Acquisition And Extinction Of Headache-eliciting Properties Of Trigger Factors
Funder
National Health and Medical Research Council
Funding Amount
$91,082.00
Summary
Standard advice in the clinical management of headaches is to counsel headache sufferers to avoid any factors that could trigger a headache. There is a compelling logic to this approach but is there a danger that it amounts to being over-protective in the sense that it encourages headache sufferers to 'cocoon' themselves from situations that could give rise to headaches, ultimately resulting in them losing their ability to cope with such situations. Certainly, avoiding situations that elicit anx ....Standard advice in the clinical management of headaches is to counsel headache sufferers to avoid any factors that could trigger a headache. There is a compelling logic to this approach but is there a danger that it amounts to being over-protective in the sense that it encourages headache sufferers to 'cocoon' themselves from situations that could give rise to headaches, ultimately resulting in them losing their ability to cope with such situations. Certainly, avoiding situations that elicit anxiety leads to a sensitisation process whereby the situations elicit greater anxiety. And the converse is true, exposure to anxiety-eliciting situations results in a desensitisation process whereby the situations elicit less anxiety. Whether avoidance or exposure is more appropriate in the management of headache disorders depends on the processes by which sensitivity to trigger factors is gained and lost. Two studies will be completed that test different models of these processes. The expected outcome of these studies is that they will support the theory that stimuli acquire the capacity to elicit headaches as a function of individuals trying to avoid or escape from any factor that they believe could trigger a headache. This sensitisation process can be reversed by prolonged exposure to headache trigger factors. Such results would suggest that the established practice of counselling headache sufferers to avoid triggers is counterproductive as it may lead to a reduction of headaches in the short-term but may also lead to an insidious sensitisation process that ultimately results in an increase in headaches. Given that headaches are so common and associated with such high direct and indirect costs, changes in clinical management arising from these findings could have major benefits to individuals, families and society.Read moreRead less
Combined Electroacupuncture And Cognitive Behavioural Therapy For Tension-type Headache: A Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$302,068.00
Summary
Tension-type headache (TTH) affects many and the direct and indirect costs are significant. Medications are either not effective long-term or have side-effects. Acupuncture and Cognitive behavioural therapy (CBT) are effective and safe treatments. The combination of acupuncture and CBT could provide a better outcome. We will undertake a rigorous clinical study to evaluate this. This is the first examination of the combination, and will be of significant value to patients and to clinicians.
Trigeminal pain includes such disorders as headache, migraine, trigeminal neuralgia, dental and temporomandibular joint pain. These disorders affect more than 10 % of the population and many of the afflicted get only partial relief from current treatments. Trigeminal pain is conveyed from the head to the brain via primary afferent nerves. Work in the current proposal focuses on transmission of information in the brainstem as well as in the primary afferent nerves. Previously our group has report ....Trigeminal pain includes such disorders as headache, migraine, trigeminal neuralgia, dental and temporomandibular joint pain. These disorders affect more than 10 % of the population and many of the afflicted get only partial relief from current treatments. Trigeminal pain is conveyed from the head to the brain via primary afferent nerves. Work in the current proposal focuses on transmission of information in the brainstem as well as in the primary afferent nerves. Previously our group has reported that adenosine- 5' triphosphate (ATP) causes an increase in excitatory neurotransmission from primary afferent nerves; such an increase has been reported to be painful in previous human and animal studies. Recently we have shown that the ATP induced increase in neurotransmission is dependant on activation of a specific excitatory receptor, the N-methyl D aspartate (NMDA) receptor, which has been widely implicated in other brain functions such as memory, and in disorders such as neuron death following stroke. The chief investigators involved in this application plan to study the role of the ATP receptor and the interaction with NMDA receptors in an inflammatory trigeminal pain model. Electrophysiological, pharmacological and immunohistochemical studies will be performed in order to address the aims of this proposal. A greater understanding of how these receptors modulate neurotransmission in pain pathways will lead to a greater understanding of trigeminal pain and the potential development of new therapeutics.Read moreRead less
The Population Impact Of Human Papillomavirus Vaccination On Circulating Genotypes
Funder
National Health and Medical Research Council
Funding Amount
$249,259.00
Summary
Infection with human papillomavirus (HPV) is very common. Persistent infection can cause abnormal changes to cervical cells as found on Pap smears and if untreated, over time can develop into cervical cancer. Recently, a vaccine was introduced in Australia for women aged 12-26. To monitor the effectiveness of this vaccine, young women aged 18-22 will be asked to self-collect a sample for HPV detection which will determine if HPV types targeted by vaccine are reducing in prevalence.
Optimising Cervical Screening After The Introduction Of HPV Vaccination In Australia: Modelling Of Outcomes
Funder
National Health and Medical Research Council
Funding Amount
$316,089.00
Summary
This research project will aid decision-making about how best to perform cervical screening in Australia after the introduction of vaccination against the human papillomavirus (or HPV). The project will use computer simulation techniques to explore different scenarios for vaccination and screening and to determine the optimal approach. This project involves a group of international collaborators with expertise in a number of areas including cancer epidemiology, screening for cancer, and computer ....This research project will aid decision-making about how best to perform cervical screening in Australia after the introduction of vaccination against the human papillomavirus (or HPV). The project will use computer simulation techniques to explore different scenarios for vaccination and screening and to determine the optimal approach. This project involves a group of international collaborators with expertise in a number of areas including cancer epidemiology, screening for cancer, and computer simulation methods. HPV is the virus responsible for the development of cervical cancer, and clinical trials have demonstrated that HPV vaccines administered to adoloescent girls are very effective at preventing disease that might have led to cancer in the future. However, Australia currently has a very effective Pap smear screening program, and in the first phase after the introduction of vaccination it will be important for women to continue being screened as usual. In the long term, HPV vaccination is expected to reduce the need for Pap smears. The research will involve a very detailed simulation of how HPV is transmitted in the Australian population, and how this will change after vaccination. The simulation will address questions of importance for any future public HPV vaccination program, such as whether males should be vaccinated as well as females. The simulation will also be used to determine the optimal starting age and frequency of Pap smears in the future. The outcomes of the research will be very important for policy-makers. In the long term, this research will ensure that the best recommendations are formulated for the timing and frequency of Pap smears after HPV vaccination is introduced.Read moreRead less
Behavioural Management Of The Triggers Of Recurrent Headache: Avoidance Versus Coping
Funder
National Health and Medical Research Council
Funding Amount
$503,233.00
Summary
The traditional approach to headache management is to advise that the best way to prevent headaches is to avoid the trigger factors. This approach has never been systematically evaluated, however, and it may lead to headache sufferers losing tolerance for the factors that could precipitate a headache. This study will be the first to evaluate the traditional approach, and will also evaluate an innovative approach that includes techniques designed to desensitise people to headache triggers.
Evaluation Of Primary HPV Testing For Cervical Screening In Australia
Funder
National Health and Medical Research Council
Funding Amount
$701,037.00
Summary
The overall aim of the project is to use simulation modelling to perform a detailed evaluation of new approaches to cervical screening in Australia, taking into account the implementation of the National HPV Vaccination Program. The project involves collaboration between Australian researchers and investigators at the National Cancer Institute USA. We will integrate local and international data to lead the world in understanding how cervical screening should best be performed in the context of H ....The overall aim of the project is to use simulation modelling to perform a detailed evaluation of new approaches to cervical screening in Australia, taking into account the implementation of the National HPV Vaccination Program. The project involves collaboration between Australian researchers and investigators at the National Cancer Institute USA. We will integrate local and international data to lead the world in understanding how cervical screening should best be performed in the context of HPV vaccination.Read moreRead less
Perinatal Outcomes Following Treatment For Cervical Dysplasia
Funder
National Health and Medical Research Council
Funding Amount
$98,600.00
Summary
A very high proportion of women in Australia have regular cervical screening ('pap' tests) for early detection of any early abnormal changes of the cervix. Women with abnormalities are referred for further investigation and some go on to have the areas with abnormalities treated either by surgical removal of small amounts of tissue or by other heat or laser treatments of affected areas. Many women having these treatments are of child-bearing age and may not have had children, or may seek to have ....A very high proportion of women in Australia have regular cervical screening ('pap' tests) for early detection of any early abnormal changes of the cervix. Women with abnormalities are referred for further investigation and some go on to have the areas with abnormalities treated either by surgical removal of small amounts of tissue or by other heat or laser treatments of affected areas. Many women having these treatments are of child-bearing age and may not have had children, or may seek to have more children after treatment. There are unanswered questions about the extent to which any or all of these treatments might, by changes to the cervix, lead to preterm birth in any subsequent pregnancy. In the proposed study, records relating to women referred from 1982 to 2000 for assessment and possible treatment of cervical abnormalities at a major hospital will be linked to Victorian birth records from 1983 to 2001. This will allow a comparison of preterm birth in the group of women referred with cervical abnormalities, with preterm births in the Victorian population, and comparing women who do and don't have treatment, taking into account other important factors such as the mother's age, and her previous pregnancies. The information will be of value to women themselves, to gynaecologists and to screening services.Read moreRead less
Effective Immunotherapy For HPV Associated Cervical Cancer Precursor Lesions
Funder
National Health and Medical Research Council
Funding Amount
$482,640.00
Summary
Vaccines to prevent cervical cancer are currently being developed. These will be used to prevent infection with the causal virus, papillomavirus. However, there are very many people world wide who already have papillomavirus infection, which could turn into cancer at any point over the next 30 years. Therefore, there is a need for a vaccine that could be given along with the preventative vaccine, which would treat existing infections. This study addresses the characteristics of the immune respon ....Vaccines to prevent cervical cancer are currently being developed. These will be used to prevent infection with the causal virus, papillomavirus. However, there are very many people world wide who already have papillomavirus infection, which could turn into cancer at any point over the next 30 years. Therefore, there is a need for a vaccine that could be given along with the preventative vaccine, which would treat existing infections. This study addresses the characteristics of the immune response required to treat existing papillomavirus infections, since this is not currently known.Read moreRead less