Evaluation Of A Rapid Behavioural Treatment For Sleep Onset Insomnia
Funder
National Health and Medical Research Council
Funding Amount
$268,500.00
Summary
Chronic insomnia is a prevalent health problem that affects 5-10% of the population. It is associated with significant physical and mental health problems as well as lowered quality of life. By far the most common treatment for insomnia continues to be sleeping tablets despite the problems of drug dependence, daytime impairment and long term loss of effect. It is also despite the evidence that behavioural therapies are more effective in the long term. In clinical experiments stimulus control the ....Chronic insomnia is a prevalent health problem that affects 5-10% of the population. It is associated with significant physical and mental health problems as well as lowered quality of life. By far the most common treatment for insomnia continues to be sleeping tablets despite the problems of drug dependence, daytime impairment and long term loss of effect. It is also despite the evidence that behavioural therapies are more effective in the long term. In clinical experiments stimulus control therapy (SCT) is consistently the most effective of the behavioural therapies. However, SCT is difficult to carry out over the 4-6 week period necessary for effective treatment. If the treatment process could be shortened, it may increase the number of successful treatments. We have developed a laboratory procedure which includes the effective elements of SCT. These elements include sleep restriction and the experience of one rapid sleep onset each night. Our procedure involves some sleep deprivation and the experience of many (over 40) rapid sleep onsets over just one day. Therefore, it condenses 40 nights of the re-training benefits of SCT into just one day. A preliminary study has shown this procedure to be as effective as normal SCT. However, with no follow-up therapy to the procedure the initial gains tended to diminish with time. Our proposal is to test and extend the possible benefits of this new treatment procedure. We will compare it with the standard SCT as well as combine it with SCT. We feel that the greatest benefit may be to use the laboratory procedure as a kick start to SCT, which will by-pass the most difficult first 2--3 weeks of SCT. This will greatly reduce the time as well as absolutely improve the outcome. In further studies the laboratory procedure may be transferred to the patient s home, thereby further increasing its effectiveness. We feel the proposal will lead to a significant improvement in the non-drug treatment of insomnia.Read moreRead less
Resistant forms of childhood acute lymphoblastic leukaemia (ALL) constitute a leading cause of cancer-related deaths in children. Despite tremendous improvements in therapy, 25-30% of patients still experience a relapse and many of them occur in patients stratified as low risk. Further treatment is often toxic, frequently unsuccessful and carries the risk of significant long-term morbidity. For the design of more appropriate therapy, information on the biology of relapsed ALL is urgently require ....Resistant forms of childhood acute lymphoblastic leukaemia (ALL) constitute a leading cause of cancer-related deaths in children. Despite tremendous improvements in therapy, 25-30% of patients still experience a relapse and many of them occur in patients stratified as low risk. Further treatment is often toxic, frequently unsuccessful and carries the risk of significant long-term morbidity. For the design of more appropriate therapy, information on the biology of relapsed ALL is urgently required. The sequencing of the human genome and advanced screening technology (microarrays) allow the detailed analysis of expression patterns in large numbers of specimens. We propose to study the genetic features of this disease by investigating 28 childhood ALL patients from whom we have stored specimens received at two time points, one at diagnosis and one at relapse. The hypothesis of this study is that relapsed leukaemias display genetic features which are correlated to their resistance to therapy. The specific questions we will be asking are: (1) Which genes are expressed at high levels in leukaemia specimens at the time of relapse while not expressed (or expressed at lower levels) at the time of diagnosis and vice versa? (2) What is the function of differentially expressed genes? (3) Is the pattern of gene expression correlated with resistance to the particular drug therapy used? (4) Is the leukaemia clone at relapse related or unrelated to the clone present at diagnosis, as determined by receptor rearrangement? The expression levels of identified discriminator genes will be confirmed by real-time quantitative polymerase chain reaction (PCR). The quality of this set of specimens makes them particularly suited to achieve the stated goals, providing a unique opportunity to investigate drug resistance in childhood ALL. The data generated will provide the basis for the examination of genes suitable as new therapeutic targets.Read moreRead less
Self-limiting Anti-inflammatory Actions Of Glucocorticoids In Asthma
Funder
National Health and Medical Research Council
Funding Amount
$377,036.00
Summary
Asthma is a disease characterised by excessive narrowing of the airway tubes resulting in difficulty exhaling air from the lungs. Symptoms of asthma include coughing, wheezing, shortness of breath and difficulty in breathing. Asthma affects almost 1 in 5 Australians and is especially prevelant in children. One in every three Australians will suffer from symptoms of asthma at some time in their life and despite current therapy, asthma is responsible for the deaths of more than 700 Australians eve ....Asthma is a disease characterised by excessive narrowing of the airway tubes resulting in difficulty exhaling air from the lungs. Symptoms of asthma include coughing, wheezing, shortness of breath and difficulty in breathing. Asthma affects almost 1 in 5 Australians and is especially prevelant in children. One in every three Australians will suffer from symptoms of asthma at some time in their life and despite current therapy, asthma is responsible for the deaths of more than 700 Australians every year. Airway tubes of asthmatics have more and larger contractile muscle cells lining the tubes. This increase in muscle mass results from chemicals that are released from white blood cells that migrate into the airway tubes during and after asthma attacks. This thickening slows airflow through the airway tubes because the muscle mass bulges into the holes of the tubes and when the muscle shortens the total diameter of the tubes decrease. We have recently shown that steroids used by asthmatics to treat the white blood cell contribution to the disease can reduce the growth of airway muscle. However, when the muscle has been pretreated with factors that are present in the inflamed airway, the anti-growth effects of steroids are prevented. This effect of the steroids is due to reduced production of a substance called prostaglandin E2 which can also reduce the growth of muscle. Thus, whilst steroids may help in treating some of the symptoms of asthma, they may be suboptimal in the treatment of muscle thickening and other aspects of the disease which involve cell division and multiplication. Our specific question in the next phase of this research is whether steroid inhibition of the release of prostaglandins compromises the useful actions of steroids on the growth of the airway tubes. The findings of this proposed study will provide new information on the role of steroids in asthma and may lead to better therapeutic strategies for the treatment of severe asthma.Read moreRead less