recipient. The
total salary requested must be based on a full-time, 12-month staff
appointment.  It must be consistent both with the established salary structure
at the institution and with salaries actually provided by the institution from
its own funds to other staff members of equivalent qualifications, rank, and
responsibilities in the department concerned.  If full-time, 12-month salaries
are not currently paid to comparable staff members, the salary proposed must
be appropriately related to the existing salary structure. The candidate must
devote at least 75% professional effort to the career development program.

The institution may supplement the NIH salary contribution up to a level that
is consistent with the institution's salary scale; however, supplementation
may not be from Federal funds unless specifically authorized by the Federal
program from which such funds are derived.  Because the salary amount provided
by this award is based on the full-time institutional salary, no other PHS 
funds may be used for salary supplementation.  Institutional supplementation
of salary must not require extra duties or responsibilities that would
interfere with the purpose of the career development program.  Under expanded
authorities, however, institutions may rebudget funds within the total costs
awarded to cover salaries consistent with the institution's salary scale.

Research Development Support: The NIEHS and NINDS will provide up to $25,000
per year for the following expenses:  (a) tuition, fees, and books related to
career development; (b) research expenses, such as supplies, equipment and
technical personnel; c) travel to research meetings or training; (d)
statistical services including personnel and computer time. 

Ancillary Personnel Support: Salary for mentors, secretaries and
administrative assistants is not allowed.

Facilities and Administrative Costs: These costs, which were formerly called
indirect costs, will be reimbursed at 8 percent of modified total direct

Evaluation:  In carrying out its stewardship of human resource related
programs, the NIH may begin requesting information essential to an assessment
of the effectiveness of this program.  Accordingly, recipients are hereby
notified that they may be contacted after the completion of this award for
periodic updates on various aspects of their employment history, publications, 
support from research grants or contracts, honors and awards, professional
activities, and other information helpful in evaluating the impact of the

Other Income: Fees resulting from clinical practice, professional
consultation, or other comparable activities required by the research and
research-related activities of this award may not be retained by the career
award recipient.  Such fees must be assigned to the grantee institution for
disposition by any of the following methods:

The funds may be expended by the grantee institution in accordance with the
NIH policy on supplementation of career award salaries and to provide fringe
benefits in proportion to such supplementation. Such salary supplementation
and fringe benefit payments must be within the established policies of the
grantee institution.


Prospective applicants are asked to submit a letter of intent that includes a
descriptive title of the proposed research, the name, address, and telephone
and facsimile numbers of the Principal Investigator, the identities of the
proposed mentor and other key personnel, their participating institutions, and
the number and title of this RFA.  Although a letter of intent is not required
and is not binding, and does not enter into the review of a subsequent
application, its provision is highly encouraged.  The information it contains
will allow NIH staff to estimate the workload and avoid potential conflicts of
interest in the review process planning.  

The letter of intent is to be sent to Dr. Linda Bass at the NIEHS at the
address given below by the letter of intent receipt date listed at the heading
of this RFA.


Applications are to be prepared using Section IV of the grant application form
PHS 398 (rev. 4/98).  These forms are available at most institutional offices
of sponsored research and from the Division of Extramural Outreach and
Information Resources, National Institutes of Health, 6701 Rockledge Drive,
MSC 7910. Bethesda, MD 20892-7910, telephone 301/710-0267, email: 

They may also be downloaded from the Internet at:

The application must contain the following:

o  Candidate:  The application should outline the nature of the candidate's
commitment to a career in patient-oriented or basic research and present
evidence of the candidate's potential to develop into an independent
investigator.  The application should describe the candidate's immediate and
long-term career objectives, explaining how the award will contribute to their 
attainment.  A commitment of at least 75 percent effort to the research
program is required.

o  Three sealed letters of recommendation addressing the candidate's potential
for a research career. The mentor's statement (see below) must not be included
as one of the letters of recommendation.

o  Career Development Plan:  A description of the career development plan,
incorporating consideration of the candidate's goals and prior experience.  It
must describe a systematic plan to obtain the necessary theoretical and
conceptual background, in addition to the research experience and skills,
necessary to launch an independent career in clinical or basic research.  
Candidates for the K23 award must describe the availability of courses such as
research design, biostatistics, epidemiology, and ethical and regulatory
issues at their institution and the integration of these studies into their
career development plan.  Less experienced candidates may require a phased
developmental period in which the first one to two year(s) of the award are 
largely of a didactic nature followed by a period of intense, supervised
research experience. Candidates with more experience at the time of
application may need a shorter didactic period and may already have an
adequate theoretical background. In any case, the career development plan must
be specifically tailored to the needs of the individual candidate and the
ultimate goal of achieving independence as a clinical researcher.

o  Training in the Responsible Conduct of Research:  Candidates must describe
plans to receive instruction in the responsible conduct of research. These
plans must detail the proposed subject matter, format, frequency, and duration
of instruction.  No award will be made if an application lacks this component.

o  Research Plan:  The research plan must be described as outlined in form PHS
398 including sections on the Specific Aims, Background and Significance,
Progress Report/Preliminary Studies, Research Design and Methods.  The
candidate should consult with the mentor regarding the development of this

o  Mentor's Statement:  The application must include a statement from the
mentor including information on his or her qualifications in the research area
proposed by the candidate and previous experience as a research supervisor. 
The application must also include information to describe the nature and
extent of supervision that will occur during the proposed award period.  
Similar information must be provided by any co-mentor.  If more than one
mentor is proposed, the respective areas of expertise and responsibility
should be described.

o  Environment and Institutional Commitment:  The sponsoring institution must
document a strong, well-established research and training program related to
the candidate's area of interest including a high-quality research environment
with staff capable of productive collaboration with the candidate. The
sponsoring institution must provide a statement of commitment to the 
candidate's development into a productive, independent investigator.  The
institutional statement also must commit to provision of release time from
normal clinical, teaching or administrative duties necessary to meet the 75%
effort requirement of this award.

o  Budget:  The total direct costs requested must be consistent with the 
award limits described above. Applicants seeking information on award limits
should contact one of the individuals listed in the INQUIRIES section at the
end of this announcement.  

Applicants who will be using the resources within a General Clinical Research
Center (GCRC) during the course of the award are requested to include a letter
of agreement from either the GCRC program director or the principal
investigator with the application.

The RFA label available in the PHS 398 (rev. 4/98) application form must be
affixed to the bottom of the face page of the application.  Failure to use
this label could result in delayed processing of the application such that it
may not reach the review committee in time for review. 
In addition, the RFA title and number of the request for applications must be
typed on line 2 of the face page of the application and the YES box must be

The sample RFA label available at:
https://grants.nih.gov/grants/funding/phs398/label-bk.pdf has been modified to
allow for this change.  Please note this is in pdf format.

Submit a signed, typewritten original of the application with the Checklist
and three photocopies of the signed application, in one package to:

BETHESDA, MD 20892-7710
BETHESDA, MD 20817 (for express/courier service)

At the time of submission, two additional copies of the application must be
sent to:

Linda K. Bass, Ph.D.
Scientific Review Administrator
Scientific Review Branch
Division of Extramural Research and Training

National Institute of Environmental Health Sciences
PO Box 12233 MD EC-24
Research Triangle Park, NC 27709
Telephone (919) 541-1307
Fax: (919) 541-2503
email: bass@niehs.nih.gov


Applications will be reviewed for completeness by the Center for Scientific
Review and responsiveness to the RFA by NIEHS. Incomplete and/or nonresponsive
applications will be returned to the applicant without further consideration. 
Applications that are complete and responsive will be evaluated for scientific
and technical merit by a peer review group convened by the NIEHS in accordance
with the standard NIH peer review procedures.  As part of the initial merit
review, all applications will receive a written critique.  Applications may
undergo a streamlined review process.  In this process, only those
applications deemed to have the highest scientific merit, generally the top
half of applications under review, will be discussed, assigned a priority
score, and receive a second level review by the NIEHS and NINDS national
advisory councils

The following review criteria will be applied:


o  Quality of the candidate's academic and clinical record;
o  potential to develop as an independent clinical researcher focusing on
basic or  patient-oriented research; and
o  commitment to a career in  research.

Career Development Plan

o  Likelihood that the career development plan will contribute substantially
to the scientific development of the candidate;
o appropriateness of the content and duration of the proposed didactic and
research phases of the award; and
o consistency of the career development plan with the candidate's career goals
and prior research experience. 

Training in the Responsible Conduct of Research

o Quality of the proposed training in responsible conduct of research.

Research Plan

o  Scientific and technical merit of the research question, design and
o  appropriateness of the research plan to the stage of research development
and as a vehicle for developing the research skills as described in the career
development plan;
o  adequacy of the plan's attention to gender and minority issues associated
with projects involving human subjects, and 
o  adequacy of plans for including children, as appropriate, for the
scientific goals of the research, or justification for exclusion.

Reviewers recognize that an individual with limited research experience is
less likely to be able to prepare a research plan with the breadth and depth
of that submitted by a more experienced investigator.  Nevertheless, a
fundamentally sound research plan must be provided.  For candidates who
require substantial didactic training as part of their program, the research
plan may cover less than the full period of the award.


o  Appropriateness of mentor(s) research qualifications in the area of this
o  quality and extent of mentor's proposed role in providing guidance and
advice to the candidate;
o  previous experience in fostering the development of more junior
o  history of research productivity and support; and
o  adequacy of support for the proposed research project.

Environment and Institutional Commitment

o  Adequacy of research facilities and the availability of appropriate
educational opportunities;
o  quality and relevance of the environment for scientific and professional
development of the candidate; 
o  applicant institution's commitment to the scientific development of the
candidate and assurances that the institution intends the candidate to be an
integral part of its research program; 
o  applicant institution's commitment to an appropriate balance of research
and clinical responsibilities including the commitment of 75 percent of the
candidate?s effort to research and research related activities.


Justification of the requested budget in relation to career development goals
and research aims.


Letter of Intent Receipt Date:     November 5, 1999
Application Receipt Date:          January 11, 2000
Peer Review Date:                  March, 2000
Council Review:                    May, 2000
Earliest Anticipated Start Date:   July 1, 2000


Award criteria that will be used to make award decisions include: 

o  scientific merit (as determined by peer review)
o  programmatic priorities
o  availability of funds


Inquiries are encouraged.  The opportunity to clarify any issues or questions
from potential applicants is welcome.  Direct inquiries regarding K08 and K23
programmatic issues to:

Carol Shreffler, Ph.D.
Division of Extramural Research and Training
National Institute of Environmental Health Science
Box 12233, MD EC-23
Research Triangle Park, NC 27709
Telephone: (919) 541-1445
FAX: (919) 541-5064
Email: shreffl1@niehs.nih.gov

Eugene J. Oliver, Ph.D.
Division of Stroke, Trauma, and Neurodegenerative Disorders
National Institute of Neurological Disorders and Stroke
6001 Executive Boulevard, Room 2203
Bethesda, MD 20892
Telephone: (301) 496-5680
FAX: (301) 480-1080
Email: eollc@nih.gov

Direct inquiries regarding fiscal matters to:

Ms. Jackie Russell
Division of Extramural Research and Training
National Institute of Environmental Health Science
Box 12233, MD EC-22
Research Triangle Park, NC 27709
Telephone:  (919) 541-0751
FAX:  (919) 541-2860
Email: russell@niehs.nih.gov

Mary Graham
Grants Management Branch
National Institute of Neurological Disorders and Stroke
6001 Executive Boulevard, Room 3256
Bethesda, MD 20892
Telephone: (301) 496-7359
FAX: (301) 402-02119
Email: pd23n@nih.gov


This program is described in the Catalog of Federal Domestic Assistance No.
93.113 and 93.866.  The Mentored Clinical Scientist Development Awards are
made under the authority of Title III, Section 301 of the Public Health
Service (PHS) Act as amended (Public Law 78-410, as amended, 42 USC 241). The
Code of Federal Regulations, Title 42 Part 52 and Title 45 Part 74, are
applicable to this program.  This program is not subject to the
intergovernmental review requirements of Executive Order 12372 to Health
Systems Agency review.

The PHS strongly encourages all grant and contract recipients to provide a
smoke-free workplace and promote the non-use of all tobacco products.  In
addition, Public Law 103-227, the Pro-Children Act of 1994, prohibits smoking
in certain facilities (or in some cases, any portion of a facility) in which
regular or routine education, library, day care, health care or early
childhood development services are provided to children.  This is consistent
with the PHS mission to protect and advance the physical and mental health of
the American people.

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