February 2016

Updates from TRIPLL

The Translational Research Institute on Pain in Later Life (TRIPLL) is an NIH funded Edward R. Roybal Center. Our eNewsletter features recent news, events and funding opportunities related to pain and aging. In this issue we highlight research on abnormal brain morphology in knee osteoarthritis patients, beliefs about comprehensive pain management, and the relationship between neuromuscular impairment and mobility in older adults with or without back pain.
In This Issue
RECENT RESEARCH
Abnormal Subcortical Brain Morphology in Patients with Knee Osteoarthritis

Chronic pain is one of the most prominent symptoms in patients with knee osteoarthritis (KOA). A study from researchers Mao et al. in Frontiers in Aging Neuroscience examined the size of subcortical brain structures between groups of patients with and without knee osteoarthritis. The researchers used high-resolution magnetic resonance imaging to compare the subcortical morphology of 26 patients with KOA to 31 demographically similar, healthy subjects. Additionally, the researchers employed a visual analogue scale to assess pain intensity in their participants. While no correlation was found between pain intensity and the size of subcortical structures, the researchers found that the normalized volume of the bilateral caudate nucleus was significantly smaller in patients with KOA than their healthy counterparts. Additionally, the imaging data suggest that the hippocampus might be smaller in patients with KOA. These results are contrary to results from another imaging study where patients with Rheumatoid Arthritis, also characterized by chronic pain, had larger caudate nuclei than healthy controls. Mao et al. concede that the cross-sectional design of their study does not imply causality and hope that future studies will examine brain morphology of KOA patients over time.

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Patients' perceptions of a chronic pain rehabilitation program; Changing the conversation 

An interdisciplinary approach to pain management that includes pharmacological, biopsychosocial, and behavioral interventions has been shown in past research to be more effective than medication, alone. However, little attention has been paid to patients' attitudes toward this comprehensive approach to chronic pain, which may affect treatment adherence and clinical outcomes. A recent study published in Current Medical Research and Opinion examined how patients enrolled in a comprehensive chronic pain rehabilitation program perceived their treatment. 498 adults (mean age = 49 years) were interviewed using survey measures at admission and discharge. The researchers found that patients' reported pain (both severity and interference) decreased significantly after the program. Eighty-five percent of patients endorsed relaxation skills as the most important pain management skill they learned. Moderating and modifying behavior and engaging in physical interventions like physical therapy, exercise or stretching were also highly endorsed by participants. Interestingly, none of the patients endorsed opioids as one of the most important parts of their treatment. The authors hope these results may be used to facilitate conversations about integrated pain management between patients and providers.

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The Relationship Among Neuromuscular Impairments, Chronic Back Pain, and Mobility in Older Adults

Research addressing chronic back pain in younger adults has shown that certain neuromuscular impairments associated with symptoms of back pain lead to different motor strategies to achieve the same functional task. In order to explore this relationship in an older adult population, Makris et al examined the effects of neuromuscular impairments on mobility in patients with and without back pain in a cross-sectional study of 430 older adults (135 older adults with back pain). Mobility was assessed in the form of gait speed, standing balance, a chair stand task, and basic lower extremity function. Measuring leg strength, velocity, and coordination, as well as knee and ankle range of motion assessed neuromuscular impairment. Makris et al found that trunk extensor muscle endurance, leg strength, and coordination were significantly decreased in older adults with back pain, as compared to those without pain. Additionally, participants with back pain had a slower measured gait speed, chair stand, and worse lower extremity function. From these results, the authors recommend that resistance training rehabilitation programs for older adults with back pain are tailored toward neuromuscular impairments "most prominent among those with back pain to enhance mobility," such as trunk extensor muscle endurance. 

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UPCOMING EVENTS
TRIPLL Work in Progress Seminar

Date:  Friday, March 11, 2016
Time: 12:00 PM - 1:30 PM
Location: Call 212-746-7362
Presenters: Dr. Erin York Cornwell & Dr. Nancy Wells

Monthly TRIPLL Work in Progress (WIP) seminars are primarily devoted to reviewing and critiquing grant proposals prior to submission. Seminars serve as a "mini-study section," where proposals are carefully reviewed in advance by seminar attendees and interdisciplinary feedback is given to the presenter. Presenters circulate their materials one week in advance of the seminar to allow group members to carefully review the work. WIP seminars have helped enhance the grant-writing skills of investigators who have gone on to obtain federal and nonfederal funding. If you are interested in learning more about our WIP Seminars, please contact Zachary Goodman at zsg2001@med.cornell.edu.

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TRIPLL mHealth & Pain Webinar Series: Robert Jamison

Title: mHealth Technology for Management of Pain: Implementation of a Smartphone Pain App and Activity Data Recorder with Chronic Pain Patients "
Presenter: Robert Jamison, Ph.D., Professor, Departments of Anesthesia and Psychiatry, Brigham and Women's Hospital, Harvard Medical School 
Date:  Monday, February 29, 2016
Time 3:00 PM - 4:00 PM

There has been an explosion of mobile devices that have been used to track health data and change the approach to management of chronic diseases. Mobile health technology is the fastest growing sector of the communications industry and smart phones are available for the majority of the population worldwide. mHealth allows for easy, time-effective coverage of patients at a low cost and offers significant opportunities to improve access to health care, contain costs, and improve clinical outcomes. These devices and programs allow data to be transferred to health care professionals and can offer interventions to a greater number of patients than could be seen individually. A critical barrier to incorporation of technology in assessing and delivering behavioral treatments for patients with pain are outcome studies that demonstrate improvement of care with a decrease in healthcare utilization. Dr. Jamison will review the literature on the use of smartphone pain apps, web-based electronic pain assessment programs, text messaging, and activity monitors, to help manage pain patients' conditions remotely and that have the potential to decrease healthcare utilization. He will detail the content, face validity, reliability, usability, expense, and technical issues associated with the use of mHealth technology and describe findings from a year-long study of patients with cancer and noncancer chronic pain who are using a smartphone pain app and an activity monitor. This study was designed to assess whether a smartphone pain app (downloaded for free on Android and iPhone devices) would allow patients and physicians to more easily 1) identify factors exacerbating or relieving pain, 2) modify treatment, and 3) help the individuals understand and control their pain. Initial results demonstrate the benefits of movement monitors and 2-way supportive messaging to improve compliance. Future study opportunities with increased focus on preventative health, remote feedback, and wellness tracking using mHealth technology for persons with pain will be presented.

Click here  to registe r for this  free webinar. 
Aging 2.0 New York: The Human Side of Aging Tech

Date/Time:  6:00PM - 8:30 PM;  Thursday, February 25, 2016
LocationBlueprint Health, 447 Broadway, Floor 2, New York City, New York 10013 

This Aging2.0 speaker event will explore how technology can be complementary to- rather than competitive with- services provided by humans.  Josh Bruno, CEO of Hometeam (caregiving), Gaspard de Dreuzy, CEO of Pager (on-demand doctors), and Jay Parkinson, CEO of Sherpaa (telemedicine), will expand on the importance of human interaction in their respective businesses, and discuss how technology can be used to improve the care experience by making more efficient use of time and resources.

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Cornell University Health Tech Conference

Date/Time: 
12:30 PM - 6:00 PM, March 4, 2016
LocationThe Great Hall at Cooper Union, 7 East 7th Street, New York, NY, 10003

This conference explores current trends and expanding, new market opportunities in the health sector. Many of these opportunities are made possible by advances in technological innovation. Innovators and leaders, ranging from hospitals, research centers, academia, pharmaceuticals, investors, and incubators will present a fascinating, multifaceted view of emerging trends and the future of health and healthcare services made possible utilizing technology. Join us for this deeply engaging and exciting meeting of the minds!

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FUNDING OPPORTUNITIES 
Ruth L. Kirschstein National Research Service Awards for Individual Postdoctoral Fellows (F32)
 
NIH
Funding Amount: Variable
Due Date:
April, August, December
 
The proposed postdoctoral training must be within the broad scope of biomedical, behavioral, or clinical research and must offer an opportunity to enhance the fellow's understanding of the health-related sciences and extend his/her potential for a productive research career. The proposed postdoctoral training must be within the broad scope of biomedical, behavioral, or clinical research and must offer an opportunity to enhance the fellow's understanding of the health-related sciences and extend his/her potential for a productive research career. Fellowship awardees are required to pursue their research training on a full-time basis. Research clinicians must devote full-time to their proposed research training and must restrict clinical duties within their full-time research training experience to activities that are directly related to the research training experience. A Kirschstein-NRSA fellowship (F32) may not be used to support studies leading to the M.D., D.O., D.D.S., D.V.M., or other similar health-professional degrees.

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Minority Medical Faculty Development Program (MMFDP)
 
Robert Wood Johnson Foundation
Funding Amount : Variable
Due Date: 3 PM, March 15, 2016 for online portion of application.

The Harold Amos Medical Faculty Development Program supports basic/biomedical, clinical, dental, nursing, and health services/epidemiology research. The purpose of the AMFDP award is to facilitate the transition of the newly-trained clinician who wishes to develop into an independent investigator. The information requested in the application process is essential for screening as well as for interviewing applicants.

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We welcome your feedback about what you would like included in future eNewsletters. 
Email suggestions and news items to zsg2001@med.cornell.edu.

  

The Translational Research Institute on Pain in Later Life (TRIPLL) is an
NIA funded Edward R. Roybal Center with a focus on persistent pain due to both cancer and non-cancer related causes. TRIPLL is a collaboration between investigators at Weill Cornell Medical College, Cornell University in Ithaca and The Hebrew Home at Riverdale.