martes, 28 de abril de 2015

NCCIH’s FY 2014 Funding Priorities and Research Focus | NCCIH

NCCIH’s FY 2014 Funding Priorities and Research Focus | NCCIH

National Center for Complementary and Integrative Health (NCCIH)



NCCIH’s FY 2014 Funding Priorities and Research Focus

The National Center for Complementary and Integrative Health (NCCIH) at the National Institutes of Health (NIH) funds and conducts research to help answer important scientific and public health questions about complementary health approaches. NCCIH works to determine what is promising, what helps and why, what doesn’t work, and what is safe.

NCCIH’s Funding Priorities

This graphic depicts two priority areas covering what NCCIH studies[1]: mind and body practices (acupuncture, massage, meditatino, spinal manipulation, deep-breathing exercises, hypnotherapy, qi gong, tai chi, etc.) and natural products (herbs, botanicals, dietary supplements, probiotics, etc.).  Six important questions about complementary health approaches include: pain; interactions and safety; biological effects; mechanisms; healthy behaviors; and symptoms.

Setting Funding Priorities

The field of complementary and integrative health encompasses a large and diverse array of practices, products, and disciplines. To best focus its research investment, NCCIH adopted a strategic plan in 2011 that outlined a framework of factors for setting research priorities including
  • Scientific promise
  • Amenability to rigorous scientific study
  • Potential to change health practices
  • Relationship to real world use.

NCCIH’s Grant Portfolio

NCCIH’s most recent grants demonstrate a diverse and robust research portfolio designed to address significant public health needs. They reflect the framework for priority setting in the Center's current strategic plan.

NCCIH’s Budget at NIH

NIH is the Nation’s medical research agency and is the largest source of funding for medical research in the world. In FY 2014, the entire NIH budget was approximately $30.1 billion. NCCIH’s overall budget that same year was about $124 million, or 0.4 percent of the total NIH budget (46KB PDF) [NIH].

NCCIH’s Key Areas of Research

Pain Research: Employing Mind and Body Approaches

A major focus for NCCIH is research related to chronic pain, an enormous public health problem that affects 100 million Americans and costs up to $635 billion per year in treatments and lost productivity.2Current drug-based treatment options are only partially effective and can have serious side effects. Thus, NCCIH’s research exploring nonpharmacologic approaches, such as mind and body practices, that may help in treating chronic pain is a top priority. In fact, about 30 percent of our cumulative portfolio supports research on pain. We are playing a key role not only in determining the value of nonpharmacologic approaches and self-management strategies, but also in understanding the neuroscience of pain.
  • NCCIH plays a leadership role in the NIH Pain Consortium and our scientific staff is co-chairing the steering committee for the NIH Task Force on Research Standards for Chronic Low Back Pain, which developed recommendations for core measures of back pain for use in clinical research to help advance the field. In April 2014, the Task Force published results from its work, including a full reportwith recommendations on standards, an executive summary, journal articles, and a uniform minimal dataset.
  • NCCIH is involved in an ongoing initiative to stimulate research on the use of complementary approaches for pain and symptom management in military and veteran populations. In September 2014, NCCIH, the Department of Veterans Affairs, and the National Institute on Drug Abuseannounced funding of 13 research projects, totaling approximately $21.7 million over 5 years, to explore nondrug approaches to managing pain and related health conditions in U.S. military personnel, veterans, and their families.
  • NCCIH’s intramural research program, based on the NIH campus, focuses on the role of the brain in perceiving, modifying, and managing pain, with the long-term goal of improving clinical management of chronic pain through the integration of pharmacological and nonpharmacologic approaches. The program is investigating the role of the brain in pain processing and control, and how factors such as emotion, attention, environment, and genetics affect pain perception. Complementary health practices often used to control pain, such as meditation and yoga, are also being studied.

Natural Product Research: Investigating Safety and Mechanisms

Research on the safety of natural products is another major priority for NCCIH, given the widespread availability and use of these products by the public. An area of particular need is better scientific information about interactions between natural products and drugs. Well-documented examples include interactions involving St. John’s wort or grapefruit juice. Each has an ability to decrease or increase the blood concentration of various prescription medications. In October 2014, NCCIH announced a plan to fund a Center of Excellence for Natural Product Drug Interaction Research to provide leadership in the study of these important interactions.

Recent Research From NCCIH

A young African-American woman meditates next to a pool.
According to a recent study, mindfulness-based stress reduction, a type of meditation, may improve quality of life and decrease perceived stress in people with ulcerative colitis. 3
An older african american woman.
A special issue of the journal Nutrition was devoted entirely to research conducted at a Botanical Research Center partly funded by NCCIH. Topics covered in the special issue included new approaches to enhancing the bioavailability of substances from plants, how traditional herbal remedies can be screened to evaluate their possible medicinal properties, and various aspects of the herbsArtemisia and St. John’s wort.4
Doctor speaking to elderly man.
An NCCIH-funded systematic review of 14 clinical trials suggested that yoga and meditation-based therapies may help people quit smoking. In various studies, participation in these mind and body practices was linked to increased rates of abstinence from smoking, reductions in cigarette cravings or the desire to smoke, or decreases in the number of cigarettes smoked per day.5
A doctor performing acupuncture on a man's back.
A study of the human microbiome suggested that some bacteria that live in our bodies manufacture antibiotics, and that these substances may be capable of fighting infection. The research was conducted using techniques that identify the DNA blueprint for production of microbial natural products—a technique that holds great promise for understanding many aspects of the interactions between microbes and their human hosts.6

Looking Ahead: NCCIH Research in Progress

A doctor prepares a man for insertion into a CAT scan machine.
In 2002, 2007, and 2012, NCCIH funded supplements to the National Health Interview Survey to collect information about Americans’ use of complementary health approaches. Analyses of the 2012 data are in progress, and new insights are emerging about current patterns of use of complementary approaches by adults and children.
Person standing on a weight scale.
With obesity a growing national health crisis and costs mounting to $147 billion a year, can mind and body stress management programs improve outcomes in a workplace-based weight loss program?7
Woman holds her back in pain.
Lower back pain affects 80 percent of Americans at some point in their lives and is a leading form of disability. Researchers are seeking to understand what role nonpharmacologic approaches, such as manipulative and body-based interventions, play in managing symptoms.8

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