1996 — 1997 |
Ironson, Gail H |
P01Activity Code Description: For the support of a broadly based, multidisciplinary, often long-term research program which has a specific major objective or a basic theme. A program project generally involves the organized efforts of relatively large groups, members of which are conducting research projects designed to elucidate the various aspects or components of this objective. Each research project is usually under the leadership of an established investigator. The grant can provide support for certain basic resources used by these groups in the program, including clinical components, the sharing of which facilitates the total research effort. A program project is directed toward a range of problems having a central research focus, in contrast to the usually narrower thrust of the traditional research project. Each project supported through this mechanism should contribute or be directly related to the common theme of the total research effort. These scientifically meritorious projects should demonstrate an essential element of unity and interdependence, i.e., a system of research activities and projects directed toward a well-defined research program goal. |
Core--Data Management and Biostatistics @ University of Miami School of Medicine
The Biostatistics and Data Management Core has been re-designed to provide a high level of statistical and data management support to each of the Program Project's three studies. This core component is affiliated with the Center for the Biopsychosocial Study of AIDS, and makes use of the extensive system development undertaken by that Center over the past five years. The Center is linked with the Behavioral Medicine Research Center (BMRC) in Jackson Medical Towers on the Medical School Campus and with the Behavioral Medicine Building (BMRB) on the Coral Gables Campus through a high speed fiber optics communication network. The specific aims of the Biostatistics and Data Management Core fall into two broad categories. The first category is designed to provide centralized biostatistical and methodological assistance to each of the Project's studies. This assistance includes: (1) supervising all aspects of data analysis; (2) consulting on methodological issues associated with data analysis or data quality control; and, (3) developing new and creative approaches to handling statistical issues and problems. The second category is designed to provide an integrated data management structure for the three Project studies. This structure includes: (1) designing and programming screens for data entry; (2) designing and programming procedures to perform data verification through range checks; (3) designing and programming procedures to properly flag a variety of missing data types; (4) designing and programming routine reports for quality assurance and subject tracking; and, (5) designing procedures to facilitate the transfer of data between the data management system, the mainframe computer systems on the Coral Gables Campus (e.g., for analyses with SAS, BMDP, SPSS, or other specific analysis systems), and individual micro systems (e.g., for analyses with SAS-PC, SPSS-PC, SYSTAT or LIMDEP).
|
0.958 |
1996 — 2000 |
Ironson, Gail H |
R01Activity Code Description: To support a discrete, specified, circumscribed project to be performed by the named investigator(s) in an area representing his or her specific interest and competencies. |
Psychology of Health and Long Survival With Aids @ University of Miami Coral Gables
DESCRIPTION (Applicant's Abstract): In order to determine psychological factors that may be protective of health and/or related to survival in AIDS, this study proposes to compare three groups on psychological measures: 1) long-term survivors of AIDS; 2) the rare HIV positive people who have low CD4 counts (less than or equal to 50) and have always been clinically asymptomatic (asymptomatic low CD4 group; no CDC 1993 category B or C symptoms); and 3) an early "numerical" AIDS group (HIV positive people with CD4 counts between 150-200 at entry to the study who are clinically asymptomatic and have not ever had category C symptoms). Study I compares the groups cross-sectionally in order to discern any psychological differences that the long term survivor group and asymptomatic low CD4 group have, especially as compared with the early numerical AIDS group. Study II follows the early numerical AIDS group longitudinally to determine whether: 1) these psychological characteristics developed as a result of continued survival or asymptomatic status (i.e., the chicken-egg problem); 2) the psychological characteristics predict the development of symptoms and/or death (most of this group are expected to become ill and many to die within 3 years); and 3) the psychological changes precede or are a result of health status changes (related to number 1, also the chicken-egg question). The major psychological variables to be assessed through interview and questionnaire include: coping style, life involvement, communication skills (emotional expression, assertiveness), social support, beliefs (self-efficacy, optimism, fatalism), distress, and approach to health care (doctor-patient relationship, taking responsibility for health, keeping up with medical information, etc.). A model is proposed and will be tested by which the impact of AIDS and stressors may be modulated by resources and individual capacities ("trait" characteristics such as assertiveness, optimism, emotional expression) and behaviors (such as coping, keeping up with medical information) to affect health care, social isolation, depression, and sense of purpose in life and, thus, have an impact on morbidity and longevity. The study will be conducted at two sites, The University of Miami and the University of California at Los Angeles, to ensure an adequate number of the unusual people who comprise Groups 1 and 2.
|
0.958 |
1998 — 2002 |
Ironson, Gail H |
P01Activity Code Description: For the support of a broadly based, multidisciplinary, often long-term research program which has a specific major objective or a basic theme. A program project generally involves the organized efforts of relatively large groups, members of which are conducting research projects designed to elucidate the various aspects or components of this objective. Each research project is usually under the leadership of an established investigator. The grant can provide support for certain basic resources used by these groups in the program, including clinical components, the sharing of which facilitates the total research effort. A program project is directed toward a range of problems having a central research focus, in contrast to the usually narrower thrust of the traditional research project. Each project supported through this mechanism should contribute or be directly related to the common theme of the total research effort. These scientifically meritorious projects should demonstrate an essential element of unity and interdependence, i.e., a system of research activities and projects directed toward a well-defined research program goal. |
Cbsm Intervention in Women With Hiv/Aids @ University of Miami Coral Gables
stress management; cognitive behavior therapy; human therapy evaluation; female; AIDS therapy; HIV infections; health behavior; quality of life; psychological stressor; antiviral agents; psychoneuroimmunology; psychological adaptation; sex behavior; emotions; physiologic stressor; substance abuse related disorder; behavioral /social science research tag; human subject; clinical research;
|
0.958 |
1999 — 2002 |
Ironson, Gail H |
P50Activity Code Description: To support any part of the full range of research and development from very basic to clinical; may involve ancillary supportive activities such as protracted patient care necessary to the primary research or R&D effort. The spectrum of activities comprises a multidisciplinary attack on a specific disease entity or biomedical problem area. These grants differ from program project grants in that they are usually developed in response to an announcement of the programmatic needs of an Institute or Division and subsequently receive continuous attention from its staff. Centers may also serve as regional or national resources for special research purposes. |
Cbsm Effects in Postadjuvant Breast Cancer Survivors @ University of Miami Coral Gables
Breast cancer survivors encounter many stressors that may resulting in lasting, life-altering psychosocial, behavioral, and physiological sequelae. The stressors encountered throughout the course of the disease include, but are not limited to, disruption of life tasks, changes in social network, treatment-related side effects, financial hardship, and uncertainty about disease recurrence and progression. Certainly, the adverse effects of breast cancer have been well documented, but a growing body of literature reveals that some cancer survivors also report positive growth from their experience. At present, little is known about whether or how these potentially life-altering changes negative and positive can be influenced by psychosocial interventions. That is, how, if all, do psychosocial interventions buffer the negative effects of breast cancer and its treatment? How do such interventions enhance positive growth in survivors? Moreover, how do intervention-related processed influence physiological changes (i.e., in behavior, immune system functioning, and neuroendocrine functioning), which in turn, may increased or reduce the risk of breast cancer recurrence and progression? These questions are the focus of the proposed project. We propose to test the effectiveness of our group-based, cognitive behavioral stress management (CBSM intervention among White, Hispanic, and Black women who have been diagnosed with and treated for primary, early- to middle stage breast cancer (Stages I-III). The proposed project will examine the effects of CBSM on a variety of psychosocial processes (i.e., cognitive appraisals, self-efficacy, social support, and physiological arousal) immediately, 6 months, and 12 months after the intervention. Specifically, we expect intervention-related changes in these processes to foster a more rapid return to pre-diagnostic levels of quality of life, as well as enhance a sense of positive growth. We will also examine how intervention-related changes in these processes are associated with changes in health behaviors, immune system functioning, and reproductive hormone levels, which themselves may be related to disease recurrence and progression.
|
0.958 |
2003 — 2007 |
Ironson, Gail H |
R01Activity Code Description: To support a discrete, specified, circumscribed project to be performed by the named investigator(s) in an area representing his or her specific interest and competencies. |
Efficacy of An Emotional Disclosure Intervention in Hiv @ University of Miami Coral Gables
DESCRIPTION (provided by applicant): With the advent of potent combination antiretroviral therapy, persons with HIV or AIDS now face the prospect of living longer with this disease as a chronic condition. In addition to the distress of having this chronic illness, persons with HIV infection have been shown to have high rates of sexual and physical abuse, other life stresses and traumas, and depression. Our previous research and others have documented the detrimental impact of stress, depression, lack of social support and avoidant coping strategies on immune changes and disease progression in HIV infection. Studies in normal adults and those with chronic illness have further documented improvements in medical symptoms and cellular immune response among those who disclose traumatic events through writing. Thus, the goal of the current study is to test the efficacy of emotional disclosure through writing in patients with HIV infection. We will compare two interventions, that is, emotional disclosure through writing about traumatic experiences (experimental) to writing about emotionally neutral topics (control) on the following: HIV disease progression, health status, psychosocial variables, and health behavior. Our study sample of HIV infected men and women will be recruited from South Florida. We will obtain completed data on 200 patients who will be equally randomized to one of two groups: The intervention group (emotional disclosure/processing) will write for four sessions about their stressors. The control group will write for four sessions on trivial topics. All patients will be assessed at baseline, each writing session and at one, six and twelve months post intervention. We hypothesize that subjects who write about traumatic experiences will have greater reductions in HIV RNA viral load, HIV and non-HIV somatic symptoms, urinary and salivary cortisol, psychological distress, passive and self-blaming coping strategies, and risky sexual behaviors, and greater increases in CD4 T-lymphocytes, health related quality of life, self-esteem, well-being, social support, and medication adherence at the followup assessments. Among patients in the emotional disclosure intervention, we will further determine how the efficacy of the intervention varies as a function of race, gender, socio-economic status (SES), abuse/trauma history, recent stressful events, psychological symptoms, coping strategies, social support, and quality of emotional disclosure and depth processing. Confirmation of our hypotheses will have important clinical implications for the treatment of HIV infected men and women in that it will provide a rationale for the use of stress reduction through writing as an adjunct to psychological and biological based treatments.
|
0.958 |
2003 — 2007 |
Ironson, Gail H |
R01Activity Code Description: To support a discrete, specified, circumscribed project to be performed by the named investigator(s) in an area representing his or her specific interest and competencies. |
Psychobiological Processes and Health in Hiv/Aids @ University of Miami Coral Gables
[unreadable] DESCRIPTION (provided by applicant): Despite the recent advances in the treatment for HIV/AIDS there remains a significant amount of variability in disease course that may be accounted for by psychosocial and psychobiological processes. This grant requests funding to determine the impact of both psychosocial (stress, coping and related variables) and biological factors (cortisol, Cytotoxic T lymphocytes, and NK#) on disease progression and mortality in HIV/AIDS. The study includes an HIV positive sample that has been followed for 3.5 years: This proposal would add new subjects comparable to the existing cohort and new biological measures and extend follow-up for 5 to 8 years total. At entry our subjects' CD4 counts were between 150 and 500, and they had never had serious AIDS symptoms (Category C). Particular strengths of the study that give this cohort the ability to contribute new information above other cohorts studied to date include (1) Our sample has diverse groups (28% women; 36% African American; 30% Hispanic). (2) The entire study has been conducted during the time protease inhibitors have been available, which makes issues such as adherence of paramount importance. Antiretroviral levels and genotyping will be added to ensure accuracy of adherence measures and to measure the development of resistance. (3) We have been able to quantify some relatively unexplored variables such as the doctor-patient relationship, spirituality, and emotional processing. (4) We are one of the first studies to be able to predict viral load. (5) We include several biological measures that could be investigated as both predictors and as mediators of disease progression. While we have strong cross sectional and longitudinal data showing that psychosocial variables are related to CD4 and viral load changes (controlling for relevant variables), the current long-term longitudinal design should allow us to relate these psychosocial variables to the development of serious AIDS symptoms and mortality. These analyses confirm that we have identified appropriate variables for expanding explorations of psychobiological links. Major strengths of the proposed study are that it will allow us to: (a) predict critical disease end points (e.g. Category C symptoms) and mortality; and (b) relate important psychosocial variables (e.g. stress, depression coping, adherence, doctor-patient relationship) to biological processes and disease endpoints. [unreadable] [unreadable]
|
0.958 |