Vol. 18, No. 16, May 5, 1989 DATED ANNOUNCEMENTS (RFPs AND RFAs) ENDOPHTHALMITIS VITRECTOMY STUDY (EVS): PARTICIPATING CLINICS (RFA) ........ 1 National Eye Institute (84/186) Index: EYE ONGOING PROGRAM ANNOUNCEMENTS REHABILITATION AND AGING: BIOMEDICAL AND PSYCHOSOCIAL PERSPECTIVES ......... 2 National Institute on Aging (192/426) Index: AGING CLINICAL AND EPIDEMIOLOGICAL RESEARCH ON LYME DISEASE .....(429/584)......... 5 National Institute of Arthritis and Musculoskeletal and Skin Diseases Index: ARTHRITIS, MUSCULOSKELETAL AND SKIN DISEASES THE ETIOLOGY AND IMPACT OF ATROPHIC GASTRITIS AND HYPOCHLORHYDRIA IN ADVANCING AGE ..........................................(587/792)......... 7 National Institute in Aging National Institute of Diabetes and Digestive and Kidney Diseases Index: AGING, DIABETES, DIGESTIVE AND KIDNEY DISEASES SPECIAL INFORMATION KEYWORD THESAURUS .........................................(801/1356)........10 Division of Research Grants Index: KEYWORD THESAURUS DATED ANNOUNCEMENTS (RFPs AND RFAs) ENDOPHTHALMITIS VITRECTOMY STUDY (EVS): PARTICIPATING CLINICS RFA AVAILABLE: 89-EY-01 P.T. 34; K.W. 0715100, 075500 National Eye Institute Application Receipt Date: July 10, 1989 PURPOSE The National Eye Institute (NEI) invites applications for cooperative agreements to support participating clinics in the Endophthalmitis Vitrectomy Study, a multicenter clinical trial investigating the treatment of endophthalmitis. The NEI estimates that approximately 10-12 clinical centers will be needed in order to meet patient recruitment goals in a timely fashion. Awards to the Chairman, Coordinating Center, and Reading Center will be made in July 1989. BACKGROUND INFORMATION Approximately 70 percent of cases of endophthalmitis occur as a direct result of intraocular surgery. The incidence of endophthalmitis occurring after cataract surgery has been generally reported to be in the range of 1 to 4 per 1000 cases. Of specimens obtained from inside the eyes of patients that appear to have bacterial endophthalmitis, approximately 75 percent are culture positive. The actual incidence of bacterial infection may be higher since some causative organisms are difficult to culture or may have been improperly cultured. Little information is available on what can be done to decrease the incidence of infection. RESEARCH GOALS AND SCOPE The Endophthalmitis Vitrectomy Study (EVS) is a multicenter, randomized clinical trial designed to compare two plans for the initial treatment of postoperative bacterial endophthalmitis. Several clinical centers will cooperate in enrolling 420 eyes. Eyes will be randomized to one of two initial treatment groups: 1. (PPV Group) This group will have immediate pars plana vitrectomy, with culture of anterior chamber and vitreous specimens, and injection of intravitreal antibiotics. In this group, the vitreous will be retapped and antibiotics reinjected in eyes found to be doing poorly at 36-60 hours. 2. (IOAB Group) This group will have immediate anterior chamber and vitreous tap/biopsy for culture and intravitreal injection of antibiotics. In this group, initial vitrectomy will be delayed for 36-60 hours and will be performed only on eyes doing poorly. In addition, all patients will be randomized to receive or not receive intravenous antibiotics. The primary study endpoints will be visual acuity and clarity of ocular media. Initial endpoint assessment will be made at 3 months and will represent results after "initial" treatment. After this visit, the physician will have an opportunity for up to 6 months to perform procedures to clear late residual media opacification. Final endpoint assessment will occur at 9 months. MECHANISM OF SUPPORT Awards will be made as cooperative agreements. These awards entail substantial ongoing interaction between the awardee and NEI staff during performance of the project and will be subject to the same administrative requirements pertaining to all assistance awards of the U.S. Public Health Service. It is expected that approximately 10-12 awards will be made as a result of this competition. Awards will be made for project periods of four years. The present RFA is for a one-time competition only. Vol. 18, No. 16, May 5, 1989 - Page 1 APPLICATION PROCEDURES All applications submitted in response to this RFA will be reviewed for scientific and technical merit by an ad hoc initial review group that will be convened by the Review and Special Projects Officer, NEI. Applications must be received by July 10, 1989. Submit applications using Grant Application Form PHS 398, revised 9/86. To identify the application as a response to this RFA, check "YES" on item 2 of the application face page and enter "Endophthalmitis Vitrectomy Study: Clinical Center, RFA 89-EY-01". The RFA label available in the application kit must be affixed to the bottom of the face page. 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. All inquires and requests for the full text of this RFA should be directed to: Dr. Richard L. Mowery, Chief Collaborative Clinical Research Branch National Eye Institute Building 31, Room 6A49 9000 Rockville Pike Bethesda, Maryland 20892 Telephone: (301) 496-5983 No letter of intent is required. ONGOING PROGRAM ANNOUNCEMENTS REHABILITATION AND AGING: BIOMEDICAL AND PSYCHOSOCIAL PERSPECTIVES P.T. 34, CC; K.W. 0710010, 0404000, 0415001, 0415003, 0740070, 0710030 National Institute on Aging INTRODUCTION Rehabilitation is both a philosophy and a set of techniques designed to restore an individual's impaired functioning, or to maintain this functioning at the highest possible level. Recently both the theory and the practices of rehabilitation that have been developed primarily for younger disabled persons have begun to be applied to the challenging problems of older people. A combined medical and psychosocial approach to restoring, preserving, and enhancing performance and function in older people is seen as both essential and feasible. The purpose of this program announcement is to encourage research and research training on the need for and practice of rehabilitation interventions targeted at older persons with a wide range of physical and cognitive disabilities resulting either from disuse, disorders or injuries of the musculoskeletal, cardiovascular or other physiological systems. Further research is needed on biomedical, social and behavioral aspects of rehabilitation as well as the combined application of geriatric and psychosocial strategies. This announcement covers rehabilitation of both newly developed and long-established disabilities in older persons. GOALS AND SCOPE The main goal of this announcement is to encourage research on the application of rehabilitation technology and approaches toward the chronic physical and cognitive problems of many older individuals. The announcement is stimulated by the fact that medical rehabilitation has traditionally emphasized the treatment of younger individuals with acute or chronic disabilities while largely neglecting the chronic disabilities afflicting many older persons. Unlike treatment for acute conditions which may result in rapid recovery, rehabilitation for chronic conditions is often slow and based on a succession of small goals, often requiring prolonged life-style changes. The techniques that have been developed by rehabilitation professionals hold great potential for counteracting the spiraling debilitation that frequently accompanies chronic disuse and disease in older persons. However, it is important to specify how aging processes influence the outcomes of disabilities and the successful (or unsuccessful) responses to particular rehabilitation strategies. A multidisciplinary approach is encouraged involving the collaboration of rehabilitation professionals (e.g. physiatrists, orthopedists, rheumatologists, neurologists, psychologists, Vol. 18, No. 16, May 5, 1989 - Page 2 physical therapists, occupational therapists, bioengineers, nurses, social workers and vocational rehabilitation specialists) with geriatricians and with biological, social and behavioral scientists with expertise in aging. SPECIFIC TOPICS The NIA invites qualified researchers to submit proposals for research and research training in all areas of rehabilitation as it relates to the health, functioning, independence and quality of life of older persons. The following are illustrative of specific areas of interest; however, applications need not be limited to the topics listed below. o Epidemiologic studies on physical disabilities among older persons in relation to needs for rehabilitation services; methods of forecasting needs for rehabilitation services; economics and costs of rehabilitation for disabled older persons. o Development of assessment instruments to measure functional abilities at all levels of disability; determination of energy and biomechanical requirements for normal daily functions in older persons. o Effects of chronic disease conditions or combinations of conditions in older persons on possibilities for rehabilitation; in particular, effects of osteoarthritis on rehabilitation potential and design of rehabilitation regimens for the older osteoarthritic patient. o Development and assessment of methods of memory rehabilitation. Methods for stalling deterioration and promoting function in Alzheimer's disease are of special interest. o Potential of rehabilitation techniques for improving functional status of frail older persons in the community or in nursing homes; rehabilitation programs to overcome deconditioning in older persons hospitalized for acute illness and in nursing home residents. o Effects of endocrine, metabolic, muscular, neurologic and other physiologic factors on potential for restoration and maintenance of function in older persons, e.g. responsiveness of muscle to growth factors. o Analysis of everyday problems associated with aging-related sensory, cognitive, and perceptual-motor impairments, and the identification of specific interventions. The use of microcomputers either as sources of information or prompts, or as teaching instruments. o Improved regimens for rehabilitation of stroke and hip fracture for older persons; efficacy of cardiac and pulmonary rehabilitation techniques for older persons; rehabilitation regimens for older persons with peripheral vascular disease. o Improved prosthetic, assistive or apparel devices for older persons with functional deficits including balance and gait disorders; the fitting of hearing aids, the implantation of cochlear prostheses, and the use of tactile and other sensory aids; development and testing of a noise-attenuating hearing aid; acceptability of such devices. o Effects of drugs widely prescribed to older persons on physical and cognitive capacities and rehabilitation potential; nutritional factors affecting risk of disability and potential for nutritional contributions to the rehabilitation of frail older persons. o Clinical trials of therapeutic strategies for sensorineural disorders of smell and taste, such as use of flavor enhancers, special textures and configurations in food. o Impact of age and other biomedical and psychosocial factors on the onset of disability, determination of entry into rehabilitation programs and the success of the program; factors influencing whether older people return to work or continue their involvement in other productive behaviors. o Rehabilitation attitudes, behaviors, and interactions of patients, families, and rehabilitation professionals; strategies for Vol. 18, No. 16, May 5, 1989 - Page 3 increasing patient/family/health professional involvement in the rehabilitation process. o Strategies for sustaining long-term compliance to rehabilitation protocols; role of motivation and sense of personal control in rehabilitation; relationship of depression and mood to rehabilitation outcomes; effect of lifestyle and gender on outcomes for rehabilitation. o Social factors predicting recovery from, or adjustment to, acute or chronic disabilities; perceptions and definitions of causes, consequences and treatment for disability in later life; antecedents and consequences of different coping styles for dealing with chronic disabilities. APPLICATION AND REVIEW PROCEDURES The primary mechanisms for support of this program are: * Research Grants (R01) * First Independent Research Support and Transition (FIRST) Awards (R29) * Career grants, which include: Research Career Development award (K04) Clinical Investigator award (K08) * Training grants (T32) * Fellowships (F32, F33) To expedite the application's routing within NIH, under item 2 on the PHS-398 ("Response to Specific Program Announcement") on the face page of the application, type: "NIA: REHABILITATION AND AGING: BIOMEDICAL AND PSYCHOSOCIAL PERSPECTIVES". In assigning applications to NIA or other Institutes, accepted referral guidelines will be followed. Research project grant (R01 and R29) applications, fellowships (F32, F33) and research career development awards (K04) will be reviewed for scientific and technical merit by an appropriate study section in the Division of Research Grants. All other applications will be reviewed by an appropriate institute review group. Secondary review will be by the appropriate national advisory council. There are no set-aside funds for these applications. Applications compete on the basis of scientific merit with all other applications before the institute. The review criteria are the traditional considerations underlying scientific merit. Researchers considering an application in response to this announcement are encouraged to discuss their project, and the range of grant mechanisms available, with NIA staff in advance of formal submission. This can be done through either a telephone conversation or a brief letter giving the descriptive title of the proposed project and identifying the principal investigator and, when known, other key participants. The regular research project grant application form (PHS 398 Rev. 9/86) should be used for all of the award types except for the Fellowships (F32, F33) for which form 416-1 (Rev. 7/88) should be used. Application forms are available at the applicant's institutional business office or from: Office of Grants Inquiries Division of Research Grants Westwood Building, Room 449 National Institutes of Health Bethesda, Maryland 20892 Telephone: (301) 496-7441 Mail the completed application (with 6 copies) to: Division of Research Grants Westwood Building, Room 240 National Institutes of Health Bethesda, Maryland 20892** Vol. 18, No. 16, May 5, 1989 - Page 4 Receipt dates for the Research Project Grant, Career Grant, and the FIRST award applications are February 1, June 1, and October 1; those for Training Grant and Fellowship applications are January 10, May 10, and September 10. Correspondence and inquiries should be directed to: Richard Weindruch, Ph.D. Geriatrics Branch National Institute on Aging Building 31, Room 5C27 Bethesda, Maryland 20892 Telephone: (301) 496-1033 Marcia Ory, Ph.D., M.P.H. Behavioral and Social Research Program National Institute on Aging Building 31, Room 5C32 Bethesda, Maryland 20892 Telephone: (301) 496-3136 Teresa Sluss Radebaugh, Sc.D. Neuroscience and Neuropsychology of Aging Program National Institute on Aging Building 31, Room 5C35 Bethesda, Maryland 20892 Telephone: (301) 496-9350 CLINICAL AND EPIDEMIOLOGICAL RESEARCH ON LYME DISEASE P.T. 34; K.W. 0785035, 0785055, 0715125, 0715010 National Institute of Arthritis and Musculoskeletal and Skin Diseases I. PURPOSE The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) invites applications for grants to conduct clinical and epidemiological research on Lyme disease (Lyme borreliosis). II. BACKGROUND Lyme disease is a spirochetal disease, usually transmitted by the bite of a tick, most often by a nymphal Ixodes dammini, when they are prevalent in the Spring. It has become the most common tick-borne illness in the United States. In 1988, about 5,000 new cases of Lyme disease were reported to the Center for Disease Control by 43 states. While this represents a considerable increase over the 2,800 cases reported by 35 states in 1986, the true incidence of new cases is probably several times larger due to considerable underreporting. Lyme disease was initially called Lyme arthritis when it was first described in the United States in 1976. Soon it was recognized that the condition has both early and late manifestations that involve the skin and the joints, as well as the nervous and cardiovascular systems. It has now been recognized that one or another of the components of the illness has been observed in Europe over the last century. The first manifestation of Lyme disease is an erythematous skin rash that expands from the site of the tick bite. This lesion, manifested by central clearing and presenting a target-like appearance, is called erythema migrans (formerly erythema chronicum migrans). It is often associated with a flu-like syndrome. Subsequently, a variety of acute and/or chronic signs and symptoms may appear involving the skin and the musculoskeletal, cardiovascular and nervous systems. The responsible spirochete, Borrelia burgdorferi, discovered in 1981, has been identified in most tissues and organs of infected hosts. The clinical picture of Lyme disease, as with other spirochetal diseases, seem to have early, middle and late stages. Lyme disease appears to be responsive to treatment with antibiotics, such as penicillin, erythromycin and the tetracyclines, especially when given early in the course of the illness. Whether or not early antibiotic treatment prevents progression to the late stages of Lyme disease is unclear. The case definition of Lyme disease has been a problem for both clinicians and epidemiologists studying this condition. The diagnosis of Lyme disease is usually made following the observation of erythema migrans subsequent to a tick bite in an endemic area. In non-endemic areas, supporting serologic Vol. 18, No. 16, May 5, 1989 - Page 5 evidence (presence of elevated antibody titers to B. burgdorferi) is sought. The sero-diagnosis of Lyme disease is currently fraught with difficulties. There are high percentages of false-negative and false-positive results. Detectable sero-conversion does not appear to occur until several weeks after the infecting tick bite; not all individuals develop detectable antibodies or typical illness. Some people appear to be particularly susceptible to developing the late manifestations of Lyme disease. It has been suggested that immunogenetic determinants may play a role in the development of the persistent arthritis associated with Lyme disease. There is also evidence of overdiagnosis of Lyme disease, especially in endemic areas. III. RESEARCH OBJECTIVES AND SCOPE There are many research opportunities to address clinical and epidemiological questions surrounding Lyme disease. The goal of this Program Announcement is to encourage research proposals that address the following questions and other avenues of appropriate investigation. o What are the early and late manifestations of Lyme disease with respect to cutaneous, rheumatic, neurologic, and cardiac complications? o Are other organ systems involved? o Are there discrete stages of Lyme disease? o What are the optimal classification criteria for Lyme disease for: a) clinical research; and b) epidemiologic investigations? o What are the prevalence and incidence rates: a) across the United States; and b) around the world? o Is Lyme disease spreading or just being increasingly recognized? o Does Lyme disease vary geographically? If so, what are the reasons for the variation? Are there different seasonal patterns in various climates? o What are the risk factors for Lyme disease: a) age b) sex c) race d) occupational factors e) recreational factors? f) others? IV. MECHANISMS OF SUPPORT AND REVIEW PROCEDURE Applications considered appropriate responses to this Program Announcement are the traditional research project grant (R0l, R29), the Small Business Innovation Research grant (R43) and the postdoctoral fellowship (F32). The specific application forms and kits required in applying for these grants and fellowships are available in the business or grants and contracts offices of most academic and research institutions or may be obtained from: Office of Grants Inquiries Division of Research Grants National Institutes of Health Westwood Building, Room 449 Bethesda, Maryland 20892 Telephone: (301) 496-7441 Applications in response to this announcement will be reviewed in competition with other applications and in accordance with the usual National Institutes of Health (NIH) peer review procedures. The initial review for scientific and technical merit will be made by an appropriate review group of the Division of Research Grants, NIH. Funding decisions will be based upon relative scientific merit, program relevance, and the availability of appropriated funds. V. APPLICATION PROCEDURE Applications will be accepted in accordance with the usual receipt dates for the the different funding mechanisms mentioned in Section IV above. Vol. 18, No. 16, May 5, 1989 - Page 6 On the first (face) page, item 2 of the application, the word "Yes" should be checked and the phrase "CLINICAL AND EPIDEMIOLOGICAL RESEARCH ON LYME DISEASE" should be typed in the space provided. The original and six copies of the application should be sent or delivered to: Application Receipt Office Division of Research Grants National Institutes of Health Westwood Building, Room 240 Bethesda, Maryland 20892** VI. STAFF CONTACT Investigators with specific questions are encouraged to contact: Steven J. Hausman, Ph.D. Deputy Director, Extramural Program National Institute of Arthritis and Musculoskeletal and Skin Diseases National Institutes of Health Westwood Building, Room 403 Bethesda, Maryland 20892 Telephone: (301) 496-7495 THE ETIOLOGY AND IMPACT OF ATROPHIC GASTRITIS AND HYPOCHLORHYDRIA IN ADVANCING AGE P.T. 34, CC; K.W. 0715085, 0785055, 0411005, 0710095, 0710100, 0715035 National Institute on Aging National Institute of Diabetes and Digestive and Kidney Diseases BACKGROUND Hypochlorhydria, or reduced production of stomach acid, is most commonly attributed to atrophic gastritis. The prevalence of both atrophic gastritis of the fundic gland and hypochlorhydria are known to increase with advancing age and occur about equally in men and women. Though relatively few prevalence studies have been conducted in free-living, healthy populations, evidence indicates that atrophic gastritis and accompanying hypochlorhydria may occur in 20 to 30 percent of the older population. Two histological types of gastritis have been identified: 1) type A which spares the antrum and may be related to autoimmune factors and pernicious anemia, and 2) type B (or nonspecific) antral gastritis with patchy acute and chronic inflammation of the body of the stomach. Hyperplasia of the mucosal cells of the stomach are common in type B atrophic gastritis patients and may be associated with malignant changes (especially in type B). Despite these observations very little is known about the etiology of atrophic gastritis. Hypochlorhydria predisposes to bacterial colonization of the small intestine, specifically by campylobacter pylori and nontyphoid salmonelloses. In some instances, the infections themselves may also cause hypochlorhydria. Other exogeneous factors may also affect stomach pH including low pH foods, fatty acids, and volatile fatty acids produced by gut bacteria. The production and concentration of a number of gastrointestinal hormones and peptides change in response to hypochlorhydria. The amount of somatostatin and pepsinogen decreases while gastrin concentrations increase. The absolute numbers of IgG, IgM and IgA producing cells also appear to increase in the presence of reduced hydrogen-ion concentrations. Each of these substances has been proposed as a clinical indicator of atrophic gastritis. The ratio of pepsinogen I to pepsinogen II has shown promise as a non-invasive screening tool for prevalence studies. Hypochlorhydria is known to decrease the absorption and utilization of several essential nutrients. An increased pH decreases the solubility of zinc, copper, nickel, manganese, iron and calcium. Recent studies show that except for citrate salts, the absorption of calcium contained in food is affected far less by reduced stomach acid than are calcium supplements, especially calcium carbonate. Some investigators now think that the decrease in calcium absorption due to hypochlorhydria may adversely affect bone metabolism in susceptible persons. In addition, a rise in stomach pH in conjunction with a decrease in pepsin may encourage the formation of complexes such as the zinc-amino acid complex which decreases the bioavailability of zinc. Vol. 18, No. 16, May 5, 1989 - Page 7 Hypochlorhydria also compromises folate and vitamin B12 status. Vitamin B12 depletion and/or loss of intrinsic factor result in pernicious anemia. Patients with this disease usually have circulating intrinsic factor antibody and are at higher risk for other autoimmune diseases. However, the presence of intrinsic factor antibody does not always indicate a B12 deficiency. Although atrophic gastritis decreases the bioavailibility of folate, higher than usual folate levels are seen in some patients. These higher levels may be related to an accumulation of 5-methyl tetrahydrofolate in serum due to a vitamin B12 deficiency and/or greater folate synthesis by intestinal flora resulting from bacterial overgrowth secondary to hypochlorhydria. Atrophic gastritis is the most strongly associated risk factor for stomach cancer. An increase in stomach pH may enhance the formation of carcinogenic nitrosamines and metaplasia of stomach tissue. It is also of note that incidence of ulcers, with high gastric acidity, is inversely related to stomach cancer. The absorption of drugs may also be reduced by changes in gastric pH. Conversely, drugs such as omeprazol cause hypochlorhydria. GOALS AND SCOPE While it is evident that atrophic gastritis and hypochlorhydria can impair the absorption of nutrients and drugs, there is insufficient evidence to judge how much of an impact they make on the health of older persons. The goal of this announcement is to encourage research concerning the incidence, etiology, and clinical significance of these conditions. Since most studies of hypochlorhydria and atrophic gastritis to date have used animal models or clinic populations, the National Institute on Aging (NIA) and the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) are particularly interested in epidemiological studies of the distribution and health impact of hypochlorhydria and atrophic gastritis in the U.S. population, especially in the oldest age groups. These studies should include standardized case definitions geared to measurable end points. They should also employ sensitive and specific screening tools that correlate well with comprehensive histologic examinations. Research is also solicited on the causes and interactions of hypochlorhydria and atrophic gastritis among older persons and their influence on: gut hormones and peptides, hyperplasia of stomach cells, gastric emptying and bacterial overgrowth. More information is needed on the mechanisms that result in decreased absorption of nutrients and drugs, and what role interactions of nutrients, foods, and bacteria play in these processes. This research offers a unique opportunity for interdisciplinary collaboration. The NIA and NIDDK encourage integrated proposals from gerontologists, geriatricians, gastroenterologists, nutritionists, epidemiologists and basic scientists. The NIH urges applicants for grants to give added attention (where feasible and appropriate) to the inclusion of minority groups and/or women in the study populations for research. SPECIFIC OBJECTIVES The NIA and NIDDK seek applications to test hypotheses and elucidate mechanisms including, but not limited to, the following general areas: Studies on the clinical significance and health impact of hypochlorhydria in older persons, including prevalence and incidence and associated morbidity. Because some morbid effects may only develop after many years, longitudinal as well as cross-sectional studies are encouraged. Classification of the forms of chronic atrophic gastritis in older persons and determination of their major risk factors and causal mechanisms: genetic, infectious, autoimmune, environmental and/or other. Determination of the role of the intestinal bacterial overgrowth syndrome in the development of macro- and micronutrient depletion in the elderly, including the effects on folate, vitamin B12, calcium, trace metals, and lipids. Also studies of the affects of bacterial overgrowth on the intestinal mucosa. Identification of the effects of atrophic gastritis and hypochlorhydria on absorption and other age-related factors affecting gastrointestinal absorption of nutrients. Vol. 18, No. 16, May 5, 1989 - Page 8 Clarification of the role of hypochlorhydria in altering the action of drugs in the gastrointestinal lumen and drug absorption. Study of the premalignant characteristics of the stomach in chronic atrophic gastritis and specifically determination of the relationship of cellular and proliferative changes in the stomach to the development of gastric cancer. MECHANISMS OF SUPPORT The primary mechanisms of support for this program are: Research Project Grant (RO1) Program Project Award (P01) (contact NIA prior to submission) First Award (R29) Career Awards, which include: Special Emphasis Research Career Award (K01) in Nutritional and Metabolic Factors in Aging Research Career Development Award (K04) Clinical Investigator Award (K08) Academic Award (K08) REVIEW PROCEDURES Applications will be assigned according to NIH referral guidelines and will be evaluated in accordance with the usual NIH peer review procedures, based on scientific merit. Following study section review, the applications will be evaluated by the appropriate National Advisory Council. Awards will be based on available funds. METHOD OF APPLYING Applications should be submitted on the PHS form 398 (revised 9/86). Application deadlines are February 1, June 1, and October 1. Under Item 2 - Response to Specific Program Announcement, enter: Etiology and Impact of Atrophic Gastritis and Hypochlorhydria. If your institution does not have NIH research grant application kits, copies may be obtained by writing: Office of Grants Inquiries Division of Research Grants National Institutes of Health Bethesda, Maryland 20892 Telephone: (301) 496-7441 Forward the original plus 6 copies of the completed application to: Division of Research Grants National Institutes of Health Westwood Building, Room 240 Bethesda, Maryland 20892** INQUIRIES AND CORRESPONDENCE Potential applicants interested in obtaining further information may contact: Ann W. Sorenson, Ph.D. Director, Nutrition and Gastroenterology Program National Institute on Aging Building 3l, Room 5C27 Bethesda, Maryland 20892 Telephone: (301) 496-1033 or Frank A. Hamilton, M.D., M.P.H. Program Director, Gastrointestinal Neuroendocrinology and Mobility Division of Digestive Diseases and Nutrition National Institute of Diabetes and Digestive and Kidney Diseases Westwood Building, Room 3A15 Bethesda, Maryland 20892 Telephone: (301) 496-7821 Vol. 18, No. 16, May 5, 1989 - Page 9 KEYWORD THESAURUS TERMS FOR USE IN THE NIH GUIDE HEALTH AND SAFETY/MEDICAL SCIENCES/BIOMEDICAL (A Major Section of the national Keyword Thesaurus) "+" signifies NIH additions since 9/88 Revision 0705000 ANATOMICAL SYSTEMS/SITES 0705005 Bone Marrow 0705010 Brain 0705015 Cardiovascular System 0705020 Connective Tissue 0705025 Digestive System 0705030 Endocrine System 0705035 Fetus 0705040 Immune System 0705045 Lymphatic System 0705050 Musculoskeletal System 0705055 Nervous System 0705060 Placenta 0705065 Respiratory System 0705070 Sensory System 0705075 Urogenital System 0706000 BIOMEDICAL ENGINEERING 0735005 Automated Clinical Analysis* 0706010 Bioelectric Phenomena 0706020 Clinical Engineering 0706030 Medical/Diagnostic Imaging 0706040 Physiological Controls and System 0710000 DISCIPLINES/FIELDS, MEDICAL/BIOMED 0710005 Adolescent Health 0710010 Aging/Gerontology 1002001 Anatomy* 1002052 Animal Development* 0201013 Animal Diseases/Pathology* 0201016 Animal Genetics/Breeding* 0201018 Animal Physiology/Morphology* 0401001 Anthropology, Cultural/Social* 1004015 Artificial Intelligence/Cybernetic 1002003 Bacteriology* 0404000 Behavioral/Social Studies/Service 0414015 Behavioral/Experimental Psychology 0710013 Biochemical Engineering 1003002 Biochemistry* 1003015 Biochemistry, Carbohydrates* 1003016 Biochemistry, Lipids* 1003017 Biochemistry, Nucleic Acid* 1003018 Biochemistry, Proteins* 0710015 Bioengineering 1002000 Biological Sciences* 1215015 Biology, Behavioral* 1002004 Biology, Cellular* 1002006 Biology, Developmental/Evolution 1002008 Biology, Molecular* 1002009 Biology Radiation* 0710020 Biomechanics 0710030 Biomedical Research, Multidiscipl 1002012 Biometry* 1013004 Biophysics* 0710033 Biosystematics 0710035 Biotechnology 1002013 Botany* 1003019 Catalysis/Kinetics* 1003003 Chemical Dynamics* 1013020 Chemical Physics* 1003006 Chemical Synthesis* 1003008 Chemistry, Analytical* 0710040 Chemistry, Clinical 1003012 Chemistry, Organic* 1003014 Chemistry, Physical* 0414004 Clinical Psychology* 1004000 Computer Science* 1002015 Cytology* 0413001 Demography* 0414006 Developmental Psychology* 0710045 Drug Metabolism 1002016 Ecology* 0414007 Educational Psychology* 0500000 Education* 0710050 Electrophysiology 1002017 Embryology* 0710055 Enzymology 1002019 Genetics* 1002021 Histology* 1002053 Human Development* 0710060 Immunochemistry 0710065 Immunogenetics 0710070 Immunology 0710075 Immunopathology 1004017 Information Science/Systems* 0410000 Linguistics/Philology* 0901026 Management Sciences* 0710080 Medicinal Chemistry 0607010 Microelectronics* 1002027 Microbiology* 0413003 Migration* 1002058 Molecular Genetics* 1002028 Mutagenics* 1002029 Mycology* 0710085 Neurophysiology 1002030 Neuroscience* 0710090 Nuclear Medicine 0710095 Nutrition/Dietetics 1013017 Optics* 1002032 Parasitology* 0710100 Pharmacology 0710130 Pharmacy 0710103 Photobiology 0414011 Physiological Psychology* 1002040 Plant Sciences* 1002041 Plant Virology* 1009013 Polymer Science* 0413004 Population Biology* 0414012 Psychobiology* 0414020 Psychodynamics* 0414000 Psychology* 0710105 Psychopathology 1013026 Radiation Physics* 0710110 Reproductive Endocrinology 0710115 Reproductive Physiology 0414014 Social Psychology* 0417000 Sociology* 0710120 Speech Pathology 1010013 Statistics* 1003022 Surface Chemistry* 1007009 Toxicology* 0710125 Transplantation Immunology 1002045 Viral Studies (Virology)* 1002047 Zoology* 0715000 DISEASES/MEDICAL PROBLEMS 0715005 Accidents 0404001 Addiction* 0715006 Adverse Effects 0715008 AIDS 0404003 Alcohol/Alcoholism* 0715010 Arthritis 0715013 Asthma 0715015 Autoimmunity 0715020 Behavioral Medicine 0715030 Birth/Congenital Defects 0715032 Blood Diseases 0715033 Burns 0715035 Cancer/Carcinogenesis 0715040 Cardiovascular Diseases 0715041 Caries 0715042 Cerebrovascular Disorders 0715043 Chronic Fatigue 0715045 Communicable Diseases 0715050 Communicative Disorders, Hearing 0715055 Communicative Disorders, Speech 0715060 Convulsive Disorders 0715044 Death/Mortality 0715070 Death, Dying, and Physical Needs 0715072 Depression 0715075 Diabetes 0715080 Diabetic Retinopathy 0715085 Digestive Diseases & Disorders 0404009 Drugs/Drug Abuse* 0715090 Dyslexia 0715095 Emotional/Mental Health 0715100 Eye Diseases 0715103 Fungal Diseases+ 0715105 Hyperplasia 0715110 Hypersensitivity 0715115 Hypertension 0715120 Immune System Disorders 0715026 Inflammation 0715125 Infectious Diseases/Agents 0715027 Injury 0715129 Mental Disorders 0715130 Mental Retardation 0715135 Metabolic Diseases 0715136 Muscle Disorders 0715137 Neonatal Disorders 0715138 Neurological Disorders 0715140 Neuromuscular Disorders 0715145 Obesity 0715148 Oral Diseases 0715149 Orphan/Rare Diseases+ 0715150 Pain 0715155 Perinatal Disorders 0715157 Periodontal Diseases 0715160 Pregnancy Disorders 0715162 Psychosis 0715165 Pulmonary Diseases 0715167 Reproductive Disorders 0715170 Rheumatic Diseases 0715175 Safety 0715177 Schizophrenia 0715180 Senile Dementia 0715182 Sexually Transmitted Diseases 0715185 Skin Diseases 0715187 Sleep Disorders 0404019 Smoking Behavior 0715190 Stillbirth 0715195 Stress 0715200 Stroke 0715205 Sudden Infant Death Syndrome 0404020 Suicide 0715210 Trauma 0715215 Tumor Immunology 0715220 Venereal Diseases 0404023 Violent Behavior* 0720000 EDUCATION/INSTRUCTION 0502002 Alcohol Education* 0720005 Biomedical Research Training 0503007 Computer Aided Instruction* 0502009 Dental Health Education* 0502011 Drug Education* 0502000 Educational Instruction Programs* 0507002 Emotionally Disturbed, Education* 0507004 Handicapped Education* 0502017 Health and Safety Education* 0503016 Instruction Materials & Practices 0720010 Learning Disorders+ 0503018 Learning Motivation* 0507005 Learning Disabled Education* 0502024 Medical Education* 0502027 Nursing Education* 0502028 Nutrition Education* 0502045 Pharmacy Education* 0725000 ENVIRONMENT 1007005 Air Pollution* 1007001 Environmental Biology* 1007002 Environmental Chemistry* 0725005 Environmental Health 1007003 Environmental Effects* 0725010 Health & Safety Standards, Environ 0725015 Health, Radiation Effects 1007006 Land Pollution* 0725020 Occupational Health and Safety 0725025 Poison Control 0715175 Safety* 1007008 Water Pollution* 0730000 HEALTH CARE 0730005 Child/Maternal Health 0730010 Family Health/Planning/Safety 0730015 Folk Medicine 0408006 Health Care Economics* 0730020 Health Care Administration 0730025 Health Facilities Studies 0730030 Health Insurance 0730035 Health Maintenance Organizations 0730040 Health Manpower/Professions 0730045 Health Records 0730050 Health Services Delivery 0730055 Hospices 0730060 Nursing Homes 0730065 Patient Care and Education 0730070 Public Health 0730080 Vital Statistics 0735000 INSTRUMENTS/INSTRUMENTATION/DEVICE 0735005 Automated Clinical Analysis 1004002 Computer Aided Design* 1004004 Computer Graphics* 1004005 Computer Modeling* 1004008 Computer Storage & Retrieval* 1013038 Electron Microscopy* 0735015 Instrumentation, Medical 0740000 Intervention, Agents for 1002024 Instrumentation, Biological* 1014001 Instrumentation, Scientific* 1004020 Library Automation* 0706030 Medical/Diagnostic Imaging* 1013039 Microscopy* 1004022 Pattern Recognition* 1005020 Remote Sensing* 1013034 Spectroscopy* 0607023 Telemetry* 0607024 Ultrasonic Technology* 0740000 INTERVENTION, AGENTS FOR 0740005 Antibiotics 0740010 Anticonvulsants 0740011 Antisera 0740012 Antivirals 0740013 Biofeedback 0740015 Biological Response Modifiers 0740018 Chemopreventive Agents 0740020 Chemotherapeutic Agents 0740021 Dosage Forms+ 0740023 Immune Enhancers 0740025 Pharmaceuticals 0740030 Prosthetic Device, Hearing 0740035 Prosthetic Device, Heart 0740040 Prosthetic Device, Kidney 0740045 Prosthetic Device, Limbs 0740050 Prosthetic Device, Neural 0740055 Prosthetic Device, Pancreas 0740060 Prosthetic Device, Speech 0740065 Prosthetic Device, Vision 0740070 Prosthetic Devices (General) 0740075 Vaccine 0745000 INTERVENTION, TYPES OF 0745003 Chemoprevention 0745005 Chemotherapy 0745010 Dental Health & Hygiene 0745015 Detoxification 0745020 Diagnosis, Medical 0745025 Dialysis 0745027 Disease Prevention+ 0745030 Exercise 0745032 Gene Therapy+ 0745035 Health Promotion 0745037 Hyperthermia 0745040 Immunosuppression 0745045 Immunotherapy 0745047 Neural Stimulation 0745050 Preventive Dentistry 0745055 Preventive Medicine 0745060 Psychotherapy 0745062 Radiotherapy 0415001 Rehabilitation/Therapy, Emotional 0415002 Rehabilitation/Therapy, Occupation 0415003 Rehabilitation/Therapy, Physical 0745065 Transplantation of Organs 0745070 Treatment, Medical+ 0750000 MATERIALS/PRODUCTS 0750005 Biomaterials 0750010 Blood/Blood Products/Transfusions 0750015 Breast Milk 0750020 Contraceptives 0202001 Food Additives* 1009007 Materials Composite* 1009008 Materials, Polymeric* 0750025 Natural Products 0755000 METHODOLOGIES/PROCEDURES 0755055 Abortion (Induced) 0755005 Amniocentesis 0755010 Bioassay 0755015 Clinical Trial 1002049 Cloning of Cells* 1002050 Cloning of Organisms* 0755018 Data Management/Analysis+ 0755020 Disease Model 0755025 Drug Design 0755030 Etiology 0202002 Food Analysis* 0755035 Gene Cloning 0755040 Genetic Manipulation 0755041 Molecular Cloning+ 0755042 Molecular Probes 0755045 Nucleic Acid Sequencing 0413000 Population Studies* 0755050 Preservation of Organs/Tissue 0414013 Psychometrics* 0411005 Risk Factors/Analysis* 0404021 Surveys & Survey Research* 0755060 Screening of Drugs/Agents 0760000 MOLECULAR/CELLULAR ENTITIES 0760002 Biochemical Markers 0760003 Biological Markers 0760004 Cell Components+ 0760005 Collagen 0760010 Endorphins 0760013 Enzymes 0760015 Gene Products 0760020 Growth Factors 0760025 Hormones 1215018 Human Genome* 0760030 Hybridomas 0760035 Inhibitors 0760040 Lipoproteins 0760042 Lymphocytes 0760045 Monoclonal Antibodies 0760050 Neurotransmitters 0760053 Nucleic Acids 0760055 Opiates 0760060 Peptides 0760065 Prostaglandins 0760070 Proteins and Macromolecules 0760075 Receptors 0760080 Recombinant DNA 0760085 Steroids 0765000 NATURAL PROCESSES 1002048 Biodegradation* 0765005 Bioenergetics 0765010 Biosynthesis 0765012 Drug Resistance+ 0765015 Gene Regulation 0765020 Metabolism 0765022 Metabolism, Amino Acid 0765025 Metabolism, Lipid 0765030 Metabolism, Mineral 0765031 Metabolism, Nucleotide 0765032 Metabolism, Protein 0765033 Pathogenesis 0765035 Pathophysiology 1002042 Reproduction* 0765040 Wound Healing 0770000 PATIENT/VOLUNTEER CLASSIFICATION 0403001 Adolescents* 0403019 Adults* 0770005 Children (Patients) 0770010 Handicapped/Disabled 0770015 Hospitalized Patient 0403020 Infants* 0770020 Outpatient 0403017 Volunteers* 0775000 PHYSIOLOGICAL/DEVELOPMENT PROCESS 0404004 Child Psychology/Development* 0414005 Cognitive Development/Process* 0775005 Hearing 0413002 Human Reproduction/Fertility* 0775010 Lactation 0410001 Language Acquisition & Development 1002059 Morphogenesis* 0775015 Physical Growth/Retardation 1002034 Physiological Processes* 0775020 Pregnancy 0775025 Prenatal Factors 0775030 Teratology 1002044 Physiology, Vertebrate* 1002046 Vision* 0780000 RESEARCH RESOURCES 1002002 Animal Breed. & Facil., Scientific 0780005 Biological Resources 0780010 Biomed. Research Resources, Other 0780015 Cell Lines 0780017 Chemicals/Materials+ 0780018 Computing Resources+ 1103002 Research Libraries* 0780020 Tissue Culture 0780025 Organs+ 0780030 Registries+ 1014002 SCIENCE PLANNING/POLICY* 0201011 Animal Care* 1014003 Animal Research Policy* 0783015 Health Planning/Policy 0783005 Human Subjects Policy 0783010 Medical Ethics* 1014004 Ethics/Values in Science & Technol 1014006 Grants Administration/Policy+ 0785000 SPECIALTIES OF MEDICAL AND ALLIED 0785005 Aerospace Biomedicine 0785010 Allergy 0785015 Anesthesiology 0785020 Audiology 0785025 Cardiology 0785030 Chiropractic 0785035 Clinical Medicine, General 0785040 Dentistry 0785045 Dermatology 0785050 Endocrinology 0785055 Epidemiology 0785060 Gastroenterology 0785065 Health, Allied Fields 0785070 Hematology 0785075 Medical Genetics 0785080 Medicine, Family Practice 0785085 Medicine, Internal 0785090 Midwifery 0785095 Nephrology 0785100 Neuroanatomy 0785105 Neuroendocrinology 0785110 Neurology 0785115 Neuropharmacology 0785120 Neurosurgery 0785125 Nurse Practitioner 0785130 Nursing 0785135 Obstetrics - Gynecology 0785140 Oncology 0785145 Ophthalmology 0785150 Optometry 0785155 Orthopedics 0785160 Otorhinolaryngology 0785165 Pathology 0785170 Pediatrics 0785175 Periodontics 0785180 Physical Medicine and Rehab. 0785185 Psychiatry 0785190 Radiology 0785195 Rheumatology 0785200 Serology 0785205 Sports Medicine 0785210 Surgery 0785215 Tropical Medicine 0785220 Urology 0201058 Veterinary Medicine* 0790000 STRUCTURE/FUNCTION 1003001 Atomic & Molecular Structure* 0790005 Membrane Structure/Function 0790010 Nucleic Acid Structure/Function 0790015 Ultrastructure 0795000 TECH. ASSESSMENT/TRANSFER/OUTREACH 0403004 Community/Outreach Programs* 0795003 Disease Control+ 1016002 Technology Assessment* 1016003 Technology Planning/Policy* 1016004 Technology Transfer* 0795005 Therapy Evaluation ------------------------------------------------------------------------------ KEYWORD THESAURUS PROGRAM TYPES AND TARGET GROUPS Program Types Target Group/Beneficiary 01 Analytical Services AA Children and Youth 02 Capital Construction BB Disadvantaged (Economically) 04 Centers: Research/Demonstration/Service CC Elderly 05 Challenge/Fund Raising DD Handicapped/Disabled 06 Consulting/Visiting Personnel EE Migrant 08 Cultural Outreach FF Minorities 12 Demonstration FA Minorities, Alaskans 14 Development (Institutional/Departmental) FB Minorities, Asians 16 Dissemination of Information FC Minorities, Blacks 18 Equipment/Instrumentation FD Minorities, Hispanics 20 Exhibitions, Collections, Performances FE Minorities, Native Americans 22 Fellowships GG Refugees 23 Financial Aid (Scholarships & Loans) HH Veterans 24 General Operating Support II Women 25 Instruction/Curriculum Development 26 International Exchange Programs 28 Materials Acquisition (Books, Tapes, etc.) 30 Preservation/Restoration 32 Publication 34 Research 36 Resources (Shared/Non-Acquisition) 38 Service Delivery Programs 40 Student Support (Incl. Dissertation Support) 42 Symposiums, Conferences, Workshops, Institutes, Seminars 44 Training/Traineeships/Apprenticeships/Internships 46 Translations/Editing 48 Travel For additional information, or suggestions, about using the Keyword Thesaurus, please contact Dr. John C. James, Division of Research Grants, Westwood Room 109 National Institutes of Health, Bethesda, MD 20892 (BITNET address: ZNS@NIHCU). Several abbreviated forms of RFAs for current, as well as historical, searching and other more complete indexes based on the Thesaurus have been prepared and can be mailed or transmitted electronically to those who are interested. The complete Keyword Thesaurus, keyed to major federal or state government agencies that sponsor a variety of scientific, educational, and cultural programs, may be obtained from: Rodman and Associates, 1950 Stemmons Freeway, Dallas, TX 75207 Tel. 214-746-5345