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APS Announces Recipients of the 2006 Future Leaders in Pain Research Small Grants The 2006 Future Leaders in Pain Research Small Grants Program offered funding for five researchers, in the amount of $20,000. To be eligible, grant applicants must be APS members who are within 6 years of completion of their terminal degree and have not yet been awarded major NIH or foundation grant funding. There were twenty competitive applications for funding this year. Members of the APS Small Grants Committee reviewed and scored the applications in preparation for selection of grant recipients. APS is proud to announce the following 2006 grant recipients. Each of the recipients will attend the Annual Scientific Meeting to report on the progress of their research studies to the members of the Small Grants Committee. Marie Hoeger
Bement, PT PhD Beth D. Darnall,
PhD Jill C. Fehrenbacher,
PhD Bryan C. Hains,
PhD Theodore J.
Price, PhD APS gratefully acknowledges Endo Pharmaceuticals and Cephalon for their generous funding of the 2006 grants program and extends special thanks to the members of the Grants Committee for their efforts on behalf of the program. APS
Small Grants Committee The 2007 grant application information will become available in May. Applications will be due in July.
Pain Bill Reintroduction Expected in 2007 While the new Congress busies itself with leadership initiatives and snaring prize committee assignments, the Pain Care Coalition (PCC) is working on a new legislative strategy to secure passage of a comprehensive pain care legislation that has failed in the previous two Congresses. The PCC includes APS, the American Academy of Pain Medicine, the American Headache Society, and the American Society of Anesthesiology. Democrats are now the majority in the House and Senate, and the first priorities, according to PCC legislative counsel Robert Saner, are to determine if the Republican lead sponsor of the previous pain bills, Rep. Mike Rogers of Michigan, is still interested in pushing pain legislation, and to recruit majority party lead sponsors in the House and Senate. ”It’s really not possible to engage members right now,” said Saner, “so our focus is on identifying Democrats who might step forward on behalf of pain care and continue our collaboration with Congressman Rogers.” Saner further noted that PCC didn’t come away from the last Congress empty handed, even though the Pain Care Policy Act of 2005 never made it through the House Energy and Commerce Committee. “While it was frustrating we weren’t more successful in moving the Rogers bill, language from it was included in the NIH reform legislation,” he said. “Specifically, chronic pain is now recognized as a disease category that needs to be tracked. I see this as a significant achievement that could pay off in the future in requiring NIH to track pain research funding and report to Congress every year on what the Institutes are spending on chronic pain.” In 2007, PCC will change its legislative strategy and support two separate but different pain bills. One will focus on the military and veterans, and will be considered by the Veterans and Armed Services committees and subcommittees in the House and Senate. The other would be a less aggressive version of the previous Rogers bills that would focus on empowering the Pain Care Consortium within NIH and contain other HHS-related provisions similar to the Rogers bill. “During deliberations on the NIH reform bill, we saw there is strong bipartisan consensus against creating new units at NIH,” said Saner. “Even though Democrats traditionally are partial to healthcare legislation, it’s clear that proposals to establish regional pain centers and other units within NIH wouldn’t get much support on either side of the aisle. Our approach now is to pursue an appropriations strategy to get seed money for the Pain Care Consortium to become a more effective advocate for pain care and pain research.” Sponsoring a pain bill for the military and veterans involves different committees and offers opportunities to recruit new cosponsors and supporters in the House and Senate. Saner added that satisfying pain care needs of soldiers wounded in Iraq and Afghanistan could generate considerable support for the legislation. Saner hopes
that one or both pain bills will be introduced by April. “That
means the timing of the Capitol Hill visits scheduled during the
APS Annual Meeting in May will be beneficial for educating House
and Senate members about increasing federal funding for pain care
and pain research.” Register
Now!
The APS 26th
Annual Scientific Meeting will be a lively arena for interdisciplinary
exchange among pain scientists and healthcare professionals. In
the ever-expanding field of pain management, new trends, techniques,
therapies, and diagnostic procedures become available almost daily.
Knowledge of these is crucial for the practicing healthcare professional
when selecting the most efficacious treatment for the individual
patient. By attending and participating in the meeting, you will
be able to relate clinical insights presented to questions of basic
science, and to translate scientific innovations to your clinical
practice.
NIH
Pain Consortium 2nd Annual Symposium May
1, 2007 The NIH Pain Consortium will hold its second annual symposium, Advances in Pain Research, immediately before the APS Annual Scientific Meeting. Panel sessions will be presented by NIH researchers and will highlight advances in inflammatory, neuropathic, treatment-induced, and visceral pain. Poster sessions will be presented by NIH-supported investigators. The meeting is open to the public. This meeting is sponsored by the NIH. For additional information, please contact Linda Porter, PhD, NINDS, at 301/496-9964.
Each year the APS Special Interest Groups plan a variety of education sessions and business meetings for members. The following sessions are scheduled to take place during the annual meeting. Thursday, May 3 Basic
Science Genetics
and Pain Interdisciplinary
Pain Rehabilitation Measurement
in Pain and Its Impact, Part I Nursing
Issues Pain
in Infants, Children, and Adolescents Psychosocial
Research
Clinical
Trials Disparity
in Pain Management Ethics Palliative
Care Pharmacotherapy
Measurement
of Pain and Its Impact, Part II
Balanced Pain Policy Initiative The American Pain Society was invited to be part of the Balanced Pain Policy Initiative, which is led by the Center for Practical Bioethics and includes the National Association of Attorneys General, the Federation of State Medical Boards, American Academy of Pain Medicine (AAPM), American Pain Foundation, Pain and Policy Studies Group, Drug Enforcement Administration, and others, and was formed to promote balanced public policy. The group is developing a research project to ensure that all people with pain have access to the most appropriate medications and to prevent controlled substances from being diverted for illicit purposes. As members of this group, APS and AAPM recently conducted a qualitative survey on prescribing practices and attitudes. Over 470 physician members from the two organizations participated. These results will be shared with the work group at its next meeting on January 17. Watch for more information in next month’s APS E-News.
News Highlights from The Journal of Pain
Sex
and Pain-Related Psychological Variables are Associated with Thermal
Pain Sensitivity for Patients with Chronic Low Back Pain There have been many published studies comparing and evaluating thermal pain sensitivity in healthy subjects, but not much research has been conducted on those with clinical pain syndromes. The authors studied 33 patients with low back pain to explore whether sex differences existed for thermal pain sensitivity and if sex, fear avoidance beliefs, and/or pain catastrophizing influenced thermal-pain sensitivity. This is known as the Fear-Avoidance Model of Exaggerated Pain Perception (FAMEPP). The authors hypothesized that women with chronic low back pain would exhibit elevated pain sensitivity in response to evoked pain stimuli and that fear-avoidance beliefs and catastrophizing would significantly influence pain sensitivity for all subjects regardless of gender. The authors defined fear avoidance beliefs as comprising an individual’s pain experiences, present stress level, pain behavior, and personality traits. Catastrophizing was described as a general negative expectation that experienced pain will inevitably result in the worst possible outcome. Based on self-report questionnaires of the study subjects, the authors concluded that sex differences were evident in this group because women showed lower pain tolerance. However, the survey results also indicated that fear avoidance beliefs were the only unique influence on first-pulse response to pain stimuli in both women and men. Therefore, fear avoidance was associated with immediate thermal-pain sensitivity.
The intent of this study was to review and clarify past mixed research findings related to establishing fear of pain as a critical variable stimulating hypervigilance and vulnerability to the disabling effects of pain. A previous study had found that fear of pain was associated with faster detection of weak electrical stimuli regardless of clinical status. The researchers reviewed recently published dot-probe data from 36 patients with musculoskeletal pain and from 29 healthy subjects. They concluded that patients with high pain fear levels displayed hypervigilance for all word types presented during the dot-probe task compared to those with low fear levels. The high pain fear subjects were almost exclusively musculoskeletal pain patients. It appears from the data that high pain fear is associated with a general hypervigilance for potentially threatening stimuli. Fear of pain, therefore, can be used to categorize people more or less vulnerable to the disabling effects of pain, as those with high fear are likely to selectively react to all potentially threatening stimuli in their environment.
Persistent pain is commonly treated in the primary care setting and musculoskeletal pain is the most frequently reported type of pain. The purpose of this study was to identify and describe subgroup profiles of these patients based on self-reported pain intensity, disability, self efficacy, fear of movement, and catastrophizing. The researchers evaluated self-report questionnaires given to two groups of 215 and 161 patients at the start of physical therapy. Three subgroups were identified in the first group and replicated in the second. They were labeled as “high self-efficacy and low fear avoidance,” “low self-efficacy and low fear avoidance” and “low self-efficacy and high fear avoidance.” The authors stated that the high self-efficacy and low fear avoidance group was the largest subgroup in both samples, and therapeutic management of these patients could be based on a general fitness approach in which they would be expected to self-manage extensively. For those with a combination of high pain levels and disability and low self-efficacy, the authors recommended a treatment approach that would enhance self-efficacy beliefs regarding the performance of desired activities by focusing on mastery of required motor skills. For the third subgroup, characterized by high pain levels and disability and high fear avoidance, they advocated an approach that assesses what movements or activities elicit fear and to follow up with gradual activity increases to reduce catastrophizing and fear and to enhance self-efficacy.
Travel Support for the APS 26th Annual Scientific Meeting APS will again offer Young Investigator Awards for travel to the 2007 meeting. Awards are available to individuals presenting paper or poster abstracts at the meeting, May 2–5, 2007, in Washington, DC. Applicants may be from any research training background (basic or clinical science, psychology, medicine, or biostatistics) and may be at any level in training, including students, residents, predoctoral trainees, postdoctoral fellows, or those who have completed their postdoctoral training within the last 3 years. All applicants must be members of APS. Please consult with your institution to verify that you can accept a cash award from APS before submitting an application for Young Investigator funding. Some institutions have policies that only allow for in-kind contributions, and APS will distribute cash awards to those chosen to receive Young Investigator awards. To apply for funding, complete the Young Investigator Travel Stipend Application located on the APS Web site (beginning January 15, 2007). Applications must be completed online by February 19, 2007. If you have difficulty completing the application, contact Jennifer Reinard at jreinard@connect2amc.com or 847/375-4833. Applications will be reviewed by the APS Scientific Program Planning Committee and stipends will be awarded by March 12, 2007. Notifications will be sent to all applicants after March 12. All eligible young investigators will receive their travel grants at the Annual Meeting. The APS travel stipend program is made possible through external grants as well as an allocation of operating funds from the American Pain Society.
Centers
of Excellence: Deadline Is Almost Here!
Country Profiles on Opioid Availability Now Available The Pain & Policy Studies Group (PPSG) recently announced enhancements to the international section of its Web site that may be useful for individuals and organizations interested in improving availability and access to essential opioid medications. The PPSG Web site now offers country profiles that provide standardized information about opioid availability and key policy-related indicators for every country in the world. Each country profile contains graphs that portray the trend in reported national consumption of principal opioids as an indicator of opioid availability. Key policy-related indicators are provided, including whether the country is a party to the international conventions that require governments to estimate their medical requirements for opioids and to report consumption statistics to the International Narcotics Control Board. Country profiles can be accessed directly at www.painpolicy.wisc.edu/internat/countryprofiles.htm or from the PPSG home page.
Overcoming
Legal Barriers to Competent and Compassionate Pain Relief for Patients
with Chronic Nonmalignant Pain Veterans
Health Administration National Pain Management Strategy: Update
and Future Directions Practical
Controlled Trials: Researching the Therapeutic Ritual and All Its
Parts
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May
2–5, 2007
The
following highlights summarize selected articles from the December
2006 issue (volume 8, number 1).
Past issues of the APS Bulletin are archived online for
your convenience and reference. This month, we’re highlighting
three articles that perhaps you may have missed when they were first
published.