IMHA On The Move – November 2012

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Message from the Interim Scientific Director

Welcome to the November edition of IMHA on the move! November is both Osteoporosis Month and Pain Awareness Week (4th-10th). Each of these conditions affect millions of Canadians and researchers are hard at work, trying to improve the health and wellbeing of people affected by these two conditions.

I would like to dedicate the rest of my message to the Canadian Skin Patient Conference - "Skin Matters" - that I attended last month. It was an honour for me to give some opening remarks and to have been able to attend. With over 260 participants, most of whom were skin patients, this event provided a sense of community for many people living with a skin condition who had previously felt isolated and alone.

Some of the highlights included the 3 motivational speakers: Dennis Gardin, Charlene Pell and Alvin Law – who recounted their experiences of living with a physical difference and finding the courage to overcome life's challenges.

Dennis, an international speaker, businessman, and former television host, was burned to over 70% of his body when he was 14. He spoke about overcoming self-limiting beliefs and recognizing the power we have to design and live the life we desire. Charlene, a survivor of a burn she acquired in an airplane accident, is a world-renowned speaker on staring. Her interactive workshop explored a number of issues including – why people stare, and how it feels to be stared at. This session was about breaking down barriers and feeling confident to respond to stares. Alvin was born without arms because of a morning sickness drug, Thalidomide. He shared his story about growing up with parents who refused to see his physical difference as a limitation. These three speakers set a positive and open tone that persisted throughout the conference.

Skin research was also covered in a number of sessions. A panel of 4 researchers, presented new and exciting dermatology research which was followed by an engaging question and answer period. Dr. Marla Shapiro shared a presentation on skin vaccines, and Drs. Baranking and Friemann – cosmetic dermatologists – covered the need to know on a number of cosmetic procedures and treatments.

A session on sexual intimacy was particularly emotional. People shared their personal struggles of intimacy and coping with a skin condition. Skin patients also came together in over 60 breakout sessions focused on different skin conditions, and some attended workshops for non-profit organizations to raise the profile of some of the little known skin conditions.

It has been a busy and productive month. I hope that you will enjoy reading updates and news from IMHA and our community.

Sincerely,

Phillip Gardiner PhD, Interim Scientific Director
Institute of Musculoskeletal Health and Arthritis

Funding Opportunities

For information on current funding opportunities, please visit IMHA's Funding Opportunities.

Team Grant – Health Challenges in Chronic Inflammation Initiative
Application deadline: November 15, 2012.

Master's Award: Winter 2013 Priority Announcement
Application deadline: February 1, 2013.

Knowledge Translation Prize
Application deadline: February 18, 2013.

Undergraduate : Mobility, musculoskeletal health and arthritis
The purpose of this funding opportunity is to provide undergraduate and health professional students with opportunities to undertake research projects with established health researchers in an environment that provides strong mentorship. For the first time since the inception of this program, IMHA has allocated funds for at least one fundable application in the area of myalgic encephalitis or fibromyalgia. The application deadline is January 15, 2013, with funding to begin in May.

The Measure of Success

The Canadian Institutes of Health Research (CIHR) are pleased to introduce their annual report, entitled CIHR Annual Report 2011-12: The Measure of Success.

CIHR takes the measurement of success seriously. Last year, as a part of ongoing efforts to assess performance, CIHR hosted a prestigious International Review Panel (IRP). Their report highlights actions taken to implement the recommendations of the IRP, and how these recommendations align with the overall strategic plan.

As CIHR works to build a sustainable research enterprise, they are helping create a healthier future for all Canadians.

Osteoporosis Month

Building knowledge to strengthen bones.

Osteoporosis is a disease that causes bones to become thin and porous. As a result, bones weaken and break easily. The fractures, which most commonly affect the wrist, hip and spine, are a serious health problem, causing hospitalization, long-term disability and increased risk of death in older adults.

Sometimes referred to as the "silent thief", osteoporosis progresses without symptoms and is often only diagnosed following a fracture. By that time, however, much of the damage has been done and it's difficult to rebuild the bone structure. That's why it's important to catch osteoporosis early and to promote effective ways to prevent, treat or manage the disease.

That's also why research is important. The CIHR Institute of Musculoskeletal Health and Arthritis supports strategic research and knowledge translation on osteoporosis and other bone health issues. The Institute recently funded three research teams that will study different areas of bone health. For example, Dr. Robert Young at Simon Fraser University and his team will study new mechanisms, therapeutic targets and technologies for regenerating bone. This work may lead to new treatments for osteoporosis.

CIHR has funded other osteoporosis research that has yielded important results. Dr. Sumit Majumdar at the University of Alberta, for instance, led a recently published study that found a simple education intervention increased osteoporosis treatment rates. The study involved patients who visited emergency departments and had chest x-rays taken that incidentally revealed spinal fractures. Patients were more likely to obtain treatment for osteoporosis if they and their family physicians received follow up information that explained the guidelines for treating osteoporosis. By getting proper follow up care, these patients may avoid devastating fractures and the high cost of treating them.

The excellent work of Dr. Majumdar shows how researchers can make a difference in identifying ways to improve patient care and reduce health care costs.

To learn more about osteoporosis and its impact in Canada, visit:

Pain Awareness Week

Message from the Canadian pain Coalition

Poorly managed pain is a serious, yet unrecognized, health problem. It is a silent epidemic.

One in five adults1 and 5-8% of our children2 are severely impacted by chronic pain and the prevalence increases with age.3 "Undermanaged moderate to severe daily pain can negatively impact every aspect of our lives from personal and work productivity to social and family life. At the very least it is devastating and demoralizing. At its worst, the pain is disabling and deadly," says Lynn Cooper, President of the Canadian Pain Coalition and member of the IMHA Partnership and Knowledge Translation Committee. Research indicates that people living with pain have double the risk of suicide as compared with people without chronic pain.4 Chronic pain is associated with the worst quality of life as compared with other chronic diseases such as chronic lung or heart disease.5

The Canadian Pain Coalition (CPC) established National Pain Awareness Week (NPAW) with a Senate Declaration in 2004. Since then, health professionals, consumer groups, health organizations, industry and government have embraced this week in growing numbers. "National Pain Awareness Week is a focal point each year to increase awareness, provide education and focus action surrounding the understanding and effective, timely management of acute and chronic pain in Canada," says Cooper. The CPC runs annual campaigns that include its signature NPAW poster distribution, public education events, media activities and advocacy initiatives. NPAW 2012 key messages focus on the need for a National Pain Strategy which addresses the significant shortfalls in equitable access to best practice pain management, pain education for health care providers and people living with pain, and continuing research concerning pain. CPC is asking Canadians to endorse the National Pain Strategy.

The Canadian Pain Coalition is a partnership of pain consumer and health organizations, individuals who live with pain, health professionals treating pain and researchers studying more effective ways of managing pain. The goals of the CPC are to: (i) promote sustained improvement in the understanding, treatment, management and prevention of all types of pain in Canada; (ii) promote awareness of pain issues among the general public; provide educational information about pain management to people who live with pain; and, (iii) to be the "National Voice of People with Pain" in discussions with government and policy makers.

CPC's educational accomplishments include: establishing the Pain Resource Centre, Canada's medically vetted, evidence based web resource for pain and pain management and hosting public education forums like the Transitions Living Well with Chronic Pain symposia and video series. Awareness building activities involve creating the Pennies for Pain Fundraising/Awareness Campaign and the annual CPC Walk to End Pain. Recent advocacy initiatives have centered on partnering with the Canadian Pain Society (CPS), in consultation with extensive stakeholders, to write and promote the National Pain Strategy for Canada. Ongoing work to obtain support for the National Pain Strategy includes: co-hosting the first ever Canadian Pain Summit in Ottawa on April 24, 2012 which was attended by over 200 stakeholders and Members of Parliament; holding a Parliament Hill Day and a day at Queen's Park in Ontario; obtaining extensive media attention about Canada's pain issues and reaching out to Canadians to endorse the strategy.

More information about National Pain Awareness Week activities across Canada and the Canadian Pain Coalition.

Opioids – what you need to know

Opioids such as codeine, oxycodone, and synthetic narcotics like fentanyl are drugs used to relieve pain. While these drugs can be very effective, the risk of addiction and accidental overdose are serious concerns for doctors who prescribe them. Dr. Andrea Furlan and her team have recently published the Opioid Manager which distils onto one double sided page, the key information from the 200-page Canadian Guideline for Safe and Effective Use of Opioids for Chronic Non-Cancer Pain which she and her team released in 2010.

The Opioid Manager is available on the McMaster University website and can be used by physicians prescribing these drugs to recovering workers and other patients with chronic non-cancer pain (CNCP), including post-surgery, post-trauma, back and arthritis pain. Dr. Furlan added the "watchful dose" to the guidelines. "This is a new concept, because we have always been taught that opioids did not have a ceiling dose" Furlan points out. Read more about the watchful dose on the Institute for Work & Health website.

As an expert in pain research, Dr. Furlan has talked about opioids and the problem of abuse during a CIHR Café Scientifique on Chronic Pain, on the CBC program White Coat Black Art, and during a keynote address [ PDF (6.58 MB) - external link ] that she gave at the Canadian Pain Society in 2011, in celebration of the first anniversary of the Canadian Opioid Guideline.

IMHA was pleased to have Dr. Furlan take part in our first Young Investigators Forum last June (2012), where she presented a poster on her work.

Dr. Andrea Furlan is a CIHR New Investigator from Drug Safety and Effectiveness Network (DSEN), an associate scientist at the Institute for Work & Health, a member of the editorial board of the Cochrane Back Review Group, a physician and scientist at the Toronto Rehabilitation Institute-UHN and assistant professor in the Department of Medicine's Division of Physiatry at the University of Toronto. She has over 60 publications in peer-reviewed journals, has written two book chapters and has been an invited speaker at many local, national and international conferences.

Good News Story

On October 17, we held our annual Research Ambassador meeting to award the 2012 "IMHA Research Ambassadors Knowledge Translation Award". The IMHA Research Ambassadors (RAs) are a group of non-scientist consumers (patients) that help us carry out knowledge translation activities and ensure that the consumer voice is heard. Knowledge translation (KT) broadly defined, is the translation of scientific research into improved health for Canadians, and is regarded by CIHR as an essential part of the research process. Recommended to us by our partner organizations, our RAs come from different backgrounds and bring with them a unique set of skills and experiences. What ties them all together is an undeniable energy and passion for improving the health and quality of life of people with musculoskeletal, oral health, and skin conditions.

IMHA is delighted to announce the 2012 winners of the "IMHA Research Ambassadors Knowledge Translation Award". The "IMHA Research Ambassadors Knowledge Translation Award" was created in order to encourage CIHR applicants to write excellent lay abstracts. Lay abstracts are half page summaries of the research projects submitted to CIHR as part of a grant application. They are written to be easily understood by the general population which is why our RAs are the perfect group to do the review.

The RAs reviewed the lay abstracts of the IMHA funded grants from the 2011-2012 fiscal year and the top abstract from each research theme (biomedical; clinical; health systems and services; and social cultural, environmental, population health) was selected for the award (there was no social cultural, environmental, population health application this year funded by IMHA). The selected lay abstracts were considered to be well written, easily understood by a lay audience, comprehensive and highly informative. In particular, they:

  1. included all salient points
  2. adequately explained technical terms when introduced
  3. had a logical flow of thought that was easy to follow
  4. described anticipated results that were likely to impact future research in the area
  5. were appropriately presented in general language
  6. were clear and logical in the explanation of the research project

We would like to congratulate the following Principal Investigators who wrote abstracts chosen for this award (in no particular order): Robin N. Michel, Vinod Chandran, and Joy C. MacDermid.

Partner Corner

Wired Café: Arthritis management in a Digital World

In our increasingly wired and wireless world, how can we use technology to improve health? This was the hot topic sparking debate on the evening of October 16, 2012 in Vancouver, where the Wired Café: Arthritis management in a Digital World took place.

With about 40 people in the room, another 40 people participating via live stream, and an active Twitter feed projected on the wall, this Café was a glimpse into the future of healthcare and arthritis management in a digital world.

Dr. Lori Tucker is working to help youth with arthritis gain access to the support and information they need to successfully manage their arthritis. With her team, Dr. Tucker has developed several online resources including their newly launched LEAP website which encourages kids with arthritis to be active.

Dr. Linda Li works on developing web-based tools to support people living with arthritis. Her ANSWER decision aid is currently being tested and will help people make informed decisions about taking methotrexate, a drug used to treat rheumatoid arthritis.

Many people living with arthritis, experience chronic pain. One of Dr. Diane Gromala's research interests involves using immersive virtual reality to reduce chronic pain. This technology is becoming widely used as a means of treating both acute and chronic pain without the use of opioids.

While technology offers many exciting possibilities, it is important to consider the role of ethics in using technology to deliver health information through digital media. Dr. Anne Townsend acknowledged that while the shift to digital media in health is exciting for some, others may not be comfortable with the new levels of autonomy that these media enable and may prefer more traditional means of delivering healthcare.

The tech-talk sparked a lively discussion with questions from the audience, Twitter and online participants. While this may seem futuristic to some, these 4 researchers are hard at work, tapping into technology to manage arthritis and demonstrate the potential for digital media to benefit the health of the population at large.

Dr. Lori Tucker is a Pediatric Rheumatologist at BC Children's Hospital and a Clinical Associate Professor at UBC; Dr. Linda Li is an Associate Professor at UBC and Senior Scientist at the Arthritis Research Centre of Canada; Dr. Diane Gromala is a Canada Research Chair and Professor at the School of Interactive Arts and Technology at SFU; and Dr. Anne Townsend is a medical sociologist and Research Associate in the Department of Occupational Science / Occupational Therapy at UBC.

Call for Papers on population health intervention research for a themed section of the journal Preventive Medicine

A working definition of Population Health Intervention Research (PHIR) is "the use of scientific methods to produce knowledge about policy, program, and resource distribution approaches that operate within or outside of the health sector and have the potential to impact health at the population level."

This themed issue will feature conceptual and theoretical papers about the foundations of PHIR, systematic and realist reviews of literature on population health interventions and related processes/outcomes, and research articles describing the processes and/or results of population health intervention studies using a range of research designs and methods. We also encourage submissions involving multiple jurisdictions, sectors, disciplines, and communities in high, middle- and low-income countries.

This themed issue is co-sponsored by Preventive Medicine and the Canadian Institutes of Health Research-Institute of Population and Public Health, through the Population Health Intervention Research Initiative for Canada.

The deadline for submissions is November 30, 2012. The call for papers is also posted online.

Contact Us

CIHR - Institute of Musculoskeletal Health and Arthritis
Department of Molecular Genetics
Faculty of Medicine, University of Toronto
The Banting Institute
100 College St., Room 207B
Toronto, ON, M5G 1L5
Tel: 416-946-7243
Email: imha.iala.cihr.irsc@utoronto.ca

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  1. Moulin, D., A. J. Clark, et al. (2002). "Chronic pain in Canada, prevalence, treatment, impact and the role of opioid analgesia." Pain Res Manage 7: 179-184.
  2. Huguet A, Miró J. (2008) The severity of chronic pediatric pain: An epidemiological study. J Pain 9(3):226-36.
  3. Hadjistavropoulos, T., S. Gibson, et al. (2010). Pain in older persons : a brief clinical guide. Chronic Pain Management: A Clinical Guide. M. E. Lynch, K. D. Craig and P. W. H. Peng. Oxford, UK, Wiley-Blackwell: 311-318.
  4. Tang, N. and C. Crane (2006). "Suicidality in chronic pain: review of the prevalence, risk factors and psychological links." Psychol Med 36: 575-586.
  5. Choiniere, M., D. Dion, et al. (2010). "The Canadian STOP-PAIN Project-Part 1: Who are the patients on the waitlists of multidisciplinary pain treatment facilities? ." Can J Anesth 57: 539-548.

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