News from TRIPLL
|Does life course socio-economic position influence chronic disabling pain in older adults? A general population study.|
A recent study published in the European Journal of Public Health sought to determine whether socio-economic status influenced chronic pain prevalence among older adult populations. A 36 item short-form survey was employed to measure the pain interference and socio-economic status of study participants. A total of 11309 individuals (age 65 and older) were sent surveys annually over a 3-year period, and 2533 individuals completed and returned surveys consistently during the course of the study. The authors found a correlation between chronic disabling pain and socioeconomic status in which older adults with lower education and occupational opportunities displayed higher prevalence of disabling pain. The authors state, "persons who started life with a minimum level of education or less and subsequently spent most of their working life in a manual or routine occupation were twice as likely to report pain in later life."
Older adults living with osteoarthritis: examining the relationship of age and gender to medicine use.
Osteoarthritis is a prevalent condition among older adults that can cause severe pain, disability, and discomfort. The Canadian Journal on Aging recently published a study that sought to determine the variations in pain medication use among older adults with osteoarthritis. The authors found that "the pharmacological management of OA - that is, likelihood of use of acetaminophen, NSAIDs, and opioid analgesics - is further differentiated by age and gender, when controlling for severity of OA-related symptoms, co-occurring chronic conditions, self-rated health, patient educational level, social support availability, and access and frequency of contact with a physician." The authors suggest that health care professionals closely monitor the use of non-prescribed acetaminophen, especially among older adults with higher reports of osteoarthritis related pain, as they are more likely to self medicate and abuse pain medications.
Are older adults who volunteer to participate in an exercise study fitter and healthier than non-volunteers? The participation bias of the study population.
A recent study published in the Journal of Physical Activity and Health addressed whether exercise bias existed in exercise- based intervention studies designed for older adults. The authors employed a self-reported questionnaire that was mailed to 1000 older adults of which 535 individuals responded. Of the 535 respondents, 233 agreed to participate in a exercise study offered at the end of the survey. The authors found that the volunteer group consisted of healthier, younger, and fitter individuals in comparison to the 270 individuals who chose not to participate in the exercise study. The study suggests that caution must be used when analyzing the results of an exercise intervention to ensure that participants accurately depict the patient population, and not consist entirely of individuals who exercise more than the average population of older adults.
Undertreatment of pain in older adults: An application of beneficence.
In the most recent edition of Nursing Ethics a study evaluated the role of beneficence in effectively treating pain conditions among older adults. Older adults commonly experience various acute and chronic pain conditions, and often these conditions are underassesed or undertreated. The focus of the study was to determine the efficacy of incorporating Beauchamp and Childress' 3 principals of beneficence into a pain management program. The goal of the program was to improve pain conditions among older adults and educate nurses on their "role as patient advocates in pain management."
TRIPLL Internship for Undergraduate Students
This summer TRIPLL hosted 5 volunteer interns from June-August. The interns worked on two separate TRIPLL projects as well as their own personal research projects. Listed below are brief project summaries provided by each intern.
John Hopkins University
I focused on how social media can be used for pain management in older adults. I worked with Dr. Reid to develop and define the idea. Dr. Reid also introduced me to several researchers who work in health and social media. I consulted with these researchers, and I also spoke with the former national chair of the Arthritis Foundation in order to understand the organization's perspective on the potential of social media for this population. My work involved a review of the literature as well as various websites. I am synthesizing my findings and preparing a draft of a paper with Dr. Reid, which we hope to submit for peer-review publication in the fall.
This summer I focused on the role of mobile health (mHealth) technology as tools that may help to improve pain management among older adults. This work involved a review of existing literature as well as focus groups with older adults to understand that perceived barriers and facilitators to using mHealth devices to monitor pain and report symptoms and outcomes associated with treatment. Focus groups were conducted with older adults drawn from primary care practice as well as seniors attending a senior center in Central Harlem. I analyzed the focus group data along with a first year medical student and am working with the student and Dr. Reid to complete a manuscript that summarizes our primary findings.
For my individual project, I researched methods for managing opiod-induced side effects among older adults with pain conditions. This project involved reviewing existing literature on the topic and talking with experts in the field. I found that opioid analgesics can provide essential pain relief for older adults, but the development of constipation, nausea, sedation, as well as other bothersome side effects (e.g., itching) can negatively impact quality of life and lead to discontinuation of treatment. I also learned that patient education and physician awareness are essential for developing accurate reports of side effects and thorough symptom assessments. During the summer, I developed a database listing all relevant articles on the management of opiod-induced side effects among older adults. I am completing a synthesis of these studies and will prepare a manuscript for publication this fall.
New York University
During the summer I searched multiple databases (e.g., Ovid, PubMed, EMBASE) to identify articles that focused on beliefs older adults maintain regarding pain and aging. The few studies (or reviews) that I found on this topic reported similar findings: many older adults believe pain is a natural part of aging and do not seek help for it, while others believe that enduring pain is an acceptable coping strategy. Recent studies have discovered a correlation between the belief that pain cannot be avoided as we age, and the under-treatment of chronic pain issues. The studies I found also suggest that future studies are needed to develop ways to educate health care professionals and their older patients about pain, and why they do not need to endure it as they age. I am working with Dr. Reid to synthesize these results and write a review article on the topic that we hope to submit for publication in the coming months.
In my project, I researched the relevant scientific literature and summarized the available data on the safety of opioid analgesics in the management of pain in older adults. I have searched multiple databases to identify relevant articles for review. My sample contains a broad range of articles that used varying research designs to assess opioid safety. I am currently analyzing the results and will be looking to see whether adverse event rates vary as a function of exposure duration (amount of time on the medication) as well as study design. I also aim to describe the demographic differences in the various study populations and characterize the investigations based on whether they are 'efficacy' or 'effectiveness' studies. The overall goal of my work is to summarize what is known regarding the safety of opioid use in older adults. This information could be very useful for clinicians as well as groups who develop pain guidelines.
The following list includes upcoming seminars, meetings, and conferences that focus on aging, pain, or general research methods
|September Work-in-Progress Seminar |
September 19, 2012
12:00 pm - 1:30 pm
To attend please contact Marcus Warmington at firstname.lastname@example.org or (212) 746-1801.
TRIPLL Webinar Series
The TRIPLL Webinar series will return in the fall. Dates will be announced at a later time.
Movement & Meditation to Ease Chronic Pain
When living with pain, it is easy to find yourself avoiding daily activities, opting to stay still and avoiding unnecessary movement. Unfortunately, not moving your muscles and joints often leads to more pain. Let's get moving! Join us for this gentle class that will utilize the movements of yoga and stretching in addition to breathing awareness and meditation to help ease stiffness, aches and pains.
For more information: www.hss.edu/pped or (212) 606-1613.
The Faculty Development Collaborative Program in Geriatrics
is a training program designed to enhance the knowledge and skills of health professions faculty in inter-professional teaching, leadership, project development and program implementation in geriatrics. This course will prepare health professions faculty from multiple disciplines to utilize contemporary evidence-based educational strategies, inter-professional team approaches, and innovative evaluation processes in teaching collaborative patient- centered care.
Application deadline is November 12, 2012
Utica Geriatric Scholar Certificate Program
September 13, 20, 27, 2012 & October 4, 11, 2012
This five-day educational conference, held one day each week for five weeks, is offered at the Masonic Care Community, Utica, NY and provides professional training in interdisciplinary geriatrics & gerontology. The program is co-provided by the Columbia University Stroud Center's Statewide Geriatric Psychiatry Residency/Fellowship Program and the Consortium of NY Geriatric Education Centers (CNYGEC), in conjunction with Upstate Medical University, Binghamton Clinical Campus CARES Project and the Masonic Care Community. This program has been submitted to The New York State Office of Mental Health, Bureau of Psychiatric Services and Research Institute Support. The New York State Office of Mental Health, Bureau of Psychiatric Services Research Institute Support is accredited by the Medical Society of the State of New York (MSSNY) to provide continuing medical education for physicians.
GAPNA 2012 - Gerontological Advanced Practice Nurses Association
September 19, 2012- September 22, 2012
GAPNA (formerly NCGNP) was founded in 1981 by a small group of GNPs with the intention of offering the first continuing education conference designed specifically to meet the needs of advanced practice nurses. Currently, GAPNA represents the interests of certified advanced practice nurses who work with older adults in a wide variety of practice settings. GAPNA is the organization of choice for advanced practice nurses who want to pursue continuing education in gerontological care and who seek peer support from experienced clinicians.
NGNA 2012 Annual Convention
Early registration ends on 09/07/2012.
Regular registration starts on 09/08/2012 and ends on 09/28/2012.
Late registration starts on 09/29/2012.
All times are 12:00am (GMT-05:00) Eastern Time (US & Canada).
Geriatric Society of America "Charting New Frontiers in Aging"
San Diego Convention Center
Hotels: San Diego Marriott Marquis & Marina, Omni San Diego, Hilton San Diego Gaslamp Quarter
San Diego, California
November 14-18, 2012
Pain Related Funding
Pilot and Feasibility Clinical Research Grants in Arthritis and Musculoskeletal and Skin Diseases (R21)
"Program Announcement (PA) Number: PAR-10-282
This FOA, issued by National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) of the National Institutes of Health, encourages exploratory/developmental clinical research related to the prevention or treatment of arthritis and musculoskeletal and skin diseases, conditions, and/or injuries. The Pilot and Feasibility Clinical Research Grants Program is designed to allow initiation of exploratory, short-term clinical studies, so that new ideas may be investigated without stringent requirements for preliminary data. The short-term studies should focus on research questions that are likely to gather critical preliminary data in support of a future, planned clinical trial. They can include testing new or prevention strategies, a new intervention, or unique combinations of therapies. A high priority is the use of such studies to help stimulate the translation of promising research developments from the laboratory into clinical practice."
Mechanistic Studies of Pain and Alcohol Dependence (R01)
"Program Announcement (PA) Number: PA-11-267
This Funding Opportunity Announcement (FOA) encourages applications that propose to conduct mechanistic studies on the relationship between alcohol drinking, alcohol dependence and pain. An association between chronic pain conditions and alcohol dependence has been revealed in numerous studies with episodes of alcohol abuse antedating chronic pain in some people and alcohol dependence emerging after the onset of chronic pain in others. Pain transmission and alcohol's reinforcing effects share overlapping neural substrates giving rise to the possibility that chronic pain states significantly affect alcohol use patterns and promote the development of dependence and addiction. In addition, long term alcohol intoxication and alcohol dependence induce pain symptoms and may exacerbate chronic pain arising from other sources. The objective of this FOA is to understand genetic, pharmacological and learning mechanisms underlying the association between the propensity to drink alcohol and pain responses."
Mayday Fund of New York
"The Mayday Fund is dedicated to alleviating the incidence, degree, and consequence of human physical pain.
The Mayday Fund's current grant-making targets are projects that result in clinical interventions to reduce the toll of physical pain, pediatric pain, pain in non-verbal populations, and pain in the context of emergency medicine. Mayday will also continue to be proactive in its commitment to promote networking between veterinary and human medicine, especially in an effort to inform measurements of pain in non-verbal populations. Finally, the trustees of the Mayday Fund wish to be nimble enough to respond as special opportunities present themselves. Grants are made only to public charities and educational institutions officially recognized as such by the IRS. The Mayday Fund concentrates its activities in the United States. On occasion, grants have been made to Canadian organizations when the project has an effect that reaches beyond Canada. Grants cannot be made to individuals."
Applications are continuous and no specified due date is applied.
Age Related Funding
Translational Research at the Aging/Cancer Interface (TRACI) (R01)
Program Announcement (PA) Number: PA-12-136
This Funding Opportunity Announcement (FOA) encourages translational research proposals in the overlapping areas of human aging and cancer, linking basic and clinical research relevant to the care of older cancer patients through both bench-to-bedside and bedside-to-bench approaches. Ultimately, information from the research supported by this initiative should improve the health and well-being of elderly patients at risk for, or diagnosed with, cancer and decrease the functional impairment and morbidity associated with cancer in this population.
T1 Translational Research: Novel interventions for prevention and treatment of age-related conditions (R21)
Program Announcement (PA) Number: PAS-11-280
This funding opportunity announcement (FOA) encourages exploratory/developmental R21 research projects to accelerate the pace of development of novel therapeutics involving biologics, pharmacological and non-pharmacological approaches for preventing and treating key health issues affecting the elderly. For the purposes of this FOA, T1 translational research on aging is defined as the application of basic and clinical biomedical findings towards the development of new strategies for prevention and treatment of age-related pathologies. For projects proposing basic research that is being conducted in animal models, the potential to treat a clinical age-related pathology must be clearly stated in the proposal. Direct relevance of the data to a clinical aging condition must be established and clearly stated in the application.
Translational Research to Help Older Adults Maintain their Health and Independence in the Community (R01)
Program Announcement (PA) Number: PA-11-123
The National Institute on Aging (NIA) and the Administration on Aging (AoA) invite applications using the R01 award mechanism for translational research that moves evidence-based research findings towards the development of new interventions, programs, policies, practices, and tools that can be used by community-based organizations to help elderly individuals remain healthy and independent, and living in their own homes and communities. The goal of this FOA is to support translational research involving collaborations between academic research centers and community-based organizations with expertise serving the elderly (such as city and state health departments, city/town leadership councils, and Area Agencies on Aging) that will enhance our understanding of practical tools, techniques, programs and policies that communities across the nation can use to more effectively respond to needs of their aging populations.
Mechanism Mediating Osteoarthritis in Aging
Program Announcement (PA) Number: PA-12-018
"This Funding Opportunity Announcement (FOA) issued by the National Institute on Aging (NIA) and the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) invites applications on research employing genetically defined and modified mouse models, other animal models such as dogs and monkeys or archived human joint tissues to explore the biological mechanisms underlying osteoarthritis. Osteoarthritis is a significant problem in the elderly population, and a major contributor to mobility limitations that are endemic in this population and, therefore, is an important element in the research missions of NIA and NIAMS. Inflammatory processes are evident in advanced stages of osteoarthritis, and are likely to be major contributors to the chronic pain that is the most common symptom of the condition. However, for the purpose of this announcement, osteoarthritis is distinguished from other joint diseases, such as rheumatoid arthritis, in which inflammation arising from autoimmunity is the primary cause of tissue damage. The root causes of joint degeneration in osteoarthritis remain unclear. Research efforts in the past have focused primarily on the more advanced stages of osteoarthritis, but relatively little is understood about the initial changes triggering disease etiology and early progression. This FOA is intended to encourage and accelerate the characterization of new or underutilized models and the testing of hypotheses that will lead to an improved understanding of the mechanisms mediating osteoarthritic progression."
Notice of Intent to Publish a Funding Opportunity Announcement (FOA) on Multidisciplinary Studies in HIV/AIDS and Aging (R03)
Notice Number: NOT-AG-12-004
"The National Institute on Aging (NIA) announces a trans-NIH Funding Opportunity Announcement (FOA) on Multidisciplinary Studies in HIV/AIDS and Aging. This FOA will encourage applications proposing to study HIV infection, HIV-associated conditions, HIV treatment, or biobehavioral or social factors associated with HIV/AIDS in the context of aging and/or in older adults. The research areas encouraged in this FOA are based, in part, on the recommendations of the Working Group on HIV and Aging convened by the NIH Office of AIDS Research. These areas include, but are not limited, to the following:
* Cellular and molecular mechanisms of HIV in aging
* Biomarkers or clinical indices of HIV-associated pathology
* HIV-Associated Non-AIDS (HANA) conditions / Co-morbidities
* HIV-Associated Neurocognitive Disorders (HAND)
* Intervention studies (prevention or treatment)
* Social, behavioral, and mental health studies
The FOA is expected to be published in Spring 2012 with non-standard receipt dates beginning in Summer 2012. Multiple other NIH Institutes and Centers are expected to participate."
Please direct all inquiries to:
Basil Eldadah, MD, PhD
Division of Geriatrics and Clinical Gerontology
National Institute on Aging
7201 Wisconsin Ave, Suite 3C307
Bethesda, MD 20892
Network and Infrastructure Support for Development of Interdisciplinary Aging Research (R24)
Program Announcement (PA) Number: PA-12-064
"The purpose of this FOA is to provide network and infrastructure support to foster development of novel interdisciplinary research approaches on important topics in aging research. This FOA will use the NIH Resource-Related Research Project (R24) mechanism to facilitate research networks that will advance specific scientific goals through activities such as meetings, conferences, small scale pilots, short term training opportunities, and visiting scholar programs, and dissemination activities to encourage growth and development in these interdisciplinary areas."
National Science Foundation funding grant "General & Age-Related Disabilities Engineering (GARDE)"
"The General & Age Related Disabilities Engineering (GARDE) program supports research that will lead to the development of new technologies, devices, or software for persons with disabilities. Research may be supported that is directed to the characterization, restoration, and/or substitution of human functional ability or cognition, or to the interaction of persons with disabilities and their environment. Areas of particular recent interest are disability-related research in neuroscience/neuroengineering and rehabilitation robotics. Emphasis is placed on significant advancement of fundamental engineering and scientific knowledge and not on incremental improvements. Proposals should advance discovery or innovation beyond the frontiers of current knowledge in disability-related research. Applicants are encouraged to contact the Program Director Ted Conway at email@example.com, or call (703) 292-7091, prior to submitting a proposal."
The New Investigator Awards in Alzheimer's Disease
"Funded by The Rosalinde and Arthur Gilbert Foundation and The Diane and Guilford Glazer Foundation, the major goal of this partnership program is to support important research in areas in which more scientific investigation is needed to improve the prevention, diagnosis, and treatment of Alzheimer's disease. The program will also serve to encourage junior investigators in the United States and Israel to pursue research and academic careers in the neurosciences, and Alzheimer's disease in particular. Projects in basic and translational research related to Alzheimer's disease (AD) that are clinically relevant, will be considered. Projects that focus on healthy brain aging are also considered. For one of the awards, priority may be given to an investigator with a research interest related to healthy brain aging. Areas of research could for example include learning and memory, nutrition, exercise, cardiovascular risk factors, as they relate to the brain and the aging process. The applicant must be an independent investigator with assigned independent space as assigned by the departmental chair or equivalent official, and must be within the first ten years of receiving a doctoral degree by July 1, 2011. Exceptions to the ten year rule may be requested for unusual circumstances by emailing an NIH-style bio-sketch to AFAR at firstname.lastname@example.org .The proposed research must be conducted at any type of not-for-profit setting in the United States or Israel."
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-Ithaca, Columbia University's Mailman School of Public Health, Hospital for Special Surgery, Memorial Sloan Kettering Cancer Center, Visiting Nurse Service of New York and Council of Senior Centers & Service of NYC, Inc.
For more information on TRIPLL please contact Marcus Warmington at email@example.com.