Gastrointestinal Biopsychosocial Research Center

描述（由申请人提供）：此R24申请要求基础设施支持，以建立胃肠道生物心理社会（身心）研究中心。研究人员长期以来一直在NIH资助的关于功能性胃肠疾病的病理生理学和治疗的研究，包括肠易激综合征，大便失禁和骨盆底协同失调。这些都是普遍的疾病- 15%的肠易激惹，2-7%的大便失禁，约2%的骨盆底协同失调-大大损害生活质量，并导致每年超过250亿美元的总医疗保健费用。肠易激综合征的病理生理学中心研究主题包括内脏疼痛感知的作用及其通过认知和心理过程的调节，调节内脏疼痛的中枢神经系统机制的神经影像学研究，生殖激素对肠易激综合征的影响，压力的作用，滥用史和其他心理社会因素对临床结果的影响，肠易激综合征通过遗传和社会学习的代际传递，以及肠易激综合征与其他躯体疾病的过度共病。临床试验研究包括评估认知行为疗法、催眠、抗抑郁药、肠易激惹患者教育以及大便失禁和便秘的生物反馈。要求为下列核心提供支助：（1）行政核心。(2)研究核心由研究协调员和全职招聘人员组成。(3)与研究者共同开展多中心研究的机构研究网络（马约诊所、华盛顿大学、多伦多大学）。(4)数据技术核心，提供可扫描的纸质和互联网管理的问卷，用于数据采集的自动电话系统，以及用于跟踪登记和管理多中心研究的互联网软件。(5)生物统计学核心提供生物统计支持和数据管理。(6)种子赠款核心每年为青年研究人员的4个试点项目提供资金。(7)通过中心通讯和网站传播研究成果的教育/传播核心。我们还要求支持招聘一名新的教师，在感染后肠易激惹的专业知识。拟议的中心是大学范围内，包括心理学，精神病学，外科（妇科），神经放射学，牙科和公共卫生学院的调查人员。

DESCRIPTION (provided by applicant): This R24 application requests infrastructure support to establish a Gastrointestinal Biopsychosocial (mind-body) Research Center. The investigators have a longstanding record of NIH-funded research on the pathophysiology and treatment of functional GI disorders including irritable bowel syndrome, fecal incontinence, and pelvic floor dyssynergia. These are prevalent disorders-- 15% for irritable bowel, 2-7% for fecal incontinence, and approximately 2% for pelvic floor dyssynergia--that greatly impair quality of life and result in aggregate health care costs exceeding $25 billion annually. Center research themes on the pathophysiology of irritable bowel include the role of visceral pain perception and its modulation by cognitive and psychological processes, neuroimaging studies of central nervous system mechanisms modulating visceral pain, effects of reproductive hormones on irritable bowel symptoms, the role of stress, abuse history, and other psychosocial factors on clinical outcomes, intergenerational transmission of irritable bowel through heredity and social learning, and excess comorbidity of irritable bowel with other somatic disorders. Clinical trial research includes evaluation of cognitive behavior therapy, hypnosis, antidepressants, and patient education for irritable bowel, and biofeedback for fecal incontinence and constipation. Support is requested for the following cores: (1) Administrative core. (2) Research core consisting of study coordinators and full-time recruiter. (3) Research network of institutions that carry out multicenter studies jointly with the investigators (Mayo Clinic, University of Washington, University of Toronto). (4) Data technology core that provides scannable paper and internet-administered questionnaires, automated telephone systems for data acquisition, and intemet software for tracking enrollment and managing rnulticenter studies. (5) Biometry core providing biostatistical support and data management. (6) Seed grant core providing funding for 4 pilot projects by young investigators annually. (7) Education/ dissemination core to disseminate research findings through a Center newsletter and website. We also request support to recruit a new faculty member with expertise in post-infectious irritable bowel. The proposed Center is university wide and includes investigators from psychology, psychiatry, surgery (gynecology division), neuroradiology, dentistry, and the school of public health.