Full Text HL-94-015


NIH GUIDE, Volume 23, Number 24, June 24, 1994

RFA:  HL-94-015

P.T. 34

  Cardiovascular Diseases 

National Heart, Lung, and Blood Institute

Letter of Intent Receipt Date:  November 30, 1994
Application Receipt Date:  January 12, 1995


The National Heart, Lung, and Blood Institute (NHLBI) of the National
Institutes of Health announces the fourth national competition for
Vascular Disease Academic Awards.  These awards have the dual purpose
of encouraging the development and/or improving the quality of the
clinical, educational, and research programs in vascular disease and of
encouraging the professional development of the awardee so that he or
she can serve as the focal point for multidisciplinary interactions in
the field of vascular medicine.


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 (RFA), Vascular Disease Academic Award, is related to
the priority areas of heart disease and stroke and chronic disabling
diseases.  Potential applicants may obtain a copy of "Healthy People
2000" (Full Report:  Stock No. 017-001-00474-0 or Summary Report:
Stock No. 017-001-00473-1) through the Superintendent of Documents,
Government Printing Office, Washington, DC 20402-9325 (telephone 202


Each School of Medicine or Osteopathy in the United States and its
possessions or territories is eligible to compete for a nonrenewable
Vascular Disease Academic Award for a project period that does not
exceed five years.  An individual institution may submit one
application only for a given receipt date.  Institutions that have
already received a Vascular Disease Academic Award may not apply for a
further award.

A candidate for an award must:

o  hold the M.D. or D.O. degree or the equivalent;

o  be a citizen or non-citizen national of the United States, or have
been lawfully admitted to the United States for permanent residence at
the time of application;


The mechanism of support for this program is the Academic/Teacher Award
(K07).  An applicant for a systemic or pulmonary vascular disease award
may request up to $100,000 direct costs in the first year and an
applicant for a combined systemic and pulmonary vascular award may
request up to $125,000, with no more than a four percent increase in
each additional year.

For the purpose of this award, vascular medicine is defined as the
clinical discipline that has as its objectives:  (1) clinical
characterization, (2) pathogenesis, (3) diagnosis, (4) treatment, and
(5) prevention of systemic and/or pulmonary vascular disease.  To be
responsive to this RFA, an application must provide for a program in
systemic or pulmonary vascular disease or a combined program in both
systemic and pulmonary vascular disease.  A systemic vascular program
should include cerebral, coronary, aortic, renal, peripheral and
lymphatic circulations and address such disorders as atherosclerosis,
lipid metabolic disorders, hypertension, lymphedema, thrombosis,
vasculitis, and vasospastic disorders.  A pulmonary vascular disease
program should include primary and secondary pulmonary hypertension,
pulmonary vasculitis and pulmonary thromboembolism.  Combined programs
must include major time commitments of investigators from both the
systemic vascular and pulmonary vascular areas.

The institution must:

o  sponsor a candidate with sufficient clinical training, research, and
teaching experience in one or more aspects of vascular medicine to
develop and implement a successful vascular disease program and who has
a career interest in vascular disease including improvement of
educational and research programs;

o  provide evidence of commitment by the administration, by the Dean of
the School of Medicine or Osteopathy, and by appropriate departmental
and divisional chairpersons to facilitate implementation of the
proposed program and to continue the vascular disease program
subsequent to the award period;

o  provide facilities that will allow for quality patient care,
rigorous vascular research, and education;

o  identify the educational resources (patients, staff, material)
necessary to implement the proposed program;

o  provide the awardee with time to acquire the educational skills
necessary for personal development as a teacher, and for the
development of the vascular medicine curriculum;

o  present plans to develop or improve the vascular disease educational
programs within the institution.

It would be important to the development of the Vascular Disease
Program that the following areas and related programs be present or
planned at the institution:

o  strong basic and clinical research in areas relevant to vascular
biology and medicine to provide better understanding of mechanisms
operative in patients with vascular disease;

o  clinical research on how best to improve the detection and
management of the high-risk patient and to prevent vascular disease;

o  active participation in national protocol studies in order to
provide the most advanced treatment as an option for patients with
vascular disease and its complications;

o  established core facilities that provide safe and effective
monitoring for patients on new types of treatment.  Such facilities
could be regional or national resources;

o  incorporation of the concepts of this award into an ongoing
fellowship training program that would facilitate rotations of trainees
in other relevant areas of vascular disease; and

o  programs to deal with the logistic, economic, social, and behavioral
aspects of vascular medicine.

Qualifications of the candidate should include a research background
and significant current research in some facet of vascular medicine.
The applicant should have an academic appointment at a level (i.e.,
associate professor or higher) that will enable him/her to exert a
meaningful influence on the coordination of the multidisciplinary field
involved in vascular disease within the institution.  The candidate
should also be able to provide:  (a) clinical consultation and primary
care to patients with a broad variety of vascular disease, (b)
leadership and guidance in education and research, and (c) modern
teaching approaches to the various aspects of vascular medicine.  Women
and minority applicants are encouraged to apply.

A candidate for an award must:

o  have sufficient clinical training and research experience in
vascular disease to be effective in developing and actively
implementing a high-quality comprehensive program in vascular medicine;

o  present a program for improving the curriculum in the grantee
institution that will emphasize the clinical application of important
vascular medicine concepts and will involve students, house staff, and
fellows in the practice of these concepts;

o  establish an advisory committee for the program composed of
appropriate individuals at the institution and associated hospitals;

o  commit a minimum of 25 percent of his/her effort to developing,
improving, and implementing a vascular disease program although a 50
percent commitment is encouraged;

NOTE:  Although awardees are encouraged to devote 50 percent effort to
developing, improving, and implementing a vascular disease program, it
is recognized that some individuals with appropriate credentials may
not be able to commit 50 percent effort.  Based on adequate
justification, which should include significant time commitment to
research in the area of vascular disease, prospective awardees may
propose to commit less than 50 percent of their time to this award.  In
no case will applications proposing less than 25 percent effort be
considered responsive to this RFA;

o  where necessary, specify a program for enhancing his/her educational
skills essential to developing or improving the vascular medicine

o  delineate his/her particular plans for and commitments to research
in vascular disease;

o  detail a plan for the evaluation of the program and agree to present
an annual status report based on this evaluation;

o  agree to meet annually with other recipients of Vascular Disease
Academic Awards to exchange ideas, methods, and program strategies.


The number and types of new awards made each year will depend on the
availability of funds, program balance, and the scientific merit of the
applications received.

Subject to the availability of necessary funds and consonant with the
objectives of the Vascular Disease Academic Award, the NHLBI will
provide funds annually for not more than five awards for a project
period of up to five years.  The total amount of funds available for
the first year of support will be $675,000.  Awards will be limited to
one for each eligible school and are not renewable.  The NHLBI
anticipates offering the Vascular Disease Academic Award for five
competitions.  This RFA is the fourth solicitation.



This Academic Award was initiated to expedite rapid and effective
application of new developments in diagnosis and management of the
individual patient with vascular disease.  The purpose of this Academic
Award is to provide financial support for individuals, in conjunction
with their institutions, to develop and implement approaches to the
coordinated care of patients with vascular disease, who require a
variety of expert consultation.  In conjunction with this program, it
is also expected that complementary educational and research programs
will be developed or are already in place.

An ideal program in vascular disease should include, but is not limited
to, the following characteristics:

o  an integrated faculty and staff with interests and functions related
to both the basic and clinical aspects of vascular disease as an
interdepartmental program with common goals and standardized diagnostic
and therapeutic approaches;

o  a coordinated clinical approach to the management of patients with
vascular disease;

o  an effective multidisciplinary curriculum in basic and clinical
aspects of vascular disease in medical and nursing schools;

o  a training program utilizing the latest diagnostic, management, and
prevention approaches to vascular disease, for residents and fellows;

o  an out-reach program from the tertiary center to the practicing
physician in all communities to enhance referrals and provide optimal

o  a sound educational basis for promising young clinicians and
scientists so they may later participate in advanced research training
in the field of vascular disease;

o  an existing mechanism for implementing clinical research protocols
and applying new approaches for diagnosis and management of vascular
disease; and

o  an institutional environment that facilitates the exchange of
information and educational evaluation techniques concerning anew
diagnostic, therapeutic, and preventive measures in vascular disease.

The objectives of this Vascular Disease Academic Award are therefore:

1.  To stimulate the development and coordination of clinical,
educational, and research programs in Schools of Medicine or Osteopathy
directed toward enhancement of diagnostic and therapeutic skills in the
clinical management of patients with a wide variety of vascular

2.  To promote, where appropriate, professional development of the
awardee so that he/she can serve as the focal point for
multidisciplinary interactions promoting effectiveness in clinical
care, teaching, and research in the field of vascular medicine; and

3.  To enable the grantee institution to continue clinical,
educational, and research programs in vascular medicine after the award
is concluded.

A variety of approaches will be needed to achieve these objectives.
Effective approaches will vary with the needs of each institution and
might include:

o  coordination of faculty and staff to integrate both the basic and
clinical aspects of vascular disease into an interdisciplinary program
with improved diagnostic and therapeutic strategies and common
educational and research goals;

o  organization of an interdepartmental vascular consultation service
and outpatient clinic for initial and follow-up evaluation of patients
with vascular disease;

o  development and application of prophylactic approaches to patients
with vascular disease and its complications;

o  upgrading of laboratory support systems by the institution to
provide the latest in diagnosis and management of patients with
vascular disease;

o  provision of formal and informal postgraduate education including
seminars in vascular disease;

o  establishment of out-reach programs from the tertiary center to the
practicing physician in communities of all sizes;

o  establishment of a "hotline" information center for both physicians
and patients who have questions about vascular disease;

o  integrated training of research fellows, house staff, nurses, and
support staff in modern aspects of vascular medicine; and

o  provision of short-term (e.g., summer or part-time) research
experiences in ongoing basic and clinical research programs in areas
related to vascular diseases.


The Award may provide funds for:

o  Salary for the awardee - not to exceed $62,500 plus fringe benefits
for 50 percent effort; levels of effort at less than 50 percent, to a
minimum acceptable for this Award of 25 percent, should be accompanied
by a commensurate level of reduction in the salary request.  Salary
requests must not exceed actual institutional salary rates.

o  The awardee may devote up to a total of 100 percent effort as an
Academic Awardee and as principal or participating investigator on any
other NIH-supported grant(s) or contract(s) and may receive
remuneration from such grant(s) or contract(s) accordingly.

An example of an investigator who receives the Academic Award at a
level of effort of 25 percent, who wishes to devote 60 percent of
effort to Federally-sponsored research, and whose institutional salary
is $130,000 is the following:

Academic Award          25 percent effort      $ 31,250

Other Federally supported
 grants and contracts  60 percent effort       $ 75,000

Total salary from Federal sources              $106,250

(Based on the current ceiling of $125,000: $125,000 x 0.6)

Salary contribution from grantee's
      institution                              $ 23,750

Total salary                                   $130,000

o  part-time salaries - may be allowable for support of staff, e.g.,
physicians who are co-investigators, educational consultants with
expertise in curriculum development or evaluation strategies, physician
assistants, or nurse coordinators.  Salaries for a limited number of
students to augment their vascular disease learning experiences during
the summer or an elective quarter of the academic year may be allowed.
This might include, for example, support for a student to participate
in a research program focused on some aspect of vascular disease;

o  travel - to enable the awardee to develop clinical and educational
skills and to meet with other awardees to exchange ideas;

o  supplies - necessary to conduct the proposed program;

o  equipment - it is expected that equipment will be available to the
candidate and is not normally allowed for this award;

o  consultant fees - for a limited number of experts in the area of
vascular disease, medical education, or program evaluation; and

o  fringe benefits and applicable indirect costs as described in
"Instructions for Preparing Applications."

Awards are not to include funds for research fellowships.  Applicants
are advised to consult NHLBI staff listed below during the preparation
of the application.



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 new policy results from
the NIH Revitalization Act of 1993 (Section 492B of Public Law 103-43)
and supersedes and strengthens the previous policies (Concerning the
Inclusion of Women in Study Populations, and Concerning the Inclusion
of Minorities in Study Populations) which have been in effect since
1990.  The new policy contains some new provisions that are
substantially different from the 1990 policies.

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 9, 1994 (F 59 11151), and reprinted in the
NIH GUIDE FOR GRANTS AND CONTRACTS of March 18, 1994, Volume 23, Number

Investigators may obtain copies from these sources or from the program
staff or contact persons listed below.  Program staff may also provide
additional relevant information concerning the policy.


Prospective applicants are asked to submit, by November 30, 1994, a
letter of intent, countersigned by the applicant's Department Chairman,
Dean of the School of Medicine or Osteopathy, and Director of the
Hospital(s).  It should include a descriptive title of the proposed
research, the name address, and telephone number of the Principal
Investigator, the identities of other key personnel and participating
institutions, and the number and title of the RFA in response to which
the application may be submitted.  Although a letter of intent is not
required, is not binding, and does not enter into the review of
subsequent applications, it assists the NHLBI staff to estimate the
potential review workload and to avoid conflict of interest in the

The letter of intent is to be sent to:

C. James Scheirer, Ph.D.
Division of Extramural Affairs
National Heart, Lung, and Blood Institute
Westwood Building, Room 557
Bethesda, MD  20892


Applications for the Vascular Disease Academic Award must be received
by January 12, 1995, by the National Institutes of Health for review by
the National Heart, Lung, and Blood Advisory Council on June 1-2, 1995.
The requested start date for funding should be July 1, 1995.

Applications are to be submitted on the research grant application form
PHS 398 (rev. 9/91).  The form is available in an applicant
institution's office of sponsored research and from the Office of
Grants Information, Division of Research Grants, National Institutes of
Health, 5333 Westwood Avenue, Room 449, Bethesda, MD 20892, telephone
301/710-0267.  Specific instructions for preparing an Academic Award
application are available from the individuals listed under INQUIRIES.

The RFA label available in the PHS 398 (rev. 9/91) 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
the review.  In addition, "RFA:  HL-94-015 Vascular Disease Academic
Award" must be typed on Line 2a of the face page of the application
form and the "YES" box must be marked.

Applicants are expected to conform to the 25 page limit as directed in
the application kit (PHS 398).  Appendices containing supporting
materials may be submitted with the application, but may not be used to
circumvent this requirement.  Exceptions to this page limit must be
explicitly granted by the scientific review administrator.

Send or deliver an original completed application and three signed,
exact photocopies to:

Division of Research Grants
Westwood Building, Room 240
National Institutes of Health
Bethesda, MD  20892**

At the same time, applicants must also send two additional copies of
the application to Dr. James Scheirer at the address listed under


Upon receipt, applications will be reviewed by NIH staff for
completeness and for responsiveness by the NHLBI.  Incomplete
applications will be returned to the applicant without further
consideration.  If NHLBI staff find that the application is not
responsive to the RFA, it will be returned without further

Applications that are complete and responsive to the RFA will be
evaluated for scientific and technical merit by an appropriate peer
review group convened by the NHLBI in accordance with the review
criteria stated below.  As part of the initial merit review, a process
(triage) may be used by the initial review group in which applications
will be determined to be competitive or non-competitive based on their
scientific merit relative to other applications received in response to
the RFA.  Applications judged to be competitive will be discussed and
be assigned a priority score, and will also receive a second level of
review by the National Heart, Lung, and Blood Advisory Council.
Applications determined to be non-competitive will be withdrawn from
further consideration and the principal investigator and the official
signing for the applicant organization will be promptly notified.

The review criteria for a Vascular Disease Academic Award will include
assessment of both the sponsoring institution and the candidate and
will be based on the Eligibility Requirements and Research Objectives
as outlined in this RFA.  It is anticipated that no applicant
interviews will be held.


The anticipated award date is July 1, 1995.  Awards will be made
according to priority score, availability of funds, and programmatic


Written and telephone inquiries concerning this RFA are encouraged.
The opportunity to clarify and issues or questions from potential
applicants is welcome.  Special supplemental instructions for
preparation of Academic Award applications can be obtained by
contacting one of the individuals indicated below.

Direct inquiries regarding programmatic issues to:

Carol H. Letendre, Ph.D.
Division of Blood Diseases and Resources
National Heart, Lung, and Blood Institute
Federal Building, Room 516
Bethesda, MD  20892
Telephone:  (301) 496-8966

David M. Robinson, Ph.D.
Division of Heart and Vascular Diseases
National Heart, Lung, and Blood Institute
Federal Building, Room 416
Bethesda, MD  20892
Telephone:  (301) 496-5656

Carol E. Vreim, Ph.D.
Division of Lung Diseases
National Heart, Lung, and Blood Institute
Westwood Building, Room 6A16
Bethesda, MD  20892
Telephone:  (301) 594-7430

Questions regarding fiscal matters may be addressed to:

Mrs. Marie A. Willett
Division of Extramural Affairs
National Heart, Lung, and Blood Institute
Westwood Building, Room 4A12
Bethesda, MD  20892
Telephone:  (301) 594-7434


This program is described in the Catalog of Federal Domestic Assistance
No. 93.838.  Awards are made under authorization of the Public Health
Service Act, Title IV, Part A (Public Law 78-410, as amended by Public
Law 99-158, 42 USC 2241 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.

The Public Health Service (PHS) strongly encourages all grant
recipients to provide a smoke-free workplace and promote the non-use of
all tobacco products.  This is consistent with the PHS mission to
protect and advance the physical and mental health of the American


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