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Joining forces to ease chronic pain

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triplllogo-smallerBy Sheri Hall for the BCTR

Pain relievers are some of the most commonly-used medicines among older adults. But a Cornell-based organization called the Translational Research Institute on Pain in Later Life, or TRIPLL, is exploring alternative ways to alleviate pain in older adults.

TRIPLL is one of the most active and long-standing collaborations among the Cornell campuses — comprising researchers and graduate students at the Bronfenbrenner Center for Translational Researcher (BCTR), Weill Cornell Medicine, and Cornell Tech, plus dozens of community organizations serving seniors in New York City.

“It’s a very broad and deep collaboration,” said Karl Pillemer, TRIPLL co-director and director of the BCTR. “Because of our use of video conferencing, Skype and frequent meetings, it’s honestly not much different than if we were all in the same building. A number of us work with our TRIPLL colleagues even more than with people on our own campuses.”

TRIPLL was founded in 2009 with a grant from the National Institute on Aging. It is one of 12 federally-funded Edward R. Roybal Centers for Translational Research on Aging across the nation; each one focuses on a different aspect related to the health and well-being of older Americans.

TRIPLL brings together faculty from a variety of disciplines, including clinical medicine, epidemiology, gerontology, the social and behavioral sciences, computer science to focus non-pharmacologic methods of pain relief.

“Pain is a huge problem — it’s one of the things that keeps people homebound,” says Riverdale Senior Services director Julia Schwartz-Leeper, who regularly uses the institute’s webinars to train her staff. “The work that TRIPLL does is critically important.”

Karl Pillemer and Elaine Wethington

Karl Pillemer and Elaine Wethington

As the American population ages, the issue of treating pain in older adults is only getting more pressing. TRIPLL co-director Dr. Elaine Wethington, a medical sociologist and an associate director at the BCTR, notes that one-third of older adults has chronic pain — “and the majority of those find inadequate relief.”

Effective, evidence-based alternatives to pharmaceuticals are needed because many older adults have pre-existing conditions, such as heart failure or kidney problems, that pain medicines can exacerbate. The epidemic of opioid abuse also complicates matters. Fear of addiction may discourage older people from taking pain drugs. And reducing the number of opioid prescriptions keeps the drugs out of a medicine cabinet where they could be misused by family members or others, Pillemer said.

“Our inability to deal with chronic pain through non-drug methods is a huge problem,” he said. “In terms of an issue that makes the largest number of people miserable, chronic pain is at the top. But it’s not a high-profile problem that has an easy cure, so it doesn’t attract as much research funding.”

In an effort to combat the problem, TRIPLL’s researchers award grants for pilot studies; hold monthly seminars linking researchers on the various campuses; mentor graduate students, post-docs, fellows and junior faculty; and serve as a resource to New York City community service agencies, whose tens of thousands of clients provide a deep bench of volunteers for research studies.

“For years there’s been a consensus among researchers that pain is not just a biological phenomenon, it’s also a social and a psychological one, but there are few centers in the United States that look at pain from this biopsychosocial perspective,” Wethington said. “Our commitment is to understand these aspects as completely as we can — to get really smart people working on them, to publish papers in places where they’ll have an effect on practice.”

This story is adapted from an article that was first published in Weill Cornell Medicine, Vol. 16, No. 1.

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Spring 2017 Talks at Twelve

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This semester we welcome speakers from across campus and across the U.S. for our spring 2017 Talks at Twelve series. Talks at Twelve are held in the Beebe Hall second floor conference room and lunch is served. These talks are free and open to all. No RSVP or registration is required, but notice is appreciated if a larger group is planning to attend (email pmt6@cornell.edu).

 

Wednesday, February 22, 12:00-1:00pm
Mental and Behavioral Health Facilities: Critical Research and Design Recommendations
Mardelle M. Shepley, Design and Environmental Analysis, Cornell University

 

 

comfortTuesday, March 7, 12:00-1:00pm
Beyond the Peer-Reviewed Article: Making Research Relevant for Community Stakeholders and Policymakers
Megan Comfort, Behavioral Health and Criminal Justice Research Division, Research Triangle Institute

 

 

Thursday, March 16, 12:00-1:00pm
Pain and Presence: The Clinical Use of Media
Andrea Stevenson Won, Communication, Cornell University

 

 

 

Thursday, April 13, 12:00-1:00pm
Healthy Base Initiative: Evaluating Programs to Encourage Healthy Eating, Active Lifestyles, and Tobacco-Free Living
Marney Thomas, BCTR, Cornell University

 

 

Thursday, April 20, 12:00-1:00pm
Data Driven Policy-Making in Child Welfare
Dana Weiner, Chapin Hall Center for Children, University of Chicago

 

 

 

Tuesday, April 25, 12:00-1:00pm
Weill Cornell Behavioral Geriatrics: Cognitive Impairment in Hospitalized Adults & Palliative & Mental Health Care
Elissa Kozlov and Keiko Kurita, Weill Cornell Medical College

 

 

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Doing Translational Research podcast: Corinna Loeckenhoff

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Aging is Not Dying
Wednesday, May 4, 2016

Corinna Loeckenhoff
Department of Human Development, Cornell University

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Gerontological Society selects experts on aging as fellows

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By Tyler Alicea ‘16, MPS ‘17 for the College of Human Ecology tumblr

wethington loeckenhoff

Wethington and Loeckenhoff

For their work on aging, two College of Human Ecology faculty members have been named fellows for the Gerontological Society of America.

Corinna Loeckenhoff, associate professor of human development and associate professor of gerontology in medicine at Weill Cornell Medical College (WCMC), and Elaine Wethington, professor of human development and of sociology and professor of gerontology in geriatrics at WCMC, were two of 94 professionals named on May 31 to the society, which is the largest of its kind seeking to understand aging in the United States.

As fellows, Loeckenhoff and Wethington are being recognized for their “outstanding and continuing work in gerontology,” specifically in the behavioral and social sciences section of the society.

Loeckenhoff, who directs the Laboratory for Healthy Aging and oversees Cornell’s gerontology minor, researches various topics related to health, personality, and emotions across the lifespan. She has taught undergraduate and graduate level courses on the various aspects of adult development and healthy aging.

Wethington, director of undergraduate studies for the Department of Human Development and associate director of the Bronfenbrenner Center for Translational Research, focuses on stress and how outside factors can affect one’s physical and mental health.

The society will formally recognize Loeckenhoff, Wethington, and its other new fellows at its 2016 Annual Scientific Meeting in New Orleans this November.

Gerontological Society selects experts on aging as fellows - College of Human Ecology tumblr

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Nursing home residents commonly abused by neighbors

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By Heather Lindsey for the Cornell Chronicle:

pillemer lachs

Pillemer and Lachs

Twenty percent of people living in nursing homes are abused by other residents, according to a study by researchers in the College of Human Ecology and Weill Cornell Medicine.

“We were very surprised by the prevalence of aggression,” said senior author Karl Pillemer, the Hazel E. Reed Professor in the College of Human Ecology’s Department of Human Development and professor of gerontology in medicine at Weill Cornell Medicine, who published the findings June 13 in the Annals of Internal Medicine. “We thought it would be common, but we did not anticipate that 1 in 5 people would be involved in a resident-to-resident incident.”

In addition to the physical injuries that can result from these abusive incidents, “the emotional toll that can result from being victimized incessantly can be overwhelming,” said lead author Dr. Mark Lachs, co-chief of the Division of Geriatrics and Palliative Medicine and the Irene F. and I. Roy Psaty Distinguished Professor of Clinical Medicine at Weill Cornell Medicine.

The Cornell researchers and colleagues at the Research Division of Hebrew Home at Riverdale evaluated 2,011 residents in 10 nursing home facilities during a one-month period. Of those individuals, 407, or 20.2 percent, had experienced a least one resident-to-resident incident of mistreatment.

Nine percent of victims experienced verbal abuse. Five percent encountered physical abuse, and less than 1 percent sexual abuse. Another 5 percent suffered “other” types of abuse, such as invasion of privacy and menacing gestures.

The most common types of verbal aggression were screaming at another resident and using foul language. Physical aggression most often included hitting and pushing. Going into another resident’s room without permission and taking or touching another person’s property were common examples of invasion of privacy.

A major risk factor for aggression was cognitive impairment, said Pillemer, who is also director of the Bronfenbrenner Center for Translational Research at Cornell. “You have people who would otherwise not be violent but who have serious aggressive episodes,” he said.

People who were younger and more physically active, meaning they were able to wander into other residents’ rooms, were more likely to be involved in an abusive incident, he said.

Crowding in common spaces such as hallways and lounges also increased risk. Conflict occurred more frequently in the winter months, presumably when patients had limited space to interact indoors, and in nursing homes with lower staffing levels, said Lachs, who is also professor of medicine at Weill Cornell Medicine.

The first steps toward addressing the problem are improving staff awareness and developing clear protocols for dealing with aggression among residents, Pillemer said. Individualized care is also important. Some people who are at greater risk of becoming aggressors may need more supervision than others.

One obstacle to addressing this form of aggression is that regulatory agencies and media have traditionally focused on physical abuse of residents by staff.

“This certainly occurs, and we should have zero tolerance for it,” Lachs said. “But this study suggests that one is much more likely to experience physical or verbal harm from another resident than from a staff member.”

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Congrats to the 2015-16 Kendal Scholarship awardees

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This year the BCTR awarded Kendal at Ithaca Scholarships, recognizing excellent student work in the field of gerontology, to Sylvia Lee, a sophomore in Human Biology, Health, and Society, and Arwah Yaqub, a senior in Near Eastern Studies.

Sylvia Lee

Sylvia Lee

"I am so excited and grateful to receive the scholarship. Whether I become a doctor or a researcher in the future, my dream is to help elders who suffer from chronic pain. Gerontology minor has offered me a new perspective on what my role at Cornell is and can be - I’m reminded that I’m not just a distressed pre-med student, who simply works towards becoming this person in the future, but that I’m given this opportunity to start living out my visions now, here on campus."

Beyond her coursework in gerontology, Sylvia worked in Nathan Spreng’s Laboratory of Brain and Cognition in the Department of Human Development throughout her freshmen year. There she focused on analyzing and collecting research participants’ memory and cognitive data by transcribing and conducting analysis on recalled autobiographical memories during fMRI tests. This fall semester, Sylvia began work in Corinna Loeckenhoff’s Laboratory for Healthy Aging, also in the Department of Human Development.

She recently joined Alzheimer’s Help and Awareness, a student-run organization, and received training to volunteer at Clare Bridge, a Brookdale Senior Living community that serves special-care needs of individuals with Alzheimer’s disease and other forms of dementia.

Sylvia specifically has an interest in the study of neurodegenerative diseases and chronic pain in elders. She plans to pursue a career in medicine and research. Her current interest lies mostly in the molecular and neurobiological processes that underlie the causes of chronic pain in elders and how chronic pain is treated, cared for, and managed by healthcare providers and families.

 

Arwah Yaqub

Arwah Yaqub

"The Kendal Scholarship is a gracious opportunity that has helped nurture my passion for gerontology. The kind spirit and vision at the core of this award has been pivotal in helping me integrate other disciplines of study, most of which I initially believed were incongruous with the field. [the donor's] commitment to an education that elucidates the cultural, biological, and economic implications of gerontology, as well as experiential learning, is inspirational, to say the least."

Last year, Arwah served as a volunteer for MEDART, a committee associated with Cornell’s MEDLIFE student chapter. Through this committee, she provided company to residents of Ithaca’s Beechtree Center for Rehabilitation and Nursing. Many of these residents are sensory impaired, her group designed simple, weekly art projects to do with residents. Joining the Alzheimer’s Help and Awareness Club at Cornell also helped fortify Arwah's passion for gerontology.

Arwah joined Corinna Loeckenhoff's Healthy Aging Lab over a year ago. The lab research aims to better understand age differences in social relations, personality traits, and emotional experiences and to unravel the effects of these three factors in health-related behaviors and outcomes.

As an aspiring physician, she believes that an understanding of aging across the lifespan is indispensable to the profession.

 

The Kendal at Ithaca Scholarship

To foster a closer tie between Cornell and Kendal at Ithaca, the nearby continuing care retirement community, an anonymous Cornell alumnus and Kendal resident established a Kendal at Ithaca Scholarship in the Bronfenbrenner Center for Translational Research.

Each year, the Kendal scholarship award goes to an undergraduate or graduate student interested in gerontology. Preference is given to a student who has some hands-on experience and is anticipating a career in the field.

The donor, who built a career in the corporate world after graduating from Cornell in the 1940s, wished to remain anonymous so that the focus of the scholarship is on the Kendal/Cornell connection. The donor pointed out that “creating a closer link between the two generations of Kendal and Cornell means more students have a chance to learn about the colorful, interesting lives and careers of retirees, and more residents have an opportunity to better understand students of today – their hopes, thoughts, and dreams. Greater involvement will be very stimulating for both.”

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Loeckenhoff reaps early career award in gerontology

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news-loeckenhoff-inpostCorinna Loeckenhoff, director of the BCTR's Gerontology Minor and center faculty affiliate, has been recognized by the Gerontological Society of America with the 2014 Margret M. and Paul B. Baltes Foundation Award in Behavioral and Social Gerontology.

Loeckenhoff is an associate professor in the Department of Human Development, where she also serves as director of the Laboratory for Healthy Aging. She has published over 35 refereed journal articles, many in the flagship journals in psychology and aging. Her groundbreaking research revolves around age differences in socioemotional functioning and their implications for health-related decision making and outcomes. Recently she has focused on translating findings from laboratory-based decision-making paradigms to real-world healthcare settings.

She co-organized the 2013 Bronfenbrenner Conference (with Anthony Ong) on New Developments in Aging, Emotion, and Health, which brought together international experts to explore different aspects of issues related to aging and emotions and different approaches of addressing these issues. A book from the conference presentations will be published by the American Psychological Association in 2015.

 

Löckenhoff Earns GSA’s 2014 Baltes Foundation Award - Gerontological Society of America
Loeckenhoff reaps early career award in gerontology - Cornell Chronicle

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Meghan McDarby awarded 2013-14 Kendal Scholarship

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0089_12_043.jpgMeghan McDarby (HD, '14)  is working towards a minor in gerontology and is this year's recipient of the Kendal at Ithaca Scholarship. Meghan serves as co-program coordinator of Cornell Elderly Partnership, where her responsibilities include: fostering and maintaining visit relationships with local skilled-nursing and assisted-living facilities; working closely with academic and faculty advisors to arrange guest lectures; coordinating projects at the local nursing facilities and applying for grants to fund these projects; and facilitating relationships between Cornell students and older adults in the Ithaca community.

Meghan worked as a research assistant with Dr. Elaine Wethington between 2011-2013. She worked with Wethington and Dr. Cary Reid, Weill Cornell, on a project funded by the Translational Research Institute on Pain in Later Life about pain disparities in racial and ethnic minority older adults.  Meghan is currently completing her senior honors thesis, which is an attempt to better understand rural older adults’ attitudes about and knowledge of hospice care and how these individual-level factors may play a role in explaining the disparity in use of hospice in rural areas as compared to urban areas. For this research process, she is performing qualitative interviews with older adults in Tompkins County (Trumansburg, Groton, Ithaca, and Lansing).

Meghan visits weekly with a Kendal at Ithaca resident, who she met in January 2012 during an internship. Additionally, she has other regular visits with local elders and works with others, assisting with exercise and daily life. She recently completed a volunteer training program at Hospicare and has just begun volunteering there.

Of her work in gerontology at Cornell, Meghan says,

"... gerontology is the foundation of my future career. I aspire to be a geriatrician in a rural, under-served area in the northeast United States. I have a profound interest in end-of-life care alternatives, holistic care approaches, as well as increasing patient empowerment and health literacy for older adults. The gerontology minor has been integral in fostering the development of my long-term goals; the pairing of my individual extra-curricular experiences with the knowledge I have learned in the classroom has woven the supportive framework as I pursue my career in the field of medicine."

 

The Kendal at Ithaca Scholarship

To foster a closer tie between Cornell and Kendal at Ithaca, the nearby continuing care retirement community, an anonymous Cornell alumnus and Kendal resident established a Kendal at Ithaca Scholarship in the Bronfenbrenner Center for Translational Research.

Each year, the Kendal scholarship award goes to an undergraduate or graduate student interested in gerontology. Preference is given to a student who has some hands-on experience and is anticipating a career in the field.

The donor, who built a career in the corporate world after graduating from Cornell in the 1940s, wished to remain anonymous so that the focus of the scholarship is on the Kendal/Cornell connection. The donor pointed out that “creating a closer link between the two generations of Kendal and Cornell means more students have a chance to learn about the colorful, interesting lives and careers of retirees, and more residents have an opportunity to better understand students of today – their hopes, thoughts, and dreams. Greater involvement will be very stimulating for both.”

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Talks at Twelve: Cary Reid, Kavita Ahluwalia, & Rachel Sherrow, Tuesday, May 21, 2013

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Using Community-Based Participatory Research to Address Oral Health in NYC Meals-on-Wheels Recipients
Cary Reid, Kavita Ahluwalia, & Rachel Sherrow

Tuesday, May 21, 2013
12:00-1:00PM
Beebe Hall, 2nd floor conference room



This talk is open to all. Lunch will be served. Metered parking is available in the Plantations lot across the road from Beebe Hall.

This is a BCTR Innovative Pilot Study Grant recipient talk.

Community-based senior services, such as case management, transportation, senior centers, etc., are designed to help the growing number of community-dwelling older adults maintain independence and prevent institutionalization. Meals-on-Wheels (MOW) is one such service, designed to provide food and nutrition for a particularly vulnerable subset of older adults -- those who are unable to prepare meals due to cognitive and/or physical impairments and who, without the service would be unable to remain in the community. Although MOW has frequent household contact with recipients, has been in existence for almost 40 years, and serves one million Americans daily, there has been little systematic examination of its potential utility to provide health promotion/disease prevention messages and/or interventions, which may prove to be critical for the prevention of future institutionalization. We have chosen to address oral health because it is central to food consumption, and is important to ensuring the MOW delivers meals recipients can actually eat. The goal of this on-going work is to bring together MOW stakeholders and researchers to collaborate on capacity-building and future funding initiatives to translate and integrate evidence-based oral health promotion and disease prevention into the MOW systems. This work, uses a community-academic partnership, and has resulted in the development of a number of policy changes that will be implemented city-wide. Pilot development, implementation and testing of health promotion/disease prevention interventions that target NYC meal recipients is underway, and the partnership is actively seeking additional funding to sustain and expand this work.

Cary Reid, Weill School of Graduate Medical Sciences, Cornell University
Kavita Ahluwalia, College of Dental Medicine, Columbia University
Rachel Sherrow, Citymeals-on-Wheels

 

Dr. Cary  Reid is an Associate Professor and Director of the Office of Geriatric Research in the Division of Geriatrics and Palliative Medicine at Weill Cornell Medical College.  Dr. Reid obtained his medical degree from the University of South Carolina. He subsequently completed internship, residency, and chief-residency training at Dartmouth-Hitchcock Medical Center in New Hampshire. He completed fellowship training in both clinical epidemiology and geriatric medicine at Yale University. Dr. Reid taught, conducted research at Yale University before joining the faculty at Weill Cornell Medical College in 2003.  Dr. Reid has received many research awards over the years, including a Robert Wood Johnson Generalist Physician Scholar Award and a highly coveted Paul Beeson Faculty Scholar on Aging Research Award. He is a section editor of the journal Pain Medicine and  currently directs an NIH-funded multi-institutional center called “The Translational Research Institute on Pain in Later Life” or TRIPLL. The center supports translational research on pain and aging in New York City. Institutional partners include Weill Cornell, Columbia University, Hospital for Special Surgery, Memorial Sloan Kettering, Cornell University (Ithaca campus), Council of Senior Centers & Service of NYC, Inc. and the Visiting Nurse Service of New York. His research focuses on improving the management of pain among older persons. Current projects include testing non-pharmacologic strategies for pain among older persons in both clinical and non-clinical settings, identifying barriers to the use of self-management strategies for pain, and examining optimal strategies for managing pain across ethnically diverse populations of older persons. Additional areas of interest include the epidemiology and treatment of substance use disorders in older persons.

Kavita P. Ahluwalia is an Associate Professor of Clinical Dental Medicine at Columbia University’s College of Dental Medicine Dr. Ahluwalia is particularly interested in working with communities to address oral health in vulnerable populations. She has successfully used community-based participatory research principles to find creative and unexpected ways of integrating oral health and healthcare into existing care systems to develop sustainable programs that bridge the divide between dentistry and other health professions. Dr. Ahluwalia has received funding from the National Institute on Aging, Centers for Disease Control and Prevention, National Cancer Institute, Federal Emergency Management Agency, American Legacy Foundation, W.K. Kellogg Foundation, and the New York State Department of Health. She is currently Principal Investigator on a study funded by the New York State Department of Health to assess oral care delivery for people with dementia, and was recently funded by the National Institute on Aging to address oral pain and ability to eat among older adults receiving Meals-on-Wheels in NYC. She is also working with Columbia University’s Earth Institute to address oral health among poor rural children in two districts in India. Dr. Ahluwalia, who is Director of the College’s DDS/MPH program, is an active member of Isabella Homecare’s Steering Committee and a member of the Harlem Health Promotion Center’s Health Advisory Board. She received a DDS and MPH from the University of Michigan at Ann Arbor and completed a residency in Dental Public Health at the VA in Perry Point, MD.

Rachel Sherrow is Chief Program Officer of City meals-on-Wheels where she works to provide a continuum of meals on wheels and companionship for home bound elderly throughout the year. Although the beginning of her career was spent working with youth, for the past fifteen years, she has advocated for the elderly of New York City at various not-for profits. Rachel has worked for The New York Foundation for Senior Citizens, The Educational Alliance, and the Henry Street Settlement. She received her Master’s Degree in Social Work from Yeshiva University. She is currently working to prevent hunger among the most at risk clients Citymeals–on-Wheels serves.

 


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