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APS
26th Annual Scientific Meeting
Online registration is open. Register today! Corporate
Satellite Symposia Thursday, May 3 1–2:30
pm
Friday, May 4 7–8:30
am
Noon–1:30
pm
6:30–8:30
pm
Fun
Run/Walk at the National Zoo
The Fun Run/Walk is a fundraiser for our "Dream No Small Dreams" campaign. Your $20 entrance fee will serve as a donation to help support the initiatives of the Decade of Pain Control and Research. Endo Pharmaceuticals, Inc., Chadds Ford, PA, has generously offered to support the Fun Run/Walk and will match all entrance fees. Your $20 entrance fee becomes a $40 donation to the "Dream No Small Dreams" campaign! For more information, visit our Web site at www.ampainsoc.org.
Vote in APS Elections Through February 28 APS members can still vote in the APS national elections. A January 23 e-mail to you contains the Web address to the online election ballot and your login information. Vote to elect
a president-elect, treasurer, three directors-at-large, three nominating
committee past presidents, and four nominating committee members-at-large.
Voting ends on February 28. Let's make this a record breaking election year. If you have questions, contact Dionne Wilson at 847/375-4875.
Legislation Calls for $620 Million Increase for NIH With one day to spare, the Senate, on Wednesday, cleared a $463.5 billion spending measure earlier passed by the House of Representatives to fund much of the government for the remainder of the fiscal year. Known as a continuing resolution (CR), the bill will fund government spending through September 30, 2007—the end of the 2007 fiscal year. The legislation, which President Bush is expected to sign, provides funding for programs covered by the nine unfinished fiscal 2007 appropriations bills. Prior to adjournment in December, the 109th Congress passed a previous CR or "stop gap" spending measure through February 15 because agreement could not be achieved on nine of the 11 appropriations bill. The new CR bundles those remaining spending bills together. Although the CR freezes most spending at FY 2006 levels, Congressional appropriators shifted approximately $10 billion to increase funding for some domestic programs. For example, the legislation provides a $620 million increase for NIH, which will allow NIH to award an additional 500 research grants to biomedical scientists researching cancer, heart disease, and diabetes. Moreover, it will create a new $40 million program to support innovative research and would provide $91 million for grants to first time investigators, who represent the next generation of biomedical researchers. The resolution also includes $69 million for the National Children's Study. The full text of H.J.Res. 20 is available on the House Rules Committee Web site at www.rules.house.gov/110/text/110th_hjres20.pdf.
APS and Center for Practical Bioethics Survey Physicians APS continues to be an active member of the National Pain Work Group and its Balanced Pain Policy Initiative. The initiative would help ensure that all people in pain have access to appropriate medications, but that controlled-substance pain prescriptions not be misused or used for illicit purposes. Recently APS assisted the Center for Practical Bioethics, one of the leaders of the National Pain Work Group in Kansas City, MO, in conducting an online survey of APS and American Academy of Pain Medicine physician members on their perceptions of the current legal environment surrounding prescribing controlled-substance painkillers. Of 2,214 physicians who were mailed surveys, 20% or 467 physicians responded. According to the survey results, a large majority (85%) of respondents either agreed or strongly agreed that pain patients are often more difficult to treat than other patients. Although 61% reported knowing at least one professional who had been investigated as a result of pain management practices involving controlled-substance medications, 10% of respondents indicated that they had been personally investigated. However, about a third (36%) of responding physicians indicated they were "very concerned" or "extremely concerned" that they might be investigated in the near future.
News Highlights from The Journal of Pain
Predictors
of Topical Anesthetic Effectiveness in Children Despite application of topical anesthetic drugs, some children experience significant pain from the insertion of intravenous catheters. Little is known about factors contributing to the variable efficacy of topical anesthetics, but studies show that children who are younger and have more difficult temperaments are likely to report pain and exhibit more distress during needlesticks. In this study, 218 children ages 4 to 10 were evaluated while undergoing catheter insertion. Topical anesthetics were applied in accordance with manufacturers' specifications, DNA samples were taken, and the children completed the Oucher Pain Assessment Scale. The purpose of the study was to describe the variability of topical anesthetic effectiveness and identify predictors of children's self-reported pain during IV insertions following pretreatment with a topical lidocaine anesthetic. DNA from all subjects was analyzed for three genes believed to influence topical anesthetic effectiveness from their known role in stabilizing membranes that initiate and conduct nerve impulses. The authors reported that children who were more active and had one of the targeted genotypes (EDNRA TT) were more likely to report higher pain intensity from IV insertion despite pretreatment with topical lidocaine. They also found that gender, ethnicity, number of previous painful procedures, and type of topical anesthetic were not associated with pain scores.
According to several studies, the amount of pain and distress children experience during needlestick procedures is significantly influenced by parental behavior. Certain behaviors are associated with child coping and other patients with distress. Humor, commands to use coping strategies, and nonprocedural conversation are associated with increased coping with immunization pain. Empathy, criticisms, apologies, giving control to the child, and reassurance are linked with child distress. In this study, the authors provided a detailed linguistic description of spontaneous reassurances by parents during pediatric immunizations. They examined speech tones, anticipating that parental reassurances would end on a rising voice tone, based on the link between reassuring parental responses and increased child distress. They expected that voice tones ending on a rise would be associated with increased child distress and higher parental anxiety than tones ending in a falling-off pattern. Videotapes of 28 five-year-old children receiving immunizations with their parents were analyzed. Audio clips were digitized in a computer phonetic program that identified voice tone categories. Contrary to the authors' expectations, the majority of voice tones used in the reassuring comments from parents ended with a fall in pitch, which communicated certainty and protectiveness instead of uncertainty and vulnerability. They concluded there was no significant relationship between tones ending in a rise and child distress, parental anxiety, or parental anticipation of child distress. The authors noted that comprehensive understanding of parental reassurance is valuable because it is the most common response to children in acute pain. Results of this study and others can be used to help parents and healthcare professionals interact with children in a manner that promotes coping and reduces pain and distress during immunizations.
Pain is normal following surgical limb loss, but some amputees develop chronic pain. Although published research has shown preamputation pain is a risk factor for pain following surgery, little is known about the association between acute postsurgical pain and chronic amputation-related pain. Case studies have reported numerous examples of pain "memories" in which painful phantom sensations resemble pain experienced before amputation. Also, several studies have shown that the presence of preamputation pain increases the risk of phantom-limb pain (PLP) at 3 or 6 months following amputation, and that preamputation pain also is a risk factor for chronic PLP. This study was designed to examine the relative roles of preamputation pain and acute pain after amputation as predictors of subsequent chronic amputation-related pain. Specific questions addressed were: 1) Does preamputation pain intensity predict subsequent postoperative PLP or residual limb pain intensity? and 2) which types of acute pain are the best predictors of chronic amputation-related pain from 6 to 24 months after surgery? It was hypothesized that higher levels of pain before or soon after amputation might be a variable for selecting those most in need of early, intensive pain interventions. Fifty-seven lower-limb amputation patients were studied. The average age was 44 and 70% of the subjects required amputation from a traumatic injury. Constant pain prior to amputation was reported by 56% of study participants. Results showed that acute PLP intensity was the single best predictor of chronic pain at 6 months and 1 year, while preamputation pain was the best predictor of chronic pain at 2 years. The authors noted that pain before amputation might produce functional changes or somatic memories in the nervous system that persist after limb loss or are reactivated by the peripheral injury of amputation. The study also suggests that both preamputation pain and acute pain soon after amputation might be associated with bothersome chronic pain. This finding might help to identify individuals at greatest risk for chronic pain problems and most in need of early and intensive pain interventions.
Funding Announcement: Neurobiology of Migraine (R01) The National Institute of Neurological Disorders and Stroke, National Institute on Deafness and Other Communication Disorders, National Institute of Dental and Craniofacial Research, and National Institute of Environmental Health Sciences issued a program announcement to attract innovative and cross disciplinary proposals to expand our current knowledge of the neurobiology of migraine. Research of interest includes the study of predictive and susceptibility factors, the mechanisms underlying the phases of migraine, modulatory influences that induce and sustain headache, and relevant therapeutic development. The research community is encouraged to expand on the emerging scientific discoveries related to neural and inflammatory mechanisms, and genetic contributions to migraine headache. This announcement also highlights the need to explore endogenous, genetic, environmental, and lifestyle triggers and influences on migraine. For more information, click here.
Funding Announcement: Neural Mechanisms and Risk Factors for Progression (R01) of Migraine The National Institute of Neurological Disorders and Stroke (NINDS) and National Institutes of Health (NIH) solicits R01 grant applications from institutions and organizations that propose research to assess the susceptibility, risk factors, mechanisms, and preventive measures relevant to the progressive nature of migraine headaches. Risk factors have emerged as potential contributors to the progression from infrequent to chronic daily headache, including lifestyle, genetic influences, age, and physiology. Other factors may contribute to increased likelihood of stroke and co-morbid pain conditions. It is important to identify the subpopulation of patients at risk in order to develop preventive measures and improve therapies. Identification of risk factors may offer clues to better understanding of the mechanisms underlying susceptibility to secondary neurological consequences. The research community is encouraged to recognize the importance of recent research findings on the pathophysiology, relevant genetic mutations, and neuronal consequences of migraine and to apply appropriate advances in technology, such as imaging and nanotechnology to aid future discoveries related to the mechanisms and consequences of migraine progression. Researchers with expertise in related areas, such as channel structure and function, ischemic stroke, neurovascular biology, and genetics are well-positioned to contribute to new avenues of discovery in migraine research and are encouraged to apply. For more information click here.
Volunteer Spotlight: Jerry Gebhart, PhD
"As a basic scientist interested in pain, I had limited access to clinicians to better understand the patient-care side," said Gebhart. "APS was attractive to me as it followed the multidisciplinary blueprint created by John Bonica when he founded the International Association for the Study of Pain (IASP). I enjoyed the opportunities APS meetings provided to bring together basic scientists and clinicians." Soon after joining, Gebhart served on the ethics committee, the annual scientific meeting program committee, and others. It wasn't long before the nominating committee chose him to run for the board of directors. He went on to serve as APS President from 1997–1998. While he was APS President, the organization was exploring options for developing a new journal. At the time, APS published Pain Forum, a popular publication with members that consisted mainly of reviews and opinion articles. Because it didn't contain original scientific research, APS was unable to have Pain Forum indexed by the National Library of Medicine. "The Board wanted an indexed journal and we first approached the American Academy of Pain Medicine with a proposal to collaborate," recalled Gebhart. "They, however, didn't want to mix basic science and clinical pain management in one journal, so we moved forward on our own and began publishing The Journal of Pain as the new peer-review publication for APS." Upon ending his term as president, Gebhart was tapped to become the first–so far the only–editor-in-chief of the new journal. In the last 8 years, the publication has made great strides under Gebhart's volunteer stewardship toward achieving his goal of becoming the best journal in the pain field. "We're getting more and more high-quality submissions from around the world and we have a great editorial board, which is setting very high standards." he said. "I'm pleased with the way APS members have embraced the journal." In 2006, Gebhart accepted "an offer I couldn't refuse" to leave Iowa to become director of the Center of Pain Research at the University of Pittsburgh. A major focus in his new role will be fostering translational pain research. In 2008, Gebhart will be named president of IASP. "My goal in leading IASP will be to promote better interactions with APS and the other national chapters worldwide. The organization must be more aggressive in supporting what its chapters need," he said. Looking ahead, the editor-in-chief said he intends to stay on through the new 5-year contract with medical journal publishing house Elsevier. "I don't want to be here forever, and it's never a good idea for a journal to have one editor-in-chief in place for too long," said Gebhart. For his outstanding record of volunteer service, Jerry Gebhart was awarded the APS Distinguished Service Award in 2003.
Overwhelming
Response to APS Clinical Center of Excellence in Pain Management
Awards The primary goal of the launch was to raise awareness about the program and drive award nominations. With the overwhelming response and 23 confirmed media placements in professional and trade publications, APS reaffirms its vision for creating a program that honors multidisciplinary pain programs and rewards excellence in quality patient care. The application review process has begun and is expected to conclude in early March. A diverse and distinguished group of reviewers have agreed to undertake the enormous task of identifying this year's winning programs—no easy task indeed. This year's award recipients will be announced in a special edition of E-News in March. These programs will also be recognized locally and at a special recognition event at the APS Annual Scientific Meeting in Washington, DC. Additional information about the winning programs and gala celebration will be available in March.
Call for Web Editorial Board Volunteers
The role of the Web site editor and Web Editorial Board is to provide consultation and general editorial direction for the Web site. This generally includes
The Web Editorial Board comprises six or more members from varied disciplines representing the diverse membership of APS. Committee work is generally conducted by phone and e-mail, and periodic conference calls are scheduled at the convenience of the members.
Submit information no later than March 1. For additional information, contact Cynthia Porter at cporter@connect2amc.com or call 847/375-4786.
Meeting Travel Award Deadline Is Rapidly Approaching! APS will again offer Young Investigator Awards for travel to the 26th Annual Scientific Meeting, May 2-5, in Washington, DC. Awards are available to individuals presenting paper or poster abstracts at the meeting. Applicants may be from any research training background (basic or clinical science, psychology, medicine, or biostatistics) and at any level in training. Therefore, students, residents, predoctoral trainees, postdoctoral fellows, or those who have completed their postdoctoral training within the last three years are welcome to apply. However, all applicants must be members of APS. Before submitting an application, please consult with your institution to verify that you can accept a cash award from APS. Some institutions have policies that allow for only in-kind contributions, and APS will be distributing 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. Applications must be completed online by February 19. If you have difficulty completing the application, contact Jennifer Reinard at jreinard@connect2amc.com or call 847/375-4833. Applications will be reviewed by the APS Scientific Program Planning Committee, and stipends will be awarded by March 12. 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 and an allocation of APS operating funds.
Fetal
Pain: What the Evidence Can and Cannot Tell Us
APS 26th Annual Scientific Meeting
Program
Evaluation Speakers'
Presentations Online For more information, please check the APS Web site at www.ampainsoc.org after May 30, or call 847/375-4715.
APS Appeared at AAHPM Annual Assembly One of the priorities of the APS strategic plan is to disseminate state-of-the-art science and clinical applications through lectures to outside organizations. As such, Patrick Mantyh, PhD, presented an APS-supported lecture, "Cancer Pain From the Laboratory to the Clinic," at the 2007 Annual Assembly of the American Academy of Hospice and Palliative Medicine (AAHPM) on February 15. APS also exhibited at the AAHPM Annual Assembly.
Update Your Contact Information! The 2007 APS Membership Directory will be published and distributed this summer. To ensure that your listing is accurate, log on to the Members Only section of the APS Web site. Enter your Web
ID (for first-time visitors, this is your Member ID) and Password
and click "Update Your Own Member Record." Please note:
APS does not sell or distribute your personal information. |
May
2–5, 2007
Visit
the APS bookstore to purchase a T-shirt with a panda design. Children-size
T-shirts are available this year! And back by popular demand, "I
slept in to support the run" T-shirts also are available.
The
following highlights summarize selected articles from the February
2007 issue (volume 8, number 2).
Best
known within APS as the editor-in-chief of The Journal of Pain,
Jerry Gebhart, PhD, first became interested in APS as a researcher
and assistant professor at the University of Iowa in the 1970s.
APS
wishes to acknowledge several members of the Web Editorial Board
who are completing their service on the committee. Michael Clark,
PhD, has chaired the committee since his appointment in 2002. Under
his leadership the committee has met routinely to address issues
of content and policy for the Web site. Paul Arnstein, PhD 
RN,
Allen Lebovits, PhD, and Stuart Derbyshire, PhD, are also concluding
their terms on the committee after several years of service. All
have been actively involved in consulting on the recent redesign
and improvements to the Web site. We thank them for their service
and appreciate the results of their collective endeavors.
Ron
Gironda, PhD, has been appointed to fill the role of chair of the
Web Editorial Board for the coming term. At this time APS is recruiting
new volunteers to serve on this committee. 
Past
issues of the APS Bulletin are archived online for your
convenience and reference. This month, we're highlighting
an article that you may have missed when it was first published.
Handout
Materials