1985 |
Berk, Michael A |
R03Activity Code Description: To provide research support specifically limited in time and amount for studies in categorical program areas. Small grants provide flexibility for initiating studies which are generally for preliminary short-term projects and are non-renewable. |
Physical Training &Adrenergic Receptors in Hypertension @ University of Cincinnati
Essential hypertension, accounting for greater than 90% of all hypertension, affects between 15 and 20% of all adults and is a significant risk factor for excess morbidity and mortality due to arteriosclerotic and cerebrovascular disease. Reduction of even mild hypertension has been shown to decrease long-term morbidity and mortality due to vascular disease. Excess sympathetic nervous system activity has been postulated as an etiologic factor in essential hypertension but direct measurement of circulating plasma norepinephrine and epinephrine levels as an indicator of sympathetic dysfunction has been equivocal. Direct studies of adrenergic receptor-effector mechanisms in essential hypertension have been scant but are suggestive of a generalized receptor-effector abnormality in hypertensive subjects. The present study is designed to study the effects of physical training, a modality known to reduce sympathetic activity, on adrenergic-receptor effector mechanisms and their relationship to blood pressure. Beta-2 and alpha-2 adrenergic receptors will be measured on circulating mononuclear leukocytes and platelets, respectively, in untreated hypertensive subjects (n=10) and matched normal controls (n=10) at baseline, after a one-month period with no therapy and after 12 weeks of bicycle ergometer exercise at 60% maximal oxygen consumption for 30 minutes, three times per week. Receptor studies will include standard saturation curves to measure apparent dissociation constant (Kd) and receptor density (Beta max). Beta-2 receptors will be measured with Iodocycopindolol-125, a Beta antagonist, an Alpha-2 receptors with [H-3]-UK-14304, an Alpha-2 agonist. In addition, competition studies will be done in the presence and absence of Gpp(NH)p to determine the percentage of receptors in high and low affinity binding states. Adenylate cyclase activity in response to isoproterenal stimulation (Beta-2) and epinephrine inhibition (Alpha-2) will also be done. It is expected that 1) hypertensive subjects will exhibit altered adrenergic receptor status when compared to normal controls that will correct after physical training and 2) correction of receptor abnormality will be correlated with a decrease in blood pressure.
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0.916 |
2011 — 2014 |
Berk, Michael |
R34Activity Code Description: To provide support for the initial development of a clinical trial or research project, including the establishment of the research team; the development of tools for data management and oversight of the research; the development of a trial design or experimental research designs and other essential elements of the study or project, such as the protocol, recruitment strategies, procedure manuals and collection of feasibility data. |
1/2-a Randomized Trial of Internet-Based Interventions For Bipolar Disorder @ University of Melbourne
DESCRIPTION (provided by applicant): Psychosocial treatments are efficacious adjunctive treatments for persons with bipolar disorder. The use of internet platforms to deliver education and support for psychiatric disorders is increasingly common, but there is limited systematic research on the benefits of such programs. Internet based interventions have the potential to offer unlimited supportive resources with immediate access, minimal cost, convenience and flexibility. MoodSwings 2.0 is the next evolution of an internet-based intervention for individuals with bipolar disorder (www.moodswings.net.au), and is based on a validated face-to-face intervention, the MAPS project, which includes elements of psychosocial interventions including CBT, IPSTRT, psychoeducation, motivational interviewing, problem solving, goal setting, early warning signs and relapse prevention plans. Modules of MoodSwings 2.0 include symptom and disorder information as well as an asynchronous moderated peer discussion board. The program includes many interactive tools to optimize comprehension and retention of module content. MoodSwings 2.0 represents a significant improvement to earlier beta tested versions, with an improved platform, increased user navigation and interactive tools, and additional features designed to facilitate greater interest and interaction with program content. The program is not intended to serve as primary care for individuals with bipolar disorders. The proposed study includes the revision of MoodSwings 2.0, and a 12-month assessment of its use and benefits in patients with bipolar disorder. We propose a 2-site, 3-arm randomized parallel group stepped design (exposure to moderated peer discussion board only, discussion board plus psychoeducation, or discussion board, psychoeducation, and online interactive psychosocial tools). The collaborative sites (Palo Alto, CA and Melbourne, Australia) will enroll 300 participants with SCID-confirmed diagnoses of bipolar disorder I, II, or NOS. Interaction with research staff will occur through phone interviews and email correspondence, as participants will be recruited from any geographic location, providing inclusion criteria are met of a bipolar diagnosis, age 21-65, computer access, and local health care consisting of at least 2 provider visits in the past year and local emergency care. Exclusions are limited to current manic or psychotic symptoms. Utilization of the online MoodSwings 2.0 program is voluntary, and the program captures time spent in each content area over 12 months as an outcome of interest. Outcomes are assessed at quarterly intervals via phone interview with raters blind to group assignment as well as online self report. The primary outcome is the change in depressive symptoms over 12 months, assessing if there is additive benefit to the three components (education, discussion board, and interactive psychosocial tools) on improvement. Exploratory aims include symptoms of elevated mood, health services utilization, evidence of relapse (time to intervention), function, quality of life and medication adherence.
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